Study Examines Role of Fibroblast Growth Factors in Psoriasis, Metabolic Pathways

It is already known that pre-existing obesity or multiple sclerosis increases the risk of psoriasis due to chronic, systemic metabolic inflammatory states, and a recent study examined the role of fibroblast growth factors 21 and 23 (FGF21 and FGF23, respectively) in these metabolic pathways.

The study aimed to evaluate the serum level of FGF21 and FGF23 in patients with psoriasis and elucidate the possible interplay between disease activity, metabolic or inflammatory parameters, and systemic treatment.

FGF21 and FGF23 are used as markers of cardiometabolic disorders, which are common comorbidities in psoriasis. Writing in the Journal of Clinical Medicine, researchers discussed a study of 44 participants that aimed to define any links between psoriasis severity and concentration of the 2 factors.

Of the 44, 33 were patients (21 male and 12 female) with an exacerbation of plaque-type psoriasis. The control group was made up of 11 healthy participants matched by sex, age and body mass index. Patients with other types of psoriasis, such as malignancy, pregnancy, and inflammatory disease were excluded.

The study group was split into 3 groups—those with a PASI score under 10 (mild), those with a score between 10-20 (moderate), and those above 20 (severe). Fasting samples were taken from both the control and study group at the start of the study and after 3 months of systemic treatment with acitretin or methotrexate.

Serum FGF21 levels were higher in patients compared with the control group (P <.05). FGF21 levels regarding psoriasis activity were significantly increased in all 3 subgroups compared to the controls (P < .05). Of note, FDF21 levels were 3 times higher in the most obese patients.

Regarding FGF23, no significant changes were found beside positive correlation with aspartate transferase (P < .05). There was no correlation between total PASI and FGF23 and no significant effect of systemic treatment on FGF21 and FGF23 levels was found.

After methotrexate therapy, FGF21 levels remained unchanged. However, a nearly 3-fold decrease in FGF21 concentration after acitretin-based treatment was observed (P < .05).

The researchers said that they are the first to demonstrate elevated serum FGF21 concentrations in patients with plaque-type psoriasis, compared with healthy controls, and they said that FGF21 levels might be helpful in predicting the risk of cardiometabolic comorbidities development in patients with severe psoriasis and obesity. The authors said their findings raise the question of considering psoriasis as a state of metaflammation, and of using FGF21 as a novel biomarker for the disease.

Reference

Kiluk P, Baran A, Kaminski TW, Maciaszek M, Flisiak. The level of FGF 21 as a new risk factor for the occurrence of cardiometabolic disorders amongst the psoriatic patients [published online December 13, 2019]. J. Clin. Med. doi:10.3390/jcm8122206.