Review

Neuro-dermatological association between psoriasis and depression: an immune-mediated inflammatory process validating skin-brain axis theory

  • Received: 26 January 2021 Accepted: 08 March 2021 Published: 10 March 2021
  • Objective 

    Our study's motive was to recognize various immune-mediated inflammatory processes involved in the pathogenesis of depression and psoriasis and interlink between them based on inflammatory mediators.

    Methods 

    A careful and comprehensive literature search was done through various databases like PubMed, Google Scholar, and EBSCO. A total of 56 studies were included in our study after careful screening.

    Results 

    The immune-mediated inflammatory process was significantly associated with the pathogenesis of both depression and psoriasis. Most of the inflammatory markers involved in Psoriasis (TNF-α, IL-2, IL-6, IL-23, IL-1β, IL-10), and increased serotonin transporters (5-HTT) were also found in the pathogenesis of depression, showing the immune-inflammatory linkage between psoriasis and major depression. Based on immune chemistry, the levels of CD2+, CD4+, CD8+ T-lymphocytes were also found to be raised in both depression and psoriasis, validating their relationship. Hyperactivity of HPA-axis was also found another interlink between them along with reduced melatonin amount.

    Conclusions 

    According to various studies, the neuro-dermatological association between psoriasis and depression is significant. Different immune markers involved in the pathogenesis of depression and psoriasis also show the bidirectional association between them. However, this association between psoriasis and depression is positively correlated, but more work is required to answer why all depressed patients fail to develop psoriasis and why all psoriatic patients fail to develop depression.

    Citation: Shahzaib Maqbool, Arham Ihtesham, Muhammad Nadeem Langove, Sara Jamal, Tabdar Jamal, Hafiz Abu Safian. Neuro-dermatological association between psoriasis and depression: an immune-mediated inflammatory process validating skin-brain axis theory[J]. AIMS Neuroscience, 2021, 8(3): 340-354. doi: 10.3934/Neuroscience.2021018

    Related Papers:

  • Objective 

    Our study's motive was to recognize various immune-mediated inflammatory processes involved in the pathogenesis of depression and psoriasis and interlink between them based on inflammatory mediators.

    Methods 

    A careful and comprehensive literature search was done through various databases like PubMed, Google Scholar, and EBSCO. A total of 56 studies were included in our study after careful screening.

    Results 

    The immune-mediated inflammatory process was significantly associated with the pathogenesis of both depression and psoriasis. Most of the inflammatory markers involved in Psoriasis (TNF-α, IL-2, IL-6, IL-23, IL-1β, IL-10), and increased serotonin transporters (5-HTT) were also found in the pathogenesis of depression, showing the immune-inflammatory linkage between psoriasis and major depression. Based on immune chemistry, the levels of CD2+, CD4+, CD8+ T-lymphocytes were also found to be raised in both depression and psoriasis, validating their relationship. Hyperactivity of HPA-axis was also found another interlink between them along with reduced melatonin amount.

    Conclusions 

    According to various studies, the neuro-dermatological association between psoriasis and depression is significant. Different immune markers involved in the pathogenesis of depression and psoriasis also show the bidirectional association between them. However, this association between psoriasis and depression is positively correlated, but more work is required to answer why all depressed patients fail to develop psoriasis and why all psoriatic patients fail to develop depression.



    加载中


    Ethical statement



    Ethical values were considered with full capacity by each author.

    Competing interest



    The authors declare no conflict of interest.

