Systemic inflammation and imbalance between endothelial injury and repair in patients with psoriasis are associated with preclinical atherosclerosis

Pirro, Matteo; Stingeni, Luca; Vaudo, Gaetano; Mannarino, Massimo Raffaele; Ministrini, Stefano; Vonella, Marilisa; Hansel, Katharina; Bagaglia, Francesco; Alaeddin, Abdalkader; Lisi, Paolo

doi:10.1177/2047487314538858

Cited by 42 publications

(43 citation statements)

References 43 publications

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“…10 An increased frequency of systemic conditions such as smoking, metabolic syndrome (MetS), cardiovascular disease and obesity have been reported in psoriasis. 8,[11][12][13][14][15][16] Such comorbidities are probably mediated by T-helper 1 (Th1) cytokines. 17 The association of psoriasis with accelerated atherogenesis is currently a topic of major interest.…”

Section: Introductionmentioning

confidence: 99%

Subclinical atherogenesis in patients with mild psoriasis: A role for IL-6?

Lise

Baptista

Petersen

et al. 2017

Rev. Assoc. Med. Bras.

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Summary Introduction: A link of psoriasis with subclinical atherosclerosis has been postulated and cytokine network might intermediate this association. Few data are available in patients with mild psoriasis. We evaluated carotid intima-media thickness (cIMT) in drug-free psoriatic individuals and controls. In parallel, we searched for associations of cIMT with disease activity indexes and serum interleukins (IL) in psoriatic patients. Method: An experienced radiologist performed the cIMT analyses. Cytokine concentrations were assessed by flow cytometry. Disease activity was evaluated based on psoriasis area and severity index (PASI) as well as body surface area (BSA). Results: Sixty-five (65) patients and 64 controls were studied. Mean age of patients (50.9 years) did not differ from controls (p=0.362). A low PASI and BSA (< 10) prevailed (69.2% and 56.9%, respectively). Median levels of IL-12p70, TNF-α, IL-1β and IL-10 were significantly lower in cases than in controls (adjusted p<0.05), while IL-6 and IL-8 medians did not differ between groups (adjusted p>0.05). Smoking habit and diabetes mellitus predominated in cases (p=0.002). An altered cIMT (≥ 0.9 mm) was more frequent in cases than in controls (23.8% versus 8.5%, adjusted p=0.045). Mean cIMT was higher in cases with a borderline significance (p=0.057). cIMT scores did not correlate to PASI (rs=0.066; p=0.250) or BSA (rs=0.175; p=0.185), but did correlate significantly with serum IL-6 (rs=0.26; p=0.005). Conclusion: Subclinical atherosclerosis was more frequent in patients with mild psoriasis than controls. cIMT in psoriatic individuals correlated with serum IL-6, pointing to an eventual proatherogenic role of IL-6 in these patients. Newer studies should clarify the connection of atherogenesis with cytokines in psoriasis.

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Section: Introductionmentioning

confidence: 99%

Subclinical atherogenesis in patients with mild psoriasis: A role for IL-6?

Lise

Baptista

Petersen

et al. 2017

Rev. Assoc. Med. Bras.

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“…In addition, the release of Th1 and Th17 type cytokines such as interferon (IFN)-γ, interleukin (IL)-2 and TNF- α in both conditions has been demonstrated [2, 8, 19]. Additionally, vascular endothelial growth factor (VEGF), which is a potent proangiogenic factor intensively released during psoriasis and atherosclerosis, has also been reported to play an effective role in atherosclerosis development by inducing intimal hyperplasia in endothelial cells through mitogenic effects [8–10]. Furthermore, quality of life in patients with psoriasis has been affected both psychologically and physiologically, and behavioral disturbances such as tendency to smoking and alcohol consumption, and obesity may be frequently observed in these patients and present a risk of atherosclerosis [10, 20].…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, vascular endothelial growth factor (VEGF), which is a potent proangiogenic factor intensively released during psoriasis and atherosclerosis, has also been reported to play an effective role in atherosclerosis development by inducing intimal hyperplasia in endothelial cells through mitogenic effects [8–10]. Furthermore, quality of life in patients with psoriasis has been affected both psychologically and physiologically, and behavioral disturbances such as tendency to smoking and alcohol consumption, and obesity may be frequently observed in these patients and present a risk of atherosclerosis [10, 20]. Thus, there is a need for a screening method to detect cardiac involvement and atherosclerosis that can develop for various reasons in patients with psoriasis [21].…”

Section: Discussionmentioning

confidence: 99%

“…Apart from known risks such as hypertension, diabetes mellitus, smoking and alcohol intake, it is thought that the chronic inflammation observed in psoriasis also has a major role in the development of atherosclerosis and vascular endothelial injury [1–7]. Immunological factors mediated by Th1, Th17 activation, and reduced T regulatory (Treg) cell function, and known to be important in pathogenesis of chronic inflammatory diseases such as psoriasis and psoriatic arthritis, have also been shown to play a role in the pathogenesis of atherosclerosis and cardiovascular diseases [8–10]. …”

Section: Introductionmentioning

confidence: 99%

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Can pregnancy-associated plasma protein-A be a marker for the assessment of atherosclerosis risk in patients with chronic plaque psoriasis?

