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Kang H, Song J, Cheng Y. HDL regulates the risk of cardiometabolic and inflammatory-related diseases: Focusing on cholesterol efflux capacity. Int Immunopharmacol 2024; 138:112622. [PMID: 38971111 DOI: 10.1016/j.intimp.2024.112622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 06/29/2024] [Accepted: 07/01/2024] [Indexed: 07/08/2024]
Abstract
Dyslipidemia, characterized by higher serum concentrations of low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), triglyceride (TG), and lower serum concentrations of high-density lipoprotein cholesterol (HDL-C), is confirmed as a hallmark of cardiovascular diseases (CVD), posing serious risks to the future health of humans. Aside from the role of HDL-C concentrations, the capacity of cholesterol efflux to HDL is being identified as an enssential messurement for the dyslipidemic morbidity. Through inducing the progression of reverse cholesterol transport (RCT), the HDL-related cholesterol efflux plays a vital role in atherosclerotic plaque formation. In addition, increasing results demonstrated that the relationships between cholesterol efflux and cardiovascular events might be influenced by multiple factors, such as atherosclerosis, diabetes, and, inflammatory diseases. These risk factors could affect the intracellular composition of HDL, which might subsqently influence the cholesterol efflux process induced by HDL particle. In the present comprehensive article, we summarize the latest findings which described the modulatory roles of HDL in cardiometabolic disorders and inflammatory related diseases, focusing on its capacity in mediating cholesterol efflux. Moreover, the potential mechanisms whereby HDL regulate the risk of cardiometabolic disorders or inflammatory related diseases, at least partly, via cholesterol efflux pathway, are also well-listed.
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Affiliation(s)
- Huiyuan Kang
- Department of Cardiology, the Xiamen Cardiovascular Hospital of Xiamen University, Xiamen, Fujian, China
| | - Jingjin Song
- Department of Cardiology, the Xiamen Cardiovascular Hospital of Xiamen University, Xiamen, Fujian, China
| | - Ye Cheng
- Department of Cardiology, the Xiamen Cardiovascular Hospital of Xiamen University, Xiamen, Fujian, China.
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Zhang M, Fan S, Hong S, Sun X, Zhou Y, Liu L, Wang J, Wang C, Lin N, Xiao X, Li X. Epidemiology of lipid disturbances in psoriasis: An analysis of trends from 2006 to 2023. Diabetes Metab Syndr 2024; 18:103098. [PMID: 39146906 DOI: 10.1016/j.dsx.2024.103098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 07/12/2024] [Accepted: 08/05/2024] [Indexed: 08/17/2024]
Abstract
INTRODUCTION A strong link has been established between psoriasis and lipid disturbances; however, no study has systematically examined their global epidemiology. METHODS We searched six databases from their inception up to October 1, 2023. Data analysis was conducted using Stata SE 15.1. We performed subgroup, meta-regression, and sensitivity analyses to assess the heterogeneity of the pooled studies. RESULTS Our review included 239 studies comprising 15,519,570 participants. The pooled prevalence rate of dyslipidemia among individuals with psoriasis was 38 %. CONCLUSION Patients with severe psoriasis should undergo screening for lipid abnormalities. This can facilitate the early detection of lipid dysfunction and associated cardiovascular comorbidities.
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Affiliation(s)
- Miao Zhang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Siwei Fan
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Seokgyeong Hong
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Xiaoying Sun
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Yaqiong Zhou
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Liu Liu
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Jiao Wang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Chunxiao Wang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Naixuan Lin
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Xiayi Xiao
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China.
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Taliercio M, Lebwohl M. Psoriasis Comorbidities and Their Treatment Impact. Dermatol Clin 2024; 42:405-416. [PMID: 38796272 DOI: 10.1016/j.det.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2024]
Abstract
Psoriasis, a systemic inflammatory disease classically presenting with cutaneous lesions, has significant involvement in other organ systems. This article explores the prevalence, clinical manifestations, screening mechanisms, and laboratory testing by which to evaluate these comorbidities. Treatment approach for these comorbidities must combine patient preference with established treatment algorithms while recognizing innovative therapeutics currently under development.
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Affiliation(s)
- Mark Taliercio
- Department of Dermatology Clinical Trials, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, 5th Floor, New York, NY 10029, USA.
| | - Mark Lebwohl
- Department of Clinical Therapeutics, Icahn School of Medicine at Mount Sinai, 5, East 98th Street, 5th Floor, New York, NY 10029, USA
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Letonja J, Petrovič D. A Review of MicroRNAs and lncRNAs in Atherosclerosis as Well as Some Major Inflammatory Conditions Affecting Atherosclerosis. Biomedicines 2024; 12:1322. [PMID: 38927529 PMCID: PMC11201627 DOI: 10.3390/biomedicines12061322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/05/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
It is generally accepted that atherosclerosis is a chronic inflammatory disease. The link between atherosclerosis and other inflammatory diseases such as psoriasis, type 2 diabetes mellitus (T2DM), and rheumatoid arthritis (RA) via metabolic, inflammatory, and immunoregulatory pathways is well established. The aim of our review was to summarize the associations between selected microRNAs (miRs) and long non-coding RNAs (lncRNAs) and atherosclerosis, psoriasis, T2DM, and RA. We reviewed the role of miR-146a, miR-210, miR-143, miR-223, miR-126, miR-21, miR-155, miR-145, miR-200, miR-133, miR-135, miR-221, miR-424, let-7, lncRNA-H19, lncRNA-MEG3, lncRNA-UCA1, and lncRNA-XIST in atherosclerosis and psoriasis, T2DM, and RA. Extracellular vesicles (EVs) are a method of intracellular signal transduction. Their function depends on surface expression, cargo, and the cell from which they originate. The majority of the studies that investigated lncRNAs and some miRs had relatively small sample sizes, which limits the generalizability of their findings and indicates the need for more research. Based on the studies reviewed, miR-146a, miR-155, miR-145, miR-200, miR-133, and lncRNA-H19 are the most promising potential biomarkers and, possibly, therapeutic targets for atherosclerosis as well as T2DM, RA, and psoriasis.
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Affiliation(s)
- Jernej Letonja
- Institute of Histology and Embryology, Faculty of Medicine, University of Ljubljana, Korytkova 2, 1000 Ljubljana, Slovenia;
- Laboratory for Histology and Genetics of Atherosclerosis and Microvascular Diseases, Institute of Histology and Embryology, Faculty of Medicine, University of Ljubljana, Korytkova 2, 1000 Ljubljana, Slovenia
| | - Danijel Petrovič
- Institute of Histology and Embryology, Faculty of Medicine, University of Ljubljana, Korytkova 2, 1000 Ljubljana, Slovenia;
- Laboratory for Histology and Genetics of Atherosclerosis and Microvascular Diseases, Institute of Histology and Embryology, Faculty of Medicine, University of Ljubljana, Korytkova 2, 1000 Ljubljana, Slovenia
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Osigwe PC, Agomoh CE, Osigwe IS, Akumiah FK. The Association Between Psoriasis and Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analysis of Observational Studies. Cureus 2024; 16:e63379. [PMID: 38947134 PMCID: PMC11213549 DOI: 10.7759/cureus.63379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2024] [Indexed: 07/02/2024] Open
Abstract
Psoriasis is a chronic immune-mediated disease affecting the skin, nails, and/or joints. It is associated with systemic inflammation and may also be linked to an increased risk of atherosclerotic cardiovascular disease (ASCVD). The objectives of this study were to determine the overall risk of ASCVD in patients with psoriasis and to evaluate the risk according to ASCVD type and the severity of psoriasis. This was a systematic review and meta-analysis of observational studies reporting the association between psoriasis and one or more of the clinical types of ASCVD. We searched Medical Literature Analysis and Retrieval System Online (MEDLINE) via PubMed, Excerpta Medica Database (EMBASE), Scopus, Bielefeld Academic Search Engine (BASE), and Google Scholar for relevant studies in the English language from the beginning of their records to July 2023. Study selection and data extraction were conducted by four independent reviewers. A total of 21 observational studies (three cross-sectional, one case-control, and 17 cohort) were included in this review, representing a total of 778,049 patients with psoriasis and 16,881,765 control subjects without psoriasis. The included studies had varying degrees of covariate adjustment, and thus, their findings may have been subject to residual confounding. All the meta-analyses used the adjusted effect sizes and were based on the random-effects model. However, the cohort studies were analysed separately from the non-cohort studies (the case-control and cross-sectional studies). There was a significant association between psoriasis and ASCVD (cohort studies: hazard ratio (HR), 1.21; 95% confidence interval (CI), 1.14 to 1.28; I2 = 63%; p < 0.001; non-cohort studies: odds ratio (OR), 1.60; 95% CI, 1.34 to 1.92; I2 = 31%; p = 0.23). Psoriasis was also significantly associated with myocardial infarction (cohort studies: HR, 1.20; 95% CI, 1.10 to 1.31; I2 = 60%; p < 0.001; non-cohort studies: OR, 1.57; 95% CI, 1.15 to 2.15; I2 = 74%; p = 0.05), coronary artery disease (cohort studies: HR, 1.20; 95% CI, 1.13 to 1.28; I2 = 67%; p < 0.001; non-cohort studies: OR, 1.60; 95% CI, 1.34 to 1.92; I2 = 31%; p = 0.23), aortic aneurysm (HR, 1.45; 95% CI, 1.04 to 2.02; I2 = 67%; p = 0.08) but not with ischaemic stroke (HR, 1.14; 95% CI, 0.96 to 1.36; I2 = 44%; p = 0.17). Pooled analysis in terms of the severity of psoriasis showed that both mild (cohort studies: HR, 1.17; 95% CI, 1.08 to 1.26; I2 = 74%; p < 0.001; non-cohort studies: OR, 1.54; 95% CI, 1.25 to 1.90; I2 = 0%; p = 0.50) and severe (cohort studies: HR, 1.43; 95% CI, 1.23 to 1.65; I2 = 65%; p < 0.001; non-cohort studies: OR, 1.65; 95% CI, 1.29 to 2.12; I2 = 25%; p = 0.26) psoriasis were significantly associated with ASCVD. Psoriasis (including mild and severe disease) is associated with an increased risk of ASCVD, including coronary artery disease (CAD) and aortic aneurysm (AA). ASCVD risk assessment and prevention should be prioritised in all adult psoriasis patients. Future observational studies investigating the association between psoriasis and ASCVD should conduct a more comprehensive adjustment of covariates.
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Affiliation(s)
- Pacelli C Osigwe
- Department of Cardiology, Bronglais General Hospital, Aberystwyth, GBR
| | | | - Ifunanya S Osigwe
- Department of Medicine, Bronglais General Hospital, Aberystwyth, GBR
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Zhou Q, Jin X, Li H, Wang Q, Tao M, Wang J, Cao Y. Cholesterol and low-density lipoprotein as a cause of psoriasis: Results from bidirectional Mendelian randomization. J Eur Acad Dermatol Venereol 2024; 38:710-718. [PMID: 38031463 DOI: 10.1111/jdv.19670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Psoriasis is an inflammatory disease that affects many people. However, the causal effect of lipid metabolism on psoriasis has not yet been verified. This study aimed to identify the genetic relationship between serum lipid levels and psoriasis. METHODS Bidirectional two-sample Mendelian randomization (MR) was used to analyse the causal relationship between cholesterol and psoriasis. The outcome of the forward causality test was psoriasis. In the analysis of reverse causality, psoriasis was exposed, and 79 single-nucleotide polymorphisms were detected in the genome-wide association study (GWASs) database from the IEU GWASs Project. MR-Egger regression, inverse variance-weighted, weighted median, weighted mode and simple mode were used for the MR analyses. RESULTS The level of triglyceride, lipase member N, chylomicrons, extremely large very low-density lipoprotein (VLDL) particles, high-density lipoprotein (HDL) cholesterol levels, cholesterol esters in large HDL, cholesterol esters in medium HDL and cholesterol esters in medium VLDL have not affected the development of psoriasis. However, total cholesterol, total free cholesterol, low-density lipoprotein (LDL) cholesterol levels, cholesterol esters in large VLDL and cholesterol esters in medium LDL were unidirectional causal effects on psoriasis. CONCLUSION Bidirectional two-sample MR analysis indicated that high levels of total cholesterol, total free cholesterol, LDL cholesterol, cholesterol esters in large VLDL and cholesterol esters in medium LDL are genetic risk factors for psoriasis.
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Affiliation(s)
- Qiujun Zhou
- Zhejiang Chinese Medical University Affiliated Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, Zhejiang, China
- First Clinical Medicine College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xiaoliang Jin
- First Clinical Medicine College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Hui Li
- First Clinical Medicine College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Qionglin Wang
- First Clinical Medicine College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Maocan Tao
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Jinhui Wang
- Zhejiang Chinese Medical University Affiliated Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, Zhejiang, China
| | - Yi Cao
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
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Pantoja CJ, Li H, Rodante J, Keel A, Sorokin AV, Svedbom A, Teague HL, Stahle M, Mehta NN, Playford MP. Serum Beta-Defensin-2 is a biomarker for psoriasis but not subclinical atherosclerosis: Role of IL17a, PI-3 kinase and Rac1. JEADV CLINICAL PRACTICE 2024; 3:150-159. [PMID: 38646149 PMCID: PMC11031204 DOI: 10.1002/jvc2.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/20/2023] [Indexed: 04/23/2024]
Abstract
Background Beta-defensins (BDs) are antimicrobial peptides secreted upon epithelial injury. Both chemotactic and antimicrobial properties of BDs function as initial steps in host defense and prime the adaptive immune system in the body. Psoriasis, a chronic immune-mediated inflammatory disease, has both visible cutaneous manifestations as well as known associations with higher incidence of cardiometabolic complications and vascular inflammation. Objectives We aimed to investigate the circulating expression of beta-defensin-2 (BD2) in psoriasis at baseline compared to control subjects, along with changes in BD2 levels following biologic treatment at one-year. The contribution of BD2 to subclinical atherosclerosis is also assessed. In addition, we have sought to unravel signaling mechanisms linking inflammation with BD2 expression. Methods Multimodality imaging as well inflammatory biomarker assays were performed in biologic naïve psoriasis (n=71) and non-psoriasis (n=53) subjects. A subset of psoriasis patients were followed for one-year after biological intervention (anti-Tumor Necrosis Factor-α (TNFα), n=30; anti-Interleukin17A (IL17A), n=21). Measurements of circulating BD2 were completed by Enzyme-Linked Immunosorbent Assay (ELISA). Using HaCaT transformed keratinocytes, expression of BD2 upon cytokine treatment was assessed by quantitative polymerase chain reaction (qPCR) and ELISA. Results Herein, we confirm that human circulating BD2 levels associate with psoriasis, which attenuate upon biologic interventions (anti-TNFα, anti-IL-17A). A link between circulating BD2 and sub-clinical atherosclerosis markers was not observed. Furthermore, we demonstrate that IL-17A-driven BD2 expression occurs in a Phosphatidylinositol 3-kinase (PI3-kinase) and Rac1 GTPase-dependent manner. Conclusions Our findings expand on the potential role of BD2 as a tractable biomarker in psoriasis patients and describes the role of an IL-17A-PI3-kinase/Rac signaling axis in regulating BD2 levels in keratinocytes.
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Affiliation(s)
- CJ. Pantoja
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Maryland
| | - H. Li
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Maryland
| | - J. Rodante
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Maryland
| | - A. Keel
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Maryland
| | - AV. Sorokin
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Maryland
| | - A. Svedbom
- Division of Dermatology and Venerology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - HL. Teague
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Maryland
| | - M. Stahle
- Division of Dermatology and Venerology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - NN. Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Maryland
| | - MP. Playford
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Maryland
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Cai D, Zheng Z, Hu J, Fu Y, Song Y, Lian J. Immune-mediated inflammatory diseases and the risk of valvular heart disease: a Mendelian randomization study. Clin Rheumatol 2024; 43:533-541. [PMID: 37505304 DOI: 10.1007/s10067-023-06693-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/26/2023] [Accepted: 07/01/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Observational studies have suggested that immune-mediated inflammatory diseases (IMIDs) are associated with a higher risk of valvular heart disease (VHD). But the potential causal association is not clear. Therefore, we used Mendelian randomization (MR) analysis to assess the causal association of IMIDs with VHD risk. METHODS A two-sample MR analysis was performed to confirm the causal association of several common IMIDs (systemic lupus erythematosus, SLE; rheumatoid arthritis, RA; multiple sclerosis, MS; ankylosing spondylitis, AS; psoriasis, PSO; inflammatory bowel disease, IBD) with the risk of VHD. The exposure data is derived from published genome-wide association studies (GWASs) and outcome data come from the FinnGen database (47,003 cases and 182,971 controls). Inverse-variance weighted (IVW), MR-Egger, and weighted median methods were performed to assess the causal association. The study design applied univariable MR and multivariable MR. RESULTS The MR analysis indicated that several genetically predicted IMIDs increased the risk of VHD, including SLE (odds ratio (OR) = 1.014; 95% confidence interval (CI) = < 1.001,1.028 > ; p = 0.036), RA (OR = 1.017; 95% CI = < 1.002,1.031 > ; p = 0.025), and IBD (OR = 1.018; 95% CI = < 1.002,1.033 > ; p = 0.023). Multivariable MR indicated that the adverse effect of these IMIDs on VHD was dampened to varying degrees after adjusting for smoking, obesity, coronary artery disease, and hypertension. CONCLUSION Our findings support the first genetic evidence of the causality of genetically predicted IMIDs with the risk of developing into VHD. Our results deliver a viewpoint that further active intervention needs to be explored to mitigate VHD risk in patients with SLE, RA, and IBD. Key Points • Genetically predicted systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and inflammatory bowel disease (IBD) are causally associated with valvular heart disease (VHD). • To reduce the risk of VHD in patients with SLE, RA, and IBD, active interventions should be further explored.
