Pantethine in psoriasis: mechanism described in mice, pilot trial in 24 patients

A group of researchers from Beijing has described a link between metabolism and the development of psoriasis, according to pravda.ru. The work was published in the Journal of Experimental Medicine (JEM). The authors report that pantethine, a derivative of vitamin B5, may reduce inflammation in this disease pravda.rupravda.rupravda.ruOpen source ↗. The results come from laboratory experiments in mice and a small clinical study of 24 people.

The vanin–pantethine–cholesterol axis

Dendritic cells recognize threats, capture antigens and pass the signal to T cells. They also produce chemical signals that trigger inflammation. In autoimmune conditions, including psoriasis, these cells become hyperactive and sustain chronic inflammation by attacking the body's own tissues.

The researchers noted a high level of the enzyme vanin in cells of patients with psoriasis. Vanins take part in converting pantethine into vitamin B5, which cells need to produce energy. According to the authors, excess vanin activity lowers pantethine stores inside dendritic cells, which increases cholesterol production. Cholesterol in turn acts as a stimulus that makes immune cells overactive. This is the vanin–pantethine–cholesterol axis the authors describe as regulating inflammation.

Mouse experiments and a pilot trial

In the experiments, suppressing vanins helped prevent the development of psoriasis in mice. Restoring pantethine levels also reduced cholesterol accumulation in cells and limited excessive activation of the immune system pravda.rupravda.rupravda.ruOpen source ↗.

In the clinical study, 24 patients received standard ointment treatment (a combination of calcipotriene and betamethasone), and half of the group additionally took pantethine tablets. After 12 weeks, skin condition improved more noticeably in those who received the supplement, especially in patients who initially had elevated blood cholesterol.

The authors stress that the data are preliminary. A sample of 24 people is too small for firm conclusions, and it has not been shown that the described biological mechanism caused the improvement in patients. The clinical test has the status of a proof of concept rather than final evidence of efficacy. The researchers note that pantethine may in future become a supporting tool in the therapy of autoimmune diseases, but larger clinical trials are needed to confirm this.