Safety and Efficacy of Etanercept Monotherapy for Moderate-to-severe Plaque Psoriasis:A Prospective 12-week Follow-up Study

Etanercept has been shown to be effective for the treatment of moderate-to-severe plaque psoriasis. Since most clinical trials examined etanercept in combination with other drugs, the efficacy and safety of etanercept monotherapy for moderate-to-severe plaque psoriasis have not been well established. This prospective study enrolled 61 Chinese patients with moderate-to-severe plaque psoriasis to explore the efficacy and safety of etanercept monotherapy. These patients were treated with etanercept at a subcutaneous dose of 25 mg, twice a week, for 12 weeks. All the 61 patients completed the treatment and showed significant improvement in psoriasis area and severity index（PASI） scores. At 4, 8, and 12 weeks after treatment, the response rates（PASI75） were 0%, 21.31%, and 40.98%, respectively. It was concluded that etanercept monotherapy is efficacious and safe for patients with moderate-to-severe plaque psoriasis.

Therapeutic Effect and Safety of Ustekinumab for Plaque Psoriasis: A Meta-analysis

Objective To evaluate the efficacy and safety of ustekinumab in the therapy of plaque psoriasis. Methods Literatures published up to November 2013 were collected from Cochrane library, MEDLINE, and PubMed which were related with ustekinumab for plaque psoriasis. The efficacy was estimated using relative risk of Psoriasis Area and Severity Index （PASI） 75 response rate at the week 12 endpoint in clinical trials, and adverse effects were also analyzed. Meta-analysis was carried out by using Review Manager 5.1. Results Six randomized control trials consistent with the inclusion criteria were selected and reviewed. Ustekinumab 45 mg group and 90 mg group could get better therapeutic effect compared with the placebo group （all P〈0.00001）. Furthermore, ustekinumab 90 mg group was more effective than ustekinumab 45 mg group （P=0.01）. Adverse effects in the 6 trials were mentioned including headache, upper respiratory tract infection, nasopharyngtis, infection, serious infection, cardiovascular events, and malignant tumors. There were no statistically significant differences of these adverse effects among three groups （all P〉0.0S）, except that infection rate in ustekinumab 45 mg group was higher than the placebo group （P=0.02）. Conclusions Ustekinumab is an effective and safe therapeutic method for plaque psoriasis. However, further longer time analysis of safety is needed.

Therapeutic effect of plaque psoriasis by fire acupuncture based on theory of midnight-noon ebb-flow

Objective:To observe the clinical efficacy,immune inflammatory factors and hemorheology of patients with plaque psoriasis by using fire acupuncture combined with the theory of midnight-noon ebb-flow.Methods:Sixty-two patients with plaque psoriasis who met the diagnosis and inclusion criteria were randomly divided into control group and fire acupuncture with midnight-noon ebb-flow,with 31 cases in each group.The control group was treated with carpotriol ointment for external use,while the fire acupuncture group was treated with fire acupuncture with midnight-noon ebb-flow on the basis of the former and selected points by the opening method through midnight-noon ebb-flow theory.The patients in both groups were treated for 8 weeks and followed up for 4 weeks.The levels of PASI,DLQI,PSQI,HAMA,hs-CRP,TNF-αand hemorheology indexes in 2 groups before and after treatment were observed,including the comparison of whole blood viscosity,plasma viscosity and hematocrit.Results:PASI,DLQI,PSQI,HAMA,hs-CRP,TNF-α,blood viscosity and hematocrit levels were significantly improved after treatment(P<0.05,P<0.01),and the group in fire acupuncture with midnight-noon ebb-flow was significantly better than control group after treatment(P<0.01).Conclusion:fire acupuncture with midnight-noon ebb-flow can improve the sleep quality of patients with psoriasis,relieve anxiety and effectively improve the blood cell rheology and microcirculation,alleviate clinical symptoms and improve the quality of life.

Psoriasis: A Comprehensive Review on the Aetiopathogenesis and Recent Advances in Long-Term Management of Patients with Plaque Psoriasis

Immense changes have been introduced in psoriasis treatment, including successful systemic treatment of inflammation and education of psoriatic patients. The focus of this review is the latest developments in the understanding of the aetiopathogenesis of psoriasis, the significance of its comorbidities, treatment possibilities and long-term management using the latest insight provided by pharmacogenetics and identification of biomarkers. The successful control of the disease leads to reduction of myocardial infarction and long-term cardiovascular risk but is usually achieved after various therapeutic attempts until the best-matched treatment for the individual is identified. There is a high unmet medical need for revealing biomarkers associated with disease prognosis, comorbidities, response to therapy and adverse effects. More studies have to be performed for identification and validation of biomarkers and implementation of personalized medicine into clinical practice.

