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Skin sodium accumulates in psoriasis and reflects disease severity

Sodium can accumulate in the skin at concentrations exceeding serum levels. A high sodium environment can lead to pathogenic T helper 17 cell expansion. Psoriasis is a chronic inflammatory skin disease in which IL-17‒producing T helper 17 cells play a crucial role. In an observational study, we meas...

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Main Authors: Maifeld, András (Author) , Wild, Johannes (Author) , Karlsen, Tine V. (Author) , Rakova, Natalia (Author) , Wistorf, Elisa (Author) , Linz, Peter (Author) , Jung, Rebecca (Author) , Birukov, Anna (Author) , Gimenez-Rivera, Vladimir-Andrey (Author) , Wilck, Nicola (Author) , Bartolomaeus, Theda (Author) , Dechend, Ralf (Author) , Kleinewietfeld, Markus (Author) , Forslund, Sofia K. (Author) , Krause, Andreas (Author) , Kokolakis, Georgios (Author) , Philipp, Sandra (Author) , Clausen, Björn E. (Author) , Brand, Anna (Author) , Waisman, Ari (Author) , Kurschus, Florian (Author) , Wegner-Kops, Joanna (Author) , Schultheis, Michael (Author) , Luft, Friedrich C. (Author) , Boschmann, Michael (Author) , Kelm, Marcus (Author) , Wiig, Helge (Author) , Kuehne, Titus (Author) , Müller, Dominik N. (Author) , Karbach, Susanne (Author) , Markó, Lajos (Author)
Format: Article (Journal)
Language:English
Published: January 2022
In: The journal of investigative dermatology
Year: 2022, Volume: 142, Issue: 1, Pages: 166-178.e8
ISSN:1523-1747
DOI:10.1016/j.jid.2021.06.013
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jid.2021.06.013
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0022202X21014238
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Author Notes:András Maifeld, Johannes Wild, Tine V. Karlsen, Natalia Rakova, Elisa Wistorf, Peter Linz, Rebecca Jung, Anna Birukov, Vladimir-Andrey Gimenez-Rivera, Nicola Wilck, Theda Bartolomaeus, Ralf Dechend, Markus Kleinewietfeld, Sofia K. Forslund, Andreas Krause, Georgios Kokolakis, Sandra Philipp, Björn E. Clausen, Anna Brand, Ari Waisman, Florian C. Kurschus, Joanna Wegner, Michael Schultheis, Friedrich C. Luft, Michael Boschmann, Marcus Kelm, Helge Wiig, Titus Kuehne, Dominik N. Müller, Susanne Karbach and Lajos Markó
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Summary:Sodium can accumulate in the skin at concentrations exceeding serum levels. A high sodium environment can lead to pathogenic T helper 17 cell expansion. Psoriasis is a chronic inflammatory skin disease in which IL-17‒producing T helper 17 cells play a crucial role. In an observational study, we measured skin sodium content in patients with psoriasis and in age-matched healthy controls by Sodium-23 magnetic resonance imaging. Patients with PASI > 5 showed significantly higher sodium and water content in the skin but not in other tissues than those with lower PASI or healthy controls. Skin sodium concentrations measured by Sodium-23 spectroscopy or by atomic absorption spectrometry in ashed-skin biopsies verified the findings with Sodium-23 magnetic resonance imaging. In vitro T helper 17 cell differentiation of naive CD4+ cells from patients with psoriasis markedly induced IL-17A expression under increased sodium chloride concentrations. The imiquimod-induced psoriasis mouse model replicated the human findings. Extracellular tracer Chromium-51-EDTA measurements in imiquimod- and sham-treated skin showed similar extracellular volumes, rendering excessive water of intracellular origin. Chronic genetic IL-17A‒driven psoriasis mouse models underlined the role of IL-17A in dermal sodium accumulation and inflammation. Our data describe skin sodium as a pathophysiological feature of psoriasis, which could open new avenues for its treatment.
Item Description:Gesehen am 16.03.2022
Physical Description:Online Resource
ISSN:1523-1747
DOI:10.1016/j.jid.2021.06.013

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