{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:50:29Z","timestamp":1791521429885,"version":"4.3.4"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Psoriasis is a chronic systemic inflammatory disease that imposes a considerable burden of metabolic comorbidities. Metabolic dysfunction-associated steatotic liver disease (MASLD) is particularly common among patients with psoriasis, which may be attributed to shared metabolic and immune-inflammatory pathogenic pathways. However, evidence linking peripheral T-cell profiles to clinical phenotypes remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a cross-sectional study. A total of 408 participants were enrolled stratified into three groups: 206 patients with plaque psoriasis, 100 subjects undergoing routine health examinations (RHE group), and 102 patients with isolated MASLD. All participants underwent vibration-controlled transient elastography (VCTE) via FibroScan\u00ae, with simultaneous acquisition of Liver Stiffness Measurement (LSM) and Controlled Attenuation Parameter (CAP). Comprehensive clinical and laboratory data were collected for further analysis. In a subset of 49 psoriasis participants (32 patients with psoriasis and MASLD and 17 patients with psoriasis alone), peripheral T-cell subpopulations were quantified using flow cytometry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Psoriasis patients had a higher MASLD prevalence than participants in RHE group (65.5% vs. 46.0%, P\u00a0=\u00a00.002), with psoriasis independently associated with MASLD (adjusted OR\u00a0=\u00a02.282, 95% CI: 1.181-4.408). Body mass index (BMI), hyperuricemia, insulin resistance-related indices (triglyceride glucose index [TyG], TyG-BMI), and uric acid-to-high-density lipoprotein cholesterol ratio (UHR) were linked to concomitant MASLD in psoriasis patients. Elevated liver enzymes were associated with severe hepatic steatosis grades. An exploratory model combining BMI, TyG and hyperuricemia exhibited favorable performance for MASLD screening, with an area under the receiver operating characteristic curve (AUC) of 0.84 (95% CI, 0.78-0.89). Compared with patients with psoriasis alone, those with coexisting MASLD showed elevated circulating IL-17+ Th17 cells and an increased Th17\/Treg ratio, and this immune imbalance correlated positively with the grade of hepatic steatosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Psoriasis is independently associated with MASLD. Psoriasis patients with coexisting MASLD present metabolic abnormalities along with peripheral Th17\/Treg immune imbalance. The exploratory model combining BMI, the TyG index and hyperuricemia shows good performance for MASLD screening. These findings highlight the importance of multidisciplinary management for patients with psoriasis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1958145","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:27:05Z","timestamp":1791520025000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Th17\/Treg imbalance and clinical characteristics in psoriasis patients with metabolic dysfunction-associated steatotic liver disease: a cross-sectional analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Sai","family":"Dong","sequence":"first","affiliation":[{"name":"Department of Dermatology, Peking University People\u2019s Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixuan","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Peking University People\u2019s Hospital, Peking University Hepatology Institute","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Bao","sequence":"additional","affiliation":[{"name":"Health Management Center, Peking University People\u2019s Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University People\u2019s Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanglei","family":"Mu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University People\u2019s Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianzhong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University People\u2019s Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houmin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University People\u2019s Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Peking University People\u2019s Hospital, Peking University Hepatology Institute","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University People\u2019s Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2009.04.020","article-title":"Non-alcoholic fatty liver disease in patients with chronic plaque psoriasis","volume":"51","author":"Gisondi","year":"2009","journal-title":"J Hepatol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2009.06.008","article-title":"Prevalence, characteristics and severity of non-alcoholic fatty liver disease in patients with chronic plaque psoriasis","volume":"51","author":"Miele","year":"2009","journal-title":"J Hepatol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/bjd\/ljae147","article-title":"Insulin resistance impairs biologic agent response in moderate-to-severe plaque psoriasis: insights from a prospective cohort study in China","volume":"191","author":"Huang","year":"2024","journal-title":"Br J Dermatol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1844","DOI":"10.1016\/j.immuni.2023.06.021","article-title":"Obesity-induced dysregulation of skin-resident PPAR\u03b3(+) Treg cells promotes IL-17A-mediated psoriatic inflammation","volume":"56","author":"Sivasami","year":"2023","journal-title":"Immunity"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.06.003","article-title":"New trends on obesity and NAFLD in Asia","volume":"67","author":"Fan","year":"2017","journal-title":"J Hepatol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-024-00857-0","article-title":"Managing the patient with psoriasis and metabolic comorbidities","volume":"25","author":"Bellinato","year":"2024","journal-title":"Am J Clin Dermatol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25052660","article-title":"Intersecting pathways: Nonalcoholic fatty liver disease and psoriasis duet-a comprehensive review","volume":"25","author":"Costache","year":"2016","journal-title":"Int J Mol Sci"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.17235\/reed.2019.6263\/2019","article-title":"Psoriasis and fatty liver: a harmful synergy","volume":"111","author":"Olveira","year":"2019","journal-title":"Rev Esp Enferm Dig"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s10753-023-01883-6","article-title":"Low-dose interleukin-2 for psoriasis therapy based on the regulation of Th17\/Treg cell balance in peripheral blood","volume":"46","author":"Qiao","year":"2023","journal-title":"Inflammation"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1597204","article-title":"Increased frequencies of human Th-17 CD4+ T-cells and decreased T-regulatory cells in patients with early and advanced metabolic dysfunction-associated steatotic liver disease","volume":"16","author":"Supruniuk","year":"2025","journal-title":"Front Immunol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaf344","article-title":"High prevalence of MASLD in psoriasis and psoriatic arthritis assessed with multiparametric magnetic resonance imaging","volume":"64","author":"James","year":"2025","journal-title":"Rheumatol (Oxford)"},{"key":"B12","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1016\/j.jhep.2024.04.031","article-title":"On the management of metabolic dysfunction-associated steatotic liver disease (MASLD)","volume":"81","year":"2024","journal-title":"J Hepatol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.10.044","article-title":"Psoriasis is independently associated with nonalcoholic fatty liver disease in patients 55 years old or older: results from a population-based study","volume":"70","author":"van der Voort","year":"2014","journal-title":"J Am Acad Dermatol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2022.1609","article-title":"Association between psoriasis and nonalcoholic fatty liver disease among outpatient US adults","volume":"158","author":"Ruan","year":"2022","journal-title":"JAMA Dermatol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1016\/j.autrev.2014.07.001","article-title":"Obesity in autoimmune diseases: not a passive bystander","volume":"13","author":"Versini","year":"2014","journal-title":"Autoimmun Rev"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12407","article-title":"Obesity is an independent risk factor for non-alcoholic fatty liver disease: evidence from a meta-analysis of 21 cohort studies","volume":"17","author":"Li","year":"2016","journal-title":"Obes Rev"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.178","article-title":"Metabolically healthy obesity and the development of nonalcoholic fatty liver disease","volume":"111","author":"Chang","year":"2016","journal-title":"Am J Gastroenterol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002739","article-title":"Evidence of a causal relationship between body mass index and psoriasis: a mendelian randomization study","volume":"16","author":"Budu-Aggrey","year":"2019","journal-title":"PloS Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0331740","article-title":"Insulin resistance markers HOMA-IR, TyG and TyG-BMI index in relation to heart failure risk: NHANES 2011-2016","volume":"20","author":"Lu","year":"2025","journal-title":"PloS One"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1388967","article-title":"Positive association between insulin resistance and fatty liver disease in psoriasis: evidence from a cross-sectional study","volume":"15","author":"Zhong","year":"2024","journal-title":"Front Immunol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"4564","DOI":"10.1038\/s41467-024-48956-0","article-title":"Development of a novel non-invasive biomarker panel for hepatic fibrosis in MASLD","volume":"15","author":"Verschuren","year":"2024","journal-title":"Nat Commun"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2019.0001n","article-title":"Application of transient elastography in nonalcoholic fatty liver disease","volume":"26","author":"Zhang","year":"2020","journal-title":"Clin Mol Hepatol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdin.2026.03.009","article-title":"Prevalence and risk factors of fatty liver disease in psoriasis: a systematic review and meta-analysis based on NAFLD\/MAFLD diagnostic criteria","volume":"26","author":"Shen","year":"2026","journal-title":"JAAD Int"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.62438\/tunismed.v103i5.5661","article-title":"Predictive factors of significant fibrosis in metabolic dysfunction-associated steatotic liver disease","volume":"103","author":"Mensi","year":"2025","journal-title":"Tunis Med"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaf111","article-title":"Machine learning-based biomarker identification for early diagnosis of metabolic dysfunction-associated steatotic liver disease","volume":"110","author":"Boullion","year":"2025","journal-title":"J Clin Endocrinol Metab"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2008.083592","article-title":"Serum gamma-glutamyltransferase: new insights about an old enzyme","volume":"63","author":"Lee","year":"2009","journal-title":"J Epidemiol Community Health"},{"key":"B27","doi-asserted-by":"publisher","first-page":"23","DOI":"10.25259\/IJDVL_42_2023","article-title":"High level of gamma-glutamyltransferase is a possible risk factor for psoriasis: a nationwide population-based cohort study","volume":"91","author":"Oh","year":"2025","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2010.03988.x","article-title":"Cross-sectional study on the correlation of serum uric acid with disease severity in Korean patients with psoriasis","volume":"36","author":"Kwon","year":"2011","journal-title":"Clin Exp Dermatol"},{"key":"B29","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1097\/00124743-200002000-00001","article-title":"Hyperuricemia in psoriatic arthritis: prevalence and associated features","volume":"6","author":"Bruce","year":"2000","journal-title":"J Clin Rheumatol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1038\/nature04516","article-title":"Gout-associated uric acid crystals activate the NALP3 inflammasome","volume":"440","author":"Martinon","year":"2006","journal-title":"Nature"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1003746","article-title":"P2Y6 receptor signaling pathway mediates inflammatory responses induced by monosodium urate crystals","volume":"188","author":"Uratsuji","year":"2012","journal-title":"J Immunol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.09.005","article-title":"Hyperuricemia in patients with chronic plaque psoriasis","volume":"70","author":"Gisondi","year":"2014","journal-title":"J Am Acad Dermatol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20187547","article-title":"Serum uric acid levels and hyperuricemia in patients with psoriasis: a hospital-based cross-sectional study","volume":"93","author":"Gui","year":"2018","journal-title":"Bras Dermatol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usy097","article-title":"Hyperuricemia is associated with a higher prevalence of metabolic syndrome in military individuals","volume":"183","author":"Liu","year":"2018","journal-title":"Mil Med"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1152\/ajpcell.00600.2006","article-title":"Adverse effects of the classic antioxidant uric acid in adipocytes: NADPH oxidase-mediated oxidative\/nitrosative stress","volume":"293","author":"Sautin","year":"2007","journal-title":"Am J Physiol Cell Physiol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.12.009","article-title":"Uric acid may serve as the sixth cardiometabolic criterion for defining MASLD","volume":"80","author":"He","year":"2024","journal-title":"J Hepatol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.02.026","article-title":"Uric acid in pediatric MASLD definition: is it time to implement diagnostic criteria","volume":"80","author":"Di Sessa","year":"2024","journal-title":"J Hepatol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S520688","article-title":"Association between uric acid to HDL-C ratio and metabolic dysfunction-associated steatotic liver disease in type 2 diabetes mellitus: a cross-sectional study","volume":"18","author":"Zhu","year":"2025","journal-title":"Diabetes Metab Syndr Obes"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1474384","article-title":"Association between serum uric acid-to-high-density lipoprotein cholesterol ratio and metabolic dysfunction-associated steatotic liver disease among Chinese children with obesity","volume":"15","author":"Liu","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v31.i48.112972","article-title":"Serum uric acid-to-high-density lipoprotein cholesterol ratio and cardiovascular risk in Asian patients with metabolic dysfunction-associated steatotic liver disease","volume":"31","author":"Wang","year":"2025","journal-title":"World J Gastroenterol"},{"key":"B41","doi-asserted-by":"publisher","first-page":"11278","DOI":"10.1038\/s41598-025-94651-5","article-title":"Serum uric acid to high-density lipoprotein cholesterol ratio predicts all-cause mortality in adults with metabolic dysfunction associated steatotic liver disease","volume":"15","author":"Ou","year":"2025","journal-title":"Sci Rep"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.16696","article-title":"Liver-skin axis: a new view or viewed already","volume":"179","author":"Nobili","year":"2018","journal-title":"Br J Dermatol"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1007\/s10787-025-02027-y","article-title":"Psoriasis beyond the skin: systemic inflammation as a bridge to metabolic and hepatic comorbidities","volume":"34","author":"Karmbir","year":"2026","journal-title":"Inflammopharmacology"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2016.05.020","article-title":"Metabolic inflammation-associated IL-17A causes non-alcoholic steatohepatitis and hepatocellular carcinoma","volume":"30","author":"Gomes","year":"2016","journal-title":"Cancer Cell"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2014.09.024","article-title":"3, 3\u2019-Diindolylmethane alleviates steatosis and the progression of NASH partly through shifting the imbalance of Treg\/Th17 cells to Treg dominance","volume":"23","author":"Liu","year":"2014","journal-title":"Int Immunopharmacol"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2022.0040","article-title":"Effects of interleukin-17 inhibitors on hepatic fibrosis index in patients with psoriasis and metabolic dysfunction-associated fatty liver disease: directed acyclic graphs","volume":"28","author":"Takamura","year":"2022","journal-title":"Clin Mol Hepatol"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1111\/dth.15065","article-title":"Can secukinumab improve liver fibrosis? A pilot prospective study of 10 psoriatic patients","volume":"34","author":"Magdaleno-Tapial","year":"2021","journal-title":"Dermatol Ther"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v30.i48.5205","article-title":"GLP-1, GIP\/GLP-1, and GCGR\/GLP-1 receptor agonists: Novel therapeutic agents for metabolic dysfunction-associated steatohepatitis","volume":"30","author":"Singh","year":"2024","journal-title":"World J Gastroenterol"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2026.1753","article-title":"Ixekizumab with or without tirzepatide in adults with psoriasis and overweight or obesity: A phase 3b randomized clinical trial","volume":"162","author":"Lebwohl","year":"2026","journal-title":"JAMA Dermatol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1958145\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:27:06Z","timestamp":1791520026000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1958145\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,9]]},"references-count":49,"alternative-id":["10.3389\/fimmu.2026.1958145"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1958145","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,9]]},"article-number":"1958145"}}