Skip to main content

Advertisement

SpringerLink
Log in

Trace Elements Homeostatic Imbalance in Psoriasis: a Meta-Analysis

  • Published:
Biological Trace Element Research Aims and scope Submit manuscript

Abstract

Studies point out that trace elements take vital roles in immunological and inflammatory reactions, such as psoriasis, while the conclusions are controversial. The purpose of this study was to analyze the existing literatures and explore the relationship between the risk of psoriasis and four trace elements zinc (Zn), copper (Cu), iron (Fe), and selenium (Se). We identified 42 studies through the databases PubMed, Embase, Cochrane Library, Google Scholar, and Web of knowledge. After the meta-analysis, the serum zinc, iron, and selenium levels showed no remarkable difference between psoriasis and controls. The people with psoriasis showed a higher level of zinc in lesion tissue (standard mean difference (SMD) = 14.43; 95% confidence interval (CI), 7.89–20.97; P < 0.0001), and a higher level of serum copper than controls (SMD = 18.23; 95% CI, 5.06–31.40; P = 0.007). Our findings indicated that the trace element of copper and zinc levels are in a homeostatic imbalance in psoriasis patients when compared with controls, which raise the question whether this imbalance can be taken as the therapy target for psoriasis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Wacewicz M, Socha K, Soroczynska J, Niczyporuk M, Aleksiejczuk P, Ostrowska J, Borawska MH (2017) Concentration of selenium, zinc, copper, Cu/Zn ratio, Total antioxidant status and C-reactive protein in the serum of patients with psoriasis treated by narrow-band ultraviolet B phototherapy: a case-control study. J Trace Elem Med Biol 44:109–114

    Article  CAS  Google Scholar 

  2. Deng Y, Chang C, Lu Q (2016) The inflammatory response in psoriasis: a comprehensive review. Clin Rev Allergy Immunol 50:377–389

    Article  CAS  Google Scholar 

  3. Qi M, Huang X, Zhou L, Zhang J (2014) Four polymorphisms of Vegf (+405c>G, −460t>C, −2578c>a, and -1154g>a) in susceptibility to psoriasis: a meta-analysis. DNA Cell Biol 33:234–244

    Article  CAS  Google Scholar 

  4. Wu LS, Li FF, Sun LD, Li D, Su J, Kuang YH, Chen G, Chen XP, Chen X (2011) A Mirna-492 binding-site polymorphism in Bsg (Basigin) confers risk to psoriasis in central south Chinese population. Hum Genet 130:749–757

    Article  CAS  Google Scholar 

  5. Liu P, He Y, Wang H, Kuang Y, Chen W, Li J, Chen M, Zhang J, Su J, Zhao S, Chen M, Tao J, Chen X, Zhu W (2017) The expression of Mctla-4 in skin lesion inversely correlates with the severity of psoriasis. J Dermatol Sci 89(3):233–240

  6. Li Y, Su J, Li F, Chen X, Zhang G (2017) Mir-150 regulates human keratinocyte proliferation in hypoxic conditions through targeting Hif-1alpha and Vegfa: implications for psoriasis treatment. PLoS One 12:e0175459

    Article  Google Scholar 

  7. Michalska-Mosiej M, Socha K, Soroczynska J, Karpinska E, Lazarczyk B, Borawska MH (2016) Selenium, zinc, copper, and Total antioxidant status in the serum of patients with chronic tonsillitis. Biol Trace Elem Res 173:30–34

    Article  CAS  Google Scholar 

  8. Prasad AS (2008) Zinc in human health: effect of zinc on immune cells. Mol Med 14:353–357

    Article  CAS  Google Scholar 

  9. Wright JA, Richards T, Srai SK (2014) The role of Iron in the skin and cutaneous wound healing. Front Pharmacol 5:156

    Article  Google Scholar 

  10. Wang C, Fang Z, Zhu Z, Liu J, Chen H (2017) Reciprocal regulation between Hepcidin and erythropoiesis and its therapeutic application in erythroid disorders. Exp Hematol 52:24–31

    Article  CAS  Google Scholar 

  11. Shi Q, Yang XQ, Cui X (2011) The effects of Fecl(3) and Fe-Edta on the development of psoriasis. Biol Trace Elem Res 140:73–81

    Article  CAS  Google Scholar 

  12. Chan S, Gerson B, Subramaniam S (1998) The role of copper, molybdenum, selenium, and zinc in nutrition and health. Clin Lab Med 18:673–685

