{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:33:54Z","timestamp":1791329634682,"version":"4.3.1"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No. 82260283"],"award-info":[{"award-number":["No. 82260283"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Science and Technology Plan Project of Provincial Health Commission in 2025","award":["No. 202510823"],"award-info":[{"award-number":["No. 202510823"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Psoriasis is a chronic inflammatory autoimmune disease that affects physical and mental health. Mental stress has been shown to exacerbate human psoriasis by unknown mechanism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Peripheral blood mononuclear cells (PBMCs) were collected from patients with psoriasis and mental stress-treated psoriatic mice. The expression levels of TLR9\/MyD88\/NF-\u03baB pathway-related molecules were analyzed by qRT-PCR and western blotting. Histological examination of skin lesions was examined using hematoxylin-eosin staining. The ratios of Treg\/CD4\n                      <jats:sup>+<\/jats:sup>\n                      T cells and Th17\/Treg cells were determined by flow cytometry. The associations among mental stress, the TLR9\/MyD88\/NF-\u03baB pathway, and psoriasis were explored using pharmacological inhibitors and lentiviral transfection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our findings demonstrated a significant upregulation of TLR9\/MyD88\/NF-\u03baB pathway-associated molecules in the PBMCs of psoriasis patients, accompanied by elevated expression of inflammatory factors. These observations were validated using a mouse model of psoriasis. Notably, mental stress was shown to activate the TLR9\/MyD88\/NF-\u03baB pathway and enhance inflammatory factor production, while simultaneously increasing the Th17\/Treg ratio and decreasing the Treg\/CD4\n                      <jats:sup>+<\/jats:sup>\n                      T ratio. Therapeutic interventions including antipsychotic sertraline, pathway-specific inhibitors, and lentiviral transfection significantly ameliorated inflammatory markers and improved psoriasis severity grading.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results of this study demonstrates that mental stress induces inflammation and immune dysregulation, exacerbating psoriasis progression. These findings provide valuable insights into the pathophysiological mechanisms underlying psoriasis progression, particularly the mental stress-mediated immunoregulatory axis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0344474","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T18:29:09Z","timestamp":1772821749000},"page":"e0344474","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["TLR9\/MyD88\/NF-\u03baB signaling mediates mental stress-induced exacerbation of psoriasis through immune dysregulation in a mouse 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