Association Between Neopterin And Oxidative Stress in Patients with Psoriasis

Abstract

Background: Recent literature has focused on the oxidative stress and inflammatory biomarkers to play an important role in the pathogenesis and clinical course of psoriasis. Objectives: The study was designed to evaluate serum levels of neopterin and selected oxidative stress biomarkers (lactate dehydrogenase (LDH), malondialdehyde (MDA) and thiobarbituric acid reactive substances (TBARS)) in psoriasis patients and their correlation with disease severity and interrelationships in the context of the role of oxidative stress in psoriasis pathophysiology. Methods: This case–control cross-sectional study was conducted on 62 patients with clinically diagnosed psoriasis and 48 apparently healthy persons as a control group recruited from the Central Laboratory of Al-Sadr Medical City, Al-Najaf, Iraq during the period from June 2025 to January 2026. Patients were categorized into mild, moderate and severe psoriasis groups according to disease severity evaluated by the Psoriasis Area and Severity Index (PASI). Results: The levels of serum neopterin, LDH, MDA and TBARS in patients with psoriasis were significantly higher than those in healthy controls (p < 0.01). A statistically significant trend for increasing biomarker levels according to disease severity was noted, with maximum values being recorded in patients with severe psoriasis. Pearson correlation analysis showed that neopterin was significantly positively correlated with both LDH (r = 0.341, p = 0.002) and MDA (r = 0.487, p = 0.008). On the other hand, neopterin showed a positive, although non-significant, correlation with TBARS (r = 0.168, p = 0.121). Conclusion: Serum neopterin and biomarkers of oxidative stress were significantly increased in patients with psoriasis and the levels progressively elevated according to disease severity. The observed positive peaks between neopterin and oxidative stress markers suggest that the immune activation do trigger the oxidative damage synergistic and mutual with each other in psoriasis pathogenic versus.

Keywords:

Psoriasis, Neopterin, LDH, MDA, TBARS

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