    Article  CAS  Google Scholar 

  13. Savaskan NE, Brauer AU, Kuhbacher M, Eyupoglu IY, Kyriakopoulos A, Ninnemann O, Behne D, Nitsch R (2003) Selenium deficiency increases susceptibility to glutamate-induced excitotoxicity. FASEB J 17:112–114

    Article  CAS  Google Scholar 

  14. Fang YZ, Yang S, Wu G (2002) Free radicals, antioxidants, and nutrition. Nutrition 18:872–879

    Article  CAS  Google Scholar 

  15. Saghazadeh A, Mahmoudi M, Dehghani Ashkezari A, Oliaie Rezaie N, Rezaei N (2017) Systematic review and meta-analysis shows a specific micronutrient profile in people with down syndrome: lower blood calcium, selenium and zinc, higher red blood cell copper and zinc, and higher salivary calcium and sodium. PLoS One 12:e0175437

    Article  Google Scholar 

  16. Greaves M, Boyde TR (1967) Plasma-zinc concentrations in patients with psoriasis, other dermatoses, and Venous Leg Ulceration. Lancet 2:1019–1020

    Article  CAS  Google Scholar 

  17. Molokhia MM, Portnoy B (1970) Neutron activation analysis of trace elements in skin. V. Copper and zinc in psoriasis. Br J Dermatol 83:376–381

    Article  CAS  Google Scholar 

  18. Portnoy B, Molokhia MM (1972) Zinc and copper in psoriasis. Br J Dermatol 86:205

    Article  CAS  Google Scholar 

  19. Tsambaos D, Orfanos CE (1977) Zinc distribution disorder in psoriasis. Arch Dermatol Res 259:97–100

    Article  CAS  Google Scholar 

  20. Morgan ME, Hughes MA, McMillan EM, King I, Mackie RM (1980) Plasma zinc in psoriatic in-patients treated with local zinc applications. Br J Dermatol 102:579–583

    Article  CAS  Google Scholar 

  21. McMillan EM, Rowe D (1983) Plasma zinc in psoriasis: relation to surface area involvement. Br J Dermatol 108:301–305

    Article  CAS  Google Scholar 

  22. Cimmino MA, Pane L, Cutolo M, Valente T, Rovida S (1986) Zinc concentrations in rheumatoid and psoriatic arthritis. Are they relevant to the inflammatory process? Scand J Rheumatol 15:403–406

    Article  CAS  Google Scholar 

  23. Leung RS, Turnbull AJ, Taylor JA, Russell-Jones R, Thompson RP (1990) Neutrophil zinc levels in psoriasis and seborrhoeic dermatitis. Br J Dermatol 123:319–323

    Article  CAS  Google Scholar 

  24. Oztürk G, Erba D, Gelir E, Gülekon A, Imir T (2001) “Natural killer cell activity, serum immunoglobulins, complement proteins, and zinc levels in patients with psoriasis vulgaris.” clinical trial; controlled clinical trial; research support, non-U.S. Gov’t. Immunol Investig 30(3):181–190. http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/979/CN-00373979/frame.html. Accessed 31 Jan 2003

    Article  Google Scholar 

  25. Arora PN, Dhillon KS, Rajan SR, Sayal SK, Das AL (2002) Serum zinc levels in cutaneous disorders. Med J Armed Forces India 58:304–306

    Article  CAS  Google Scholar 

  26. Nigam P (2005) Serum zinc and copper levels and Cu: Zn ratio in psoriasis [1]. Indian J Dermatol Venereol Leprol 71:205–206

    Article  CAS  Google Scholar 

  27. Bimola Devi C, Jibankumar Singh S, Nandakishore T, Sunil Singh S, Rupachandra Singh L, Kunjeshwori Devi S (2011) Variation of serum zinc level in psoriasis. J Med Soc 25:38–41

    Google Scholar 

  28. Shahidi-Dadras M, Namazi N, Khalilazar S, Younespour S (2012) Trace elements status in psoriasis and their relationship with the severity of the disease. Iran J Dermatol 15:38–41

    Google Scholar 

  29. Ala S, Shokrzadeh M, Golpour M, Salehifar E, Alami M, Ahmadi A (2013) Zinc and copper levels in Iranian patients with psoriasis: a case control study. Biol Trace Elem Res 153:22–27

