A widely available nutritional supplement derived from vitamin B5 may offer a promising new approach in treating psoriasis, according to a Chinese study. Scientists have found that pantethine can calm immune cells involved in autoimmune inflammation, preventing the development of psoriasis in mice and improving symptoms in a small human clinical trial.
The results, published on October 27 in the Journal of Experimental Medicine (JEM)reveal an unexpected link between cholesterol production and the immune system. By interfering with this process, pantethine may help reduce excessive immune activity that causes psoriasis and potentially other autoimmune diseases.
How Overactive Immune Cells Contribute to Psoriasis
At the center of the discovery are dendritic cells, specialized immune cells that help organize the body’s defenses. These cells act as coordinators, identifying potential threats and directing other immune cells to respond.
Dendritic cells perform this role by capturing foreign substances called antigens and presenting them to T cells, which are immune cells that recognize specific threats. They also release chemical signals that recruit additional immune cells and trigger inflammation.
Although these activities are essential for fighting infections, problems can arise when dendritic cells become too active. Instead of helping to protect the body, they can contribute to persistent inflammation and autoimmune diseases such as psoriasis.
“Emerging evidence highlights that metabolic pathways and their associated metabolites play critical roles in regulating immune cell function and autoimmune progression,” says Wei-Na Zhang, a researcher at the State Key Laboratory of Biomedical Analysis in Beijing. “But therapeutic strategies targeting metabolism in inflammatory diseases remain underexplored.”
Zhang led the research alongside Qing Xia, Ai-Ling Li and Tao Zhou, also from the State Key Laboratory of Biomedical Analysis, and Cheng-Xin Li from China’s PLA General Hospital First Medical Center in Beijing.
Scientists discover hidden link between cholesterol and psoriasis
Researchers have identified unusually high levels of enzymes called Vanins in the dendritic cells of people with psoriasis and several other autoimmune diseases. These enzymes help regulate the processing of certain substances involved in cellular metabolism.
When the scientists reduced Vanin levels, the dendritic cells became less active and less able to stimulate T cells. They also found that a drug designed to inhibit Vanins prevented the development of psoriasis in mice.
Further investigation revealed why these enzymes might play such an important role.
Vanins convert pantethine into vitamin B5, an essential nutrient that cells need to produce energy. Pantethine is already sold as a nutritional supplement and is commonly used to help lower blood cholesterol because it can reduce cholesterol production.
This link is particularly interesting because cholesterol does not just circulate in the blood. It also influences the functioning of immune cells. Previous research has shown that cholesterol can stimulate dendritic cell activity, while high blood cholesterol levels are a major risk factor for developing psoriasis.
The team discovered that excessive Vanin activity reduces the amount of pantethine available in dendritic cells. As pantethine levels decrease, cholesterol production increases, making these immune cells unusually active.
Restoring pantethine levels interrupted this process. The supplement reduced cholesterol buildup in dendritic cells and helped suppress excessive immune activation associated with inflammation.
“We found that administration of pantethine effectively alleviated psoriasis in mice, suggesting that insufficient levels of pantethine might be the crucial factor in dendritic cell hyperactivation and autoimmune inflammation following the upregulation of Vanins,” says Zhang.
Common Supplement Shows Promise in Human Psoriasis Trial
Encouraged by the lab and animal results, researchers investigated whether pantethine might also benefit people with psoriasis.
They conducted a small clinical trial involving 24 patients with this disease. All participants received topical ointment containing calcipotriene/betamethasone, a combination treatment used to control psoriasis symptoms. Calcipotriene is a vitamin D derivative that helps regulate skin cell growth, while betamethasone is a corticosteroid that reduces inflammation.
Half of the participants also took pantethine tablets, which allowed researchers to examine whether adding the supplement improved the results of standard treatment.
After 12 weeks, patients who received pantethine in addition to the prescribed ointment showed greater improvement in psoriasis symptoms. The benefits were particularly visible in participants who had high blood cholesterol levels before treatment.
These results suggest that pantethine could potentially serve as an additional treatment for psoriasis, particularly in patients whose cholesterol metabolism may contribute to inflammation.
However, the trial only involved 24 people and researchers stress that larger studies are needed to confirm the supplement’s effectiveness. Human results also do not establish that the same biological mechanism observed in laboratory experiments is responsible for improvement in patients.
“Our investigator-initiated clinical trial demonstrated encouraging therapeutic efficacy of pantethine as an adjunctive treatment in psoriasis, but these results should be interpreted as proof of concept of clinical feasibility rather than direct mechanistic validation,” Zhang said. “Overall, our study reveals the Vanin-pantethine-cholesterol axis as a key metabolic pathway governing dendritic cell activation and provides a basis for therapeutic strategies targeting several dendritic cell-mediated autoimmune diseases.”
Gn Health
