OBJECTIVE To investigate the distribution of pathogenic bacteria and the changes of Toll-like family receptor (TLR)/ nuclear factor κB (NF-κB) signaling pathway in patients with psoriasis complicated with cutaneous bacterial infection.
METHODS Three hundred psoriasis patients admitted to Linhai Hospital of Traditional Chinese Medicine from Oct. 2022 to Sep. 2023 were selected as the study subjects, among which the patients with psoriasis combined with cutaneous bacterial infections were divided into the infected group (97 cases), and the patients without combined skin infections were divided into the uninfected group (203 cases), and other 60 healthy subjects during the same period were selected as the control group. The distribution characteristics of pathogenic bacteria in the skin tissues of patients with psoriasis combined with cutaneous bacterial infection were analyzed. The expression of TLR/NF-κB signaling pathway in peripheral blood among three groups was compared. Psoriasis area severity index (PASI) and area of skin lesion (BSA) were compared between the infected and uninfected groups. The correlation between the expression of TLR/NF-κB signaling pathway and the severity of disease was analyzed by Pearson correlation analysis.
RESULTS A total of 103 strains of pathogenic bacteria were co-cultured and isolated from 97 patients with psoriasis combined with skin bacterial infections, of which 95 strains of gram-positive bacteria accounted for 92.23%, and Staphylococcus aureus (83 strains, 80.58%) was the main strain. TLR mRNA and NF-κB mRNA in peripheral blood of the infected and uninfected groups were (2.55±0.85), (1.72±0.39), (1.92±0.66) and (1.42±0.40), respectively, higher than those of control group, and the indicators above in the infected group were higher than those in the non-infected group (P < 0.05). The PASI and BSA scores in infected group were (18.79±4.91) points and (14.05±2.68) points, higher than those in uninfected group (P < 0.05). Pearson correlation analysis showed that the expression levels of TLR mRNA and NF-κB mRNA in peripheral blood were positively correlated with PASI and BSA scores (r=0.565, 0.540, 0.427 and 0.411, all P < 0.05).
CONCLUSION Staphylococcus aureus is the main pathogenic bacteria in patients with psoriasis complicated with skin bacterial infections, and the expression of TLR/NF-κB signaling pathway in peripheral blood is significantly up-regulated, which has certain diagnostic value in patients with psoriasis complicated with skin bacterial infections.
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