    [1] Strain JJ (2017) Globalization of psychosomatic medicine. Gen Hosp Psychiatry 48: 62-64. doi: 10.1016/j.genhosppsych.2017.07.003
    [2] Brown GE, Malakouti M, Sorenson E, et al. (2015) Psychodermatology. Adv Psychosom Med 34: 123-134. doi: 10.1159/000369090
    [3] Leon A, Levin EC, Koo JY (2013) Psychodermatology: an overview. Semi Cutan Med Surg 32: 64-67. doi: 10.12788/j.sder.0002
    [4] Karam RA, Zidan HE, Khater MH (2014) Polymorphisms in the TNF-α and IL-10 gene promoters and risk of psoriasis and correlation with disease severity. Cytokine 66: 101-105. doi: 10.1016/j.cyto.2014.01.008
    [5] Parisi R, Symmons DP, Griffiths CE, et al. (2013) Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol 133: 377-385. doi: 10.1038/jid.2012.339
    [6] Ovčina-Kurtović N (2016)  Significance of cytokine as a predictor for psoriasis Doctoral thesis Tuzla: Medical School of the University of Tuzla.
    [7] Chong HT, Kopecki Z, Cowin AJ (2013) Lifting the silver flakes: the pathogenesis and management of chronic plaque psoriasis. Biomed Res Int 2013: 168321.
    [8] Huerta C, Rivero E, Garcia Rodriguez LA (2007) Incidence and risk factors for psoriasis in the general population. Arch Dermatol 143: 1559-1565. doi: 10.1001/archderm.143.12.1559
    [9] Krishnadas R, Nicol A, Sassarini J, et al. (2016) Circulating tumour necrosis factor is highly correlated with brainstem serotonin transporter availability in humans. Brain Behav Immune 51: 29-38. doi: 10.1016/j.bbi.2015.08.005
    [10] Hardy GE, Cotterill JA (1982) A study of depression and obsessionality in dysmorphophobic and psoriatic patients. Br J Psychiatry 140: 19-22. doi: 10.1192/bjp.140.1.19
    [11] Gupta MA, Gupta AK, Schork NJ, et al. (1994) Depression modulates pruritus perception: a study of pruritus in psoriasis, atopic dermatitis, and chronic idiopathic urticaria. Psychosom Med 56: 36-40. doi: 10.1097/00006842-199401000-00005
    [12] Renzi C, Picardi A, Abeni D, et al. (2002) Association of dissatisfaction with care and psychiatric morbidity with poor treatment compliance. Arch Dermatol 138: 337-342. doi: 10.1001/archderm.138.3.337
    [13] Buske-Kirschbaum A, Ebrecht M, Kern S, et al. (2006) Endocrine stress responses in TH1-mediated chronic inflammatory skin disease (psoriasis vulgaris)—do they parallel stress-induced endocrine changes in TH2-mediated inflammatory dermatoses (atopic dermatitis). Psychoneuroendocrinology 31: 439-446. doi: 10.1016/j.psyneuen.2005.10.006
    [14] Gupta MA, Gupta AK, Kirkby S, et al. (1989) A psychocutaneous profile of psoriasis patients who are stress reactors. A study of 127 patients. Gen Hosp Psychiatry 11: 166-173. doi: 10.1016/0163-8343(89)90036-4
    [15] Matiushenko VP, Kutasevych YF, Havryliuk OA, et al. (2020) Effectiveness of psychopharmacotherapy in psoriasis patients with associated anxiety and depression. Dermatol Ther 33: e14292.
    [16] Fortune DG, Richards HL, Kirby B, et al. (2002) A cognitive-behavioural symptom management programme as an adjunct in psoriasis therapy. Br J Dermatol 146: 458-465. doi: 10.1046/j.1365-2133.2002.04622.x
    [17] Redighieri IP, Maia T, Nadal MA, et al. (2011) Erythrodermic psoriasis with regression after prophylaxis with isoniazid and antidepressant therapy: case report. An Bras Dermatol 86: S141-S143. doi: 10.1590/S0365-05962011000700037
    [18] Menter A, Augustin M, Signorovitch J, et al. (2010) The effect of adalimumab on reducing depression in patients with moderate to severe psoriasis: a randomized clinical trial. J Am Acad Dermatol 62: 812-818. doi: 10.1016/j.jaad.2009.07.022
    [19] Griffiths CE, Barker JN (2007) Pathogenesis and clinical features of psoriasis. Lancet 370: 263-271. doi: 10.1016/S0140-6736(07)61128-3