Identification of signal pathways and biomarkers of plaque psoriasis and prediction of potential microRNA targets via comprehensive strategies

Psoriasis is a complex skin disease and the pathogenesis of psoriasis is not clear.The purpose of this study is to identify the key driving genes and signal pathways involved in psoriasis and to predict the potential miRNA,for further understanding the pathogenesis of psoriasis.Methods:Three gene expression profiling chips,including GSE67853,GSE78097,and GSE136757 with a total of 120 samples were collected and analyzed with R software.The protein-protein interaction network of differentially expressed genes was constructed with STRING database and Cytoscape.CIBERSORT was used to evaluate the infiltration of immune cells in psoriasis tissues,and the correlation between diagnostic markers and infiltrating immune cells was analyzed.Further,the key biomarkers were identified and the targeting miRNA of crucial genes was predicted.Results:A total of 201 differentially expressed genes(163 upregulated genes and 38 downregulated genes)were determined.CXCL1,CXCL2,and CXCL8,the critical biomarkers of psoriasis,were identified by different calculation methods.The potential critical signal pathway NOD-like receptor signaling pathway of psoriasis was explored by gene expression profiling chip gene enrichment analysis and differentially expressed gene enrichment analysis.Immune cell infiltration analysis found that CXCL1,CXCL2,CXCL8 was positively correlated with macrophages M1 and T cells CD4 memory activated and negatively correlated with macrophages M2 and mast cells resting.At the same time,through miRNA prediction,we found that hsa-miR-216a-3p and hsa-miR-6750-5p can be used as potential psoriasis targets.Conclusions:This research proposes a new comprehensive strategy to identify psoriasis’s potential biomarkers through cross-validation and significant scores of different calculation methods.In this research,we identified CXCL1,CXCL2,and CXCL8 as potential key biomarkers of psoriasis,and the NOD-like receptor signaling pathway is the critical signal pathway of psoriasis.Hsa-miR-216a-3p and hsa-miR-6750-5p can be used as potential psoriasis targets.

Cholangiosepsis Caused by Neutrophilic Cholangitis in Plaque Psoriasis

Psoriasis is a common inflammatory skin disease with many comorbid conditions. We present a 37-year-old male patient with a history of plaque psoriasis, status febrilis, violent umbilical pain, elevated inflammatory markers and liver parameters. Blood cultures were tested positive for E. coli. Diagnostic findings indicated that mechanical icterus and cholangiosepsis in the context of neutrophilic cholangitis were caused by inflammatory stenosis. Neutrophilic cholangitis is often found in combination with skin diseases with intense cutaneous infiltration with polymorphonuclear leucocytes and peripherial blood neutrophilia. Interleukin-8 may play a role in the pathogenesis of neutrophilic cholangitis occurring in patients with psoriasis [1]. We showed that complications of psoriasis can also occur at unusual locations. To date no case of neutrophilic cholangitis as an elicitor of cholangiosepsis has been reported.

Efficacy and Safety of Tinefcon® Tablets in Subjects with Plaque Psoriasis: An Open Label, Non-Comparative, Multicenter, Phase IV Trial

Importance: This post-marketing surveillance study was conducted to evaluate real-world information about the efficacy and safety of oral Tinefcon? tablets (Sphaeranthus indicus based) in plaque psoriasis patients. Materials and Methods: Patients aged at least 18 years and older with clinical diagnosis of plaque psoriasis, were enrolled in this open label, non-comparative, multicenter trial. All eligible subjects received four 700 mg Tinefcon? tablets/day for 12 weeks. The primary outcome measure was percent change in Psoriasis Area Severity Index (PASI) score from baseline to week 12. The secondary outcome measures were Physician Global Assessment (PGA), Nail Psoriasis Severity Index (NAPSI), Psoriatic Arthritis Evaluation and Gene Expression Profiling and Immunohistochemistry. Results: After completion of Tinefcon? treatment at 12 weeks, more than half of subjects (52%) achieved PASI 50 response;PASI 75 response was attained in 68 (23%) subjects and PASI 90 response in 22 (7%) subjects. Five subjects with severe psoriasis achieved PASI 90 without receiving any concomitant medication. Reduction in severity as assessed by PGA was observed in more than half of patients with moderate disease. Histopathological evaluation revealed that epidermal thickness was considerably reduced in 66% of subjects. The expression of inflammatory marker S100A9 protein was(meaningfully reduced in 60% patients with non-significant reduction of Keratin 10 protein expression. Gene expression analysis showed increase down regulation of SERPINB4;PI3 and KRT16 genes after a 12-week treatment period in subjects with higher PASI scores. Conclusion: Oral Tinefcon? tablets showed good efficacy and had a favorable safety profile in plaque psoriasis patients.