    Article  CAS  Google Scholar 

  30. Dreno B, Vandermeeren MA, Boiteau HL, Stalder JF, Barriere H (1986) Plasma zinc is decreased only in generalized pustular psoriasis. Dermatologica 173:209–212

    Article  CAS  Google Scholar 

  31. Sheikh G, Masood Q, Majeed S, Hassan I (2015) Comparison of levels of serum copper, zinc, albumin, globulin and alkaline phosphatase in psoriatic patients and controls: a hospital based case control study. Indian Dermatol Online J 6:81–83

    Article  Google Scholar 

  32. Wang G, Yu X, Xiao J (2004) The serum zinc levels in child psoriasis vulgaris. Clin J Dermatol Venerol Integ Trad W Med 3:144–146

    Google Scholar 

  33. Yan Z (2004) Dynamic observation of microelement Cu: Zn ratio in psoriasis vivo. J Huaihai Med 22:365–366

    Google Scholar 

  34. Cui J, Cui R, Zhang X, Xu H, Feng J (2005) The detection of the serum microelement in psoriatic patients. Chin J Lepr Skin Dis 21:617–619

    Google Scholar 

  35. Kekki M, Koskelo P, Lassus A (1966) Serum Ceruloplasmin-bound copper and non-ceruloplasmin copper in uncomplicated psoriasis. J Invest Dermatol 47:159–166

    Article  CAS  Google Scholar 

  36. Tasaki M, Hanada K, Hashimoto I (1993) Analyses of serum copper and zinc levels and copper/zinc ratios in skin diseases. J Dermatol 20:21–24

    Article  CAS  Google Scholar 

  37. Nigam PK (2005) Serum zinc and copper levels and Cu: Zn ratio in psoriasis. Indian J Dermatol Venereol Leprol 71:205–206

    Article  CAS  Google Scholar 

  38. Rashmi R, Yuti AM, Basavaraj KH (2010) Relevance of copper and ceruloplasmin in psoriasis. Clin Chim Acta 411:1390–1392

    Article  CAS  Google Scholar 

  39. Hinks LJ, Young S, Clayton B (1987) Trace element status in eczema and psoriasis. Clin Exp Dermatol 12:93–97

    Article  CAS  Google Scholar 

  40. Narang APS, Kumar B, Kaur IJ (1994) Serum zinc and copper levels in psoriasis. Trace Elem Med 11:36–37

    Google Scholar 

  41. Butnaru C, Pascu M, Mircea C, Agoroaei L, Solovǎstru L, Vâţǎ D, Butnaru E, Petrescu Z (2008) Serum zinc and copper levels in some dermatological diseases. Rev Med Chir Soc Med Nat Iasi 112:253–257

    PubMed  Google Scholar 

  42. Ponikowska M, Tupikowska M, Kasztura M, Jankowska EA, Szepietowski JC (2015) Deranged Iron status in psoriasis: the impact of low body mass. J Cachexia Sarcopenia Muscle 6:358–364

    Article  Google Scholar 

  43. Shahidi-Dadras M, Namazi N, Younespour S (2017) Comparative analysis of serum copper, iron, ceruloplasmin, and transferrin levels in mild and severe psoriasis vulgaris in Iranian patients. Indian Dermatol Online J 8:250–253

    Article  Google Scholar 

  44. Rashmi R, Yuti AM, Basavaraj KH (2012) Enhanced ferritin/iron ratio in psoriasis. Indian J Med Res 135:662–665

    CAS  PubMed  PubMed Central  Google Scholar 

  45. Toossi P, Azizian Z, Yavari H, Fakhim TH, Amini SH, Enamzade R (2015) Serum 25-Hydroxy vitamin D levels in patients with acne vulgaris and its association with disease severity. Clin Cases Miner Bone Metab 12:238–242

    PubMed  PubMed Central  Google Scholar 

  46. Serwin AB, Wasowicz W, Gromadzinska J, Chodynicka B (2002) Selenium status in psoriasis and its relationship with alcohol consumption. Biol Trace Elem Res 89:127–137

    Article  CAS  Google Scholar 

  47. Kadry D, Rashed L (2012) Plasma and tissue osteopontin in relation to plasma selenium in patients with psoriasis. J Eur Acad Dermatol Venereol 26:66–70

    Article  CAS  Google Scholar 

  48. Donadini A, Fiora C, Regazzini R, Perini D, Minoia C (1992) Selenium plasma levels in psoriasis. Clin Exp Dermatol 17:214–216

