Increased endothelemia as an indirect marker of changes in the blood vessel endothelium in psoriasis

Background Endothelial cells have a pivotal role in the initiation and development of inflammation. The dermal microvasculature undergoes distinctive morphological changes. Central to the angiogenetic process are endothelial cell division and migration controlled by local expression of the mitogenic factor. There is considerable evidence for the development of angiogenesis in psoriatic skin. Quantitative assessment of the endothelium in psoriasis demonstrated a fourfold increase in surface area of the superficial vascular plexus in lesional skin. The rate of vascular proliferation in active psoriasis is similar to that in other angiogenic pathologies. To identify vasoproliferation in the skin adds a useful tool in the assessment of psoriasis activity in future studies of its pathogenesis. The basal level of endothelemia reflects a continuous replacement of cells. The hyperproliferation in psoriasis stimulates physiological cell replacement. The higher replacement of blood vessel endothelial cells causes an increase in circulating cell levels in the bloodstream. Endothelemia might serve as an indicator of changes in the blood vessel endothelium in psoriatics.

Objective The aim of the present study was to assess the changes in the amount of endothelial cells in the blood of psoriatic patients by comparing them with healthy controls.

Material and methods Fifty-six patients suffering from psoriasis (PASI score 35.05 ± 5.61) and 20 healthy subjects were estimated for quantitative endothelemia using the counting of endothelial cells in Burker's chamber after their isolation together with platelets and the removal of the latter by addition of adenosine diphosphate. The cells were confirmed as endothelial in origin by positive staining for von Willebrand factor. The significance of the differences was estimated by Student's t-test.

Results There were 2.02 ± 0.21 (female) and 2.3 ± 0.25 (male) endothelial cells in the control group and 4.6 ± 0.59 (female) and 5.15 ± 0.67 (male) in the psoriatic patients. The difference was statistically significant (P < 0.001).

Conclusion Expansion of the dermal microvasculature is a prominent feature in psoriasis. Endothelemia might be an indirect marker of changes in the blood vessel endothelium in psoriatic patients. No differences were found in endothelemia in psoriatics according to the gender.