Tildrakizumab for moderate-to-severe plaque psoriasis in Chinese patients:A 12-week randomized placebo-controlled phase III trial with long-term extension

Background:There is a need for effective and safe therapies for psoriasis that provide sustained benefits.The aim of this study was to assess the efficacy and safety of tildrakizumab,an anti-interleukin-23p19 monoclonal antibody,for treating moderate-to-severe plaque psoriasis in Chinese patients.Methods:In this multi-center,double-blind,phase III trial,patients with moderate-to-severe plaque psoriasis were enrolled and randomly assigned(1:1)to receive subcutaneous tildrakizumab 100 mg or placebo at weeks 0 and 4.Patients initially assigned to placebo were switched to receive tildrakizumab at weeks 12,16,and every 12 weeks thereafter.Patients in the tildrakizumab group continued with tildrakizumab at week 16,and every 12 weeks until week 52.The primary endpoint was the Psoriasis Area and Severity Index(PASI 75)response rate at week 12.Results:At week 12,tildrakizumab demonstrated significantly higher PASI 75 response rates(66.4%[73/110]vs.12.7%[14/110];difference,51.4%[95%confidence interval(CI),40.72,62.13];P<0.001)and Physician’s Global Assessment(60.9%[67/110]vs.10.0%[11/110];difference,49.1%[95%CI,38.64,59.62];P<0.001)compared to placebo.PASI 75 response continued to improve over time in both tildrakizumab and placebo-switching to tildrakizumab groups,reaching maximal efficacy after 28 weeks(86.8%[92/106]vs.82.4%[89/108])and maintained up to 52 weeks(91.3%[95/104]vs.87.4%[90/103]).Most treatment-emergent adverse events were mild and not related to tildrakizumab.Conclusion:Tildrakizumab demonstrated durable efficacy through week 52 and was well tolerated in Chinese patients with moderate-to-severe plaque psoriasis.Trial registration:ClinicalTrials.gov,NCT05108766.

COVID-19 exacerbates psoriasis progression through inducing IFN-αexpression

As a global public health issue that can cause systemic diseases,COVID-19 inflicts various harms on patients and impacts those with comorbidities.Psoriasis is primarily driven by a subset of T helper cells and the cytokines[1],and microbial infection is a predisposing factor in up to 45%of patients[2].Infection with SARS-CoV-2 may trigger the aggravation of psoriasis.Thus,we conducted a survey to explore the proportion of psoriasis patients who experienced exacerbation and relapse after SARS-CoV-2 infection and also performed a preliminary investigation into the mechanisms involved.One hundred and twenty-four psoriasis patients(79 males and 45 females)who contracted COVID-19 were followed up and provided detailed information.

Cytokine release syndrome triggered by programmed death 1 blockade(sintilimab)therapy in a psoriasis patient:A case report

BACKGROUND In recent years,immune checkpoint inhibitors(ICIs)have demonstrated remarkable efficacy across diverse malignancies.Notably,in patients with advanced gastric cancer,the use of programmed death 1(PD-1)blockade has significantly prolonged overall survival,marking a pivotal advancement comparable to the impact of Herceptin over the past two decades.While the therapeutic benefits of ICIs are evident,the increasing use of immunotherapy has led to an increase in immune-related adverse events.CASE SUMMARY This article presents the case of a patient with advanced gastric cancer and chronic plaque psoriasis.Following sintilimab therapy,the patient developed severe rashes accompanied by cytokine release syndrome(CRS).Fortunately,effective management was achieved through the administration of glucocorticoid,tocilizumab,and acitretin,which resulted in favorable outcomes.CONCLUSION Glucocorticoid and tocilizumab therapy was effective in managing CRS after PD-1 blockade therapy for gastric cancer in a patient with chronic plaque psoriasis.

