Psoriasis, non-alcoholic fatty liver disease, and cardiovascular disease: Three different diseases on a unique background

Ganzetti, Giulia; Campanati, Anna; Molinelli, Elisa; Offidani, Annamaria

doi:10.4330/wjc.v8.i2.120

Cited by 41 publications

(41 citation statements)

References 126 publications

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“…Pathogenesis of psoriasis and BCC is associated with keratinocytes hyperproliferation and their differentiation disorders, activation, adhesion, and migration of keratinocytes and endothelial cells, chronic inflammation, and angiogenesis [23,26,43,55,58]. The plasminogen system is known to be involved in all of these processes.…”

Section: Discussionmentioning

confidence: 99%

Increased expression of uPA, uPAR, and PAI-1 in psoriatic skin and in basal cell carcinomas

et al. 2017

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There is substantial evidence implicating the urokinase system in tissue remodeling during neo-vascularization, inflammation, tumor invasion, and metastasis. Regulated degradation of the extracellular matrix at the leading edge of migrating cells, mediated by uPA and uPAR, is required for tissue remodeling, invasiveness, and angiogenesis. Psoriasis and basal cell carcinoma (BCC) are the most common skin diseases. Pathogenesis of both of them is associated with keratinocyte hyperproliferation, inflammatory cell migration, and angiogenesis-processes in which the plasminogen system (uPA, uPAR, tPA, and PAI-1) plays a crucial role. In the present study, the comparative analysis of uPA, uPAR, tPA, and PAI-1 expression in the normal skin, in the biopsies of patients with psoriasis vulgaris, and BCC was carried out. uPA, uPAR, and PAI-1 expression was up-regulated in the epidermis of psoriatic skin and in tumor cells in BCC. Increased uPAR expression was detected in the derma of psoriatic lesions and in the stroma surrounding tumor cells in BCC. Increased expression of uPA in epidermal cells in psoriasis and in tumor cells in BCC suggests an important role of the uPA system for aggressively proliferating and invading cells of epidermal origin. A possible activation of the stroma, as a result of uPA-uPAR interaction between tumor cells and the surrounding stroma, is suggested.

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Section: Discussionmentioning

confidence: 99%

Increased expression of uPA, uPAR, and PAI-1 in psoriatic skin and in basal cell carcinomas

et al. 2017

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“…Some authors have posited that the link between these diseases may be the low level of systemic inflammation and the implication of insulin resistance and metabolic syndrome . The aetiopathogenic of NAFLD produces an imbalance between pro‐inflammatory (TNF‐alpha, IL‐6, leptin, visfatin and resistin) and anti‐inflammatory cytokines (adiponectin).…”

Section: Discussionmentioning

confidence: 99%

Nonalcoholic fatty liver disease puts patients with psoriasis at greater cardiovascular risk

et al. 2019

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Background/Objective: Psoriasis and nonalcoholic fatty liver disease (NAFLD) are inflammatory diseases associated with increased cardiovascular risk, but no studies have evaluated cardiovascular risk in patients with both. The objective was to assess cardiovascular risk in patients with psoriasis and NAFLD.Material and methods: Cross-sectional, singlecentre study in patients with moderate to severe psoriasis. Participants underwent liver ultrasound to determine the presence of NAFLD. Cardiovascular risk was evaluated using the calibrated Framingham function and Systematic Coronary Risk Evaluation (SCORE) charts. Statistical analyses included a descriptive analysis, chi-square tests for comparing independent samples and stepwise multiple logistic regression to identify associations with the two risk scores.Results: Psoriatic patients with NAFLD had significantly higher odds of moderate to very high 10-year cardiovascular risk compared to those without NAFLD, according to SCORE (71.5% versus 29.2%; odds ratio [OR] 6.0, 95% confidence interval [CI] 3.3-11.1; P < 0.001). Using both the SCORE and Framingham assessment methods, moderate to very high cardiovascular risk was independently associated with metabolic syndrome (Framingham: adjusted odds ratio [ORa] 5.5, 95% CI 2.3-12.9, P < 0.001; SCORE: ORa 4.7, 95% CI 1.9-11.7, P = 0.001) and systemic treatment (Framingham: ORa 3.4, 95% CI 1.4-8.5, P = 0.009; SCORE: ORa 3.2, 95% CI 1.2-8.2, P = 0.021). Using SCORE, cardiovascular risk was also associated with NAFLD (ORa of 2.8, 95% CI 1.2-6.6, P = 0.014).Conclusion: Psoriasis plus NAFLD confers higher cardiovascular risk at 10 years than psoriasis alone. In comorbid patients, more intense diagnostic efforts and follow-up are justified.

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“…Adipose tissue acts as an endocrine organ, producing adipocytokines or adipokines, which play important roles in psoriasis and NAFLD pathogenesis (Fig. ) . These include leptin, adiponectin and resistin, which are important for energy balance, lipid and glucose metabolism, insulin sensitivity, blood pressure and angiogenesis, in addition to tumour necrosis factor‐α (TNF‐α) and interleukin‐6 (IL‐6), which are vital to the inflammatory process .…”

Section: The Common Thread: Low‐grade Chronic Inflammationmentioning

confidence: 99%

Nonalcoholic fatty liver disease in patients with psoriasis: a consequence of systemic inflammatory burden?

Prussick

Miele

2018

Br J Dermatol

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Summary Patients with psoriasis are at an increased risk for nonalcoholic fatty liver disease (NAFLD) compared with the general population. However, the pathophysiology underlying this comorbidity and elucidation of effective treatment strategies are unclear. This review provides insights into the possible role of chronic, low‐grade inflammation in the pathogenesis of NAFLD in patients with psoriasis. Both conditions are associated with increased levels of proinflammatory adipokines (such as tumour necrosis factor‐α and interleukin‐6) and hepatokines, and decreased levels of adiponectin, an anti‐inflammatory adipokine. This imbalance in inflammatory mediators could result in insulin resistance and, thereby, facilitate the occurrence and progression of NAFLD in a multistep manner. All patients with psoriasis should, therefore, be considered candidates for NAFLD screening and managed accordingly. Given the common aetiology of inflammation between these conditions, it is hypothesized that biological therapies for psoriasis may attenuate the systemic inflammatory process and progression of NAFLD in patients with psoriasis.

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Psoriasis, non-alcoholic fatty liver disease, and cardiovascular disease: Three different diseases on a unique background

Cited by 41 publications

References 126 publications

Increased expression of uPA, uPAR, and PAI-1 in psoriatic skin and in basal cell carcinomas

Increased expression of uPA, uPAR, and PAI-1 in psoriatic skin and in basal cell carcinomas

Nonalcoholic fatty liver disease puts patients with psoriasis at greater cardiovascular risk

Nonalcoholic fatty liver disease in patients with psoriasis: a consequence of systemic inflammatory burden?

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