Association between endocrinological, immunological and psychosocial variables in psoriasis patients

BACKGROUND: There is limited data concerning the relationship between psychosocial problems of psoriasis patients and the function of their hypothalamic-pituitary-adrenal (HPA) axis and immunologic markers. This study aimed to determine serum levels of basal Cortisol and adrenocorticotropic hormone (ACTH) and circulating levels of various cytokines and chemokines and their association with psychological measures in psoriasis patients. METHODS: Serum concentrations of endocrinological and immunological variables were quantified, and psychiatric questionnaires were completed. RESULTS: In psoriasis patients, serum levels of ACTH, TNF-α, IL-6, IL-23, CCL-17, CCL-27, CCL-20 and CXCL-9, current psychiatric symptoms and childhood neglect scores were all higher than in controls. In addition, in psoriasis patients, physical neglect scores were related to lower basal Cortisol, whereas recent stressful life events were related to higher IL-6, IL-23 and CCL-20 levels. CONCLUSIONS: The exposure to stressful life events in childhood and just before a flare-up of psoriasis may be related to altered function of the HPA axis and an immune dysregulation in psoriasis.