Apigenin ameliorates imiquimod-induced psoriasis in C57BL/6J mice by inactivating STAT3 and NF-κB

Psoriasis is a chronic autoimmune disease featured by patches on the skin.It is caused by malfunction of immune cells and keratinocytes with inflammation as one of its key features.Apigenin(API)is a natural flavonoid with anti-inflammatory and immunoregulatory properties.Therefore,we speculated that API can ameliorate psoriasis,and determined its effect on the development of psoriasis by using imiquimod(IMQ)-induced psoriasis mouse model.Our results showed that API attenuated IMQ-induced phenotypic changes,such as erythema,scaling and epidermal thickening,and improved splenic hyperplasia.Abnormal differentiation of immune cells was restored in API-treated mice.Mechanistically,we revealed that API is a key regulator of signal transducer activator of transcription 3(STAT3).API regulated immune responses by reducing interleukin-23(IL-23)/STAT3/IL-17A axis.Moreover,it suppressed IMQ-caused cell hyperproliferation by inactivating STAT3 through regulation of extracellular signal-regulated kinase 1/2 and nuclear factor-κB(NF-κB)pathway.Furthermore,API reduced expression of inflammatory cytokines through inactivation of NF-κB.Taken together,our study demonstrates that API can ameliorate psoriasis and may be considered as a strategy for psoriasis treatment.

Causal effect of psoriasis on aortic valve stenosis:a two-sample Mendelian randomization study

Background Epidemiological studies have suggested a potential connection between psoriasis and an increased risk of aortic valve stenosis(AS),though the impact of psoriasis on AS progression remains uncertain.The study aims to investigate the causal relationship between psoriasis and AS using Mendelian randomization(MR)analysis,as well as to uncover potential mechanisms underlying this association.Methods A two-sample MR analysis was conducted using publicly available summary statistics from genome-wide association studies(GWAS)of psoriasis and AS.Cis-eQTL and significant genes were identified for each causal single-nucleotide polymorphisms(SNPs),followed by pathway enrichment and protein-protein interaction(PPI)analysis for functional evaluation.Hub genes were pinpointed by Cytospace.The transcriptional profile of AS population was acquired,and interconnected genes networks were clustered using Molecular Complex Detection(MCODE).Results Our results demonstrate a significant causal relationship between psoriasis and AS,with a genetic predisposition to psoriasis associated with a higher AS risk(odds ratio:1.46).Pathway and PPI analyses unveiled 15 hub genes,including HLA-C,HLA-B,ISG15,IFIT3,and MX2,along with immune-related pathways linking psoriasis and AS.Moreover,the transcriptional profiling of the AS database highlighted the significant involvement of adaptive immune cells in AS development.Notably,among the 15 hub genes,ISG15,MX2,OAS3,OASL,IFI6,and EPSTI1 exhibited higher expression in the AS population.Conclusion Our study provides compelling evidence supporting a causal relationship between psoriasis and AS.Furthermore,the identified hub genes and immune-related pathways may play an important role in the development of both diseases.

Coleus forskohlii shows anti-psoriatic activity in imiquimod-induced psoriasis rats

Objective:To evaluate anti-psoriatic activity of Coleus forskohlii in rats with imiquimod-induced psoriasis.Methods:Imiquimod was used to induce psoriasis in rats.Body weight,skin thickness,erythema,scaling,spleen weight,and histological alternations were measured to assess the effect of Coleus forskohlii.Furthermore,an emulgel formulation containing Coleus forskohlii 10%was prepared and characterized along with its ex vivo permeation studies.Results:The emulgel formulation containing Coleus forskohlii 10%had a pH of 5.40±0.36,with optimum spreadability of(31.67±2.08)g/(cm·s)and viscosity of(15966.67±1274.10)cps,and enhanced both the rate and the extent of drug permeation through psoriatic skin.In an ex vivo study,the quantity of drug permeated(19.18%),deposited(52.38%),and drug remaining in the donor compartments(28.31%)was satisfactory.Coleus forskohlii significantly alleviated imiquimod-induced psoriasis by increasing glutathione and superoxide dismutase activity,decreasing malondialdehyde and nitric oxide levels,and alleviating histological alternations in rat skin.Conclusions:Coleus forskohlii can alleviate imiquimod-induced psoriasis,which may be used as a therapeutic candidate for the treatment of psoriasis.

