Tissue Sodium in Patients With Psoriasis

Study Overview
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Brief Summary
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Sodium can be buffered in the skin, which mechanism is altered during aging and in certain diseases such as hypertension. High salt environment can promote autoimmunity by expanding pathogenic IL-17 producing T helper (Th17) cells. Psoriasis is a relapsing and remitting inflammatory autoimmune disease affecting the skin and joints and involves proinflammatory Th17 cells. Here we tested the hypothesis if psoriatic skin has a higher sodium content in humans.

Detailed Description
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The cytokine interleukin-17A (IL-17A) is a crucial player in the pathogenesis of the autoimmune disease of psoriasis. This neutrophil recruiting cytokine is produced by IL-17A producing CD4+ T cells (Th17) and gamma/delta T cells of the skin and evokes an inflammation circuit finally leading to the classical clinical picture of psoriasis with hyper- and parakeratosis, erythema, scaling and neutrophil abscess formation. Besides genetic factors, lifestyle factors are relevant and decide if an autoimmune disease becomes manifest. It was shown previously that increased salt (sodium chloride, NaCl) concentrations boost the induction of murine and human Th17 cells. However, more - and also clinical - studies are needed to understand the correlation between salt content and IL-17A in autoimmune diseases. This study investigates the hypothesis if skin sodium content in human psoriasis is increased in order to get further insight into the IL-17A-salt-interplay.

Official Title
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Tissue Sodium Accumulation in Patients With Psoriasis: a Pilot Study

Conditions
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Psoriasis Vulgaris, Healthy

Intervention / Treatment
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* Diagnostic Test: 23Na Magnetic resonance imaging


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age: 18-80 Body mass index (BMI) 18.5- 40 kg/m2 Glomerular filtration rate >60 ml/min/1.73m2 Exclusion Criteria: Diagnosed or treated hypertension and/or blood pressure above 140/90 at screening Palpable peripheral oedema during phyisical examination at screening Any type of diabetes mellitus and/or HgbA1c>6.5% at screening Subjects with a thyroid-stimulating hormone >4.2 mU/L at screening Psoriasis patients treated with systemic corticosteroids, chemotherapy agent (methothrexate) or with any kind of biologics/biosimilars Subjects with acute disease Pregnant or lactating women Metal or medical device implant in the body Tattoo on the lower extremities Subjects with a history of drug or alcohol abuse Subjects who are legal incapacitated or their circumstances do not enable the patient to fully understand the nature, significance and scope of this study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Healthy subjects<br>those without a condition | Diagnostic Test: 23Na Magnetic resonance imaging<br>* Measurement of skin sodium content by non-invasive 23Na Magnetic resonance imaging.<br>|
| Psoriasis patients<br>those with a condition | Diagnostic Test: 23Na Magnetic resonance imaging<br>* Measurement of skin sodium content by non-invasive 23Na Magnetic resonance imaging.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Non-invasive sodium measurement in the skin | Sodium measured in the skin by 23Na-MRI is higher in psoriasis patients vs. matched healthy individuals. | 4 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Psoriasis, Sodium, Skin