    Article  CAS  Google Scholar 

  49. Kolachi NF, Kazi TG, Afridi HI, Kazi N, Khan S, Wadhwa SK, Shah F (2012) Interaction between selenium and arsenic in biological samples of psoriasis patients. Clin Lab 58:233–243

    CAS  PubMed  Google Scholar 

  50. Kurz K, Steigleder GK, Bischof W, Gonsior B (1987) Pixe analysis in different stages of psoriatic skin. J Invest Dermatol 88:223–226

    Article  CAS  Google Scholar 

  51. Mansouri A, Hamidatou Alghem L, Beladel B, Mokhtari OE, Bendaas A, Benamar ME (2013) Hair-zinc levels determination in Algerian psoriatics using instrumental neutron activation analysis (Inaa). Appl Radiat Isot 72:177–181

    Article  CAS  Google Scholar 

  52. Poiraud C, Quereux G, Knol AC, Allix R, Khammari A, Dreno B (2012) Zinc gluconate is an agonist of peroxisome proliferator-activated receptor-alpha in the epidermis. Exp Dermatol 21:347–351

    Article  CAS  Google Scholar 

  53. Fischer PW, Campbell JS, Giroux A (1991) Effects of low copper and high zinc intakes and related changes in Cu, Zn-superoxide dismutase activity on Dmba-induced mammary tumorigenesis. Biol Trace Elem Res 30:65–79

    Article  CAS  Google Scholar 

  54. Armstrong AW, Voyles SV, Armstrong EJ, Fuller EN, Rutledge JC (2011) Angiogenesis and oxidative stress: common mechanisms linking psoriasis with atherosclerosis. J Dermatol Sci 63:1–9

    Article  CAS  Google Scholar 

  55. Maret W, Li Y (2009) Coordination dynamics of zinc in proteins. Chem Rev 109:4682–4707

    Article  CAS  Google Scholar 

  56. Anzellotti AI, Farrell NP (2008) Zinc metalloproteins as medicinal targets. Chem Soc Rev 37:1629–1651

    Article  CAS  Google Scholar 

  57. Glaser R, Harder J, Lange H, Bartels J, Christophers E, Schroder JM (2005) Antimicrobial psoriasin (S100a7) protects human skin from Escherichia coli infection. Nat Immunol 6:57–64

    Article  Google Scholar 

  58. Michaelsson G, Edqvist LE (1984) Erythrocyte glutathione peroxidase activity in acne vulgaris and the effect of selenium and vitamin E treatment. Acta Derm Venereol 64:9–14

    CAS  PubMed  Google Scholar 

  59. Atrian-Blasco E, Santoro A, Pountney DL, Meloni G, Hureau C, Faller P (2017) Chemistry of mammalian metallothioneins and their interaction with amyloidogenic peptides and proteins. Chem Soc Rev 46:7683–7693

    Article  CAS  Google Scholar 

  60. Zeng Q, Yin J, Fan F, Chen J, Zuo C, Xiang Y, Tan L, Huang J, Xiao R (2014) Decreased copper and zinc in sera of Chinese vitiligo patients: a meta-analysis. J Dermatol 41:245–251

    Article  CAS  Google Scholar 

  61. Yazdanpanah MJ, Ghayour-Mobarhan M, Taji A, Javidi Z, Pezeshkpoor F, Tavallaie S, Momenzadeh A, Esmaili H, Shojaie-Noori S, Khoddami M, Sahebkar A (2011) Serum zinc and copper status in Iranian patients with pemphigus vulgaris. Int J Dermatol 50:1343–1346

    Article  CAS  Google Scholar 

  62. Sirmali M, Uz E, Sirmali R, Kilbas A, Yilmaz HR, Altuntas I, Naziroglu M, Delibas N, Vural H (2007) Protective effects of erdosteine and vitamins C and E combination on ischemia-reperfusion-induced lung oxidative stress and plasma copper and zinc levels in a rat hind limb model. Biol Trace Elem Res 118:43–52

    Article  CAS  Google Scholar 

  63. Kadrabova J, Mad'aric A, Podivinsky F, Gazdik F, Ginter F (1996) Plasma zinc, copper and copper/zinc ratio in intrinsic asthma. J Trace Elem Med Biol 10:50–53

