AUTHOR=Jiménez Constanza , Fernández Javier , Rodríguez Camila , Mancilla Juan Felipe , Pellegrini Elizabeth , Hernández Marcela , Valenzuela Fernando , Fernández Alejandra 

TITLE=Direct impact of psoriasis on gingival crevicular fluid levels of VEGF-A in periodontitis patients: a mediation analysis

JOURNAL=Frontiers in Immunology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1477587

DOI=10.3389/fimmu.2024.1477587

ISSN=1664-3224

ABSTRACT=<sec><title>Introduction</title><p>Emerging evidence suggests that psoriasis and periodontitis are linked via systemic inflammation. However, the role of angiogenesis as an additional connecting mechanism between these diseases remains unclear.</p></sec><sec><title>Methods</title><p>This case control study explored the effect of psoriasis on the gingival crevicular fluid (GCF) levels of vascular endothelial growth factor A (VEGF-A) in patients with different stages of periodontitis. Thirty-one patients with psoriasis (P) and thirty healthy controls (C) underwent physical and intraoral evaluations, with diagnoses confirmed by dermatologists and periodontists. GCF VEGF-A was measured using a multiplex-bead immunoassay. Statistical analyses included Fisher exact tests, Student’s T-tests, linear regression models, and mediation analyses.</p></sec><sec><title>Results</title><p>Psoriasis patients had significantly lower GCF VEGF-A levels compared to controls (<italic>p</italic>=0.008). Psoriasis was negatively associated with GCF VEGF-A (<italic>p</italic>=0.006), while severe periodontitis was positively associated with GCF VEGF-A levels, regardless of tobacco use (<italic>p</italic>=0.027). Further analyses revealed that severe periodontitis significantly increased GCF VEGF-A levels only in the C group (<italic>p</italic>=0.038), but not in psoriasis patients (<italic>p</italic>&gt;0.610). Mediation analyses confirmed a significant direct and total effect of psoriasis on GCF VEGF-A (<italic>p</italic>&gt;0.002), with no significant indirect effect through periodontitis (<italic>p</italic>=0.699).</p></sec><sec><title>Discussion</title><p>Psoriasis and severe periodontitis are associated with GCF levels of VEGF-A in opposite and independent ways. In subjects with psoriasis, the impact of the dermatosis is direct with no mediation from periodontitis.</p></sec>