Platelet P‐selectin reflects a state of cutaneous inflammation: possible application to monitor treatment efficacy in psoriasis

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Please cite this paper as: Platelet P‐selectin reflects a state of cutaneous inflammation: possible application to monitor treatment efficacy in psoriasis. Experimental Dermatology 2010; 19: 736–741.Abstract:  Haemostasis‐maintaining platelets are also recognized as important modulators in the regulation of immune response. Activated platelets expressing P‐selectin (CD62P) are involved in the extravasation of leucocytes. This study evaluated platelet P‐selectin expression as a biomarker for cutaneous inflammation. P‐selectin expression was assessed by flow cytometry in 147 successive patients suffering from an inflammatory or infectious skin condition at the day of admission for in‐patient treatment as well as a day prior to demission. Forty‐one patients admitted for allergy testing served as controls. A commercially available ELISA was used in 17 patients to determine soluble P‐selectin in the plasma. In patients with psoriasis, the Psoriasis Area and Severity Index (PASI) was documented as a measure for disease severity. We observed a significant increase in platelet P‐selectin expression in patients with inflammatory or infectious disorders, when compared to the control group (3,01% vs. 1,46%; P < 0.000001). Successful treatment resulted in a significant decrease in P‐selectin expression to the level of the control group. In the case of psoriasis (n = 47), we found highly significant correlation between P‐selectin and PASI (r = 0.51; P < 0.000001), as well as between the change in the PASI and the change in P‐selectin expression (r = 0.4; P = 0.006). Platelet P‐selectin expression as determined by flow cytometry correlated well with the results of soluble P‐selectin, determined by ELISA (r = 0.63; P < 0.01). Thus, platelet P‐selectin expression may be used as an efficacy biomarker to monitor treatment success in psoriasis. As platelet P‐selectin correlates with soluble P‐selectin in patient plasma, which can be measured by ELISA, the latter is feasible also for routine use.

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