Metal allergy as a persistent factor for psoriasis.

Abstract

PURPOSE: Psoriasis is a complex, chronic inflammatory keratosis of unclear origin that is challenging to treat. In patients with psoriasis suspected of having metal allergies, the removal of oral metallic prostheses contributes to the alleviation of psoriasis symptoms. However, the relationship and mechanism of the metal removal effect and improvement in psoriasis symptoms in patients with metal allergies are unknown. This study aimed to investigate the relationship between metal allergies and psoriasis using an animal model. METHODS: In the metal allergy model, 4-week-old rats were sensitized and treated with nickel (II) chloride (NiCl) solution (provocation model). In the psoriasis model, imiquimod (IMQ) cream was applied to the shaved dorsal skin of rats (IMQ model). To create a psoriasis/metal-allergy composite rat model, we combined the provocation and IMQ models (provocation + IMQ model). Macroscopic observation, histological analysis, and quantitative gene expression analyses were performed to evaluate outcomes. RESULTS: In the IMQ model, psoriasis-like symptoms were visually observed from day 2 to day 9. In the provocation + IMQ model, psoriasis-like symptoms persisted for at least 11 days. Histological analysis revealed epidermal thickening and an increase in the number of interleukin (IL)-17-positive cells in the provocation + IMQ model on days 7 and 9. The gene expression of IL-17 in the submandibular lymph nodes and spleen increased in the provocation + IMQ model. CONCLUSIONS: The induced state of Ni allergy may contribute to the maintenance of psoriasis pathology through IL-17 activity.