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Affiliation(s)
- Dihui Cai
- Department of Cardiology, Ningbo Institute of Innovation for Combined Medicine and Engineering, Lihuili Hospital Affiliated to Ningbo University, Ningbo University, Ningbo, Zhejiang, China
| | - Zequn Zheng
- Department of Cardiology, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Clinical Research Center, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Jiale Hu
- Department of Cardiology, Ningbo Institute of Innovation for Combined Medicine and Engineering, Lihuili Hospital Affiliated to Ningbo University, Ningbo University, Ningbo, Zhejiang, China
| | - Yin Fu
- Department of Cardiology, Ningbo Institute of Innovation for Combined Medicine and Engineering, Lihuili Hospital Affiliated to Ningbo University, Ningbo University, Ningbo, Zhejiang, China
| | - Yongfei Song
- Department of Cardiology, Ningbo Institute of Innovation for Combined Medicine and Engineering, Lihuili Hospital Affiliated to Ningbo University, Ningbo University, Ningbo, Zhejiang, China
| | - Jiangfang Lian
- Department of Cardiology, Ningbo Institute of Innovation for Combined Medicine and Engineering, Lihuili Hospital Affiliated to Ningbo University, Ningbo University, Ningbo, Zhejiang, China.
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Florida EM, Li H, Hong CG, Ongstad EL, Gaddipati R, Sitaula S, Varma V, Parel PM, O'Hagan R, Chen MY, Teague HL, Playford MP, Karathanasis SK, Collén A, Mehta NN, Remaley AT, Sorokin AV. Relationship of Soluble Lectin-Like Low-Density Lipoprotein Receptor-1 (sLOX-1) With Inflammation and Coronary Plaque Progression in Psoriasis. J Am Heart Assoc 2023; 12:e031227. [PMID: 37982276 PMCID: PMC10727277 DOI: 10.1161/jaha.123.031227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/24/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Psoriasis is a chronic inflammatory condition associated with coronary artery disease risk. Uptake of oxidized low-density lipoprotein by the lectin-like low-density lipoprotein receptor-1 triggers release of the soluble extracellular domain of the receptor (sLOX-1). We sought to characterize the relationship between sLOX-1, inflammation, and coronary plaque progression in psoriasis. METHODS AND RESULTS A total of 327 patients with psoriasis had serum sLOX-1 levels measured at baseline by an ELISA-based assay. Stratification by high-sensitivity C-reactive protein ≥4.0 mg/L (quartile 4), identified 81 participants who had coronary plaque phenotyping at baseline and were followed longitudinally by coronary computed tomography angiography. Subjects within high-sensitivity C-reactive protein quartile 4 were middle-aged (51.47±12.62 years), predominantly men (54.3%) with moderate psoriasis disease severity (6.60 [interquartile range, 3.30-13.40]). In the study cohort, participants with sLOX-1 above the median displayed increased vulnerable coronary plaque features. At baseline, sLOX-1 was associated with total burden (rho=0.296; P=0.01), noncalcified burden (rho=0.286; P=0.02), fibro-fatty burden (rho=0.346; P=0.004), and necrotic burden (rho=0.394; P=0.002). A strong relationship between sLOX-1, noncalcified burden (β=0.19; P=0.03), and fibro-fatty burden (β=0.29; P=0.003) was found in fully adjusted models at baseline and 1- and 4-year follow-up. Finally, coronary plaque features progressed over 1 year regardless of biologic or systemic treatment in subjects with high sLOX-1. CONCLUSIONS Patients with psoriasis with both high sLOX-1 and high-sensitivity C-reactive protein levels have increased coronary plaque burden associated with atherosclerotic plaque progression independent of biologic and systemic treatment. Thus, sLOX-1 might be considered as a promising marker in coronary artery disease risk estimation beyond traditional risk factors. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT01778569.
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Affiliation(s)
- Elizabeth M. Florida
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Haiou Li
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Christin G. Hong
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Emily L. Ongstad
- Bioscience Cardiovascular, Research and Early Development, Cardiovascular, Renal, and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Ranjitha Gaddipati
- Bioscience Cardiovascular, Research and Early Development, Cardiovascular, Renal, and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Sadichha Sitaula
- Bioscience Cardiovascular, Research and Early Development, Cardiovascular, Renal, and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Vijayalakshmi Varma
- Translational Science and Experimental Medicine, Research and Early Development, Cardiovascular, Renal, and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Philip M. Parel
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Ross O'Hagan
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Marcus Y. Chen
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Heather L. Teague
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Martin P. Playford
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Sotirios K. Karathanasis
- NeoProgenBaltimoreMDUSA
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National HeartLung and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Anna Collén
- Projects, Research and Early Development, Cardiovascular, Renal, and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZenecaGaithersburgMDUSA
| | - Nehal N. Mehta
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Alan T. Remaley
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National HeartLung and Blood Institute, National Institutes of HealthBethesdaMDUSA
| | - Alexander V. Sorokin
- Section of Inflammation and Cardiometabolic DiseasesNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMDUSA
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Sorokin AV, Hong CG, Aponte AM, Florida EM, Tang J, Patel N, Baranova IN, Li H, Parel PM, Chen V, Wilson SR, Ongstad EL, Collén A, Playford MP, Eggerman TL, Chen MY, Kotani K, Bocharov AV, Remaley AT. Association of oxidized ApoB and oxidized ApoA-I with high-risk coronary plaque features in cardiovascular disease. JCI Insight 2023; 8:e172893. [PMID: 37698922 PMCID: PMC10619497 DOI: 10.1172/jci.insight.172893] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Oxidized apolipoprotein B (oxLDL) and oxidized ApoA-I (oxHDL) are proatherogenic. Their prognostic value for assessing high-risk plaques by coronary computed tomography angiography (CCTA) is missing. METHODS In a prospective, observational study, 306 participants with cardiovascular disease (CVD) had extensive lipoprotein profiling. Proteomics analysis was performed on isolated oxHDL, and atherosclerotic plaque assessment was accomplished by quantitative CCTA. RESULTS Patients were predominantly White, overweight men (58.5%) on statin therapy (43.5%). Increase in LDL-C, ApoB, small dense LDL-C (P < 0.001 for all), triglycerides (P = 0.03), and lower HDL function were observed in the high oxLDL group. High oxLDL associated with necrotic burden (NB; β = 0.20; P < 0.0001) and fibrofatty burden (FFB; β = 0.15; P = 0.001) after multivariate adjustment. Low oxHDL had a significant reverse association with these plaque characteristics. Plasma oxHDL levels better predicted NB and FFB after adjustment (OR, 2.22; 95% CI, 1.27-3.88, and OR, 2.80; 95% CI, 1.71-4.58) compared with oxLDL and HDL-C. Interestingly, oxHDL associated with fibrous burden (FB) change over 3.3 years (β = 0.535; P = 0.033) when compared with oxLDL. Combined Met136 mono-oxidation and Trp132 dioxidation of HDL showed evident association with coronary artery calcium score (r = 0.786; P < 0.001) and FB (r = 0.539; P = 0.012) in high oxHDL, whereas Met136 mono-oxidation significantly associated with vulnerable plaque in low oxHDL. CONCLUSION Our findings suggest that the investigated oxidized lipids are associated with high-risk coronary plaque features and progression over time in patients with CVD. TRIAL REGISTRATION CLINICALTRIALS gov NCT01621594. FUNDING National Heart, Lung, and Blood Institute at the NIH Intramural Research Program.
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Affiliation(s)
| | - Christin G. Hong
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch
| | | | | | - Jingrong Tang
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
| | - Nidhi Patel
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch
| | - Irina N. Baranova
- Department of Laboratory Medicine, Clinical Center, NIH, Bethesda, Maryland, USA
| | - Haiou Li
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch
| | - Philip M. Parel
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch
| | - Vicky Chen
- Bioinformatics/Integrated Data Sciences Section, Research Technology Branch, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - Sierra R. Wilson
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
| | | | - Anna Collén
- Projects, Research and Early Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Martin P. Playford
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch
| | - Thomas L. Eggerman
- Department of Laboratory Medicine, Clinical Center, NIH, Bethesda, Maryland, USA
| | - Marcus Y. Chen
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch
| | - Kazuhiko Kotani
- Division of Community and Family Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | | | - Alan T. Remaley
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
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11
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Florida EM, Li H, Rodante J, Teague HL, Playford MP. Myeloperoxidase and its negative relationship with cholesterol efflux capacity in patients with psoriasis: results from an observational cohort study. J Transl Med 2023; 21:743. [PMID: 37864160 PMCID: PMC10589920 DOI: 10.1186/s12967-023-04506-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 10/22/2023] Open
Affiliation(s)
- Elizabeth M Florida
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Haiou Li
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - J Rodante
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - H L Teague
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Martin P Playford
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
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12
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Boczar KE, Beanlands RS, Glassman SJ, Wang J, Zeng W, deKemp RA, Ward NC, Fehlmann CA, Wells GA, Karsh J, Dwivedi G. Anti-inflammatory effect of biologic therapy in patients with psoriatic disease: A prospective cohort FDG PET study. J Nucl Cardiol 2023; 30:1642-1652. [PMID: 36754934 PMCID: PMC10372102 DOI: 10.1007/s12350-023-03204-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/07/2022] [Indexed: 02/10/2023]
Abstract
AIM The aim of the study was to evaluate the changes in central vascular inflammation measured by FDG PET and myocardial blood flow reserve (MFR) determined by 82Rb PET following therapy with biologic agents for 6 months in patients with psoriatic arthritis (PsA) and/or cutaneous psoriasis (PsO) (group 1) and compare with PsO subjects receiving non-biologic therapy (group 2) and controls (group 3). METHODS AND RESULTS Target-to-background ratio (TBR) by FDG PET in the most diseased segment of the ascending aorta (TBRmax) was measured to assess vascular inflammation. 82Rb PET studies were used to assess changes in left ventricular MFR. A total of 34 participants were enrolled in the study (11 in group 1, 13 in group 2, and 10 controls). A significant drop in the thoracic aorta uptake was observed in the biologic-treated group (ΔTBRmax: - .46 ± .55) compared to the PsO group treated with non-biologic therapy (ΔTBRmax: .23 ± .67). Those showing response to biologic agents maintained MFR compared to who showed no response. CONCLUSION In a cohort of psoriasis patients treated with biologics, FDG uptake in the thoracic aorta decreased over the study period. Patients who demonstrated a significant anti-inflammatory response on FDG PET imaging maintained their MFR compared to non-responders.
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Affiliation(s)
- Kevin E Boczar
- University of Ottawa Heart Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- University of Ottawa, Ottawa, ON, Canada
- Division of Cardiology, Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Jerry Wang
- University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Wanzhen Zeng
- University of Ottawa Heart Institute, Ottawa, ON, Canada
- University of Ottawa, Ottawa, ON, Canada
| | | | - Natalie C Ward
- School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Christophe A Fehlmann
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Division of Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - George A Wells
- University of Ottawa Heart Institute, Ottawa, ON, Canada
- Research Methods Centre, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Jacob Karsh
- Division of Rheumatology, The Ottawa Hospital, Ottawa, ON, Canada
| | - Girish Dwivedi
- University of Ottawa Heart Institute, Ottawa, ON, Canada.
- University of Ottawa, Ottawa, ON, Canada.
- School of Medicine, University of Western Australia, Perth, WA, Australia.
- Department of Advanced Clinical and Translational Cardiovascular Imaging, Harry Perkins Institute of Medical Research, Murdoch, Australia.
- Department of Cardiology, Fiona Stanley Hospital, Murdoch, WA, Australia.
- School of Biomedical Sciences, Curtin University, Bentley, WA, Australia.
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13
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Zhang ZYO, Jian ZY, Tang Y, Li W. The relationship between blood lipid and risk of psoriasis: univariable and multivariable Mendelian randomization analysis. Front Immunol 2023; 14:1174998. [PMID: 37426655 PMCID: PMC10323678 DOI: 10.3389/fimmu.2023.1174998] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Background Psoriasis is a chronic inflammatory skin disease. Dyslipidemia may be a risk factor of psoriasis. But the causal relationship between psoriasis and blood lipid still remains uncertain. Methods The two data of blood lipid were obtained from UK Biobank (UKBB) and Global Lipid Genetics Consortium Results (GLGC). The primary and secondary database were from large publicly available genome-wide association study (GWAS) with more than 400,000 and 170,000 subjects of European ancestry, respectively. The psoriasis from Finnish biobanks of FinnGen research project for psoriasis, consisting of 6,995 cases and 299,128 controls. The single-variable Mendelian randomization (SVMR) and multivariable Mendelian randomization (MVMR) were used to assess the total and direct effects of blood lipid on psoriasis risk. Results SVMR estimates in primary data of blood lipid showed low-density lipoprotein cholesterol (LDL-C) (odds ratio (OR): 1.11, 95%, confidence interval (CI): 0.99-1.25, p = 0.082 in stage 1; OR: 1.15, 95% CI: 1.05-1.26, p = 0.002 in stage 2; OR: 1.15, 95% CI: 1.04-1.26, p = 0.006 in stage 3) and triglycerides (TG) (OR: 1.22, 95% CI: 1.10-1.35, p = 1.17E-04 in stage 1; OR: 1.15, 95% CI: 1.06-1.24, p = 0.001 in stage 2; OR: 1.14, 95% CI: 1.05-1.24, p = 0.002 in stage 3) had a highly robust causal relationship on the risk of psoriasis. However, there were no robust causal associations between HDL-C and psoriasis. The SVMR results in secondary data of blood lipid were consistent with the primary data. Reverse MR analysis showed a causal association between psoriasis and LDL-C (beta: -0.009, 95% CI: -0.016- -0.002, p = 0.009) and HDL-C (beta: -0.011, 95% CI: -0.021- -0.002, p = 0.016). The reverse causation analyses results between psoriasis and TG did not reach significance. In MVMR of primary data of blood lipid, the LDL-C (OR: 1.05, 95% CI: 0.99-1.25, p = 0.396 in stage 1; OR: 1.07, 95% CI: 1.01-1.14, p = 0.017 in stage 2; OR: 1.08, 95% CI: 1.02-1.15, p = 0.012 in stage 3) and TG (OR: 1.11, 95% CI: 1.01-1.22, p = 0.036 in stage 1; OR: 1.09, 95% CI: 1.03-1.15, p = 0.002 in stage 2; OR: 1.07, 95% CI: 1.01-1.13 p = 0.015 in stage 3) positively correlated with psoriasis, and there had no correlation between HDL-C and psoriasis. The results of the secondary analysis were consistent with the results of primary analysis. Conclusions Mendelian randomization (MR) findings provide genetic evidence for causal link between psoriasis and blood lipid. It may be meaningful to monitor and control blood lipid level for a management of psoriasis patients in clinic.
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Affiliation(s)
- Zeng-Yun-Ou Zhang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhong-Yu Jian
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Yin Tang
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Wei Li
- Department of Dermatology & Rare Disease Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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14
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Sorokin AV, Patel N, Li H, Hong CG, Sampson M, O'Hagan R, Florida EM, Teague HL, Playford MP, Chen MY, Mehta NN, Remaley AT. Estimated sdLDL-C for predicting high-risk coronary plaque features in psoriasis: a prospective observational study. Lipids Health Dis 2023; 22:55. [PMID: 37106374 PMCID: PMC10134516 DOI: 10.1186/s12944-023-01819-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/21/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Psoriasis (PSO) is a skin disorder with systemic inflammation and high coronary artery disease risk. A distinct lipid phenotype occurs in psoriasis, which is characterized by high plasma triglycerides (TGs) with typically normal or even low LDL-C. The extent to which cholesterol on LDL subfractions, such as small dense LDL-C (sdLDL-C), are associated with vulnerable coronary plaque characteristics in PSO remains elusive. METHODS A recently developed equation for estimating sdLDL-C from the standard lipid panel was utilized in a PSO cohort (n = 200) with 4-year follow-up of 75 subjects. Coronary plaque burden was assessed by quantitative coronary computed tomography angiography (CCTA). Multivariate regression analyses were used for establishing associations and prognostic value of estimated sdLDL-C. RESULTS Estimated sdLDL-C was positively associated with non-calcified burden (NCB) and fibro-fatty burden (FFB), which remained significant after multivariate adjustment for NCB (β = 0.37; P = 0.050) and LDL-C adjustment for FFB (β = 0.29; P < 0.0001). Of note, total LDL-C calculated by the Friedewald equation was not able to capture these associations in the study cohort. Moreover, in the regression modelling estimated sdLDL-C was significantly predicting necrotic burden progression over 4 years follow-up (P = 0.015), whereas LDL-C did not. Finally, small LDL particles (S-LDLP) and small HDL particles (S-HDLP), along with large and medium TG-rich lipoproteins (TRLPs) had the most significant positive correlation with estimated sdLDL-C. CONCLUSIONS Estimated sdLDL-C has a stronger association than LDL-C with high-risk features of coronary atherosclerotic plaques in psoriasis patients. CLINICAL TRIAL REGISTRATION URL: https://www. CLINICALTRIALS gov . Unique identifiers: NCT01778569.