Polat¹,

Buğdaycı²,

Şahin³

et al. 2016

pdia

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IntroductionPsoriasis is an immune-mediated chronic inflammatory dermatosis. Several studies have shown that patients with psoriasis have a much greater risk of cardiovascular diseases than the normal population. The chronic inflammation observed in psoriasis is thought to have a role in the development of atherosclerosis and vascular endothelial injury.AimTo examine serum pregnancy-associated plasma protein-A (PAPP-A) levels, which has been regarded as a marker of early stage atherosclerosis in patients with psoriasis that do not have concurrent conventional cardiovascular risk markers.Material and methodsForty-one patients diagnosed with a chronic plaque type of psoriasis and 42 equally matched healthy volunteers were included in this study. The PAPP-A levels were compared between patient and control groups and the association between PAPP-A levels and disease duration and severity were evaluated in the patient group.ResultsStatistically, serum PAPP-A levels were significantly higher in the psoriasis group than in the control group (p = 0.015). Serum PAPP-A levels were found to be positively correlated with severity (p = 0.036, r = 0.329) and duration (p = 0.014, r = 0.269) of the disease.ConclusionsAs a marker of early stage atherosclerosis, PAPP-A levels were elevated in the psoriasis group and were correlated with disease duration and severity. This elevation reveals the presence of atherosclerosis in patients with psoriasis. Further studies are needed to confirm the use of PAPP-A as an available and inexpensive screening test and cardiovascular risk assessment for all centers.

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“…In addition to the effects of CD4 T lymphocyte infiltration, proliferation of monocyte/macrophage and dendritic cells in both psoriasis and in atherosclerotic plaques increases local concentrations of Th1- and Th17-type cytokines, such as interferon (INF)-γ, IL-2, and tumor necrosis factor (TNF)-α [2, 10, 11]. Vascular endothelial growth factor, a potent pro-angiogenic factor expressed at high levels in psoriasis and atherosclerosis, can cause intimal hyperplasia of endothelial cells, contributing to the development of atherosclerosis [11–13]. …”

Section: Introductionmentioning

confidence: 99%

Assessment of subclinical cardiac damage in chronic plaque psoriasis patients: a case control study

Özden¹,

Polat²,

Öztürk³

et al. 2016

Arch Med Sci Atheroscler Dis

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Introduction: Epidemiological studies have suggested that patients with psoriasis are at an increased risk of developing cardiovascular diseases. Chronic inflammation may play a role in the pathogenesis of atherosclerosis in psoriasis patients. Recent studies have evaluated the expression of plasma endocan and homocysteine levels. Endocan is a marker of vascular endothelial damage, and homocysteine plays a role in the development of atherosclerosis. Plasma endocan and homocysteine levels, as well as echocardiographic parameters, were evaluated in patients with psoriasis to assess cardiovascular disease risk. Material and methods: This was a prospective cohort analysis of 40 patients who were diagnosed with psoriasis and 40 healthy controls matched to the patient group according to demographic and biochemical parameters. Results: Serum endocan and homocysteine concentrations were significantly higher in the psoriasis group than the control group (p < 0.001). Serum endocan concentrations correlated positively with disease duration (p < 0.001; r = 0.725). The Tei index (myocardial performance) was elevated in psoriasis patients (p < 0.001). Additionally, the E/A (mitral valve early diastolic peak flow velocity/mitral valve late diastolic peak flow velocity) and E/Em (early diastolic myocardial velocity) ratios were reduced in psoriasis patients (p < 0.001). Parameters indicative of left ventricular asynchrony were elevated significantly in the psoriasis group versus the control group (p < 0.001). Conclusions: We observed a substantial increase in serum endocan and homocysteine concentrations, and significant differences in key parameters of cardiac function, in psoriasis patients relative to controls. These results are consistent with the hypothesis that subclinical cardiac damage is increased in patients with psoriasis and that psoriasis itself may be a cardiovascular risk factor.

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Systemic inflammation and imbalance between endothelial injury and repair in patients with psoriasis are associated with preclinical atherosclerosis

Cited by 42 publications

References 43 publications

Subclinical atherogenesis in patients with mild psoriasis: A role for IL-6?

Subclinical atherogenesis in patients with mild psoriasis: A role for IL-6?

Can pregnancy-associated plasma protein-A be a marker for the assessment of atherosclerosis risk in patients with chronic plaque psoriasis?

Assessment of subclinical cardiac damage in chronic plaque psoriasis patients: a case control study

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