    [20] Gelfand JM, Gladman DD, Mease PJ, et al. (2005) Epidemiology of psoriatic arthritis in the population of the United States. J Am Acad Dermatol 53: 573. doi: 10.1016/j.jaad.2005.03.046
    [21] Palfreeman AC, McNamee KE, McCann FE (2013) New developments in the management of psoriasis and psoriatic arthritis: a focus on apremilast. Drug Des Devel Ther 7: 201-210. doi: 10.2147/DDDT.S32713
    [22] Lowes MA, Suárez-Fariñas M, Krueger JG (2014) Immunology of psoriasis. Annu Rev Immunol 32: 227-255. doi: 10.1146/annurev-immunol-032713-120225
    [23] Van der Fits L, Mourits S, Voerman JS, et al. (2009) Imiquimod-induced psoriasis-like skin inflammation in mice is mediated via the IL-23/IL-17 axis. J Immunol 182: 5836-5845. doi: 10.4049/jimmunol.0802999
    [24] Nograles KE, Zaba LC, Guttman-Yassky E (2008) Th17 cytokines interleukin (IL)-17 and IL-22 modulate distinct inflammatory and keratinocyte-response pathways. Br J Dermatol 159: 1092-1102.
    [25] Zaba LC, Krueger JG, Lowes MA (2009) Resident and “inflammatory” dendritic cells in human skin. J Invest Dermatol 129: 302-308. doi: 10.1038/jid.2008.225
    [26] Chu CC, Di Meglio P, Nestle FO (2011) Harnessing dendritic cells in inflammatory skin diseases. Semin Immuno 23: 28-41. doi: 10.1016/j.smim.2011.01.006
    [27] Nestle FO, Conrad C, Tun-Kyi A, et al. (2005) Plasmacytoid predendritic cells initiate psoriasis through interferon-alpha production. J Exp Med 202: 135-143. doi: 10.1084/jem.20050500
    [28] Nestle FO, Kaplan DH, Barker J (2009) Psoriasis. N Engl J Med 361: 496-509. doi: 10.1056/NEJMra0804595
    [29] Uyemura K, Yamamura M, Fivenson DF, et al. (1993) The cytokine network in lesional and lesion-free psoriatic skin is characterized by a Thelper type 1 cell-mediated response. J Invest Dermatol 101: 701-705. doi: 10.1111/1523-1747.ep12371679
    [30] Brunoni AR, Lotufo PA, Sabbag C, et al. (2015) Decreased brain-derived neurotrophic factor plasma levels in psoriasis patients. Braz J Med Biol Res 48: 711-714. doi: 10.1590/1414-431x20154574
    [31] Mora C, Zonca V, Riva MA, et al. (2018) Blood biomarkers and treatment response in major depression. Expert Rev Mol Diagn 18: 513-529. doi: 10.1080/14737159.2018.1470927
    [32] Rosenblat JD, Cha DS, Mansur RB, et al. (2014) Inflamed moods: a review of the interactions between inflammation and mood disorders. Prog Neuropsychopharmacol Biol Psychiatry 53: 23-34. doi: 10.1016/j.pnpbp.2014.01.013
    [33] McNally L, Bhagwagar Z, Hannestad J (2008) Inflammation, glutamate, and glia in depression: a literature review. CNS Spectr 13: 501-510. doi: 10.1017/S1092852900016734
    [34] Wong ML, Dong C, Maestre-Mesa J, et al. (2008) Polymorphisms in inflammation-related genes are associated with susceptibility to major depression and antidepressant response. Mol Psychiatry 13: 800-812. doi: 10.1038/mp.2008.59
    [35] Miller AH, Maletic V, Raison CL (2009) Inflammation and its discontents: the role of cytokines in the pathophysiology of major depression. Biol Psychiatry 65: 732-741. doi: 10.1016/j.biopsych.2008.11.029
    [36] Raison CL, Capuron L, Miller AH (2006) Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends Immunol 27: 24-31. doi: 10.1016/j.it.2005.11.006
    [37] Dantzer R (2004) Cytokine-induced sickness behaviour: a neuroimmune response to activation of innate immunity. Eur J Pharmacol 500: 399-411. doi: 10.1016/j.ejphar.2004.07.040
    [38] Mössner R, Mikova O, Koutsilieri E (2007) Consensus paper of the WFSBP Task Force on Biological Markers: biological markers in depression. World J Biol Psychiatry 8: 141-174. doi: 10.1080/15622970701263303
