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PPAR-Gamma Agonist Pioglitazone Reduced CD68+ but Not CD163+ Macrophage Dermal Infiltration in Obese Psoriatic
Ya O Yemchenko1, V I Shynkevych1, K Ye Ishcheikin1
1Ukrainian Medical Stomatological Academy, Poltava 36024, Ukraine.
Background:
Macrophages are of great importance in the development of obesity and psoriasis. Signaling via PPAR-γ in certain macrophage populations is associated with M2-like features and anti-inflammatory profile. In this research, we evaluated the anti-inflammatory action of pioglitazone by the immunohistochemical study of M1 and M2 macrophages in psoriasis-affected skin in obese patients.
Methods:
We used immunohistochemistry to characterize CD68+ and CD163+ macrophages and pathomorphological description of skin biopsy, obtained from 6 obese psoriatic patients before and after treatment with 15, 30, and 45 mg pioglitazone, once a day during 6 months. Two patients with conventional therapy and without pioglitazone served as control.
Results:
Generally, CD163+ cell quantities in psoriasis-affected skin significantly dominated over CD68+ before and after all treatment regiments. Among patients who received pioglitazone, some of them clearly responded to treatment from lowest to highest doses by decreasing CD68+ cells. In the group with 30 mg pioglitazone regiment, we detected a significant reduction of CD68+ cells in dermal infiltrates: CI 95% (16-32) before versus CI 95% (2-7) after treatment. Pioglitazone dose escalation led to certain normalization of skin morphology.
Conclusion:
The immunohistochemical study allows us to show the anti-inflammatory effect of pioglitazone in psoriatic obese patients, which can be mediated by reducing the number of СD68+ macrophages, but not СD163+ macrophages, in the affected dermis.
Insights
Pioglitazone reduced inflammatory M1 macrophages (CD68+) in obese patients with psoriasis. This study highlights pioglitazone
Area of Science:
- Immunology
- Dermatology
- Pharmacology
Background:
- Macrophages play a critical role in obesity and psoriasis pathogenesis.
- PPAR-γ signaling in macrophages influences anti-inflammatory M2-like phenotypes.
- Obesity and psoriasis often coexist, presenting complex therapeutic challenges.
Purpose of the Study:
- To evaluate the anti-inflammatory effects of pioglitazone in obese patients with psoriasis.
- To assess changes in M1 (CD68+) and M2 (CD163+) macrophage populations in psoriatic skin.
- To investigate the correlation between pioglitazone dosage and macrophage modulation.
Main Methods:
- Immunohistochemistry was used to analyze CD68+ and CD163+ macrophages in skin biopsies.
- Six obese psoriatic patients were treated with varying doses of pioglitazone (15, 30, 45 mg daily) for six months.
- Skin biopsies were collected before and after treatment; control patients received conventional therapy.
Main Results:
- CD163+ (M2-like) macrophages were more abundant than CD68+ (M1-like) macrophages in psoriatic skin.
- Pioglitazone treatment, particularly at 30 mg, significantly reduced CD68+ macrophage infiltration.
- Dose escalation of pioglitazone correlated with improved skin morphology and reduced inflammation.
Conclusions:
- Pioglitazone demonstrates anti-inflammatory effects in obese psoriatic patients.
- The therapeutic benefit appears mediated by the reduction of CD68+ macrophages.
- CD163+ macrophage levels were not significantly affected by pioglitazone treatment.
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