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Affiliation(s)
- Alexander V Sorokin
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, National Heart, Lung and Blood Institute, National Institutes of Health, 9000 Rockville Pike, Bldg 10, Clinical Research Center, Room 5-5150, Bethesda, MD, 20892, USA.
| | - Nidhi Patel
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, National Heart, Lung and Blood Institute, National Institutes of Health, 9000 Rockville Pike, Bldg 10, Clinical Research Center, Room 5-5150, Bethesda, MD, 20892, USA
| | - Haiou Li
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, National Heart, Lung and Blood Institute, National Institutes of Health, 9000 Rockville Pike, Bldg 10, Clinical Research Center, Room 5-5150, Bethesda, MD, 20892, USA
| | - Christin G Hong
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, National Heart, Lung and Blood Institute, National Institutes of Health, 9000 Rockville Pike, Bldg 10, Clinical Research Center, Room 5-5150, Bethesda, MD, 20892, USA
| | - Maureen Sampson
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, Lung and Blood Institute, National Heart, National Institutes of Health, Bethesda, MD, USA
| | - Ross O'Hagan
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, National Heart, Lung and Blood Institute, National Institutes of Health, 9000 Rockville Pike, Bldg 10, Clinical Research Center, Room 5-5150, Bethesda, MD, 20892, USA
| | - Elizabeth M Florida
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, National Heart, Lung and Blood Institute, National Institutes of Health, 9000 Rockville Pike, Bldg 10, Clinical Research Center, Room 5-5150, Bethesda, MD, 20892, USA
| | - Heather L Teague
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, National Heart, Lung and Blood Institute, National Institutes of Health, 9000 Rockville Pike, Bldg 10, Clinical Research Center, Room 5-5150, Bethesda, MD, 20892, USA
| | - Martin P Playford
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, National Heart, Lung and Blood Institute, National Institutes of Health, 9000 Rockville Pike, Bldg 10, Clinical Research Center, Room 5-5150, Bethesda, MD, 20892, USA
| | - Marcus Y Chen
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, National Heart, Lung and Blood Institute, National Institutes of Health, 9000 Rockville Pike, Bldg 10, Clinical Research Center, Room 5-5150, Bethesda, MD, 20892, USA
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, National Heart, Lung and Blood Institute, National Institutes of Health, 9000 Rockville Pike, Bldg 10, Clinical Research Center, Room 5-5150, Bethesda, MD, 20892, USA
| | - Alan T Remaley
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, Lung and Blood Institute, National Heart, National Institutes of Health, Bethesda, MD, USA
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15
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Kommoss KS, Enk A, Heikenwälder M, Waisman A, Karbach S, Wild J. Cardiovascular comorbidity in psoriasis - psoriatic inflammation is more than just skin deep. J Dtsch Dermatol Ges 2023. [PMID: 37186503 DOI: 10.1111/ddg.15071] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 02/24/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND There is a growing understanding of inflammation in psoriasis beyond its dermatological manifestation, towards systemic inflammation. Management of possible comorbidities encompassing psychological, metabolic and cardiovascular disease is recommended in national and international dermatology guidelines for treatment of psoriasis patients. Vice versa, psoriasis is being recognized as a new risk factor for cardiovascular inflammation within the cardiological community. METHODS A review of the literature was conducted. Key points regarding epidemiological, mechanistic and management aspects were summarized and put into context for physicians treating psoriasis patients. RESULTS Efforts are currently being made to better understand the mechanistic underpinnings of systemic inflammation within psoriatic inflammation. Studies looking to "hit two birds with one stone" regarding specifically cardiovascular comorbidities of psoriasis patients using established systemic dermatological therapies have so far provided heterogeneous data. The diagnosis of psoriasis entails preventive and therapeutic consequences regarding concomitant diseases for the individual patient. CONCLUSIONS The knowledge of comorbidities in psoriasis calls for pronounced interdisciplinary care of psoriasis patients, to which this article highlights efforts regarding vascular inflammation and cardiovascular disease.
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Affiliation(s)
- Katharina S Kommoss
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
- Division of Chronic Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alexander Enk
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Mathias Heikenwälder
- Division of Chronic Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ari Waisman
- Institute for Molecular Medicine, University Medical Center of Mainz, Mainz, Germany
- Research Center for Immunotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Susanne Karbach
- Center for Cardiology - Cardiology I, University Medical Center Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK) - Partner site RheinMain, Germany
| | - Johannes Wild
- Center for Cardiology - Cardiology I, University Medical Center Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK) - Partner site RheinMain, Germany
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16
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Berg AR, Petrole RF, Li H, Sorokin AV, Gonzalez-Cantero A, Playford MP, Mehta NN, Teague HL. Cholesterol efflux capacity is associated with lipoprotein size and vascular health in mild to moderate psoriasis. Front Cardiovasc Med 2023; 10:1041457. [PMID: 36891247 PMCID: PMC9986595 DOI: 10.3389/fcvm.2023.1041457] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/24/2023] [Indexed: 02/22/2023] Open
Abstract
Background and objective Psoriasis is a systemic inflammatory condition with poor cholesterol transport measured by cholesterol efflux capacity (CEC) that is associated with a heightened risk of cardiovascular disease (CVD). In psoriasis patients, we sought to characterize the lipoprotein profile by size using a novel nuclear magnetic resonance algorithm in patients with low CEC compared to normal CEC. Methods Lipoprotein profile was assessed using the novel nuclear magnetic resonance LipoProfile-4 deconvolution algorithm. Aortic vascular inflammation (VI) and non-calcified burden (NCB) were characterized via positron emission tomography-computed tomography and coronary computed tomography angiography. To understand the relationship between lipoprotein size and markers of subclinical atherosclerosis, linear regression models controlling for confounders were constructed. Results Psoriasis patients with low CEC had higher more severe psoriasis (p = 0.04), VI (p = 0.04) and NCB (p = 0.001), concomitant with smaller high-density lipoprotein (HDL) (p < 0.001) and low-density lipoprotein (LDL) particles (p < 0.001). In adjusted models HDL size (β = -0.19; p = 0.02) and LDL size (β = -0.31; p < 0.001) associated with VI and NCB. Lastly, HDL size strongly associated with LDL size in fully adjusted models (β = -0.27; p < 0.001). Conclusion These findings demonstrate that in psoriasis, low CEC associates with a lipoprotein profile comprised of smaller HDL and LDL particles which correlates with vascular health and may be driving early onset atherogenesis. Further, these results demonstrate a relationship between HDL and LDL size and provide novel insights into the complexities of HDL and LDL as biomarkers of vascular health.
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Affiliation(s)
- Alexander R Berg
- National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, United States
| | - Rylee F Petrole
- National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, United States
| | - Haiou Li
- National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, United States
| | | | - Alvaro Gonzalez-Cantero
- Dermatology Service, Hospital Universitario Ramón y Cajal, Medicine Department, Faculty of Medicine, Universidad de Alcalá, IRYCIS, Madrid, Spain.,Faculty of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - Martin P Playford
- National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, United States
| | - Nehal N Mehta
- National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, United States
| | - Heather L Teague
- National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, United States
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17
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Annexin A6 Polymorphism Is Associated with Pro-atherogenic Lipid Profiles and with the Downregulation of Methotrexate on Anti-Atherogenic Lipid Profiles in Psoriasis. J Clin Med 2022; 11:jcm11237059. [PMID: 36498634 PMCID: PMC9737844 DOI: 10.3390/jcm11237059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/15/2022] [Accepted: 11/26/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Annexin A6 (AnxA6) is a lipid-binding protein that regulates cholesterol homeostasis and secretory pathways. However, the correlation of AnxA6 polymorphism with lipometabolism has never been studied in psoriasis. OBJECTIVES To investigate the impact of AnxA6 polymorphism on lipid profiles and the expression of AnxA6 protein in both peripheral blood mononuclear cells (PBMCs) and lipometabolism in psoriasis. METHODS A total of 265 psoriatic patients received methotrexate (MTX) treatment for 12 weeks, after which their lipid profiles were determined by measuring total cholesterol (TC), triglycerides (TGs), lipoprotein (a) [LP(a)], high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein (LDL), apolipoprotein (a)1 (ApoA1), and apolipoprotein B (ApoB). In addition, AnxA6 (rs11960458) was genotyped in 262 patients and the expression of AnxA6 in PBMCs was measured by Western blotting at baseline and week 8 post-MTX treatment. RESULTS The CC genotype carriers of rs11960458 had a lower expression of AnxA6 and lower levels of the pro-atherogenic lipids TC, LDL, and ApoB compared to TC genotype carriers. MTX significantly downregulated the levels of the anti-atherogenic lipids HDL-C and ApoA1 and the level of AnxA6 in TC genotype carriers, as well as the level of TGs in CC genotype carriers. CONCLUSIONS The polymorphism of AnxA6, rs11960458, was statistically associated with the levels of pro-atherogenic lipids and with the downregulation of MTX on the levels of anti-atherogenic lipids and TGs in psoriasis.
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18
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Mietus-Snyder M, Suslovic W, Delaney M, Playford MP, Ballout RA, Barber JR, Otvos JD, DeBiasi RL, Mehta NN, Remaley AT. Changes in HDL cholesterol, particles, and function associate with pediatric COVID-19 severity. Front Cardiovasc Med 2022; 9:1033660. [PMID: 36312284 PMCID: PMC9597312 DOI: 10.3389/fcvm.2022.1033660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background Myriad roles for high-density lipoprotein (HDL) beyond atheroprotection include immunologic functions implicated in the severity of coronavirus disease-2019 (COVID-19) in adults. We explored whether there is an association between HDL and COVID-19 severity in youth. Methods A pediatric cohort (N = 102), who tested positive for COVID-19 across a range of disease manifestations from mild or no symptoms, to acute severe symptoms, to the multisystem inflammatory syndrome of children (MIS-C) was identified. Clinical data were collected from the medical record and reserve plasma aliquots were assessed for lipoproteins by NMR spectroscopy and assayed for HDL functional cholesterol efflux capacity (CEC). Findings were compared by COVID-19 status and symptom severity. Lipoprotein, NMR spectroscopy and CEC data were compared with 30 outpatient COVID negative children. Results Decreasing HDL cholesterol (HDL-c), apolipoprotein AI (ApoA-I), total, large and small HDL particles and HDL CEC showed a strong and direct linear dose-response relationship with increasing severity of COVID-19 symptoms. Youth with mild or no symptoms closely resembled the uninfected. An atypical lipoprotein that arises in the presence of severe hepatic inflammation, lipoprotein Z (LP-Z), was absent in COVID-19 negative controls but identified more often in youth with the most severe infections and the lowest HDL parameters. The relationship between HDL CEC and symptom severity and ApoA-I remained significant in a multiply adjusted model that also incorporated age, race/ethnicity, the presence of LP-Z and of GlycA, a composite biomarker reflecting multiple acute phase proteins. Conclusion HDL parameters, especially HDL function, may help identify youth at risk of more severe consequences of COVID-19 and other novel infectious pathogens.
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Affiliation(s)
- Michele Mietus-Snyder
- Children's National Hospital, Washington, DC, United States
- The Children's National Clinical and Translational Science Institute, Washington, DC, United States
- Division of Cardiology, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
- Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
| | | | - Meghan Delaney
- Children's National Hospital, Washington, DC, United States
- Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
- Division of Clinical and Laboratory Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
| | - Martin P. Playford
- Cardiovascular and Pulmonary Branch, National Institutes of Health, Bethesda, MD, United States
| | - Rami A. Ballout
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - John R. Barber
- The Children's National Clinical and Translational Science Institute, Washington, DC, United States
| | - James D. Otvos
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Roberta L. DeBiasi
- Children's National Hospital, Washington, DC, United States
- The Children's National Clinical and Translational Science Institute, Washington, DC, United States
- Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
- Division of Infectious Diseases, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
- Department of Microbiology, Immunology and Tropical Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
| | - Nehal N. Mehta
- Cardiovascular and Pulmonary Branch, National Institutes of Health, Bethesda, MD, United States
| | - Alan T. Remaley
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
- Clinical Center, Department of Laboratory Medicine, National Institutes of Health, Bethesda, MD, United States
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19
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Fabi M, Chessa MA, Panizza D, Dormi A, Gazzano A, Patrizi A, Bardazzi F, Rocca A, Filice E, Neri I, Lanari M. Psoriasis and Cardiovascular Risk in Children: The Usefulness of Carotid Intima-Media Thickness. Pediatr Cardiol 2022; 43:1462-1470. [PMID: 35316356 DOI: 10.1007/s00246-022-02869-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/04/2022] [Indexed: 02/06/2023]
Abstract
Psoriasis is a skin disorder which mostly affects adults, beginning in childhood in almost one-third of patients. In adults it is associated with increased risk for cardiovascular diseases (CVD), while this association is still debated at younger age. Our aim was to evaluate the association between psoriasis and metabolic markers and cardiovascular findings in this age group. Twenty consecutive patients previously diagnosed with psoriasis (group A) were enrolled and compared with healthy non- psoriatic age- and sex-matched subjects (group B). The severity of the disease, CV risk factors, including anthropometric data with adiposity and its distribution, blood pressure (BP), laboratory metabolic tests, echocardiography and vascular ultrasound (transcranial echo-Doppler and carotid artery echo-Doppler with carotid intima-media thickness, cIMT) were performed for each subject. Personal history for CV risk, BP, anthropometric data were similar between the two groups, while familiar history for psoriasis was more frequent in group A (p < 0.02). C-IMT was significantly higher in group A compared to B (right, p = 0.001; left, p = 0.002). In addition, c-IMT was positively correlated with disease duration, triglycerides and triglycerides/glucose. Cerebral flow velocities, cardiac measurements, systo-diastolic function, ventricle geometry and mass were normal and comparable between the two groups, and did not correlate with CV risk factors. In childhood psoriasis c-IMT could represent a marker of pre-clinical cardiovascular involvement and contribute to start a personalized management, while cardiac findings seem to be normal in the early stage of disease. Longitudinal studies can clarify the progression of CV involvement in paediatric-onset psoriasis.
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Affiliation(s)
- Marianna Fabi
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant'Orsola University Hospital, Via Massarenti, 11, Bologna, Italy
| | - Marco A Chessa
- Dermatology Division, Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), IRCCS University Hospital of Bologna S. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Davide Panizza
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant'Orsola University Hospital, Via Massarenti, 11, Bologna, Italy.
| | - Ada Dormi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Anna Gazzano
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant'Orsola University Hospital, Via Massarenti, 11, Bologna, Italy
| | - Annalisa Patrizi
- Dermatology Division, Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), IRCCS University Hospital of Bologna S. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Federico Bardazzi
- Dermatology Division, Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), IRCCS University Hospital of Bologna S. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Alessandro Rocca
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant'Orsola University Hospital, Via Massarenti, 11, Bologna, Italy
| | - Emanuele Filice
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant'Orsola University Hospital, Via Massarenti, 11, Bologna, Italy
| | - Iria Neri
- Dermatology Division, Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), IRCCS University Hospital of Bologna S. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Marcello Lanari
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant'Orsola University Hospital, Via Massarenti, 11, Bologna, Italy
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20
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Looking beyond the Skin: Pathophysiology of Cardiovascular Comorbidity in Psoriasis and the Protective Role of Biologics. Pharmaceuticals (Basel) 2022; 15:ph15091101. [PMID: 36145322 PMCID: PMC9503011 DOI: 10.3390/ph15091101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
Abstract
Psoriasis is a chronic systemic inflammatory disease associated with a higher incidence of cardiovascular disease, especially in patients with moderate to severe psoriasis. It has been estimated that severe psoriasis confers a 25% increase in relative risk of cardiovascular disease, regardless of traditional risk factors. Although the underlying pathogenic mechanisms relating psoriasis to increased cardiovascular risk are not clear, atherosclerosis is emerging as a possible link between skin and vascular affection. The hypothesis that the inflammatory cascade activated in psoriasis contributes to the atherosclerotic process provides the underlying basis to suggest that an anti-inflammatory therapy that improved atherosclerosis would also reduce the risk of MACEs. In this sense, the introduction of biological drugs which specifically target cytokines implicated in the inflammatory cascade have increased the expectations of control over the cardiovascular comorbidity present in psoriasis patients, however, their role in vascular damage processes remains controversial. The aim of this paper is to review the mechanistic link between psoriasis and cardiovascular disease development, as well as analyzing which of the biological treatments could also reduce the cardiovascular risk in these patients, fueling a growing debate on the modification of the general algorithm of treatment.
