Role of GDF-15 as an inflammatory marker in patients with psoriasis vulgaris

Abstract

Background and Design: Psoriasis is a chronic, inflammatory disease, and several biochemical markers play role in its inflammatory process. This study measured the levels of interleukin-12 (IL-12), IL-17a, IL-22 and IL-23, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-alpha) and serum growth differentiation factor-15 (GDF-15) and aimed to detect the relationship of serum GDF-15 level with inflammation and disease severity. Materials and Methods: This study included 50 consecutive patients diagnosed with plaque-type psoriasis. For all patients, dermatological examinations were performed, and psoriasis area severity index (PASI) scores were recorded. Patients with PASI <10 were considered to have mild (group 1), 10-20 moderate (group 2), and >20 severe (group 3) psoriasis. Results: No difference was observed between the patient and the control groups in terms of age, sex, IL-17a and IL-22. A statistically nonsignificant difference was detected in terms of IL-12 and IL-23. However, there was significant difference between two groups in terms of hs-CRP, TNF-alpha and GDF-15. GDF-15 was significantly different in all three groups (p<0.001). A significant correlation was observed between PASI score and disease duration (p=0.005), hs-CRP (p=0.003), TNF-alpha (p=0.002), and serum GDF-15 levels (p<0.001). The serum GDF-15 level that can predict a high PASI score was >1498.5 pg/mL (area under the curve: 0.813, p<0.001) in the receiver operating characteristic curve analysis. This study is mainly limited by the lack of follow-up and pre-and post-treatment assessment. Inflammatory markers were measured only in the serum, and their tissue levels are unknown. Conclusion: In addition to PASI score, GDF-15 levels can be a guide in monitoring treatment and systemic inflammation, determining the disease severity, and providing efficient treatment.