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Int. J. Mol. Sci. 2019, 20(8), 1908; https://doi.org/10.3390/ijms20081908

Goeckerman Therapy of Psoriasis: Genotoxicity, Dietary Micronutrients, Homocysteine, and MTHFR Gene Polymorphisms

1
Institute of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University, 50005 Hradec Kralove, Czech Republic
2
Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Kralove, Charles University, 50005 Hradec Kralove, Czech Republic
3
Institute of Hygiene and Preventive Medicine, Faculty of Medicine in Hradec Kralove, Charles University, 50003 Hradec Kralove, Czech Republic
4
Institute of Pathological Physiology, Faculty of Medicine in Hradec Kralove, Charles University, 50003 Hradec Kralove, Czech Republic
5
Clinic of Dermatology and Venereology, University Hospital Hradec Kralove, 50005 Hradec Kralove, Czech Republic
6
Department of Biomedical Sciences, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic
*
Author to whom correspondence should be addressed.
Received: 25 March 2019 / Revised: 15 April 2019 / Accepted: 16 April 2019 / Published: 17 April 2019
(This article belongs to the Special Issue Amino Acid Metabolism and Regulation in Health and Disease)
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Abstract

Goeckerman therapy (GT) of psoriasis vulgaris is based on the application of crude coal tar and ultraviolet radiation. We investigated DNA damage by the number of micronucleated binucleated cells (MNBC) in lymphocytes, serum homocysteine, vitamin B12, folic acid, and two polymorphisms (C677T and A1298C) in the MTHFR gene in 35 patients with exacerbated psoriasis vulgaris classified according to the psoriasis area and severity index (PASI) score and treated by GT. The median of PASI score decreased from nineteen to five, and MNBC increased from 10 to 18‰ after GT (p < 0.001 in both cases). Correlations of MNBC with homocysteine (Spearman’s rho = 0.420, p = 0.012) and vitamin B12 (rho = −0.389, p = 0.021) before the therapy were observed. Hyperhomocysteinemia was an independent predictor of genotoxicity (OR 9.91; 95% CI, 2.09–55.67; p = 0.003). Homocysteine was higher in females than in males (13 vs. 12 µmol/L, p = 0.045). In contrast, vitamin B12 levels in the females were lower than in the males (160 vs. 192 pmol/L, p = 0.047). Vitamin B12 in the females were negatively influenced by smoking status (160 pmol/L in smokers vs. 192 pmol/L in non-smokers, p = 0.025). A significantly higher MNBC was found in CC homozygous patients (A1298C polymorphism) than in AC heterozygotes (32 vs. 16‰, p = 0.005) and AA homozygotes (32 vs. 18‰, p = 0.036). Our data showed that homocysteine participates in the pathogenesis of psoriasis. Its serum levels correlated with MNBC and allowed the prediction of DNA damage to appear within GT. Both micronutrients status and homocysteine metabolic pathway contribute to the genotoxicity of GT. View Full-Text
Keywords: psoriasis; Goeckerman therapy; genotoxicity; homocysteine; vitamin B12; folic acid psoriasis; Goeckerman therapy; genotoxicity; homocysteine; vitamin B12; folic acid
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Beranek, M.; Malkova, A.; Fiala, Z.; Kremlacek, J.; Hamakova, K.; Zaloudkova, L.; Borsky, P.; Adamus, T.; Palicka, V.; Borska, L. Goeckerman Therapy of Psoriasis: Genotoxicity, Dietary Micronutrients, Homocysteine, and MTHFR Gene Polymorphisms. Int. J. Mol. Sci. 2019, 20, 1908.

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