{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T01:03:03Z","timestamp":1791939783639,"version":"4.3.4"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T00:00:00Z","timestamp":1591574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In psoriasis, tumor necrosis factor (TNF)\u2010\u03b1 is a key pro\u2010inflammatory cytokine that activates keratinocytes to produce other inflammatory mediators. In addition, increased serum or plasma TNF\u2010\u03b1 levels are considered to be biomarkers of psoriasis. Circulating cell\u2010free DNA (cfDNA) originates from apoptotic or necrotic cells and reflects the severity of cellular damage. Although cfDNA has recently attracted attention as a marker in the diagnosis and prognosis of various disorders, there are few reports of its clinical implications in the field of dermatology including psoriasis. The aim of this study was to investigate whether the TNF\u2010\u03b1 gene is present in the cfDNA, and whether its levels can be utilized as a biomarker for patients with psoriasis. cfDNA was isolated from serum samples of 79 patients with psoriasis vulgaris and 29 with psoriatic arthritis. The levels of TNF\u2010\u03b1 in the cfDNA were assessed by droplet digital polymerase chain reaction. In this study, we made two novel findings. First, circulating TNF\u2010\u03b1 DNA levels in the cfDNA were significantly higher in patients with psoriasis than in healthy controls. In addition, the area under the curve was 0.91, suggesting that serum TNF\u2010\u03b1 DNA levels are effective as a diagnostic biomarker. Second, the levels of TNF\u2010\u03b1 DNA copies in the cfDNA were positively correlated with the Psoriasis Area and Severity Index (PASI) score in the group of patients with a PASI score higher than 10. Generally, a PASI score of more than 10 is defined as severe psoriasis; therefore, the levels of TNF\u2010\u03b1 DNA copies in the cfDNA could be a biomarker for severity in patients with severe psoriasis. Further studies are needed to establish serum TNF\u2010\u03b1 DNA levels as a novel biomarker of psoriasis.<\/jats:p>","DOI":"10.1111\/1346-8138.15422","type":"journal-article","created":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T02:36:46Z","timestamp":1591670206000},"page":"1037-1040","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Circulating tumor necrosis factor\u2010\u03b1 DNA are elevated in psoriasis"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4369-9723","authenticated-orcid":false,"given":"Ryoko","family":"Sakamoto","sequence":"first","affiliation":[{"name":"Department of Dermatology and Plastic Surgery Faculty of Life Sciences Kumamoto University Kumamoto 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