The effect of subcutaneous methotrexate on markers of metabolic syndrome in psoriatic patients – preliminary report

Abstract

IntroductionMethotrexate (MTX) has anti-proliferative and anti-inflammatory effects in psoriasis. Moreover, low doses can reduce the risk of developing cardiovascular diseases. It turns out that psoriasis and atherosclerosis have a similar pathogenetic mechanism: the same pro-inflammatory cytokines, Th1 and Th17, are involved in both diseases.AimTo evaluate the effects of metabolic markers, protective cytokines (interleukin 10 (IL-10), transforming growth factor β (TGF-β)) and a marker of endothelial damage (endocan) in patients with plaque psoriasis.Material and methodsThe study included 24 patients aged 27–69 years (9 female, 15 male) with plaque psoriasis. The metabolic syndrome according to the International Diabetes Federation (IDF) was evaluated. The laboratory tests were performed under fasting conditions: C-reactive protein (CRP), glucose, total cholesterol, triglycerides, high-density lipoprotein (HDL), uric acid, endocan, IL-10, and TGF-β. After 12 weeks of treatment with MTX injections 15 mg/week, every patient was assessed with the same laboratory tests.ResultsAfter treatment we observed a statistically significant increase of endocan and IL-10, but no significant differences in the titer of TGF-β. C-reactive protein was reduced by approximately 54.7%. No improvement of lipid profile was observed, and even a significant increase in triglycerides was noted. Similarly, no significant difference was seen in the case of glucose and uric acid prior to and after treatment.ConclusionsMethotrexate in low doses in short-term treatment decreases CRP (anti-inflammatory effect) and increases endocan and IL-10 (potential protective role). Methotrexate is characterized by good efficacy and tolerability in therapy of patients with psoriasis.

Correlation of Radiographic Damage and Metabolic Syndrome in Spondyloarthritis: A Cross-Sectional Study

“…Maia et al, which observed metabolic syndrome in Brazilian ankylosing spondylitis patients and Papadakis et al, which observed metabolic syndrome in male Greek ankylosing spondylitis patients reported that the prevalence of metabolic syndrome was 27% and 34.9%, respectively [7,11]. The differences between this study and previous studies might be due to treatment differences because all of the patients in this study received csDMARDs which did not affect metabolic syndrome's parameters directly like anti-TNFα which was used in some of the previous studies [25].…”

The influence of tumour necrosis factor α inhibitors treatment – etanercept on serum concentration of biomarkers of inflammation and cartilage turnover in psoriatic arthritis patients

“…Early diagnosis and effective treatment protect patients from complications and severe consequences of the musculoskeletal system. In order to understand the exact etiopathogenesis of this disease, its early detection and effective treatment, various biomarkers specific to this disease are investigated [1,[4][5][6][7][8]. According to the National Institutes of Health Biomarkers Definitions Working Group, a biomarker is "a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to therapeutic intervention" [9].…”

Repurposing existing drugs for cardiovascular risk management: a focus on methotrexate

“…In 24 patients with plaque psoriasis, 12-week treatment with subcutaneous methotrexate caused a trend towards an increase in IL-10, but not TGF-β, concentrations. 60 In patients with chronic heart failure, 12-week treatment with methotrexate significantly increased the plasma concentrations of IL-10. 89 A significant increase in IL-10 concentrations after 4- or 12-week methotrexate treatment was reported in rabbit models of in-stent neo-atherosclerosis and cardiac allograft vasculopathy, and in post-myocarditis rats.…”

“…Contrasting results have been reported on the capacity of methotrexate to influence the activity of the cholesterol efflux protein and the concentrations of total cholesterol and different lipoproteins. 49 – 60 More recently, a study in cholesterol-fed rabbits receiving combined treatment with lipid core nanoparticles containing paclitaxel and methotrexate showed a significant regression of aortic plaque and intima areas. This was associated with a reduction of macrophage presence in aortic lesions, matrix metalloproteinase 9, and TNF-α gene expression when compared to control animals.…”

“…This was associated with a significant reduction in serum glucose and insulin concentrations. 62 Human studies have shown significant reductions in insulin concentrations, 63 but not glucose concentrations, 51 , 60 , 64 – 67 during methotrexate treatment. Contrasting results have been reported on the effects of methotrexate on glycated haemoglobin concentrations.…”