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21
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Piaserico S, Orlando G, Messina F. Psoriasis and Cardiometabolic Diseases: Shared Genetic and Molecular Pathways. Int J Mol Sci 2022; 23:9063. [PMID: 36012327 PMCID: PMC9409274 DOI: 10.3390/ijms23169063] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/26/2022] Open
Abstract
A convincing deal of evidence supports the fact that severe psoriasis is associated with cardiovascular diseases. However, the precise underlying mechanisms linking psoriasis and cardiovascular diseases are not well defined. Psoriasis shares common pathophysiologic mechanisms with atherosclerosis and cardiovascular (CV) risk factors. In particular, polymorphism in the IL-23R and IL-23 genes, as well as other genes involved in lipid and fatty-acid metabolism, renin-angiotensin system and endothelial function, have been described in patients with psoriasis and with cardiovascular risk factors. Moreover, systemic inflammation in patients with psoriasis, including elevated serum proinflammatory cytokines (e.g., TNF-α, IL-17, and IL-23) may contribute to an increased risk of atherosclerosis, hypertension, alteration of serum lipid composition, and insulin resistance. The nonlinear and intricate interplay among various factors, impacting the molecular pathways in different cell types, probably contributes to the development of psoriasis and cardiovascular disease (CVD). Future research should, therefore, aim to fully unravel shared and differential molecular pathways underpinning the association between psoriasis and CVD.
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Affiliation(s)
- Stefano Piaserico
- Unit of Dermatology, Department of Medicine, University of Padua, Via V. Gallucci 4, 35128 Padua, Italy
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22
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Anyfanti P, Margouta A, Goulas K, Gavriilaki M, Lazaridou E, Patsatsi A, Gkaliagkousi E. Endothelial Dysfunction in Psoriasis: An Updated Review. Front Med (Lausanne) 2022; 9:864185. [PMID: 35755028 PMCID: PMC9226899 DOI: 10.3389/fmed.2022.864185] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/24/2022] [Indexed: 12/24/2022] Open
Abstract
Although psoriasis is predominantly a chronic inflammatory skin disorder, epidemiological data provide a solid link between psoriasis, especially in its more severe forms, and increased risk for cardiovascular morbidity and mortality. Apart from the increased prevalence of traditional cardiovascular risk factors, chronic inflammation appears to act synergistically with the underlying process of endothelial dysfunction toward the development of accelerated atherosclerosis, subclinical vascular injury and subsequently, clinically evident cardiovascular manifestations. Endothelial dysfunction is regarded as an early precursor of atherosclerosis with a predictive value for the development of future cardiovascular events. A thorough understanding of the mechanisms of endothelial dysfunction in psoriasis might pave the path for the development of more accurate cardiovascular risk prediction tools and possible therapeutic targets aiming to alleviate the increased cardiovascular burden associated with the disease. The present review summarizes the available evidence about the role of chronic inflammation and other important pathophysiological mechanisms involved in the development of endothelial dysfunction in psoriasis. An overview of studies implementing the most widely applied circulating and vascular biomarkers of endothelial dysfunction in psoriasis patients will be provided, and the impact of systemic psoriasis treatments on endothelial dysfunction and patients' cardiovascular risk will be discussed.
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Affiliation(s)
- Panagiota Anyfanti
- Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia Margouta
- Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kyriakos Goulas
- Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Gavriilaki
- Postgraduate Course, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elizabeth Lazaridou
- Department of Dermatology and Venereology, School of Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini Patsatsi
- Department of Dermatology and Venereology, School of Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eugenia Gkaliagkousi
- Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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23
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Yan D, Blauvelt A, Dey AK, Golpanian RS, Hwang ST, Mehta NN, Myers B, Shi ZR, Yosipovitch G, Bell S, Liao W. New Frontiers in Psoriatic Disease Research, Part II: Comorbidities and Targeted Therapies. J Invest Dermatol 2021; 141:2328-2337. [PMID: 33888321 PMCID: PMC8464483 DOI: 10.1016/j.jid.2021.02.743] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 01/27/2021] [Accepted: 02/09/2021] [Indexed: 12/12/2022]
Abstract
Although psoriasis and psoriatic arthritis (PsA) have been classically considered to be diseases of the skin and joints, respectively, emerging evidence suggests that a combination of innate and environmental factors creates widespread immune dysfunction, affecting multiple organ systems. A greater understanding of the pathogenesis of psoriasis and the systemic effects of psoriatic inflammation has allowed for the development of new, more effective treatments. The second portion of this two-part review series examines the comorbidities associated with psoriasis and PsA as well as the most recent advances in targeted systemic therapies for these conditions.
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Affiliation(s)
- Di Yan
- The Ronald O. Perelman Department of Dermatology, NYU Langone Medical Center, New York, New York, USA
| | | | - Amit K Dey
- Cardiopulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - Rachel S Golpanian
- Itch Center, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Samuel T Hwang
- Department of Dermatology, UC Davis Medical Center, Sacramento, California
| | - Nehal N Mehta
- Cardiopulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - Bridget Myers
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Zhen-Rui Shi
- Department of Dermatology, UC Davis Medical Center, Sacramento, California
| | - Gil Yosipovitch
- Itch Center, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Stacie Bell
- National Psoriasis Foundation, Portland, Oregon, USA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, San Francisco, California.
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24
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Psoriasis and Cardiovascular Disease: Novel Mechanisms and Evolving Therapeutics. Curr Atheroscler Rep 2021; 23:67. [PMID: 34468875 PMCID: PMC9744099 DOI: 10.1007/s11883-021-00963-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Psoriasis is a chronic inflammatory skin condition that is associated with increased cardiovascular risk compared to those without psoriasis. This review will cover emerging mechanisms of cardiovascular risk, key pathways targeted with biologic therapies, and the current evidence on therapies to modulate this risk in patients with psoriasis. RECENT FINDINGS Recent scientific work has highlighted mechanisms that contribute to this enhanced risk, including the role of vascular endothelial dysfunction, platelet activation, dyslipidemia, and increased cardiometabolic comorbidities. Newer biologic and targeted synthetic therapies have transformed psoriasis treatment with high rates of clinical remission and durable skin disease control now possible. Epidemiological evidence suggests that many of these therapies may lower cardiovascular risk in psoriasis, although prospective interventional data is lacking (or mixed). Recently, caution has also been raised that some treatments may negatively affect cardiovascular risk. Overall, the current data suggests a positive or neutral ability to reduce cardiovascular risk for TNF, IL-17A, and IL-12/23p40 inhibitors, but current evidence remains conflicting for anti-IL-23/p19 and JAK inhibitors. More studies that include prospective cohorts, larger number of patients, treatment duration, and validated surrogate outcomes are needed to better evaluate the role of biologic therapies on cardiovascular risk in psoriasis.
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25
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Teklu M, Parel PM, Mehta NN. Psoriasis and Cardiometabolic Diseases: The Impact of Inflammation on Vascular Health. PSORIASIS-TARGETS AND THERAPY 2021; 11:99-108. [PMID: 34322373 PMCID: PMC8312325 DOI: 10.2147/ptt.s320016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/06/2021] [Indexed: 12/24/2022]
Abstract
Psoriasis is a common chronic inflammatory condition associated with a higher risk of cardiovascular disease. Psoriasis confers a dose-dependent increase in risk for the metabolic syndrome and its components. The metabolic syndrome and its components have been associated with higher coronary atherosclerosis in psoriasis and cardiovascular events in the general population. In this review, we discuss the role of inflammation and psoriasis in cardiometabolic diseases with a focus on the metabolic syndrome and its components. We highlight the relationship between psoriasis and important cardiovascular risk factors encompassed by obesity, dyslipidemia, insulin resistance and hypertension. Furthermore, we briefly highlight literature on anti-inflammatory therapies and their impact on the components of the metabolic syndrome as well as directly quantified coronary atherosclerosis burden.
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Affiliation(s)
- Meron Teklu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Philip M Parel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nehal N Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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26
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Alisik T, Alisik M, Nacir B, Ayhan FF, Genc H, Erel O. Evaluation of dysfunctional high-density lipoprotein levels with myeloperoxidase/paraoxonase-1 ratio in rheumatoid arthritis. Int J Clin Pract 2021; 75:e14172. [PMID: 33756027 DOI: 10.1111/ijcp.14172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/12/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The aim of this study is to evaluate dysfunctional high-density lipoprotein cholesterol (HDL) by measuring myeloperoxidase (MPO)/paraoxonase 1 (PON1) ratio in patients with rheumatoid arthritis (RA) and to investigate the relationship between dysfunctional HDL and cardiovascular disease (CVD) in RA patients. METHODS Sixty-seven healthy individuals and 130 RA patients were included in the study. Routine lipid panels (triglyceride (TG), low-density lipoprotein cholesterol (LDL), HDL, total cholesterol (TC), PON1 and MPO levels were measured. Disease activity scores-28 (DAS28) of RA patients were calculated. Cardiological examination records of the patients were assessed to detect patients who also have CVD. RESULTS There were no significant differences between RA and control groups in routine lipid profiles (P > .05 for all). MPO/PON1 ratios were significantly elevated in the RA group compared with the control group (P < .001). MPO/PON1 ratios were higher in RA patients with CVD history compared with those without CVD (P < .05). MPO/PON1 ratios were correlated with DAS28 scores (rho: 0.357, P < .001). CONCLUSION HDL dysfunction determined by the MPO/PON1 ratio may be associated with the pathophysiology of increased CVD in RA. Thus, evaluating dysfunctional HDL levels by measuring the MPO/PON1 ratio in RA patients may allow more detailed patient follow-up, as well as the reduction of CVD events in RA patients with therapeutic agents aiming to increase the functional properties of HDL by decreasing this ratio.
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Affiliation(s)
- Tugba Alisik
- Physical Medicine and Rehabilitation, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Murat Alisik
- Medical Biochemistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Baris Nacir
- Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Turkey
| | | | - Hakan Genc
- Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Turkey
| | - Ozcan Erel
- Medical Biochemistry, Yildirim Beyazit University, Ankara, Turkey
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27
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Trakaki A, Wolf P, Weger W, Eichmann TO, Scharnagl H, Stadler JT, Salmhofer W, Knuplez E, Holzer M, Marsche G. Biological anti-psoriatic therapy profoundly affects high-density lipoprotein function. Biochim Biophys Acta Mol Cell Biol Lipids 2021; 1866:158943. [PMID: 33862237 DOI: 10.1016/j.bbalip.2021.158943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/24/2021] [Accepted: 04/07/2021] [Indexed: 12/13/2022]
Abstract
Psoriasis is a common chronic inflammatory skin disease linked to increased cardiovascular risk. Functional impairment of high-density lipoprotein (HDL) may contribute to excessive cardiovascular mortality in psoriasis patients. Anti-cytokine therapies with biologics have been efficiently used for the management of psoriasis, however little data is available on the effects of biologic anti-psoriatic therapies on the composition and functionality of HDL. Blood samples were taken from 17 healthy volunteers and from 27 real-world psoriasis patients at baseline (no therapy with biologics) and after short-term (3 to 6 months) and intermediate-term (1 to 2 years) therapy. The biologics used included anti-interleukin (IL)-12/23p40 (ustekinumab), anti-IL17A (secukinumab) or anti-tumor necrosis factor-α (etanercept or adalimumab) antibodies. We observed that in psoriasis patients at baseline, metrics of HDL function including cholesterol efflux capacity of apolipoprotein B-depleted serum (p = 0.021), paraoxonase (p < 0.001) and lecithin-cholesterol acyltransferase (p < 0.001) activities were impaired, when compared to controls. Unexpectedly, we observed that short- and especially intermediate-term therapy with biologics markedly reduced HDL cholesterol efflux capacity (p < 0.001) and rendered HDL pro-inflammatory (p < 0.001), but increased paraoxonase (p = 0.009) and lecithin-cholesterol acyltransferase (p = 0.019) activities. All biologics caused similar changes in HDL composition, subclass distribution and cholesterol efflux capacity. Our results provide evidence that anti-psoriatic therapy with biologic agents is associated with changes in HDL functionality, particle composition and subclass distribution.
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Affiliation(s)
- Athina Trakaki
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
| | - Peter Wolf
- Department of Dermatology and Venereology, Auenbruggerplatz 8, 8036 Graz, Austria.
| | - Wolfgang Weger
- Department of Dermatology and Venereology, Auenbruggerplatz 8, 8036 Graz, Austria
| | - Thomas O Eichmann
- Institute of Molecular Biosciences, University of Graz, Graz, Austria; Center for Explorative Lipidomics, BioTechMed-Graz, Graz, Austria
| | - Hubert Scharnagl
- Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Julia T Stadler
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
| | - Wolfgang Salmhofer
- Department of Dermatology and Venereology, Auenbruggerplatz 8, 8036 Graz, Austria
| | - Eva Knuplez
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
| | - Michael Holzer
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
| | - Gunther Marsche
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria; BioTechMed Graz, Mozartgasse 12/II, 8010 Graz, Austria.
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28
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Hasni SA, Gupta S, Davis M, Poncio E, Temesgen-Oyelakin Y, Carlucci PM, Wang X, Naqi M, Playford MP, Goel RR, Li X, Biehl AJ, Ochoa-Navas I, Manna Z, Shi Y, Thomas D, Chen J, Biancotto A, Apps R, Cheung F, Kotliarov Y, Babyak AL, Zhou H, Shi R, Stagliano K, Tsai WL, Vian L, Gazaniga N, Giudice V, Lu S, Brooks SR, MacKay M, Gregersen P, Mehta NN, Remaley AT, Diamond B, O’Shea JJ, Gadina M, Kaplan MJ. Phase 1 double-blind randomized safety trial of the Janus kinase inhibitor tofacitinib in systemic lupus erythematosus. Nat Commun 2021; 12:3391. [PMID: 34099646 PMCID: PMC8185103 DOI: 10.1038/s41467-021-23361-z] [Citation(s) in RCA: 106] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/22/2021] [Indexed: 02/05/2023] Open
Abstract
Increased risk of premature cardiovascular disease (CVD) is well recognized in systemic lupus erythematosus (SLE). Aberrant type I-Interferon (IFN)-neutrophil interactions contribute to this enhanced CVD risk. In lupus animal models, the Janus kinase (JAK) inhibitor tofacitinib improves clinical features, immune dysregulation and vascular dysfunction. We conducted a randomized, double-blind, placebo-controlled clinical trial of tofacitinib in SLE subjects (ClinicalTrials.gov NCT02535689). In this study, 30 subjects are randomized to tofacitinib (5 mg twice daily) or placebo in 2:1 block. The primary outcome of this study is safety and tolerability of tofacitinib. The secondary outcomes include clinical response and mechanistic studies. The tofacitinib is found to be safe in SLE meeting study's primary endpoint. We also show that tofacitinib improves cardiometabolic and immunologic parameters associated with the premature atherosclerosis in SLE. Tofacitinib improves high-density lipoprotein cholesterol levels (p = 0.0006, CI 95%: 4.12, 13.32) and particle number (p = 0.0008, CI 95%: 1.58, 5.33); lecithin: cholesterol acyltransferase concentration (p = 0.024, CI 95%: 1.1, -26.5), cholesterol efflux capacity (p = 0.08, CI 95%: -0.01, 0.24), improvements in arterial stiffness and endothelium-dependent vasorelaxation and decrease in type I IFN gene signature, low-density granulocytes and circulating NETs. Some of these improvements are more robust in subjects with STAT4 risk allele.