Human Papillomavirus Within Psoriasis Plaques in a Patient With Psoriasis:A Case Report

Introduction:Psoriasis may be triggered by several factors,and its pathophysiology is related to inflammatory cellular processes.We herein describe a patient with psoriasis who developed warts on multiple psoriasis plaques and was successfully treated with systemic subcutaneous methotrexate.Case presentation:A 67-year-old man who had been diagnosed with psoriasis 14 years previously developed an outbreak of small erythematous desquamative plaques distributed symmetrically on his arms and trunk.Multiple spiny whitish papules had developed over his previously established psoriasis lesions.The appearance of the papules was consistent with viral warts.The patient was treated with systemic methotrexate injected subcutaneously and oral folic acid,both dosed weekly.This treatment produced good results.Discussion:A remarkable feature of this case is that psoriasis was the first diagnosis and that human papillomavirus(HPV)appeared over widespread erythematous squamous plaques.The pathophysiology of psoriasis is related to inflammatory cellular processes.Some authors have reported that HPV proteins may stimulate keratinocyte proliferation.Others have reported that HPV infection mostly stimulates systemic interleukin 17 production;consequently,HPV infection could provide a better environment for interleukin 17 secretion and facilitate new onset of psoriasis.One report indicated that methotrexate was discontinued in a patient who presented with both pathologies,although we had very good results.Conclusion:Psoriasis and HPV may be pathophysiologically related.HPV may stimulate keratinocyte proliferation and systemic interleukin 17 production,resulting in a better environment for psoriasis.Systemic methotrexate injected subcutaneously resulted in a good outcome in our patient.

The Application Progress of Skin Imaging Technology in Psoriasis

Skin imaging technologies such as dermoscopy, high-frequency ultrasound, reflective confocal microscopy and optical coherence tomography are developing rapidly in clinical application. Skin imaging technology can improve clinical diagnosis rate, and its non-invasiveness and repeatability make it occupy an irreplaceable position in clinical diagnosis. With the “booming development” of medical technology, skin imaging technology can improve clinical diagnosis rate. Researchers have made significant advances in assisting clinical diagnosis, prediction, and treatment of disease. This article reviews the application and progress of skin imaging in the diagnosis of psoriasis.

Systemic Amyloidosis Secondary to Psoriasis: A Rare, Autoimmune and Genetically-Determined Disorder That Is Amenable to Treatment with Cyclosporin A—Cyclosporin A for Psoriasis-Induced Amyloidosis

Background: Systemic secondary amyloidosis (SSA) is associated with chronic inflammatory disorders and/or chronic infections. Patients and Methods: Over the past 10 years;a total of 21 patients, with long-term (17 months) and extensive psoriasis (P) with psoriasis area severity index (PASI) >29, were evaluated. Results: Two patients had nephrotic syndrome (proteinuria 3.9 and 3.6 g/day) and decrease creatinine clearance (46 and 62 ml/minute). Their renal biopsy revealed Congo-red (+) nodular glomerulosclerosis that lacked immune-deposits and resisted wash with K-permanganate wash indicating SSA. Three months subsequent to Cyclosporin A (CyA) therapy with 100 mg twice daily;psoriasis improved in all patients with decrease in (PASI) from 29.5 to 3.5 1. In the 2 patients with SSA;proteinuria decreased to 2.1 and 1.8 g/day and creatinine clearance improved to 51 and 69 ml/minute. Such improvement persisted up to 2 years of follow up and up to 78 months in patients with SSA. Conclusion: psoriasis-induced SSA is an autoimmune disease, with genetic predisposition that is amenable to CyA therapy.

Moyamoya syndrome may result from psoriasis: Four case reports

BACKGROUND Moyamoya syndrome(MMS)is a group of diseases that involves more than one underlying disease and is accompanied by moyamoya vascular phenomena.Psoriasis is a chronic immune skin disease closely linked to high blood pressure and heart disease.However,psoriasis-related MMS has not been reported.CASE SUMMARY We collected data on patients with stroke due to MMS between January 2017 and December 2019 and identified four cases of psoriasis.Case histories,imaging,and hematological data were collected.The average age of the initial stroke onset was 58.25±11.52 years;three cases of hemorrhagic and one case of ischemic stroke were included.The average duration from psoriasis confirmation to the initial MMS-mediated stroke onset was 17±3.56 years.All MMS-related stenoses involved the bilateral cerebral arteries:Suzuki grade III in one case,grade IV in two cases,and grade V in one case.Abnormally elevated plasma interleukin-6 levels were observed in four patients.Two patients had abnormally elevated immunoglobulin E levels,and two had thrombocytosis.All four patients received medication instead of surgery.With an average follow-up time of 2 years,two causing transient ischemic attacks occurred in two patients,and no hemorrhagic events occurred.CONCLUSION Psoriasis may be a potential risk factor for MMS.Patients with psoriasis should be screened for MMS when they present with neurological symptoms.