    Article  CAS  Google Scholar 

  64. Kazi TG, Afridi HI, Kazi N, Jamali MK, Arain MB, Jalbani N, Kandhro GA (2008) Copper, chromium, manganese, iron, nickel, and zinc levels in biological samples of diabetes mellitus patients. Biol Trace Elem Res 122:1–18

    Article  CAS  Google Scholar 

  65. Basavaraj KH, Darshan MS, Shanmugavelu P, Rashmi R, Mhatre AY, Dhanabal SP, Rao KS (2009) Study on the levels of trace elements in mild and severe psoriasis. Clin Chim Acta 405:66–70

    Article  CAS  Google Scholar 

  66. Sato S (1991) Iron deficiency: structural and microchemical changes in hair, nails, and skin. Semin Dermatol 10:313–319

    CAS  PubMed  Google Scholar 

  67. Finzi AF (1994) Update on nutrition and psoriasis. Int J Dermatol 33:523

    Article  CAS  Google Scholar 

  68. Leveque N, Robin S, Muret P, Mac-Mary S, Makki S, Berthelot A, Kantelip JP, Humbert P (2004) In vivo assessment of iron and ascorbic acid in psoriatic dermis. Acta Derm Venereol 84:2–5

    Article  CAS  Google Scholar 

  69. Stewart MS, Spallholz JE, Neldner KH, Pence BC (1999) Selenium compounds have disparate abilities to impose oxidative stress and induce apoptosis. Free Radic Biol Med 26:42–48

    Article  CAS  Google Scholar 

  70. Rayman MP (2000) The importance of selenium to human health. Lancet 356:233–241

    Article  CAS  Google Scholar 

  71. Michaelsson G, Berne B, Carlmark B, Strand A (1989) Selenium in whole blood and plasma is decreased in patients with moderate and severe psoriasis. Acta Derm Venereol 69:29–34

    CAS  PubMed  Google Scholar 

  72. Seneczko F, Kostusiak MM, Kaszuba A (1995) Blood serum concentrations of sodium, potassium, magnesium, and calcium ion, and total calcium in patients with psoriasis vulgaris treated with Puva and Anthraline. Przegl Dermatol 82:513–520

    Google Scholar 

  73. Kharaeva Z, Gostova E, De Luca C, Raskovic D, Korkina L (2009) Clinical and biochemical effects of coenzyme Q(10), vitamin E, and selenium supplementation to psoriasis patients. Nutrition 25:295–302

    Article  CAS  Google Scholar 

  74. Toossi P, Sadat Amini SH, Sadat Amini MS, Partovi Kia M, Enamzade R, Kazeminejad A, Esmaeily Radvar S, Younespour S (2015) Assessment of serum levels of osteopontin, selenium and prolactin in patients with psoriasis compared with healthy controls, and their association with psoriasis severity. Clin Exp Dermatol 40:741–746

    Article  CAS  Google Scholar 

Download references

Funding

This work was supported by grants from the Natural Science Foundation of China (No. 81773329), the Natural Science Youth Foundation of China (NO. 81803118).

Author information

Authors and Affiliations

  1. Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, 410008, China

    Wangqing Chen

  2. Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, 410008, China

    Xingchen Zhou

  3. Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, China

    Wu Zhu

Authors
  1. Wangqing Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xingchen Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wu Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The eligibility of the studies for meta-analysis was evaluated by Wangqing Chen and Wu Zhu, the discrepancy was discussed with Xingchen Zhou, and the manuscript was written by Wangqing Chen and Xingchen Zhou.

Corresponding authors

Correspondence to Xingchen Zhou or Wu Zhu.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Figure S1

The serum zinc levels in male and female psoriasis patients (PNG 25 kb)

Figure S2

The serum zinc levels in mild and severe psoriasis patients (PNG 26 kb)

Figure S3

The serum copper levels in male and female psoriasis patients (PNG 20 kb)

Figure S4

The serum copper levels in mild and severe psoriasis patients (PNG 20 kb)

Figure S5

The serum iron levels in mild and severe psoriasis patients (PNG 20 kb)

Figure S6

The serum selenium levels in male and female psoriasis patients (PNG 21 kb)

Figure S7

The serum selenium levels in mild and severe psoriasis patients (PNG 19 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chen, W., Zhou, X. & Zhu, W. Trace Elements Homeostatic Imbalance in Psoriasis: a Meta-Analysis. Biol Trace Elem Res 191, 313–322 (2019). https://doi.org/10.1007/s12011-018-1626-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12011-018-1626-1

Keywords

Search

Navigation