TSP2 IGFBP7 GDF 15 and CD 163 in pediatric psoriasis and controls

We investigated novel biologically plausible serum biomarkers of connective tissue remodeling and inflammation: TSP2, IGFBP7, GDF15 and CD163 in pediatric patients with psoriasis. Fifty psoriasis patients and 50 control subjects were included. The Psoriasis Area and Severity Index (PASI) and Body Surface Area (BSA) measured skin disease severity. Serum TSP2, GDF15, IGFBP7 and CD163 levels were quantified using validated sandwich ELISA’s. The patients with psoriasis had predominantly low disease activity (PASI 3.2, IQR 0.8-6; BSA 3.0, IQR 1-8) and were mainly on topical treatment (84%). TSP2 and IGFBP7 levels were significantly increased in psoriasis patients compared to controls, while GDF15 levels were decreased and CD163 levels were comparable. TSP2, GDF15 and IGFBP7 differentiated psoriasis from controls with AUROC = 0.731, 0.650 and 0.736, respectively. The ROC curve of the 3-marker combination exceeded 0.8 AUC (0.806). Elevation of the matricellular serum marker TSP2 and the matricellular/inflammatory marker IGFBP7 suggest an enhanced extracellular matrix turnover even in pediatric psoriasis patients with low disease activity.