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Affiliation(s)
- Sarfaraz A. Hasni
- grid.420086.80000 0001 2237 2479Lupus Clinical Trials Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD USA
| | - Sarthak Gupta
- grid.420086.80000 0001 2237 2479Lupus Clinical Trials Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD USA ,grid.420086.80000 0001 2237 2479Systemic Autoimmunity Branch, NIAMS, NIH, Bethesda, MD USA
| | - Michael Davis
- grid.420086.80000 0001 2237 2479Lupus Clinical Trials Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD USA
| | - Elaine Poncio
- grid.420086.80000 0001 2237 2479Lupus Clinical Trials Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD USA
| | - Yenealem Temesgen-Oyelakin
- grid.420086.80000 0001 2237 2479Lupus Clinical Trials Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD USA
| | - Philip M. Carlucci
- grid.420086.80000 0001 2237 2479Systemic Autoimmunity Branch, NIAMS, NIH, Bethesda, MD USA
| | - Xinghao Wang
- grid.420086.80000 0001 2237 2479Systemic Autoimmunity Branch, NIAMS, NIH, Bethesda, MD USA
| | - Mohammad Naqi
- grid.420086.80000 0001 2237 2479Lupus Clinical Trials Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD USA
| | - Martin P. Playford
- grid.279885.90000 0001 2293 4638Section of Inflammation and Cardiometabolic Diseases, National Heart Lung and Blood Institute (NHLBI), NIH, Bethesda, MD USA
| | - Rishi R. Goel
- grid.420086.80000 0001 2237 2479Systemic Autoimmunity Branch, NIAMS, NIH, Bethesda, MD USA
| | - Xiaobai Li
- grid.410305.30000 0001 2194 5650NIH Clinical Center Biostatistics and Clinical Epidemiology Service, Bethesda, MD USA
| | - Ann J. Biehl
- grid.420086.80000 0001 2237 2479Office of the Clinical Director, NIAMS, NIH, Bethesda, MD USA
| | - Isabel Ochoa-Navas
- grid.420086.80000 0001 2237 2479Lupus Clinical Trials Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD USA
| | - Zerai Manna
- grid.420086.80000 0001 2237 2479Lupus Clinical Trials Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD USA
| | - Yinghui Shi
- grid.420086.80000 0001 2237 2479Translational Immunology Section, NIAMS, NIH, Bethesda, MD USA
| | - Donald Thomas
- Arthritis and Pain Associates of PG County, Greenbelt, MD USA
| | - Jinguo Chen
- grid.94365.3d0000 0001 2297 5165Trans-NIH Center for Human Immunology, Autoimmunity and Inflammation, NIH, Bethesda, MD USA
| | - Angélique Biancotto
- grid.94365.3d0000 0001 2297 5165Trans-NIH Center for Human Immunology, Autoimmunity and Inflammation, NIH, Bethesda, MD USA
| | - Richard Apps
- grid.94365.3d0000 0001 2297 5165Trans-NIH Center for Human Immunology, Autoimmunity and Inflammation, NIH, Bethesda, MD USA
| | - Foo Cheung
- grid.94365.3d0000 0001 2297 5165Trans-NIH Center for Human Immunology, Autoimmunity and Inflammation, NIH, Bethesda, MD USA
| | - Yuri Kotliarov
- grid.94365.3d0000 0001 2297 5165Trans-NIH Center for Human Immunology, Autoimmunity and Inflammation, NIH, Bethesda, MD USA
| | - Ashley L. Babyak
- grid.94365.3d0000 0001 2297 5165Trans-NIH Center for Human Immunology, Autoimmunity and Inflammation, NIH, Bethesda, MD USA
| | - Huizhi Zhou
- grid.94365.3d0000 0001 2297 5165Trans-NIH Center for Human Immunology, Autoimmunity and Inflammation, NIH, Bethesda, MD USA
| | - Rongye Shi
- grid.94365.3d0000 0001 2297 5165Trans-NIH Center for Human Immunology, Autoimmunity and Inflammation, NIH, Bethesda, MD USA
| | - Katie Stagliano
- grid.94365.3d0000 0001 2297 5165Trans-NIH Center for Human Immunology, Autoimmunity and Inflammation, NIH, Bethesda, MD USA
| | - Wanxia Li Tsai
- grid.420086.80000 0001 2237 2479Translational Immunology Section, NIAMS, NIH, Bethesda, MD USA
| | - Laura Vian
- grid.420086.80000 0001 2237 2479Translational Immunology Section, NIAMS, NIH, Bethesda, MD USA
| | - Nathalia Gazaniga
- grid.420086.80000 0001 2237 2479Translational Immunology Section, NIAMS, NIH, Bethesda, MD USA
| | - Valentina Giudice
- grid.279885.90000 0001 2293 4638Hematology Branch, NHLBI, NIH, Bethesda, MD USA
| | - Shajia Lu
- grid.420086.80000 0001 2237 2479Translational Immunology Section, NIAMS, NIH, Bethesda, MD USA
| | - Stephen R. Brooks
- grid.420086.80000 0001 2237 2479Biodata Mining and Discovery Section, NIAMS, NIH, Bethesda, MD USA
| | - Meggan MacKay
- grid.250903.d0000 0000 9566 0634Feinstein Institute for Medical Research, Manhasset, NY USA
| | - Peter Gregersen
- grid.250903.d0000 0000 9566 0634Feinstein Institute for Medical Research, Manhasset, NY USA
| | - Nehal N. Mehta
- grid.279885.90000 0001 2293 4638Section of Inflammation and Cardiometabolic Diseases, National Heart Lung and Blood Institute (NHLBI), NIH, Bethesda, MD USA
| | - Alan T. Remaley
- grid.279885.90000 0001 2293 4638Translational Vascular Medicine Branch, NHLBI, NIH, Bethesda, MD USA
| | - Betty Diamond
- grid.250903.d0000 0000 9566 0634Feinstein Institute for Medical Research, Manhasset, NY USA
| | - John J. O’Shea
- grid.420086.80000 0001 2237 2479Molecular Immunology and Inflammation Branch, NIAMS, NIH, Bethesda, MD USA
| | - Massimo Gadina
- grid.420086.80000 0001 2237 2479Translational Immunology Section, NIAMS, NIH, Bethesda, MD USA
| | - Mariana J. Kaplan
- grid.420086.80000 0001 2237 2479Systemic Autoimmunity Branch, NIAMS, NIH, Bethesda, MD USA
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Gourgari E, Nadeau KJ, Pyle L, Playford MP, Ma J, Mehta NN, Remaley AT, Gordon SM. Effect of metformin on the high-density lipoprotein proteome in youth with type 1 diabetes. ENDOCRINOLOGY DIABETES & METABOLISM 2021; 4:e00261. [PMID: 34277985 PMCID: PMC8279605 DOI: 10.1002/edm2.261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 12/18/2022]
Abstract
Background Youth with type 1 diabetes (T1D) have normal or elevated High‐Density Lipoprotein Cholesterol (HDL‐C), however, the function of HDL, partly mediated by the HDL proteome, may be impaired. Metformin can be used as an adjunct therapy in youth with T1D, but its effects on the HDL proteome are unknown. Objective To determine the effect of metformin on the HDL proteome. Subjects Youth (12–20 years old) with T1D who had a BMI > 90th percentile, HbA1c > 8.0% and Tanner stage 5. Methods Double‐blinded, placebo‐controlled randomized sub‐study. We examined the effects of metformin (n = 25) or placebo (n = 10) after 6 months on HDL proteome. Changes in HDL proteins were measured by data‐independent acquisition (DIA) mass spectrometry and compared between treatment groups. As a secondary outcome, associations between proteins of interest and the most studied function of HDL, the cholesterol efflux capacity (CEC), was examined. Results The relative abundance of 84 HDL‐associated proteins were measured. Two proteins were significantly affected by metformin treatment, peptidoglycan recognition protein 2 (PGRP2; +23.4%, p = .0058) and alpha‐2‐macroglobulin (A2MG; +29.8%, p = .049). Metformin did not significantly affect CEC. Changes in affected HDL proteins did not correlate with CEC. Conclusions Despite having little effect on HDL‐C, metformin increased PGRP2 and A2MG protein on HDL in youth with T1D, but had no significant effect on CEC. Further studies are needed to understand the impact of PGRP2 and A2MG on other HDL functions.
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Affiliation(s)
- Evgenia Gourgari
- Division of Pediatric Endocrinology Department of Pediatrics Georgetown University Washington DC USA
| | - Kristen J Nadeau
- Division of Pediatric Endocrinology Department of Pediatrics University of Colorado Anschutz Medical Campus Aurora CO USA
| | - Laura Pyle
- Division of Pediatric Endocrinology Department of Pediatrics University of Colorado Anschutz Medical Campus Aurora CO USA.,Department of Biostatistics and Informatics Colorado School of Public Health Aurora CO USA
| | - Martin P Playford
- Section of Inflammation and Cardiometabolic Diseases National Heart, Lung, and Blood Institute National Institutes of Health Bethesda MD USA
| | - Junfeng Ma
- Proteomics and Metabolomics Shared Resource Georgetown University Medical Center Washington DC USA
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases National Heart, Lung, and Blood Institute National Institutes of Health Bethesda MD USA
| | - Alan T Remaley
- Lipoprotein Metabolism Section National Heart, Lung and Blood Institute National Institutes of Health Bethesda MD USA
| | - Scott M Gordon
- Saha Cardiovascular Research Center University of Kentucky Lexington KY USA.,Department of Physiology University of Kentucky Lexington KY USA
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Bonacina F, Pirillo A, Catapano AL, Norata GD. HDL in Immune-Inflammatory Responses: Implications beyond Cardiovascular Diseases. Cells 2021; 10:cells10051061. [PMID: 33947039 PMCID: PMC8146776 DOI: 10.3390/cells10051061] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 12/15/2022] Open
Abstract
High density lipoproteins (HDL) are heterogeneous particles composed by a vast array of proteins and lipids, mostly recognized for their cardiovascular (CV) protective effects. However, evidences from basic to clinical research have contributed to depict a role of HDL in the modulation of immune-inflammatory response thus paving the road to investigate their involvement in other diseases beyond those related to the CV system. HDL-C levels and HDL composition are indeed altered in patients with autoimmune diseases and usually associated to disease severity. At molecular levels, HDL have been shown to modulate the anti-inflammatory potential of endothelial cells and, by controlling the amount of cellular cholesterol, to interfere with the signaling through plasma membrane lipid rafts in immune cells. These findings, coupled to observations acquired from subjects carrying mutations in genes related to HDL system, have helped to elucidate the contribution of HDL beyond cholesterol efflux thus posing HDL-based therapies as a compelling interventional approach to limit the inflammatory burden of immune-inflammatory diseases.
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Affiliation(s)
- Fabrizia Bonacina
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy;
| | - Angela Pirillo
- Center for the Study of Atherosclerosis, E. Bassini Hospital, Cinisello Balsamo, 20092 Milan, Italy;
- IRCCS MultiMedica, Sesto S. Giovanni, 20099 Milan, Italy
| | - Alberico L. Catapano
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy;
- IRCCS MultiMedica, Sesto S. Giovanni, 20099 Milan, Italy
- Correspondence: (A.L.C.); (G.D.N.)
| | - Giuseppe D. Norata
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy;
- Center for the Study of Atherosclerosis, E. Bassini Hospital, Cinisello Balsamo, 20092 Milan, Italy;
- Correspondence: (A.L.C.); (G.D.N.)
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31
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Garshick MS, Ward NL, Krueger JG, Berger JS. Cardiovascular Risk in Patients With Psoriasis: JACC Review Topic of the Week. J Am Coll Cardiol 2021; 77:1670-1680. [PMID: 33795041 DOI: 10.1016/j.jacc.2021.02.009] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/21/2021] [Accepted: 02/01/2021] [Indexed: 12/11/2022]
Abstract
Psoriasis is a chronic inflammatory skin disease that affects 2% to 3% of the U.S. population. The immune response in psoriasis includes enhanced activation of T cells and myeloid cells, platelet activation, and up-regulation of interferons, tumor necrosis factor-α, and interleukins (ILs) IL-23, IL-17, and IL-6, which are linked to vascular inflammation and atherosclerosis development. Patients with psoriasis are up to 50% more likely to develop cardiovascular disease (CV) disease, and this CV risk increases with skin severity. Major society guidelines now advocate incorporating a psoriasis diagnosis into CV risk prediction and prevention strategies. Although registry data suggest treatment targeting psoriasis skin disease reduces vascular inflammation and coronary plaque burden, and may reduce CV risk, randomized placebo-controlled trials are inconclusive to date. Further studies are required to define traditional CV risk factor goals, the optimal role of lipid-lowering and antiplatelet therapy, and targeted psoriasis therapies on CV risk.
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Affiliation(s)
- Michael S Garshick
- Center for the Prevention of Cardiovascular Disease and Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York, USA.
| | - Nicole L Ward
- Departments of Nutrition and Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - James G Krueger
- Laboratory for Investigative Dermatology, Rockefeller University, New York, New York, USA
| | - Jeffrey S Berger
- Center for the Prevention of Cardiovascular Disease and Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York, USA; Division of Hematology, Department of Medicine, New York University School of Medicine, New York, New York, USA; Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, New York, New York, USA
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32
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Casey KA, Smith MA, Sinibaldi D, Seto NL, Playford MP, Wang X, Carlucci PM, Wang L, Illei G, Yu B, Wang S, Remaley AT, Mehta NN, Kaplan MJ, White WI. Modulation of Cardiometabolic Disease Markers by Type I Interferon Inhibition in Systemic Lupus Erythematosus. Arthritis Rheumatol 2021; 73:459-471. [PMID: 32909675 PMCID: PMC11302498 DOI: 10.1002/art.41518] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 09/03/2020] [Indexed: 08/08/2024]
Abstract
OBJECTIVE Neutrophil dysregulation and the type I interferon (IFN) axis have been proposed to contribute to premature cardiovascular disease, a leading cause of mortality in patients with systemic lupus erythematosus (SLE). In the present study, we evaluated the ability of anifrolumab, a type I IFN receptor-blocking antibody, to reduce neutrophil extracellular trap (NET) formation and modulate cardiometabolic disease markers in comparison to placebo. METHODS Study subjects comprised patients with moderate-to-severe SLE who were enrolled in phase IIb of the MUSE trial (A Phase II, Randomized Study to Evaluate the Efficacy and Safety of MEDI-546 in Subjects with Systemic Lupus Erythematosus), with healthy individuals as controls. Blood samples were collected from SLE patients (n = 305) and healthy controls (n = 10-20) before the initiation of treatment (baseline) and from SLE patients after they had been treated with 300 mg of anifrolumab (n = 99) or placebo (n = 102). Baseline IFN gene signature test status was determined, and the IFN gene signature (21-gene panel) was monitored over time. Serum proteins were measured by multiplex immunoassay or ultrasensitive Simoa assay. NET complexes, cholesterol efflux capacity (CEC), and glycoprotein acetylation (GlycA) and other lipid parameters were assessed in plasma. RESULTS Formation of NET complexes and levels of tumor necrosis factor (TNF) and interleukin-10 (IL-10) were correlated with extent of type I IFN pathway activity. NET complexes and IL-10 levels were up-regulated in SLE patients compared to healthy controls (P < 0.008). The cardiometabolic disease markers CEC and GlycA were also found to be dysregulated in patients with SLE (P < 0.001 versus healthy controls). Type I IFN receptor inhibition with anifrolumab significantly reduced NET complexes and GlycA and improved CEC compared to baseline (P < 0.05) whereas no improvements were seen with placebo. Levels of TNF and IL-10 were reduced with anifrolumab compared to placebo (P < 0.05). CONCLUSION These data support a key role for type I IFNs in modulating factors contributing to SLE vasculopathy and suggest that inhibition of this pathway could decrease cardiovascular risk in individuals with SLE.
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Affiliation(s)
| | | | | | - Nickie L. Seto
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | | | - Xinghao Wang
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Philip M. Carlucci
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | | | | | | | | | - Alan T. Remaley
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Nehal N. Mehta
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Mariana J. Kaplan
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
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Srivastava AK, Chand Yadav T, Khera HK, Mishra P, Raghuwanshi N, Pruthi V, Prasad R. Insights into interplay of immunopathophysiological events and molecular mechanistic cascades in psoriasis and its associated comorbidities. J Autoimmun 2021; 118:102614. [PMID: 33578119 DOI: 10.1016/j.jaut.2021.102614] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023]
Abstract
Psoriasis is an inflammatory skin disease with complex pathogenesis and multiple etiological factors. Besides the essential role of autoreactive T cells and constellation of cytokines, the discovery of IL-23/Th17 axis as a central signaling pathway has unraveled the mechanism of accelerated inflammation in psoriasis. This has provided insights into psoriasis pathogenesis and revolutionized the development of effective biological therapies. Moreover, genome-wide association studies have identified several candidate genes and susceptibility loci associated with this disease. Although involvement of cellular innate and adaptive immune responses and dysregulation of immune cells have been implicated in psoriasis initiation and maintenance, there is still a lack of unifying mechanism for understanding the pathogenesis of this disease. Emerging evidence suggests that psoriasis is a high-mortality disease with additional burden of comorbidities, which adversely affects the treatment response and overall quality of life of patients. Furthermore, changing trends of psoriasis-associated comorbidities and shared patterns of genetic susceptibility, risk factors and pathophysiological mechanisms manifest psoriasis as a multifactorial systemic disease. This review highlights the recent progress in understanding the crucial role of different immune cells, proinflammatory cytokines and microRNAs in psoriasis pathogenesis. In addition, we comprehensively discuss the involvement of various complex signaling pathways and their interplay with immune cell markers to comprehend the underlying pathophysiological mechanism, which may lead to exploration of new therapeutic targets and development of novel treatment strategies to reduce the disastrous nature of psoriasis and associated comorbidities.
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Affiliation(s)
- Amit Kumar Srivastava
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India
| | - Tara Chand Yadav
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India
| | - Harvinder Kour Khera
- Tata Institute for Genetics and Society, Centre at InStem, Bangalore, 560065, Karnataka, India; Division of Biological Sciences, University of California, San Diego, La Jolla, CA, 92093, United States
| | - Purusottam Mishra
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India
| | - Navdeep Raghuwanshi
- Vaccine Formulation & Research Center, Gennova (Emcure) Biopharmaceuticals Limited, Pune, 411057, Maharashtra, India
| | - Vikas Pruthi
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India
| | - Ramasare Prasad
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India.
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Teklu M, Zhou W, Kapoor P, Patel N, Dey AK, Sorokin AV, Manyak GA, Teague HL, Erb-Alvarez JA, Sajja A, Abdelrahman KM, Reddy AS, Uceda DE, Lateef SS, Shanbhag SM, Scott C, Prakash N, Svirydava M, Parel P, Rodante JA, Keel A, Siegel EL, Chen MY, Bluemke DA, Playford MP, Gelfand JM, Mehta NN. Metabolic syndrome and its factors are associated with noncalcified coronary burden in psoriasis: An observational cohort study. J Am Acad Dermatol 2021; 84:1329-1338. [PMID: 33383084 DOI: 10.1016/j.jaad.2020.12.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/10/2020] [Accepted: 12/16/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Psoriasis is associated with a heightened risk of cardiovascular disease and higher prevalence of metabolic syndrome. OBJECTIVE Investigate the effect of metabolic syndrome and its factors on early coronary artery disease assessed as noncalcified coronary burden by coronary computed tomography angiography in psoriasis. METHODS This cross-sectional study consisted of 260 participants with psoriasis and coronary computed tomography angiography characterization. Metabolic syndrome was defined according to the harmonized International Diabetes Federation criteria. RESULTS Of the 260 participants, 80 had metabolic syndrome (31%). The metabolic syndrome group had a higher burden of cardiometabolic disease, systemic inflammation, noncalcified coronary burden, and high-risk coronary plaque. After adjusting for Framingham risk score, lipid-lowering therapy, and biologic use, metabolic syndrome (β = .31; P < .001) and its individual factors of waist circumference (β = .33; P < .001), triglyceride levels (β = .17; P = .005), blood pressure (β = .18; P = .005), and fasting glucose (β = .17; P = .009) were significantly associated with noncalcified coronary burden. After adjusting for all other metabolic syndrome factors, blood pressure and waist circumference remained significantly associated with noncalcified coronary burden. LIMITATIONS Observational nature with limited ability to control for confounders. CONCLUSIONS In psoriasis, individuals with metabolic syndrome had more cardiovascular disease risk factors, systemic inflammation, and noncalcified coronary burden. Efforts to increase metabolic syndrome awareness in psoriasis should be undertaken to reduce the heightened cardiovascular disease risk.