Toll-like receptors 2 polymorphism is associated with psoriasis: A case-control study in the northern Chinese population

Background:Psoriasis is a disease caused by genetics and immune system dysfunction,affecting the skin and joints.Toll-like receptors(TLRs)play an important role in triggering the innate immune response and controlling adaptive immunity.The role of TLR2 in the progression of psoriasis is not well understood.Methods:A case-control study was conducted on a northern Chinese Han population,consisting of psoriasis patients and healthy control subjects.Genotyping was performed using the tetra-primer amplification refractory mutation system-polymerase chain reaction(ARMS-PCR),and allele and genotype frequencies of four SNPs in TLR2 were analyzed in 270 psoriasis patients and 246 healthy controls.Results:Four TLR2 SNPs(rs11938228,rs4696480,rs3804099,rs5743699)were genotyped and found to be in linkage disequilibrium.The genotype distributions of rs11938228 and rs4696480 in two groups were in Hardy-Weinberg equilibrium and statistically significant except for the overdominance model.The haplotypes ATTC and ATCC were found to be protective against psoriasis.Conclusion:Our study found a correlation between TLR2 genetic variations and the likelihood of psoriasis in northern China.

Secoemestrin C Ameliorates Psoriasis-like Skin Inflammation in Mice by Suppressing the TNF-α/NF-κB Signaling Pathway

Objective Secoemestrin C(SC),an epitetrathiodioxopiperazine isolated from Aspergillus nidulans,has been previously reported to have immunomodulatory and hepatoprotective effects against acute autoimmune hepatitis.However,the effect of SC on regulating the inflammation and its underlying mechanisms in the pathogenesis of psoriasis remain unclear.This study aimed to evaluate the effects of SC on inflammatory dermatosis both in vitro and in vivo.Methods In vitro,HaCaT cells were induced with tumor necrosis factor-alpha(TNF-α,10 ng/mL)to establish an inflammatory injury model,and the expression of nuclear transcription factor-κB(NF-κB)pathway components was measured using qRT-PCR and Western blotting.An in vivo mouse model of imiquimod(IMQ)-induced psoriasis-like skin inflammation was used to evaluate the effectiveness of SC in alleviating psoriasis.Results SC significantly blocked the activation of NF-κB signaling in TNF-α-stimulated HaCaT cells.In addition,systemic and local administration of SC improved psoriatic dermatitis in the IMQ-induced mouse model.SC reduced skin scale and significantly inhibited the secretion of inflammatory factors in skin lesions.Conclusion The protective effect of SC against psoriatic-associated inflammation reveals its potential therapeutic value for treating psoriasis.

Protective effects of Bifi dobacterium breve on imiquimod-induced psoriasis in mice through secondary bile acid production and FXR-TLR4/NF-κB pathway

This study aimed to evaluate the effects of Bifi dobacterium breve CCFM683 on psoriasis and to investigate the underlying mechanisms.B.breve CCFM683 significantly ameliorated psoriasis in mice as well as elevated the deoxycholic acid(DCA)and lithocholic acid(LCA)in the colon compared with those of the imiquimod(IMQ)-treated mice.Meanwhile,B.breve CCFM683 increased the relative abundance of DCA-producing Lachnoclostridium and diminished the harmful Desulfovibrio and Prevotellaceae UCG001.Additionally,the farnesoid X receptor(FXR)in the skin was activated and the expression of the Toll-like receptor 4(TLR4)/nuclear factor kappa-B(NF-κB)pathway was inhibited,and the downstream interleukin(IL)-17 and tumor necrosis factor(TNF)-αwere downregulated whereas IL-10 was up-regulated.Moreover,the subsequent hyperproliferation of keratinocytes and the dysfunction of the epidermal barrier were improved.In conclusion,CCFM683 administration ameliorated IMQ-induced psoriasis via modulating gut microbiota,promoting the DCA production,regulating the FXR-TLR4/NF-κB pathway,diminishing proinflammatory cytokines,and regulating keratinocytes and epidermal barrier.These findings may be conducive to elucidating the mechanism for probiotics to ameliorate psoriasis and to promote its clinical trials in skin disease.