Assessment of Serum Survivin Levels as a Potential Biomarker for Disease Severity and Therapeutic Outcome: Results of a Pilot Study

Abstract Background: Psoriasis is a chronic inflammatory skin disease characterized by hyperproliferation of keratinocytes and immune dysregulation. Survivin, being an apoptosis inhibitor, could be a potential biomarker for psoriasis. Aim and Objectives: To evaluate serum survivin levels in moderate to severe psoriasis patients before and after methotrexate therapy and to assess its correlation with disease severity using Psoriasis Area and Severity Index (PASI). Patients and Methods: This study included 30 patients with moderate to severe psoriasis and 30 healthy controls. Serum survivin levels were measured at baseline and at 12 weeks of methotrexate therapy. Disease severity was assessed using PASI. Results: Serum survivin levels were considerably higher in psoriasis patients than in controls (70.3 ± 16.9 vs. 22.1 ± 9.4 pg/mL; P < 0.001). Following methotrexate therapy, serum survivin levels decreased (20.9 ± 8.0 pg/mL; P < 0.001) and PASI scores reduced in tandem from 15.3 ± 4.8 to 7.5 ± 4.4 ( P < 0.001). Improvement in PASI was significantly associated with survivin reduction (r = 0.672; P < 0.001). Limitations: Small sample size, short follow-up duration, and lack of histopathological assessment or tissue survivin evaluation. Additionally, the absence of long-term follow-up and potential noncompliance with smoking/alcohol abstinence may have influenced the findings. Conclusion: Serum survivin levels were significantly elevated in psoriasis patients compared to healthy controls and were reduced significantly following treatment with methotrexate. These changes in serum survivin levels corresponded well with decreasing PASI scores in psoriasis patients, suggesting survivin as a potential biomarker of disease activity and therapeutic response.