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Affiliation(s)
- Meron Teklu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Wunan Zhou
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Promita Kapoor
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Nidhi Patel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Amit K Dey
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Alexander V Sorokin
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Grigory A Manyak
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Heather L Teague
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Julie A Erb-Alvarez
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Aparna Sajja
- Department of Internal Medicine, Johns Hopkins University Medical Center, Baltimore, Maryland
| | - Khaled M Abdelrahman
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Aarthi S Reddy
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Domingo E Uceda
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Sundus S Lateef
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Sujata M Shanbhag
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Colin Scott
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Nina Prakash
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Maryia Svirydava
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Philip Parel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Justin A Rodante
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Andrew Keel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Evan L Siegel
- Department of Rheumatology, Arthritis and Rheumatism Associates, Rockville, Maryland
| | - Marcus Y Chen
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - David A Bluemke
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Martin P Playford
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Joel M Gelfand
- Department of Dermatology, Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Nehal N Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
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High-Density Lipoprotein (HDL) in Allergy and Skin Diseases: Focus on Immunomodulating Functions. Biomedicines 2020; 8:biomedicines8120558. [PMID: 33271807 PMCID: PMC7760586 DOI: 10.3390/biomedicines8120558] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/27/2020] [Accepted: 11/28/2020] [Indexed: 02/07/2023] Open
Abstract
From an evolutionary perspective, lipoproteins are not only lipid transporters, but they also have important functions in many aspects of immunity. High-density lipoprotein (HDL) particles are the most abundant lipoproteins and the most heterogeneous in terms of their composition, structure, and biological functions. Despite strong evidence that HDL potently influences the activity of several immune cells, the role of HDL in allergies and skin diseases is poorly understood. Alterations in HDL-cholesterol levels have been observed in allergic asthma, allergic rhinitis, atopic dermatitis (eczema), psoriasis, urticaria, and angioedema. HDL-associated apolipoprotein (apo) A-I, apoA-IV, and apoC-III, and lyso-phosphatidylcholines potently suppress immune cell effector responses. Interestingly, recent studies provided evidence that allergies and skin diseases significantly affect HDL composition, metabolism, and function, which, in turn, could have a significant impact on disease progression, but may also affect the risk of cardiovascular disease and infections. Interestingly, not only a loss in function, but also, sometimes, a gain in function of certain HDL properties is observed. The objective of this review article is to summarize the newly identified changes in the metabolism, composition, and function of HDL in allergies and skin diseases. We aim to highlight the possible pathophysiological consequences with a focus on HDL-mediated immunomodulatory activities.
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Zong J, Cheng J, Fu Y, Song J, Pan W, Yang L, Zhang T, Zhou M. Serum Metabolomic Profiling Reveals the Amelioration Effect of Methotrexate on Imiquimod-Induced Psoriasis in Mouse. Front Pharmacol 2020; 11:558629. [PMID: 33364938 PMCID: PMC7751755 DOI: 10.3389/fphar.2020.558629] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 10/12/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The imiquimod (IMQ)-induced psoriasis mouse model has been used as a model for pathogenic mechanism research, and methotrexate (MTX) is widely employed to treat various clinical manifestations of psoriasis. We explored the underlying pathogenesis of psoriasis and the treatment mechanism of the conventional drugs from the metabolic perspective of the psoriasis mouse model. METHODS Male BALB/c mice were smeared IMQ for 7 days to induce treatment-resistant psoriasis and intragastrically administered 1 mg/kg MTX. We evaluated inflammation of psoriasis-like lesions and therapeutic effects of MTX based on histological changes and immunohistochemistry. Based on gas chromatography-mass spectrometer detection of serum samples, a comprehensive metabolomics analysis was carried out to identify alterations of metabolites. RESULTS It was found that MTX ameliorated psoriatic lesions (representative erythema, scaling, and thickening) by inhibiting proliferation and differentiation of keratinocytes. Using multivariate statistical analysis to process metabolomics data, the results displayed alterations in serum metabolites among mice of the control group, IMQ group, and MTX group. Compared with group, psoriasis mice had the higher level of d-galactose and lower expression of myo-inositol, 9,12-octadecadienoic acid, and cholesterol. In contrast with the model set, serum levels of glycine, pyrrolidone carboxylic acid, d-galactose, and d-mannose were significantly decreased in the MTX group. CONCLUSION The differential metabolites, reflecting the perturbation in the pathways of inositol phosphate metabolism; galactose metabolism; glyoxylate and dicarboxylate metabolism; glycine, serine, and threonine metabolism; and glutathione metabolism, may lead to the pathogenesis of psoriasis, and they are also related to the pharmacological treatment effect of MTX on psoriasis. This study established the foundation for further research on the mechanism and therapeutic targets of psoriasis.
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Affiliation(s)
- Jiaxin Zong
- Murad Research Center for Modernized Chinese Medicine, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jieyi Cheng
- Center for Chinese Medicine Therapy and Systems Biology, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuanfeng Fu
- Murad Research Center for Modernized Chinese Medicine, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Song
- Center for Chinese Medicine Therapy and Systems Biology, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Weisong Pan
- Guangzhou Institute for Drug Control, Guangzhou, China
| | - Li Yang
- Center for Chinese Medicine Therapy and Systems Biology, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ting Zhang
- Murad Research Center for Modernized Chinese Medicine, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mingmei Zhou
- Center for Chinese Medicine Therapy and Systems Biology, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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37
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Aksentijevich M, Lateef SS, Anzenberg P, Dey AK, Mehta NN. Chronic inflammation, cardiometabolic diseases and effects of treatment: Psoriasis as a human model. Trends Cardiovasc Med 2020; 30:472-478. [PMID: 31837960 PMCID: PMC7428846 DOI: 10.1016/j.tcm.2019.11.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/22/2019] [Accepted: 11/02/2019] [Indexed: 01/25/2023]
Abstract
Chronic inflammation in humans is associated with accelerated development of cardiometabolic diseases such as myocardial infarction, stroke, and diabetes. Strong evidence from animal models and human interventional trials including CANTOS (The Canakinumab Anti-inflammatory Thrombosis Outcome Study) suggests that targeting residual systemic inflammation in humans may impart a benefit in reducing cardiometabolic diseases. Diseases associated with heightened immune-activation and systemic inflammation including psoriasis, rheumatoid arthritis, systemic lupus erythematosus, and human immunodeficiency virus infection are associated with upwards of two to seven-fold risk of future adverse cardiac events even when adjusted for traditional risk factors. Over the past decade, psoriasis has been utilized as a human model to study inflammatory-induced cardiometabolic dysfunction and to better understand residual risk due to inflammation. The high prevalence and early onset of cardiovascular disease in psoriasis enhances the likelihood of discovering novel pathways in vascular disease progression when followed over time. Furthermore, the United States Food and Drug Administration approved treatments for psoriasis include cytokine inhibitors (anti-tumor necrosis factor, anti-interleukin 17, anti-interleukin 12/23) which while treating the skin disease provide a unique opportunity to characterize how treating the inflammatory pathways may impact atherosclerosis. Herein, we provide a review of chronic inflammation, cardiometabolic disease associations, and treatment effects with a focus on psoriasis as a human model of study.
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Affiliation(s)
- Milena Aksentijevich
- National Heart, Lung, Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140 Bethesda, MD 20892, USA
| | - Sundus S Lateef
- National Heart, Lung, Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140 Bethesda, MD 20892, USA
| | - Paula Anzenberg
- National Heart, Lung, Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140 Bethesda, MD 20892, USA
| | - Amit K Dey
- National Heart, Lung, Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140 Bethesda, MD 20892, USA
| | - Nehal N Mehta
- National Heart, Lung, Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140 Bethesda, MD 20892, USA.
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Sorokin AV, Remaley AT, Mehta NN. Oxidized Lipids and Lipoprotein Dysfunction in Psoriasis. JOURNAL OF PSORIASIS AND PSORIATIC ARTHRITIS 2020; 5:139-146. [PMID: 33163854 PMCID: PMC7646705 DOI: 10.1177/2475530320950268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Psoriasis is a chronic immune-mediated inflammatory skin disease associated with increased development of metabolic abnormalities including obesity and dyslipidemia, as well as increased cardiovascular disease (CVD) risk. Shared pathophysiological mechanisms linking psoriasis to CVD include altered immune activation, elevated chronic systemic inflammation, and lipoprotein dysfunction characterized by oxidative damage to lipids and apolipoproteins. OBJECTIVE This review aims to provide evidence-based proof for existing relationships between psoriatic inflammation, lipid oxidation, and increased CVD risk. METHODS We included review articles and original research papers, published between 1980 and 2020, using the following key words: psoriasis, oxidized lipids, oxidation, dyslipidemia, and inflammation. RESULTS Systemic inflammation underlying psoriasis leads to increased skin accumulation of pro-inflammatory oxidized lipids, derived from the omega-6 fatty acids, along with counteracting anti-inflammatory lipid mediators, products of the omega-3 polyunsaturated fatty acids. Imbalance in these metabolites culminates in impaired inflammation resolution and results in multisystemic biological alterations. Sustained systemic inflammation results in excessive lipid oxidation, generating proatherogenic oxidized low- and high-density lipoproteins. Together, these pathophysiological mechanisms contribute to increased CVD risk associated with psoriasis disease. CONCLUSION Available anti-inflammatory treatment showed promising clinical results in treating psoriasis, although further research is warranted on managing associated dyslipidemia and establishing novel cardiometabolic markers specific for both skin and vascular pathology.
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Affiliation(s)
- Alexander V. Sorokin
- Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Alan T. Remaley
- Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nehal N. Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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Sands BE, Colombel JF, Ha C, Farnier M, Armuzzi A, Quirk D, Friedman GS, Kwok K, Salese L, Su C, Taub PR. Lipid Profiles in Patients With Ulcerative Colitis Receiving Tofacitinib-Implications for Cardiovascular Risk and Patient Management. Inflamm Bowel Dis 2020; 27:797-808. [PMID: 32870265 PMCID: PMC8128390 DOI: 10.1093/ibd/izaa227] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Patients with ulcerative colitis (UC) are at elevated risk of cardiovascular disease vs the general population, despite a lower prevalence of traditional risk factors, including hyperlipidemia. Mechanistic studies in patients with rheumatoid arthritis and psoriasis suggest that tofacitinib restores serum lipids to preinflammation levels by reversing inflammation-induced cholesterol metabolism changes. We reviewed data on lipid levels and cardiovascular events, alongside recommendations for managing lipid levels during tofacitinib treatment in patients with UC, based on up-to-date expert guidelines. METHODS Data were identified from a phase 3/open-label, long-term extension (OLE) tofacitinib UC clinical program (cutoff May 27, 2019). Literature was identified from PubMed (search terms "lipid," "cholesterol," "lipoprotein," "cardiovascular," "inflammation," "atherosclerosis," "tofacitinib," "rheumatoid arthritis," "psoriasis," "inflammatory bowel disease," "ulcerative colitis," "hyperlipidemia," and "guidelines") and author knowledge. Data were available from 4 phase 3 clinical trials of 1124 patients with moderately to severely active UC who received ≥1 dose of tofacitinib 5 or 10 mg twice daily in induction (two identical trials), maintenance, and OLE studies (treatment duration ≤6.8 years; 2576.4 patient-years of drug exposure). RESULTS In the OLE study, tofacitinib treatment was not associated with major changes from baseline in total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, total cholesterol/high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol, with lipid levels and ratios generally remaining stable over time. The major adverse cardiovascular events incidence rate was 0.26/100 patient-years (95% confidence interval, 0.11-0.54). CONCLUSIONS Lipid levels and ratios remained generally unchanged from baseline in the OLE study after tofacitinib treatment, and major adverse cardiovascular events were infrequent. Long-term studies are ongoing. CLINICALTRIALS.GOV IDENTIFIERS NCT01465763, NCT01458951, NCT01458574, NCT01470612.
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Affiliation(s)
- Bruce E Sands
- Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA,Address correspondence to: Bruce E. Sands, MD, Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1069, New York, NY 10029 ()
| | - Jean-Frédéric Colombel
- Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Christina Ha
- Inflammatory Bowel Disease Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Michel Farnier
- PEC2, EA 7460, University of Bourgogne—Franche Comté and Department of Cardiology, CHU Dijon-Bourgogne, Dijon, France
| | - Alessandro Armuzzi
- IBD Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniel Quirk
- Inflammation & Immunology, Pfizer Inc, Collegeville, Pennsylvania, USA
| | - Gary S Friedman
- Inflammation & Immunology, Pfizer Inc, Collegeville, Pennsylvania, USA
| | - Kenneth Kwok
- Inflammation & Immunology, Pfizer Inc, New York, New York, USA
| | - Leonardo Salese
- Inflammation & Immunology, Pfizer Inc, Collegeville, Pennsylvania, USA
| | - Chinyu Su
- Inflammation & Immunology, Pfizer Inc, Collegeville, Pennsylvania, USA
| | - Pam R Taub
- Division of Cardiovascular Medicine, University of California, San Diego, California, USA
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Baumer Y, Dey AK, Gutierrez-Huerta CA, Khalil NO, Sekine Y, Sanda GE, Zhuang J, Saxena A, Stempinski E, Elnabawi YA, Dagur PK, Ng Q, Teague HL, Keel A, Rodante JA, Boisvert WA, Tsoi LC, Gudjonsson JE, Bleck CKE, Chen MY, Bluemke DA, Gelfand JM, Schwartz DM, Kruth HS, Powell-Wiley TM, Playford MP, Mehta NN. Hyperlipidaemia and IFNgamma/TNFalpha Synergism are associated with cholesterol crystal formation in Endothelial cells partly through modulation of Lysosomal pH and Cholesterol homeostasis. EBioMedicine 2020; 59:102876. [PMID: 32646751 PMCID: PMC7502673 DOI: 10.1016/j.ebiom.2020.102876] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Inflammation plays an important role in the development of cardiovascular disease (CVD). Patients with chronic inflammation diseases have high levels of inflammation and early fatal myocardial infarction due to early, unstable coronary plaques. Cholesterol crystals (CC) play a key role in atherogenesis. However, the underlying mechanisms of endothelial cell (EC)-derived CC formation are not well understood in chronic inflammation. METHODS We utilized a combination of a mouse psoriasis model (K14-Rac1V12 mouse model) and human psoriasis patients to study the effect of inflammatory cytokines on CC formation in ECs. Lysosomal pH, alterations in lipid load and inflammatory proteins were evaluated as potential mechanisms linking inflammatory cytokines to CC formation. Coronary CT angiography was performed (n = 224) to characterize potential IFNγ and TNFα synergism on vascular diseases in vivo. FINDINGS We detected CC presence in the aorta of K14-Rac1V12 mice on chow diet. IFNγ and TNFα were found to synergistically increase LDL-induced CC formation by almost 2-fold. There was an increase in lysosomal pH accompanied by a 28% loss in pH-dependent lysosomal signal and altered vATPaseV1E1 expression patterns. In parallel, we found that LDL+IFNγ/TNFα treatments increased free cholesterol content within EC and led to a decrease in SOAT-1 expression, an enzyme critically involved cholesterol homeostasis. Finally, the product of IFNγ and TNFα positively associated with early non-calcified coronary burden in patients with psoriasis (n = 224; β = 0.28, p < 0.001). INTERPRETATION Our results provide evidence that IFNγ and TNFα accelerate CC formation in endothelial cells in part by altering lysosomal pH and free cholesterol load. These changes promote early atherogenesis and contribute to understanding the burden of CVD in psoriasis. FUNDING Funding was provided by the Intramural Research Program at NIH (NNM) and the National Psoriasis Foundation (NNM and YB).
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Affiliation(s)
- Yvonne Baumer
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA; Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Amit K Dey
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Cristhian A Gutierrez-Huerta
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Noor O Khalil
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Yusuke Sekine
- Center for Molecular Medicine, National Heart Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Gregory E Sanda
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Jie Zhuang
- Cardiovascular and Cancer Genetics Laboratory, National Heart Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Ankit Saxena
- Flow Cytometry Core, National Heart Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Erin Stempinski
- Electron Microscopy Core Facility, National Heart, Lung, and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Youssef A Elnabawi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Pradeep K Dagur
- Flow Cytometry Core, National Heart Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Qimin Ng
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Heather L Teague
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Andrew Keel
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Justin A Rodante
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - William A Boisvert
- Center for Cardiovascular Research, John A Burns School of Medicine, University of Hawaii, 651 Ilalo Street, Honolulu, HI 96813, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, 1301 E. Catherine Street, Ann Arbor, MI 48109, USA
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan, 1301 E. Catherine Street, Ann Arbor, MI 48109, USA
| | - Christopher K E Bleck
- Electron Microscopy Core Facility, National Heart, Lung, and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Marcus Y Chen
- Section of Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - David A Bluemke
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA
| | - Joel M Gelfand
- Department of Dermatology, Hospital of the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Daniella M Schwartz
- Genetics and Pathogenesis of Allergy Section, National Institute of Allergy and Infectious Diseases, 10 Center Drive, Bethesda, MD 20892, USA
| | - Howard S Kruth
- Section of Experimental Atherosclerosis, National Heart, Lung, and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Tiffany M Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Martin P Playford
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA.
