Psoriasis is an autoimmune and inflammatory skin disease. Psoriatic patients express higher levels of plasma homocysteine (Hcy) concentration and pro-inflammatory mediators than healthy people; this is frequently associated with vitamin D deficiency. The aim of this clinical study was to investigate the effects of high doses of vitamin D supplementation on the parameters of Hcy metabolism and cytokines in sera of psoriatic patients. This prospective study was conducted on 40 psoriatic patients who had the vitamin D deficiency. All patients received vitamin D 5000 IU/day for three months. Clinical and biochemical measurements were taken at baseline and at follow up (3 months). The results showed that the severity of clinical features, measured by the psoriasis area severity index (PASI) score, were considerably improved in patients after vitamin D supplementation. After vitamin D supplementation, most of the patients (n = 25 or 62.5%) had mild clinical form (p < 0.001). After twelve weeks of intervention period, there were significant increases in vitamin D and B₁₂ serum levels in comparison to the levels that had been measured at the beginning of the study (56.77 ± 14.66 nmol/L and 301.08 ± 95.02 pg/mL vs. 103.85 ± 32.20 nmol/L and 362.81 ± 118.56 pg/mL, respectively; p < 0.001). Moreover, serum levels of Hcy and folate were significantly lower at the end of the study in comparison with the initial levels (12.45 ± 1.92 µmol/L and 8.01 ± 3.88 mg/mL vs. 10.38 ± 1.66 µmol/L and 6.27 ± 2.60 mg/mL, respectively). High doses of vitamin D supplementation led to a significant decrease in pro-inflammatory cytokines (IFN-ɤ, TNF-α, IL-1β, IL-6, IL-8, and IL-17) and high-sensitivity C-reactive protein (hsCRP), whereas the production of anti-inflammatory cytokines (IL-10, IL-5) was up-regulated. In conclusion, supplementation with high doses of vitamin D could be one of the possible preventive and therapeutic measures to reduce systemic inflammation in psoriatic patients.

Introduction. Stroke is one of the leading causes of morbidity and mortality worldwide. The relationship between metabolic syndrome (MetS) and homocysteinemia (Hcy) as risk factors for ischemic stroke (IS) is not completely clear. The aim of the study was to determine the frequency of MetS, serum level of Hcy and the frequency of hyperhomocysteinemia (HHcy), as well as their association in patients with IS. Methods. The research included 53 subjects being in rehabilitation after IS and 40 subjects in the control group in rehabilitation due to the back pain problems aged 50-70 years. The diagnosis of the ischemic stroke was established by insight in the medical documentation. All subjects had to have a diagnosis of stroke confirmed by imaging (CT or MR of the endocranium). All subjects in the control group were excluded from the existence of previous stroke, myocardial infarction, angina pectoris and peripheral vascular disease. MetS was defined according to the joint statement from 2009. Results. The frequency of MetS was significantly higher in patients with IS compared to the control group (88.7% vs. 70.0%, p<0.05). The level of Hcy and the frequency of HHcy were increased in the patients with stroke compared to the control group (15.0±5.50 µmol/L vs. 11.2±2.51 µmol/L, p<0.01 and 39.2% vs. 11.4%, p<0.01, respectively). Among patients with IS, those with MetS had higher frequency of HHcy (42.2% vs. 16.7%, p<0.05) and it increased with more individual components of MetS (11.1% in patients with 3 components, 36.8% in patients with 4 components and 64.7% in patients with 5 components, p<0.05). Hcy was also in positive correlation with serum triglyceride level. Conclusion. Our results suggest that MetS and Hcy represent a significant risk factors for IS. It seems that there is an association between these risk factors in pathogenesis of the IS, but further analyses are needed to confirm this hypothesis.