The expression of serotonin transporter protein correlates with the severity of psoriasis and chronic stress
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ORIGINAL PAPER
The expression of serotonin transporter protein correlates with the severity of psoriasis and chronic stress Kristofer Thorslund • Beni Amatya • Ann Eriksson Dufva • Klas Nordlind
Received: 18 July 2012 / Revised: 4 November 2012 / Accepted: 6 November 2012 Ó Springer-Verlag Berlin Heidelberg 2012
Abstract Psoriasis may be worsened by stress and mood disorders. There is an increased expression of the serotonin transporter protein (SERT) in involved psoriatic skin as compared to non-involved psoriatic skin and normal skin. The aim of this study was to investigate if the increased expression of SERT in psoriasis correlates with the severity of disease, chronic stress, and depression. Biopsies from involved and non-involved skin from the back of 20 patients with chronic plaque psoriasis were immunohistochemically analysed, using a monoclonal antibody to SERT. The severity of psoriasis was assessed for each patient using the Psoriasis area and severity index (PASI). Levels of depression and chronic stress were measured using Beck’s Depression Inventory (BDI) and the salivary cortisol test, respectively. A positive correlation (r = 0.53; p \ 0.05) between PASI and the numbers of SERT-positive dendritic cells in the epidermis of involved psoriatic skin was determined. We also observed a negative correlation (r = -0.46; p \ 0.05) between salivary cortisol ratio levels and the numbers of SERTpositive cells in the epidermis of involved psoriatic skin, indicating a correlation between SERT expression and chronic stress. The serotonergic system may be involved in the chronic inflammation evident in psoriatic skin. Through modulating the levels of SERT, there might be a therapeutic possibility for reducing chronic inflammation in psoriasis.
K. Thorslund (&) B. Amatya A. E. Dufva K. Nordlind Department of Medicine Solna, Dermatology and Venereology Unit, Karolinska Institutet, B2:01 Karolinska University Hospital, SE-171 76 Stockholm, Sweden e-mail: [email protected]
Keywords Psoriasis Serotonin transporter protein Chronic stress
Introduction Psoriasis is a chronic inflammatory skin disease that affects 2–3 % of the adult population in Sweden [6]. Psoriasis may occur or worsen in connection with stress or mood disorders [26, 27]. The bilateral contact that occurs between the neuroendocrine and immune systems may be mediated by serotonin that acts as an important neurotransmitter and is present in high concentrations at the sites of inflammation [19–21]. The duration and magnitude of the responses to serotonin are mediated by the serotonin transporter protein (SERT), a protein with 12-transmembrane domains that mediates the high-affinity re-uptake essential for the synaptic clearance of serotonin. Two studies attempted to elucidate the correlation between serotonin transporter and psoriasis, by studying polymorphisms of the SERT gene in psoriasis [12, 24]. SERT is the target protein for serotonin reuptake inhibitors (SSRI). Case reports on the effect of SSRI in psoriasis have presen
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