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Abstract
Psoriasis is a systemic inflammatory disorder that involves complex pathogenic interactions between the innate and adaptive immune systems. Individuals with psoriasis have an increased risk of developing other chronic health diseases such cardiovascular disorders. The high incidence of cardiovascular events in the population with psoriasis could be explained by several mechanisms. The high prevalence of traditional cardiovascular risk factors and metabolic abnormalities contributes to the high cardiovascular burden in patients with psoriasis. Likewise, the presence of systemic inflammation in combination with metabolic abnormalities may act in a synergistic manner to increase cardiovascular risk in these patients. This review focused on epidemiologic and clinical evidence linking psoriasis to cardiovascular risk factors and cardiovascular disease. We described the possible pathophysiological mechanisms that justify this association and analyzed the best way to stratify the cardiovascular risk in patients with psoriasis. We also described the usefulness of the therapies frequently used in cardiovascular prevention and analyzed the impact of the specific psoriasis medication on cardiovascular risk factors or major atherosclerotic events. Knowledge of the application of different cardiovascular prevention strategies could mean an advantage in performing the difficult task of estimating cardiovascular risk and treating cardiovascular risk factors in this particular group of patients.
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Affiliation(s)
- Walter Masson
- Hospital Italiano de Buenos Aires, Perón 4190, C1199ABB, Buenos Aires, Argentina.
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuénaga 980, C1115AAD, Buenos Aires, Argentina.
| | - Martín Lobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuénaga 980, C1115AAD, Buenos Aires, Argentina
| | - Graciela Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuénaga 980, C1115AAD, Buenos Aires, Argentina
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Comparison of Omega-3 Eicosapentaenoic Acid Versus Docosahexaenoic Acid-Rich Fish Oil Supplementation on Plasma Lipids and Lipoproteins in Normolipidemic Adults. Nutrients 2020; 12:nu12030749. [PMID: 32178279 PMCID: PMC7146314 DOI: 10.3390/nu12030749] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/05/2020] [Accepted: 03/08/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have both shared and different cardiovascular effects, and commonly used fish oil supplements have considerably varied EPA/DHA ratios. Aims: We compared the effects of fish oil supplements with different EPA/DHA ratios on lipoprotein metabolism. Methods: In a double-blind, randomized cross-over study, normolipidemic adults (n = 30) consumed 12 g/day of EPA-rich (EPA/DHA: 2.3) or DHA-rich (EPA/DHA: 0.3) fish oil for 8-weeks, separated by an 8-week washout period. Results: Both fish oil supplements similarly lowered plasma TG levels and TG-related NMR parameters versus baseline (p < 0.05). There were no changes in plasma cholesterol-related parameters due to either fish oil, although on-treatment levels for LDL particle number were slightly higher for DHA-rich oil compared with EPA-rich oil (p < 0.05). Both fish oil supplements similarly altered HDL subclass profile and proteome, and down regulated HDL proteins related to inflammation, with EPA-rich oil to a greater extent. Furthermore, EPA-rich oil increased apoM abundance versus DHA-rich oil (p < 0.05). Conclusions: Overall, fish oil supplements with varied EPA/DHA ratios had similar effects on total lipids/lipoproteins, but differences were observed in lipoprotein subfraction composition and distribution, which could impact on the use of EPA versus DHA for improving cardiovascular health.
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Akhtar A, Ahmad Hassali MA, Zainal H, Khan AH. Prevalence and treatment outcomes of skin infections among elderly population: a retrospective cross-sectional study. J DERMATOL TREAT 2020; 32:778-782. [PMID: 31916477 DOI: 10.1080/09546634.2020.1714539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Geriatric population is increasing day by day throughout the world and there is a critical need to provide them the best health services including dermatological care due to their weakened immune system. The main objective of this study is to determine the prevalence and factors affecting the treatment outcomes of skin infections among elderly population.Methods: A 5-year retrospective cross-sectional study was conducted at the Department of Dermatology, Hospital Pulau Pinang. Patients aged ≥65 years of age with confirmed diagnosis of skin infection were included in the study.Results: A total of 455 patients were included and the most prevalent skin infections were eczema (27.6%) followed by dermatitis (13.8%), xerosis (13.8%), and bullous pemphigoid (8.8%). Cloxacillin (18%), Tetracycline (7.9%), and Unasyn (Ampicillin and Sulbactam) (5.7%) are the common antibiotics prescribed to treat skin infections. Age, alcohol consumption, polypharmacy, and presence of other co-morbidities are the most important factors that affected the treatment outcomes of skin infections among geriatrics.Conclusion: Eczema is the most prevalent skin infection among the elderly population. Age, consumption of alcohol, usage of more than five medicines simultaneously, and presence of co-morbidities are the main factors that are involved in better treatment outcomes of skin infections among study population.
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Affiliation(s)
- Ali Akhtar
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Palau Pinang, Malaysia
| | - Mohamed Azmi Ahmad Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceuical Sciences, Universiti Sains Malaysia, Palau Pinang, Malaysia
| | - Hadzliana Zainal
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Palau Pinang, Malaysia
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Palau Pinang, Malaysia
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Hafiane A, Favari E, Daskalopoulou SS, Vuilleumier N, Frias MA. High-density lipoprotein cholesterol efflux capacity and cardiovascular risk in autoimmune and non-autoimmune diseases. Metabolism 2020; 104:154141. [PMID: 31923386 DOI: 10.1016/j.metabol.2020.154141] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/23/2019] [Accepted: 01/05/2020] [Indexed: 12/22/2022]
Abstract
Functional assessment of cholesterol efflux capacity (CEC) to high-density lipoprotein (HDL) is an emerging tool for evaluating morbidity and mortality associated with cardiovascular disease (CVD). By promoting macrophage reverse cholesterol transport (RCT), HDL-mediated CEC is believed to play an important role in atherosclerotic lesion progression in the vessel wall. Furthermore, recent evidence indicates that the typical inverse associations between various forms of CEC and CV events may be strongly modulated by environmental systemic factors and traditional CV risk factors, in addition to autoimmune diseases. These factors influence the complex and dynamic composition of HDL particles, which in turn positively or negatively affect HDL-CEC. Herein, we review recent findings connecting HDL-CEC to traditional CV risk factors and cardiometabolic conditions (non-autoimmune diseases) as well as autoimmune diseases, with a specific focus on how these factors may influence the associations between HDL-CEC and CVD risk.
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Affiliation(s)
- Anouar Hafiane
- Department of Medicine, Faculty of Medicine, Research Institute of the McGill University Health Centre, McGill University, 1001 Decarie Blvd, Bloc E01. 3370H, Montréal, Qc H4A 3J1, Canada.
| | - Elda Favari
- Department of Food and Drug, University of Parma, Parco Area delle Scienze, 27/A, 43124 Parma, Italy.
| | - Stella S Daskalopoulou
- Department of Medicine, Division of Internal Medicine, McGill University, Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, EM1.2230, Montreal, Quebec H4A 3J1, Canada.
| | - Nicolas Vuilleumier
- Division of Laboratory Medicine, Diagnostic Department, Geneva University Hospitals, 1211 Geneva, Switzerland; Division of Laboratory Medicine, Department of Medical Specialties, Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland.
| | - Miguel A Frias
- Division of Laboratory Medicine, Diagnostic Department, Geneva University Hospitals, 1211 Geneva, Switzerland; Division of Laboratory Medicine, Department of Medical Specialties, Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland.
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Li J, Zhou C, Xu H, Brook RD, Liu S, Yi T, Wang Y, Feng B, Zhao M, Wang X, Zhao Q, Chen J, Song X, Wang T, Liu S, Zhang Y, Wu R, Gao J, Pan B, Pennathur S, Rajagopalan S, Huo Y, Zheng L, Huang W. Ambient Air Pollution Is Associated With HDL (High-Density Lipoprotein) Dysfunction in Healthy Adults. Arterioscler Thromb Vasc Biol 2020; 39:513-522. [PMID: 30700134 DOI: 10.1161/atvbaha.118.311749] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective- We aimed to assess whether exposure to higher levels of ambient air pollution impairs HDL (high-density lipoprotein) function and to elucidate the underlying biological mechanisms potentially involved. Approach and Results- In the Beijing AIRCHD study (Air Pollution and Cardiovascular Dysfunction in Healthy Adults), 73 healthy adults (23.3±5.4 years) were followed-up with 4 repeated study visits in 2014 to 2016. During each visit, ambient air pollution concentrations, HDL function metrics, and parameters of inflammation and oxidative stress were measured. Average daily concentrations of ambient particulate matter in diameter <2.5 μm were 62.9 µg/m3 (8.1-331.0 µg/m3). We observed significant decreases in HDL cholesterol efflux capacity of 2.3% (95% CI, -4.3 to -0.3) to 5.0% (95% CI, -7.6 to -2.4) associated with interquartile range increases in moving average concentrations of particulate matter in diameter <2.5 μm and traffic-related air pollutants (black carbon, nitrogen dioxide, and carbon monoxide) during the 1 to 7 days before each participant's clinic visit. Higher ambient air pollutant levels were also associated with significant reductions in circulating HDL cholesterol and apoA-I (apolipoprotein A-I), as well as elevations in HDL oxidation index, oxidized LDL (low-density lipoprotein), malondialdehyde, and high-sensitivity C-reactive protein. Conclusions- Higher ambient air pollution concentrations were associated with impairments in HDL functionality, potentially because of systemic inflammation and oxidative stress. These novel findings further our understanding of the mechanisms whereby air pollutants promote cardiometabolic disorders.
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Affiliation(s)
- Jianping Li
- From the Division of Cardiology, Peking University First Hospital, Beijing (J.L., S.L., T.Y., Y.H.).,Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center (J.L., C.Z., H.X., S.L., T.Y., B.F., M.Z., X.W., Q.Z., S.L., Y.Z., R.W., X.S., T.W., J.G., B.P., Y.H., L.Z., W.H.), Peking University, Beijing
| | - Changping Zhou
- Institute of Cardiovascular Sciences (C.Z., M.Z., X.W., J.G., B.P., L.Z.), Peking University School of Basic Medical Sciences, Beijing.,Institute of Systems Biomedicine (C.Z., M.Z., X.W., J.G., B.P., L.Z.), Peking University School of Basic Medical Sciences, Beijing.,Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center (J.L., C.Z., H.X., S.L., T.Y., B.F., M.Z., X.W., Q.Z., S.L., Y.Z., R.W., X.S., T.W., J.G., B.P., Y.H., L.Z., W.H.), Peking University, Beijing
| | - Hongbing Xu
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine (H.X., B.F., Q.Z., S.L., Y.Z., R.W., X.S., T.W., W.H., J.C.).,Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center (J.L., C.Z., H.X., S.L., T.Y., B.F., M.Z., X.W., Q.Z., S.L., Y.Z., R.W., X.S., T.W., J.G., B.P., Y.H., L.Z., W.H.), Peking University, Beijing
| | - Robert D Brook
- Division of Cardiovascular Medicine (R.D.B.), University of Michigan, Ann Arbor
| | - Shengcong Liu
- From the Division of Cardiology, Peking University First Hospital, Beijing (J.L., S.L., T.Y., Y.H.).,Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center (J.L., C.Z., H.X., S.L., T.Y., B.F., M.Z., X.W., Q.Z., S.L., Y.Z., R.W., X.S., T.W., J.G., B.P., Y.H., L.Z., W.H.), Peking University, Beijing
| | - Tieci Yi
- From the Division of Cardiology, Peking University First Hospital, Beijing (J.L., S.L., T.Y., Y.H.)
| | - Yang Wang
- Department of Prevention and Health Care, Hospital of Health Science Center (Y.W.), Peking University, Beijing
| | - Baihuan Feng
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine (H.X., B.F., Q.Z., S.L., Y.Z., R.W., X.S., T.W., W.H., J.C.)
| | - Mingming Zhao
- Institute of Cardiovascular Sciences (C.Z., M.Z., X.W., J.G., B.P., L.Z.), Peking University School of Basic Medical Sciences, Beijing.,Institute of Systems Biomedicine (C.Z., M.Z., X.W., J.G., B.P., L.Z.), Peking University School of Basic Medical Sciences, Beijing
| | - Xu Wang
- Institute of Cardiovascular Sciences (C.Z., M.Z., X.W., J.G., B.P., L.Z.), Peking University School of Basic Medical Sciences, Beijing.,Institute of Systems Biomedicine (C.Z., M.Z., X.W., J.G., B.P., L.Z.), Peking University School of Basic Medical Sciences, Beijing
| | - Qian Zhao
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine (H.X., B.F., Q.Z., S.L., Y.Z., R.W., X.S., T.W., W.H., J.C.)
| | - Jie Chen
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine (H.X., B.F., Q.Z., S.L., Y.Z., R.W., X.S., T.W., W.H., J.C.).,Institute for Risk Assessment Sciences (J.C.), University Medical Centre Utrecht, University of Utrecht, the Netherlands.,Julius Centre for Health Sciences and Primary Care (J.C.), University Medical Centre Utrecht, University of Utrecht, the Netherlands
| | - Xiaoming Song
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine (H.X., B.F., Q.Z., S.L., Y.Z., R.W., X.S., T.W., W.H., J.C.).,Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center (J.L., C.Z., H.X., S.L., T.Y., B.F., M.Z., X.W., Q.Z., S.L., Y.Z., R.W., X.S., T.W., J.G., B.P., Y.H., L.Z., W.H.), Peking University, Beijing
| | - Tong Wang
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine (H.X., B.F., Q.Z., S.L., Y.Z., R.W., X.S., T.W., W.H., J.C.).,Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center (J.L., C.Z., H.X., S.L., T.Y., B.F., M.Z., X.W., Q.Z., S.L., Y.Z., R.W., X.S., T.W., J.G., B.P., Y.H., L.Z., W.H.), Peking University, Beijing
| | - Shuo Liu
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine (H.X., B.F., Q.Z., S.L., Y.Z., R.W., X.S., T.W., W.H., J.C.)
