Monitoring Minerals and Redox Balance During Cyclosporine A Therapy in Psoriasis

Background: Psoriasis vulgaris is a systemic immune-mediated disease marked by oxidative stress and disruptions in mineral homeostasis. This study evaluated the effect of 12-week cyclosporine A (CsA) therapy on serum micro-/macroelements and redox balance in adults with moderate-severe disease. Methods: Thirty-seven patients were prospectively assessed at baseline, day 42, and day 84. Disease severity was quantified using PASI and BSA. Serum copper, zinc, magnesium, calcium, iron, sodium, and potassium were measured by atomic absorption spectrometry. Total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI = TOS/TAS × 100) were determined spectrophotometrically. Results: CsA treatment produced significant clinical improvement, demonstrated by reductions in PASI and BSA. Parallel biochemical changes included decreased copper and increased zinc, magnesium, calcium, and iron levels toward reference ranges (all p < 0.0001). TAS increased, TOS decreased, and OSI was markedly reduced, indicating restored redox balance. The Cu/Zn ratio declined throughout therapy, and elevated magnesium at week 12 correlated with greater clinical improvement. Sodium and potassium levels remained stable. Subgroup analyses suggested differing biochemical responses in smokers, patients with diabetes, and individuals with obesity. Conclusions: CsA improves psoriasis severity while ameliorating systemic oxidative stress and mineral disturbances. The Cu/Zn ratio and serum magnesium may support personalized monitoring during CsA therapy.