New Insights into Stress-Linked Psoriasis from EADV Congress
Groundbreaking Research on Stress and Psoriasis
Innovative research has provided compelling evidence that perceived stress can directly trigger the relapse of psoriatic skin lesions. This study, presented at the recent EADV Congress 2024, is the first to scientifically validate this connection in vivo.
Understanding Psoriasis and Its Triggers
Psoriasis is a chronic skin condition affecting over 6 million people across Europe, characterized by rapid skin cell production that leads to scaling and inflammation. It has long been suspected that stress is a contributing factor in exacerbating psoriasis, and this research offers conclusive evidence of this vital link.
The Experimental Study
In this comprehensive study, psoriatic lesions were induced in healthy human skin xenografts on mice. Researchers injected autologous, in vitro IL-2-preactivated peripheral blood mononuclear cells to initiate the lesions. Following the induction, the lesions were treated to achieve remission with topical dexamethasone.
To study the impact of stress, the mice were then exposed to sonic stress or a sham treatment for 24 hours. The team tracked the recurrence of psoriatic lesions over the next 14 days and observed remarkable results.
Impact of Sonic Stress on Psoriasis
Sonic stress resulted in a relapse of psoriatic lesions in all human skin xenografts within 14 days. The researchers noted significant changes in skin behaviors linked to psoriasis, including increased epidermal thickness, K16 expression, keratinocyte proliferation, and immune activation of intraepidermal cells.
Further analysis indicated that sonic stress significantly elevated immune cell presence in the skin and increased levels of proinflammatory mediators. The research demonstrated that neurogenic inflammation biomarkers were also upregulated, showcasing the profound impact of stress on skin health.
Insights from Professor Amos Gilhar
Professor Amos Gilhar, the lead researcher of the study, articulated how psychoemotional stress triggers the release of proinflammatory neuropeptides such as substance P (SP), which leads to neurogenic skin inflammation. This process activates immune cells, primarily through mast cell degranulation. Additionally, the heightened release of corticotropin-releasing hormone (CRH) and nerve growth factor (NGF) amplifies inflammation, promoting keratinocyte hyperproliferation, thus triggering and exacerbating psoriatic lesions.
Potential Therapeutic Approaches
The research team explored the efficacy of a drug called aprepitant, which is an FDA-approved anti-emetic and neurokinin-1 receptor (NK1-R) antagonist, in preventing stress-induced psoriasis relapse. Remarkably, aprepitant prevented relapse in 80% of the cases and normalized most inflammatory markers.
Professor Gilhar noted, "Aprepitant shows great promise as a potential therapy for stress-induced psoriasis exacerbations." However, he cautioned about its off-label use and emphasized the necessity for further safety data. He highlighted that while aprepitant selectively targets the substance P-induced component of neurogenic inflammation, it may not affect other mediators such as NGF and CRH, proposing that combining NK-1R antagonists with other treatments could enhance effectiveness.
Concluding Thoughts on Stress and Psoriasis
This important research opens new avenues in understanding the complex relationship between stress and psoriasis. As the medical community continues to explore these connections, findings like those presented in this study offer hope for developing effective treatments tailored to individuals suffering from this persistent skin condition.
Frequently Asked Questions
What was the main finding of the study presented at EADV Congress 2024?
The study found a direct link between perceived stress and the relapse of psoriatic skin lesions, validating this connection scientifically.
How does stress affect psoriasis according to the research?
Stress leads to the release of proinflammatory neuropeptides, triggering inflammation and exacerbating psoriasis symptoms.
What was the role of aprepitant in the study?
Aprepitant was tested as a treatment to prevent stress-induced psoriasis relapse, showing effectiveness in preventing relapse in 80% of cases.
Who conducted this important research?
The study was led by Professor Amos Gilhar, who provided significant insights into the mechanisms behind stress-induced psoriasis exacerbations.
What are the implications of this study for psoriasis treatment?
This research highlights the potential for new treatments focusing on stress management and specific medications targeting neurogenic inflammation in psoriasis patients.
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