    [39] Reichenberg A, Yirmiya R, Schuld A, et al. (2001) Cytokine-associated emotional and cognitive disturbances in humans. Arch Gen Psychiatry 58: 445-452. doi: 10.1001/archpsyc.58.5.445
    [40] Raison CL, Borisov AS, Majer M, et al. (2009) Activation of central nervous system inflammatory pathways by interferon-alpha: relationship to monoamines and depression. Biol Psychiatry 65: 296-303. doi: 10.1016/j.biopsych.2008.08.010
    [41] Wu CW, Chen YC, Yu L, et al. (2007) Treadmill exercise counteracts the suppressive effects of peripheral lipopolysaccharide on hippocampal neurogenesis and learning and memory. J Neurochem 103: 2471-2481. doi: 10.1111/j.1471-4159.2007.04987.x
    [42] Keller J, Gomez R, Williams G, et al. (2017) HPA axis in major depression: cortisol, clinical symptomatology and genetic variation predict cognition. Mol Psychiatry 22: 527-536. doi: 10.1038/mp.2016.120
    [43] Brunoni AR, Santos IS, Sabbag C, et al. (2014) Psoriasis severity and hypothalamic-pituitary-adrenal axis function: results from the CALIPSO study. Braz J Med Biol Res 47: 1102-1106. doi: 10.1590/1414-431X20143762
    [44] Mozzanica N, Tadini G, Radaelli A, et al. (1988) Plasma melatonin levels in psoriasis. Acta Derm Venereol 68: 312-316.
    [45] Quera Salva MA, Hartley S, Barbot F, et al. (2011) Circadian rhythms, melatonin and depression. Curr Pharm Des 17: 1459-1470. doi: 10.2174/138161211796197188
    [46] Kartha LB, Chandrashekar L, Rajappa M, et al. (2014) Serum melatonin levels in psoriasis and associated depressive symptoms. Clin Chem Lab Med 52: e123-e125. doi: 10.1515/cclm-2013-0957
    [47] Esposito E, Cuzzocrea S (2010) Anti-inflammatory activity of melatonin in central nervous system. Curr Neuropharmacol 8: 228-242. doi: 10.2174/157015910792246155
    [48] Tohid H, Aleem D, Jackson C (2016) Major Depression and Psoriasis: A Psychodermatological Phenomenon. Skin Pharmacol Physiol 29: 220-230. doi: 10.1159/000448122
    [49] Demirhan O, Demirbek B, Tunç E, et al. (2012) Identification of chromosome abnormalities in screening of a family with manic depression and psoriasis: predisposition to aneuploidy. Asian J Psychiatr 5: 169-174. doi: 10.1016/j.ajp.2012.02.005
    [50] Martínez-Ortega JM, Nogueras P, Muñoz-Negro JE, et al. (2019) Quality of life, anxiety and depressive symptoms in patients with psoriasis: A case-control study. J Psychosom Res 124: 109780. doi: 10.1016/j.jpsychores.2019.109780
    [51] Nicholas MN, Gooderham M (2017) Psoriasis, Depression, and Suicidality. Skin Therapy Lett 22: 1-4.
    [52] Aleem D, Tohid H (2018) Pro-inflammatory Cytokines, Biomarkers, Genetics and the Immune System: A Mechanistic Approach of Depression and Psoriasis. Rev Colomb Psiquiatr 47: 177-186. doi: 10.1016/j.rcp.2017.03.002
    [53] Kannan S, Heller MM, Lee ES, et al. (2013) The role of tumor necrosis factor-alpha and other cytokines in depression: what dermatologists should know. J Dermatolog Treat 24: 148-152. doi: 10.3109/09546634.2011.619159
    [54] Komiya E, Tominaga M, Kamata Y, et al. (2020) Molecular and Cellular Mechanisms of Itch in Psoriasis. Int J Mol Sci 21: 8406. doi: 10.3390/ijms21218406
    [55] Moon HS, Mizara A, McBride SR (2013) Psoriasis and psychodermatology. Dermatol Ther 3: 117-130. doi: 10.1007/s13555-013-0031-0
    [56] Motivala SJ, Sarfatti A, Olmos L, et al. (2005) Inflammatory markers and sleep disturbance in major depression. Psychosom Med 67: 187-194. doi: 10.1097/01.psy.0000149259.72488.09
  • Reader Comments
  • © 2021 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(4117) PDF downloads(152) Cited by(12)

Article outline

Figures and Tables

Figures(1)  /  Tables(3)

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog