{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:12:46Z","timestamp":1790284366806,"version":"4.1.0"},"reference-count":37,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Psoriasis is a chronic, immune-mediated skin condition with significant metabolic complications. Although lipid metabolism is linked to its pathogenesis, reliable biomarkers and the impact of modifiable factors remain underexplored. The aim of the present study was to identify potential biomarkers, study the affected metabolic networks, and assess the role of dietary and lifestyle factors in psoriasis. Plasma samples from 56 patients with psoriasis and 49 healthy controls were analyzed, as part of the Metabolic Biomarkers in Hashimoto\u2019s Thyroiditis and Psoriasis (METHAP) clinical trial. Using Gas Chromatography-Mass Spectrometry 23 fatty acids and their ratios were quantified, revealing significant changes in psoriasis. Specifically, lower levels of \u03b1-linoleic acid (C18:3n3), linoleic acid (C18:2n6), and gamma-linolenic acid (C18:3n6) were observed along with higher levels of eicosatrienoic acid (C20:3n3), eicosapentaenoic acid (C20:5n3), and erucic acid (C22:1n9). Total polyunsaturated fatty acids (PUFA) were significantly decreased, and the ratio of saturated to total fatty acids (SFA\/Total) was increased in psoriasis (p-values &lt; 0.0001). Linear regression identified \u03b1-linoleic acid, linoleic acid, eicosatrienoic acid, and eicosapentaenoic acid as potential biomarkers for psoriasis, adjusting for demographic, dietary, and lifestyle confounders. Network analysis revealed key contributors in the metabolic reprogramming of psoriasis. These findings highlight the association between psoriasis and fatty acid biomarkers of inflammation, insulin resistance and micronutrients deficiency, suggesting their potency in disease management.<\/jats:p>","DOI":"10.3390\/biom14091114","type":"journal-article","created":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T04:28:28Z","timestamp":1725424108000},"page":"1114","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Novel Fatty Acid Biomarkers in Psoriasis and the Role of Modifiable Factors: Results from the METHAP Clinical Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3058-429X","authenticated-orcid":false,"given":"Evangelia","family":"Sarandi","sequence":"first","affiliation":[{"name":"Laboratory of Toxicology and Forensic Sciences, Medical School, University of Crete, 71003 Heraklion, Greece"},{"name":"Metabolomic Medicine, Health Clinics for Autoimmune and Chronic Diseases, 10674 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Krueger-Krasagakis","sequence":"additional","affiliation":[{"name":"Dermatology Department, University Hospital of Heraklion, 71110 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6885-6209","authenticated-orcid":false,"given":"Dimitris","family":"Tsoukalas","sequence":"additional","affiliation":[{"name":"Metabolomic Medicine, Health Clinics for Autoimmune and Chronic Diseases, 10674 Athens, Greece"},{"name":"European Institute of Molecular Medicine, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4468-446X","authenticated-orcid":false,"given":"George","family":"Evangelou","sequence":"additional","affiliation":[{"name":"Dermatology Department, University Hospital of Heraklion, 71110 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Sifaki","sequence":"additional","affiliation":[{"name":"Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15701 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kyriakakis","sequence":"additional","affiliation":[{"name":"Laboratory of Toxicology and Forensic Sciences, Medical School, University of Crete, 71003 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstathia","family":"Paramera","sequence":"additional","affiliation":[{"name":"Neolab SA Medical Laboratory, 125 Michalakopoulou Street, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Papakonstantinou","sequence":"additional","affiliation":[{"name":"Neolab SA Medical Laboratory, 125 Michalakopoulou Street, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gottfried","family":"Rudofsky","sequence":"additional","affiliation":[{"name":"Clinic of Endocrinology and Metabolic Disorders, Cantonal Hospital Olten, 4600 Olten, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3824-2462","authenticated-orcid":false,"given":"Aristides","family":"Tsatsakis","sequence":"additional","affiliation":[{"name":"Laboratory of Toxicology and Forensic Sciences, Medical School, University of Crete, 71003 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1016\/S0140-6736(17)32130-X","article-title":"Global, Regional, and National Disability-Adjusted Life-Years (DALYs) for 333 Diseases and Injuries and Healthy Life Expectancy (HALE) for 195 Countries and Territories, 1990\u20132016: A Systematic Analysis for the Global Burden of Disease Study 2016","volume":"390","author":"Hay","year":"2017","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Peng, C., Xu, X., Chen, W., Li, X., Yi, X., Ding, Y., Yu, N., and Lu, J. (2021). Epidemiological Variations in the Global Burden of Psoriasis, an Analysis with Trends from 1990 to 2017. Front. Med., 8.","DOI":"10.3389\/fmed.2021.585634"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Sarandi, E., Krueger-Krasagakis, S., Tsoukalas, D., Sidiropoulou, P., Evangelou, G., Sifaki, M., Rudofsky, G., Drakoulis, N., and Tsatsakis, A. (2023). Psoriasis Immunometabolism: Progress on Metabolic Biomarkers and Targeted Therapy. Front. Mol. Biosci., 10.","DOI":"10.3389\/fmolb.2023.1201912"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Hu, P., Wang, M., Gao, H., Zheng, A., Li, J., Mu, D., and Tong, J. (2021). The Role of Helper T Cells in Psoriasis. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.788940"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1007\/s00018-016-2399-3","article-title":"The Obesity-Related Pathology and Th17 Cells","volume":"74","author":"Endo","year":"2017","journal-title":"Cell Mol. Life Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1038\/s41422-020-0291-z","article-title":"Targeting Immunometabolism as an Anti-Inflammatory Strategy","volume":"30","year":"2020","journal-title":"Cell Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"110968","DOI":"10.1016\/j.nut.2020.110968","article-title":"\u03c9-6\/\u03c9-3 Fatty Acid Ratio as an Essential Predictive Biomarker in the Management of Type 2 Diabetes Mellitus","volume":"79\u201380","author":"Shetty","year":"2020","journal-title":"Nutrition"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e072909","DOI":"10.1136\/bmj-2022-072909","article-title":"Association of Omega 3 Polyunsaturated Fatty Acids with Incident Chronic Kidney Disease: Pooled Analysis of 19 Cohorts","volume":"380","author":"Ong","year":"2023","journal-title":"BMJ"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Li, Z., Lei, H., Jiang, H., Fan, Y., Shi, J., Li, C., Chen, F., Mi, B., Ma, M., and Lin, J. (2022). Saturated Fatty Acid Biomarkers and Risk of Cardiometabolic Diseases: A Meta-Analysis of Prospective Studies. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.963471"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Koussiouris, J., Looby, N., Anderson, M., Kulasingam, V., and Chandran, V. (2021). Metabolomics Studies in Psoriatic Disease: A Review. Metabolites, 11.","DOI":"10.3390\/metabo11060375"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/bs.acc.2020.06.003","article-title":"Metabolic Profiling of Organic and Fatty Acids in Chronic and Autoimmune Diseases","volume":"101","author":"Sarandi","year":"2021","journal-title":"Adv. Clin. Chem."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"291","DOI":"10.3390\/pathophysiology28020019","article-title":"A Clinical Trial for the Identification of Metabolic Biomarkers in Hashimoto\u2019s Thyroiditis and in Psoriasis: Study Protocol","volume":"28","author":"Sarandi","year":"2021","journal-title":"Pathophysiology"},{"key":"ref_13","unstructured":"MetaboAnalyst, v.5.0 (2024, August 05). Available online: https:\/\/www.metaboanalyst.ca\/MetaboAnalyst\/."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"de Jong, A.J., Kloppenburg, M., Toes, R.E.M., and Ioan-Facsinay, A. (2014). Fatty Acids, Lipid Mediators, and T-Cell Function. Front. Immunol., 5.","DOI":"10.3389\/fimmu.2014.00483"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Saalbach, A., Seitz, A.-T., Kohlmann, J., Kalweit, L., Vogt, L., Selig, L., Engel, K.M., and Simon, J.C. (2023). Modulation of Dietary Fatty Acids in an Open-Label Study Improves Psoriasis and Dampens the Inflammatory Activation Status. Nutrients, 15.","DOI":"10.3390\/nu15071698"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s00403-017-1748-x","article-title":"Serum Fatty Acid Profile in Psoriasis and Its Comorbidity","volume":"309","author":"Baran","year":"2017","journal-title":"Arch. Dermatol. Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Marchlewicz, M., Polakowska, Z., Maciejewska-Markiewicz, D., Stachowska, E., Jakubiak, N., Kiedrowicz, M., Rak-Za\u0142uska, A., Duchnik, M., Wajs-Syrenicz, A., and Duchnik, E. (2024). Fatty Acid Profile of Erythrocyte Membranes in Patients with Psoriasis. Nutrients, 16.","DOI":"10.3390\/nu16121799"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1016\/j.jid.2021.02.755","article-title":"Investigation of Omega-3 Polyunsaturated Fatty Acid Biological Activity in a Tissue-Engineered Skin Model Involving Psoriatic Cells","volume":"141","author":"Simard","year":"2021","journal-title":"J. Investig. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Howie, D., Ten Bokum, A., Necula, A.S., Cobbold, S.P., and Waldmann, H. (2018). The Role of Lipid Metabolism in T Lymphocyte Differentiation and Survival. Front. Immunol., 8.","DOI":"10.3389\/fimmu.2017.01949"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3164\/jcbn.5.209","article-title":"Alterations in Plasma Fatty Acid Composition in Psoriatic Patients","volume":"5","author":"Katayama","year":"1988","journal-title":"J. Clin. Biochem. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/BF00409217","article-title":"The Fatty-Acid Spectrum in Plasma and Adipose Tissue in Patients with Psoriasis","volume":"278","author":"Vahlquist","year":"1985","journal-title":"Arch. Dermatol. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.31557\/APJCP.2019.20.4.1005","article-title":"Association of Delta-6-Desaturase Expression with Aggressiveness of Cancer, Diabetes Mellitus, and Multiple Sclerosis: A Narrative Review","volume":"20","author":"Arshad","year":"2019","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Czumaj, A., and \u015aledzi\u0144ski, T. (2020). Biological Role of Unsaturated Fatty Acid Desaturases in Health and Disease. Nutrients, 12.","DOI":"10.3390\/nu12020356"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12944-023-01999-6","article-title":"Serum Lipidomic Study of Long-Chain Fatty Acids in Psoriasis Patients Prior to and after Anti-IL-17A Monoclonal Antibody Treatment by Quantitative GC\u2012MS Analysis with in Situ Extraction","volume":"23","author":"Guo","year":"2024","journal-title":"Lipids Health Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.5114\/aoms.2019.89451","article-title":"Abnormal Serum Fatty Acid Profile in Psoriatic Arthritis","volume":"15","author":"Mysliwiec","year":"2019","journal-title":"Arch. Med. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Ikeda, K., Morizane, S., Akagi, T., Hiramatsu-Asano, S., Tachibana, K., Yahagi, A., Iseki, M., Kaneto, H., Wada, J., and Ishihara, K. (2022). Obesity and Dyslipidemia Synergistically Exacerbate Psoriatic Skin Inflammation. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23084312"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"714","DOI":"10.5114\/ada.2019.91422","article-title":"Serum Sphingolipid Level in Psoriatic Patients with Obesity","volume":"36","author":"Milewska","year":"2019","journal-title":"Adv. Dermatol. Allergol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"179","DOI":"10.3892\/etm.2021.11102","article-title":"Metabolic Comorbidities of Psoriasis (Review)","volume":"23","author":"Branisteanu","year":"2021","journal-title":"Exp. Ther. Med."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Kunz, M., Simon, J.C., and Saalbach, A. (2019). Psoriasis: Obesity and Fatty Acids. Front. Immunol., 10.","DOI":"10.3389\/fimmu.2019.01807"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1016\/j.jid.2018.03.1522","article-title":"High-Fat Diet Exacerbates Early Psoriatic Skin Inflammation Independent of Obesity: Saturated Fatty Acids as Key Players","volume":"138","author":"Herbert","year":"2018","journal-title":"J. Investig. Dermatol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Li, J., Shen, Q., Guo, C., Wang, Y., Ma, Y., and Zhang, Y. (2024). Causality of Unsaturated Fatty Acids and Psoriasis a Mendelian Randomization Study. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1280962"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"189","DOI":"10.2147\/PTT.S349791","article-title":"Psoriasis and Exercise: A Review","volume":"12","author":"Yeroushalmi","year":"2022","journal-title":"Psoriasis Targets Ther."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1038\/nri3041","article-title":"The Anti-Inflammatory Effects of Exercise: Mechanisms and Implications for the Prevention and Treatment of Disease","volume":"11","author":"Gleeson","year":"2011","journal-title":"Nat. Rev. Immunol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"527","DOI":"10.5650\/jos.ess13226","article-title":"The Proportion of Nervonic Acid in Serum Lipids Is Associated with Serum Plasmalogen Levels and Metabolic Syndrome","volume":"63","author":"Yamazaki","year":"2014","journal-title":"J. Oleo Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"154911","DOI":"10.1016\/j.phymed.2023.154911","article-title":"Nervonic Acid Improves Liver Inflammation in a Mouse Model of Parkinson\u2019s Disease by Inhibiting Proinflammatory Signaling Pathways and Regulating Metabolic Pathways","volume":"117","author":"Wang","year":"2023","journal-title":"Phytomedicine"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.3892\/mmr.2014.2136","article-title":"Endogenous N-3 Polyunsaturated Fatty Acids Protect against Imiquimod-Induced Psoriasis-like Inflammation via the IL-17\/IL-23 Axis","volume":"9","author":"Qin","year":"2014","journal-title":"Mol. Med. Rep."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"100428","DOI":"10.1016\/j.jlr.2023.100428","article-title":"Eicosapentaenoic Acid Reduces the Proportion of IL-17A\u2013Producing T Cells in a 3D Psoriatic Skin Model","volume":"64","author":"Morin","year":"2023","journal-title":"J. Lipid Res."}],"container-title":["Biomolecules"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-273X\/14\/9\/1114\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:48:18Z","timestamp":1760111298000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-273X\/14\/9\/1114"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,4]]},"references-count":37,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["biom14091114"],"URL":"https:\/\/doi.org\/10.3390\/biom14091114","relation":{},"ISSN":["2218-273X"],"issn-type":[{"value":"2218-273X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,4]]}}}