Resolution of systemic inflammation in psoriasis following herring roe oil treatment: a post hoc analysis on inflammatory biomarkers in non-severe psoriatic patients

BackgroundPsoriasis is a chronic immune-mediated inflammatory disease (IMID) with systemic involvement. In mild-to-moderate disease, circulating cytokines may inadequately capture systemic inflammatory burden. Composite haematological indices derived from complete blood counts, such as the systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), have emerged as sensitive prognostic markers of systemic inflammation, including in psoriasis. This exploratory post hoc analysis investigated the effects of orally administered herring roe oil (HRO), a phospholipid-rich marine oil, on systemic inflammation in patients with mild-to-moderate psoriasis utilizing these biomarkers. MethodsData were analysed from a randomized, double-blind, placebo-controlled 26-week clinical study which investigated HRO supplementation in patients (N = 64) with mild-to-moderate psoriasis (NCT03359577). SII, SIRI, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were calculated at baseline, week 12, and week 26 for patients where baseline complete blood counts (CBCs) were available (n = 60). Patients missing baseline CBCs were excluded from the analysis. Continuous changes were assessed using ANCOVA with baseline adjustment. Categorical responder analyses were performed with 25% and 30% reduction thresholds and stratification by baseline biomarker medians were performed to evaluate treatment responses and impact of baseline inflammation. ResultsCompared with placebo, HRO treatment resulted in significant mean reductions in SII, SIRI, and PLR at week 26, with supportive trends and responder effects observed as early as week 12 compared to placebo. Patients with elevated baseline inflammatory indices showed the greatest reductions in systemic inflammation. Stratification by baseline SII further revealed enhanced clinical benefit, with statistically significant PASI50 response rates in the HRO arm at week 26 among patients with lower baseline SII. ConclusionHRO supplementation was associated with a time{square}dependent reduction in systemic inflammatory biomarkers in mild{square}to{square}moderate psoriasis patients. These findings support the utility of composite inflammatory indices for monitoring systemic inflammation and suggest that baseline SII may have utility in predicting treatment response and may be a useful tool for stratification in clinical trials in mild to moderate psoriasis patients. These results could also suggest platform-potential of HRO for resolution{square}oriented interventions across several inflammatory conditions.