Cardiovascular and Metabolic Diseases Comorbid with Psoriasis: Beyond the Skin

Abstract

A close association of systemic inflammation with cardiovascular diseases and metabolic syndrome is recently a popular topic in medicine. Psoriasis is a chronic inflammatory skin disease with a prevalence of approximately 0.1-0.5% in Asians. It is characterized by widespread scaly erythematous macules that cause significant physical and psychological burdens for the affected individuals. The accelerated inflammation driven by the TNF-α/IL-23/IL-17A axis is now known to be the major mechanism in the development of psoriasis. Psoriasis is not a mere skin disease; it is significantly associated with cardiovascular diseases and metabolic syndrome, which suggests that the chronic skin inflammation extends the systemic inflammation beyond the skin. In this article, we review the epidemiological and pathological aspects of psoriasis and its comorbidities.

Glucagon-like peptide-1 analogue liraglutide facilitates wound healing by activating PI3K/Akt pathway in keratinocytes

“…Besides wound healing acceleration, liraglutide has been expected to be beneficial in psoriasis frequently comorbid with diabetes and cardiovascular diseases [16,25], a randomized placebo-controlled study failed to prove this expectation [26]. Given that major pathogenetic pipeline in psoriasis is TNF/IL-23/IL-17A axis, the activation of GLP-1R/PI3K/Akt pathway is not influential.…”

Tissue inflammatory biomarkers in chronic plaque psoriasis: Exploring lesional versus non‐lesional skin relative expression and possible clinical correlations

“…This explains the several comorbidities that frequently present in patients with psoriasis. [2][3][4] The pathomechanism involves a complex interaction of inflammatory chemokines, with a predominantly T-helper 17 profile, that have been shown to be elevated in serum and skin. 1,5 Conflicting results have been reported regarding clinical uses for proinflammatory biomarkers, such as correlation with clinical severity and prediction of therapeutic response.…”

“…Higher relative expression of IL12p40 in patients with above-normal BMI supports the relationship between overweight or obesity and a chronic systemic inflammatory state. 2…”

Autoimmunity and autoimmune co‐morbidities in psoriasis

“…Although the prevalence is lower in Asian populations (Chinese 5·3–7·3%, Japanese 10·5% and Korean 11·2%), psoriatic arthritis significantly hampers patients’ daily lives . Additionally, psoriasis has significant co‐morbidity with systemic inflammatory diseases, such as cardiovascular diseases and metabolic syndrome, and these conditions are currently receiving increasing attention . In parallel, a plethora of inflammatory biomarkers are elevated in psoriasis …”