| | - Yi Zhang
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine (H.X., B.F., Q.Z., S.L., Y.Z., R.W., X.S., T.W., W.H., J.C.).,Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center (J.L., C.Z., H.X., S.L., T.Y., B.F., M.Z., X.W., Q.Z., S.L., Y.Z., R.W., X.S., T.W., J.G., B.P., Y.H., L.Z., W.H.), Peking University, Beijing
| | - Rongshan Wu
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine (H.X., B.F., Q.Z., S.L., Y.Z., R.W., X.S., T.W., W.H., J.C.).,Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center (J.L., C.Z., H.X., S.L., T.Y., B.F., M.Z., X.W., Q.Z., S.L., Y.Z., R.W., X.S., T.W., J.G., B.P., Y.H., L.Z., W.H.), Peking University, Beijing
| | - Jianing Gao
- Institute of Cardiovascular Sciences (C.Z., M.Z., X.W., J.G., B.P., L.Z.), Peking University School of Basic Medical Sciences, Beijing.,Institute of Systems Biomedicine (C.Z., M.Z., X.W., J.G., B.P., L.Z.), Peking University School of Basic Medical Sciences, Beijing.,Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center (J.L., C.Z., H.X., S.L., T.Y., B.F., M.Z., X.W., Q.Z., S.L., Y.Z., R.W., X.S., T.W., J.G., B.P., Y.H., L.Z., W.H.), Peking University, Beijing
| | - Bing Pan
- Institute of Cardiovascular Sciences (C.Z., M.Z., X.W., J.G., B.P., L.Z.), Peking University School of Basic Medical Sciences, Beijing.,Institute of Systems Biomedicine (C.Z., M.Z., X.W., J.G., B.P., L.Z.), Peking University School of Basic Medical Sciences, Beijing.,Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center (J.L., C.Z., H.X., S.L., T.Y., B.F., M.Z., X.W., Q.Z., S.L., Y.Z., R.W., X.S., T.W., J.G., B.P., Y.H., L.Z., W.H.), Peking University, Beijing
| | | | - Sanjay Rajagopalan
- Division of Cardiovascular Medicine, Case Western Reserve Medical School, Cleveland OH (S.R.), Peking University, Beijing
| | - Yong Huo
- From the Division of Cardiology, Peking University First Hospital, Beijing (J.L., S.L., T.Y., Y.H.).,Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center (J.L., C.Z., H.X., S.L., T.Y., B.F., M.Z., X.W., Q.Z., S.L., Y.Z., R.W., X.S., T.W., J.G., B.P., Y.H., L.Z., W.H.), Peking University, Beijing
| | - Lemin Zheng
- Institute of Cardiovascular Sciences (C.Z., M.Z., X.W., J.G., B.P., L.Z.), Peking University School of Basic Medical Sciences, Beijing.,Institute of Systems Biomedicine (C.Z., M.Z., X.W., J.G., B.P., L.Z.), Peking University School of Basic Medical Sciences, Beijing.,Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center (J.L., C.Z., H.X., S.L., T.Y., B.F., M.Z., X.W., Q.Z., S.L., Y.Z., R.W., X.S., T.W., J.G., B.P., Y.H., L.Z., W.H.), Peking University, Beijing
| | - Wei Huang
- Department of Occupational and Environmental Health, Peking University School of Public Health, Peking University Institute of Environmental Medicine (H.X., B.F., Q.Z., S.L., Y.Z., R.W., X.S., T.W., W.H., J.C.).,Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center (J.L., C.Z., H.X., S.L., T.Y., B.F., M.Z., X.W., Q.Z., S.L., Y.Z., R.W., X.S., T.W., J.G., B.P., Y.H., L.Z., W.H.), Peking University, Beijing
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46
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Yang ZH, Amar M, Sorokin AV, Troendle J, Courville AB, Sampson M, Playford MP, Yang S, Stagliano M, Ling C, Donkor K, Shamburek RD, Mehta NN, Remaley AT. Supplementation with saury oil, a fish oil high in omega-11 monounsaturated fatty acids, improves plasma lipids in healthy subjects. J Clin Lipidol 2020; 14:53-65.e2. [PMID: 31784345 PMCID: PMC8336206 DOI: 10.1016/j.jacl.2019.10.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 10/16/2019] [Accepted: 10/23/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Fish oil enriched in omega-11 long-chain monounsaturated fatty acids (LCMUFAs; C20:1 and C22:1 isomers combined) have shown lipid-lowering and atheroprotective effects in animal models. OBJECTIVE To perform a first-in-human trial of LCMUFA-rich saury fish oil supplementation to test its safety and possible effect on plasma lipids. METHODS A double-blind, randomized, crossover clinical trial was carried out in 30 healthy normolipidemic adults (BMI <25 kg/m2; mean TG, 84 mg/dL). Treatment periods of 8 weeks were separated by an 8-week washout period. Subjects were randomized to receive either 12 g of saury oil (3.5 g of LCMUFA and 3.4 g of omega-3 FAs) or identical capsules with control oil (a mixture of sardine and olive oil; 4.9 g of shorter-chain MUFA oleate and 3 g of omega-3 FAs). RESULTS Saury oil supplementation was safe and resulted in LDL particle counts 12% lower than control oil (P < .001). Saury oil also had a minor effect on increasing HDL particle size (9.8 nm vs 9.7 nm; P < .05) based on a linear mixed effect model. In contrast, control oil, but not saury oil, increased LDL-C by 7.5% compared with baseline (P < .05). Saury oil had similar effects compared with control oil on lowering plasma TG levels, VLDL, and TG-rich lipoprotein particle counts (by ∼16%, 25%, and 35%, respectively; P < .05), and increasing HDL-C and cholesterol efflux capacity (by ∼6% and 8%, respectively; P < .05) compared with baseline. CONCLUSION Saury oil supplementation is well tolerated and has beneficial effects on several cardiovascular parameters, such as LDL particle counts, HDL particle size, and plasma TG levels.
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Affiliation(s)
- Zhi-Hong Yang
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD, USA.
| | - Marcelo Amar
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Alexander V Sorokin
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - James Troendle
- Office of Biostatistics Research, Division of Cardiovascular Sciences, NHLBI, NIH, Bethesda, MD, USA
| | | | - Maureen Sampson
- Clinical Center, Department of Laboratory Medicine, NIH, Bethesda, MD, USA
| | - Martin P Playford
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, NHLBI, NIH, Bethesda, MD, USA
| | - Shanna Yang
- Clinical Center, Nutrition Department, NIH, Bethesda, MD, USA
| | - Michael Stagliano
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Clarence Ling
- Clinical Center, Department of Laboratory Medicine, NIH, Bethesda, MD, USA
| | - Kwame Donkor
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Robert D Shamburek
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, NHLBI, NIH, Bethesda, MD, USA
| | - Alan T Remaley
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD, USA
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47
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Gelfand JM, Shin DB, Alavi A, Torigian DA, Werner T, Papadopoulos M, Takeshita J, Noe MH, Dey AK, Playford MP, Mehta NN. A Phase IV, Randomized, Double-Blind, Placebo-Controlled Crossover Study of the Effects of Ustekinumab on Vascular Inflammation in Psoriasis (the VIP-U Trial). J Invest Dermatol 2020; 140:85-93.e2. [PMID: 31326395 PMCID: PMC6926160 DOI: 10.1016/j.jid.2019.07.679] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/06/2019] [Accepted: 07/03/2019] [Indexed: 02/08/2023]
Abstract
Psoriasis is a T helper type 17 autoimmune disease associated with an increased risk cardiovascular events and mortality. Ustekinumab, an antibody to p40, blocks cytokines IL-12 and IL-23, and is a highly effective and safe treatment for psoriasis. We conducted a randomized double-blinded placebo-controlled trial to determine the effect of ustekinumab on aortic vascular inflammation (AVI) measured by imaging, and key biomarkers of inflammation, lipid, and glucose metabolism in the blood of patients with moderate-to-severe psoriasis. A total of 43 patients were randomized, and at week 12, ustekinumab-treated patients had a -18.65% (95% confidence interval = -29.45% to -7.85%) reduction in AVI, a reduction in inflammatory biomarkers, and an increase in apolipoprotein B lipoproteins compared with placebo. At week 12, placebo patients were crossed over such that all patients received ustekinumab for 52 weeks. At the end of 52 weeks of ustekinumab treatment, there was no change in AVI compared with baseline, inflammatory markers were reduced, and there were increases in selected measures of lipids and leptin. These results show that blockade of IL-12 and/or IL-23 may transiently reduce AVI, with more durable reduction in inflammatory cytokines associated with cardiovascular disease.
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Affiliation(s)
- Joel M Gelfand
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
| | - Daniel B Shin
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Abass Alavi
- Department of Radiology (Nuclear Medicine), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Drew A Torigian
- Department of Radiology (Nuclear Medicine), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tom Werner
- Department of Radiology (Nuclear Medicine), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Maryte Papadopoulos
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Junko Takeshita
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Megan H Noe
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Amit K Dey
- Section of Inflammation and Cardiometabolic Diseases, National Heart Lung Blood Institute, Bethesda, Maryland, USA
| | - Martin P Playford
- Section of Inflammation and Cardiometabolic Diseases, National Heart Lung Blood Institute, Bethesda, Maryland, USA
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart Lung Blood Institute, Bethesda, Maryland, USA
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48
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Evaluation of serum lipid, lipoprotein, and apolipoprotein levels in psoriatic patients: a systematic review and meta-analysis of case-control studies. Postepy Dermatol Alergol 2019; 36:692-702. [PMID: 31997997 PMCID: PMC6986295 DOI: 10.5114/ada.2019.91420] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 07/11/2018] [Indexed: 12/21/2022] Open
Abstract
Introduction Psoriasis is a T cell-mediated inflammatory skin disease in which fatty acids may be a link between psoriasis and its comorbidity. Aim The present meta-analysis aimed to evaluate lipid, lipoprotein, and apolipoprotein levels in the psoriatic patients compared with the control subjects. Material and methods Four databases, including Web of Science, Scopus, PubMed, and Cochrane Library were searched until July 2017. All records analysed were case-control studies. The quality of the questionnaires was evaluated using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was done by Rev Man 5.3 using mean difference (MD) and 95% confidence intervals (CIs). Results Out of 580 studies identified in four databases, 49 studies were included and analysed in this meta-analysis. The results showed that MD of total cholesterol, triglyceride, LDL, VLDL, HDL, Lp(a), Apo A1, and Apo B levels in the patients compared with the controls were (MD = 13.74 mg/dl; 95% CI: 7.72-19.75; p< 0.00001), (MD = 26.04 mg/dl; 95% CI: 20.77-31.31; p< 0.00001), (MD = 11.41 mg/dl; 95% CI: 6.26-16.57; p< 0.0001), (MD = 4.82 mg/dl; 95% CI: 3.63-6.00; p< 0.00001), (MD = -2.78 mg/dl; 95% CI: -4.53 - -1.03; p< 0.002), (MD = 8.51 mg/dl; 95% CI: 4.86-12.17; p< 0.0001), (MD = -6.60 mg/dl; 95% CI: -13.96 - 0.75; p< 0.08), and (MD = 9.70 mg/dl; 95% CI: 3.02-16.39; p< 0.004), respectively. Conclusions This meta-analysis identified abnormality of serum lipid, lipoprotein, and apolipoproteinprofiles in psoriatic patients compared with the controls as well as possibly a greater risk of atherosclerosis and cardiovascular (CV) accidents in the patients.
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49
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Feng B, Qi R, Gao J, Wang T, Xu H, Zhao Q, Wu R, Song X, Guo J, Zheng L, Li R, Huang W. Exercise training prevented endothelium dysfunction from particulate matter instillation in Wistar rats. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 694:133674. [PMID: 31756800 DOI: 10.1016/j.scitotenv.2019.133674] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/26/2019] [Accepted: 07/29/2019] [Indexed: 06/10/2023]
Abstract
Exposure to fine particulate matter (PM2.5) can result in adverse cardiovascular responses including vascular endothelial dysfunction, whereas exercise training can promote cardiovascular health. However, whether exercise training can mitigate adverse vascular response to PM2.5 has been less studied. In the present study, we aimed to investigate the preventive effect of exercise training on vascular endothelial dysfunction induced by PM2.5 instillation. Six-week old male Wistar rats (n = 32) were divided into four groups (8 rats per group) by exercise status (sedentary vs. exercised) and PM2.5 exposure (instilled vs. non-instilled). Rats received treadmill training with moderate-intensity intervals in week 1 to 6, followed by three repeated PM2.5 instillation on every other day in week 7. Body weight and blood pressure were measured for each rat regularly during exercise training and before sacrifice. At sacrifice, thoracic aortas were isolated for functional response measurement to agonists. Nitric oxide bioavailability and high-density lipoprotein (HDL) function were also assessed. We observed that exercise training significantly reduced the body weight of rats, while PM2.5 instillation had little effect. Neither exercise training nor PM2.5 instillation had significant effects on blood pressure changes. However, exercise training effectively prevented endothelium-dependent vasorelaxation dysfunction and nitric oxide bioavailability reduction from subsequent PM2.5 instillation. In addition, exercise training promoted HDL function which were characterized as increased HDL cholesterol level, cholesterol efflux capacity, and reduced oxidization index; whereas PM2.5 instillation showed limited adverse impact on HDL function. Collectively, our results indicated that exercise training could promote HDL function and protect against endothelium dysfunction from PM2.5 instillation.
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Affiliation(s)
- Baihuan Feng
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China; Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Department of Laboratory Medicine, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Rongzhen Qi
- China Institute of Sport Science, Beijing, China; Department of Physical Education, Gansu Normal University for Nationalities, Hezuo, China
| | - Jianing Gao
- Institute of Cardiovascular Sciences and Institute of Systems Biomedicine, Peking University School of Basic Medical Sciences, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University, Beijing, China
| | - Tong Wang
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
| | - Hongbing Xu
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
| | - Qian Zhao
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
| | - Rongshan Wu
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
| | - Xiaoming Song
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
| | - Jianjun Guo
- China Institute of Sport Science, Beijing, China
| | - Lemin Zheng
- Institute of Cardiovascular Sciences and Institute of Systems Biomedicine, Peking University School of Basic Medical Sciences, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University, Beijing, China
| | - Ran Li
- China Institute of Sport Science, Beijing, China.
| | - Wei Huang
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University, Beijing, China.
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50
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Sorokin AV, Kotani K, Elnabawi YA, Dey AK, Sajja AP, Yamada S, Ueda M, Harrington CL, Baumer Y, Rodante JA, Gelfand JM, Chen MY, Joshi AA, Playford MP, Remaley AT, Mehta NN. Association Between Oxidation-Modified Lipoproteins and Coronary Plaque in Psoriasis. Circ Res 2019; 123:1244-1254. [PMID: 30571459 DOI: 10.1161/circresaha.118.313608] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
RATIONALE Psoriasis is a systemic inflammatory skin disease associated with cardiovascular disease and lipid dysfunction. However, traditional lipid parameters have limited prognostic value, whereas assessing oxidation-modified lipids in this inflammatory driven condition may capture additional risk. Recently, a study showed that psoriasis was associated with increased lipid-rich coronary plaques; therefore, investigating potential relationships with oxidation-modified lipids may speed understanding of increased cardiovascular disease in psoriasis. OBJECTIVE To understand whether oxidation-modified lipids associate with traditional lipid phenotypes, cardiometabolic disease biomarkers, and total coronary plaque, with focus on noncalcified burden (NCB) by coronary computed tomographic angiography in psoriasis. METHODS AND RESULTS Psoriasis subjects and controls (n=252) had profiling for oxidation-modified LDL (low-density lipoprotein), HDL (high-density lipoprotein), Lp(a) (lipoprotein[a]), cholesterol efflux capacity, lipoprotein particle size and number by NMR spectroscopy, and PON-1 (paraoxonase-1) activity. Blinded coronary computed tomographic angiography coronary artery disease characterization included total burden, NCB, and dense-calcified burden. Compared with healthy volunteers, psoriasis subjects were older (mean age, 50.1), had increased body mass index, and homeostatic model assessment of insulin resistance. Psoriasis subjects had increase in oxidized Lp(a), Lp(a), and oxidized HDL (oxHDL; P <0.05 for all) with significant association of oxidized LDL (β=0.10; P=0.020) and oxHDL (β=-0.11; P=0.007) with NCB. Moreover, psoriasis subjects expressed significantly higher PON-1 (kU/µL) activity compared with healthy volunteers (8.55±3.21 versus 6.24±3.82; P=0.01). Finally, psoriasis treatment was associated with a reduction in oxHDL (U/mL; 203.79±88.40 versus 116.36±85.03; P<0.001) and with a concomitant decrease in NCB at 1 year (1.04±0.44 versus 0.95±0.32; P=0.03). CONCLUSIONS Traditional lipids did not capture risk of lipid-rich plaque as assessed by NCB, whereas assaying oxidation-modification of lipids revealed significant association with oxidized LDL and oxHDL. The PON-1 activity was increased in psoriasis suggesting possible compensatory antioxidative effect. Psoriasis treatment was associated with a reduction in oxHDL. These findings support performance of larger studies to understand oxidation-modified lipids in inflammatory states.
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Affiliation(s)
- Alexander V Sorokin
- From the Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, (A.V.S., Y.A.E., A.K.D., A.P.S., C.L.H., Y.B., J.A.R., M.Y.C., A.A.J., M.P.P., N.N.M.), National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Kazuhiko Kotani
- Department of Clinical Laboratory Medicine, Jichi Medical University, Shimotsuke-City, Tochigi, Japan (K.K.)
| | - Youssef A Elnabawi
- From the Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, (A.V.S., Y.A.E., A.K.D., A.P.S., C.L.H., Y.B., J.A.R., M.Y.C., A.A.J., M.P.P., N.N.M.), National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Amit K Dey
- From the Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, (A.V.S., Y.A.E., A.K.D., A.P.S., C.L.H., Y.B., J.A.R., M.Y.C., A.A.J., M.P.P., N.N.M.), National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Aparna P Sajja
- From the Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, (A.V.S., Y.A.E., A.K.D., A.P.S., C.L.H., Y.B., J.A.R., M.Y.C., A.A.J., M.P.P., N.N.M.), National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | | | - Masashi Ueda
- Hokenkagaku-West, Co, Ltd, Kyoto-City, Japan (M.U.)
| | - Charlotte L Harrington
- From the Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, (A.V.S., Y.A.E., A.K.D., A.P.S., C.L.H., Y.B., J.A.R., M.Y.C., A.A.J., M.P.P., N.N.M.), National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Yvonne Baumer
- From the Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, (A.V.S., Y.A.E., A.K.D., A.P.S., C.L.H., Y.B., J.A.R., M.Y.C., A.A.J., M.P.P., N.N.M.), National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Justin A Rodante
- From the Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, (A.V.S., Y.A.E., A.K.D., A.P.S., C.L.H., Y.B., J.A.R., M.Y.C., A.A.J., M.P.P., N.N.M.), National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Joel M Gelfand
- Department of Dermatology, Perelman School of Medicine (J.M.G.).,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia (J.M.G.)
| | - Marcus Y Chen
- From the Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, (A.V.S., Y.A.E., A.K.D., A.P.S., C.L.H., Y.B., J.A.R., M.Y.C., A.A.J., M.P.P., N.N.M.), National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Aditya A Joshi
- From the Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, (A.V.S., Y.A.E., A.K.D., A.P.S., C.L.H., Y.B., J.A.R., M.Y.C., A.A.J., M.P.P., N.N.M.), National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Martin P Playford
- From the Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, (A.V.S., Y.A.E., A.K.D., A.P.S., C.L.H., Y.B., J.A.R., M.Y.C., A.A.J., M.P.P., N.N.M.), National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Alan T Remaley
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch (A.T.R.), National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Nehal N Mehta
- From the Section of Inflammation and Cardiometabolic Diseases, Cardiovascular Branch, (A.V.S., Y.A.E., A.K.D., A.P.S., C.L.H., Y.B., J.A.R., M.Y.C., A.A.J., M.P.P., N.N.M.), National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
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