The incidence rates and risk factors of Parkinson disease in patients with psoriasis: A nationwide population-based cohort study

Causal relationships between schizophrenia and psoriasis: a two-sample Mendelian randomization study

BACKGROUND

Numerous clinical studies have investigated the association between schizophrenia and psoriasis, but the findings remain inconsistent.

METHODS

We employed Mendelian randomization (MR) methods to evaluate the causal relationship between schizophrenia and psoriasis and its subtypes. Inverse variance weighting was used as the primary approach for MR analysis, complemented by inverse magnetic resonance analysis and sensitivity testing. To identify potential mediators, we applied a two-step MR approach. Additionally, pathway and functional enrichment analyses were conducted to uncover possible mechanisms linking schizophrenia and psoriasis.

RESULTS

MR analysis indicated an association between schizophrenia and psoriasis (OR: 1.0010; p = 0.008). Subtype analyses revealed that genetic susceptibility increased the risk of developing psoriasis vulgaris (OR: 1.18; 95% CI: 1.03-1.34; p = 0.016) but was not significantly associated with arthropathy (OR: 1.04; 95% CI: 0.97-1.12; p = 0.292). Emotional states such as tenseness, tiredness, and misery fulfil the criteria of the MR two-step approach and can be considered as potential mediators of the association between schizophrenia and psoriasis vulgaris. Pathway and functional enrichment analyses suggested the involvement of oxidative stress-driven hypothalamic-pituitary-adrenal (HPA) axis pathways in the link between schizophrenia and psoriasis.

CONCLUSION

Our MR study established a significant association between schizophrenia and psoriasis vulgaris, identifying tenseness, tiredness, and misery as potential mediators. Pathway and functional enrichment analyses indicated that oxidative stress in the HPA axis may represent a shared mechanism underlying schizophrenia and psoriasis.

The modification effect of concentration on the correlation between ambient ozone and psoriasis: a hospital-based time-series study

The effects of short-term ambient ozone (O3) exposure on health outcomes have received growing concerns, but its effects on psoriasis is still unclear. The purpose of our study was to investigate the effects of short-term exposure to O3 on psoriasis, and to find out potential modifiers. A hospital-based time-series study with outpatient visit data of psoriasis was performed in Chongqing, the largest metropolitan in Southeast China. General additive models combined quasi-Poisson regression were implied to reveal the association between short-term exposure to O3 and psoriasis. Moreover, the potential modifiers were found out through subgroup analyses. Totally, 23,921 psoriasis outpatient visits were included. For the whole patient population, no significant association between exposure to O3 and outpatient visits for psoriasis was observed. Interestingly, the stratified analyses based on concentrations showed that low concentration of O3 (below the recommended limitation of 100 μg/m3 by WHO and China), rather than high concentration of O3, was negatively associated with psoriasis outpatient visits at various lag days, and the greatest decrease was observed at lag03 (-2.05%; 95%CI: -3.55%, -0.53%). Moreover, stronger associations were observed in cool seasons, patients aged 40 or above, and males. Additionally, the negative associations of low-concentration O3 on psoriasis outpatient visits were still robust in sensitivity analyses. Our study discovered that low-concentrations of O3, rather than high concentrations of O3, can be associated with decreased outpatient visits for psoriasis, especially for males, population aged 40 and above, and in cool seasons.

Psoriasis: analysis of comorbid pathology

Background. Chronic nature of course and presence of systemic inflammation in psoriasis are accompanied by the development of a great number of comorbid disorders, which not only lead to social maladjustment, but also directly affect patients’ survival. For clinicians, diagnostic search of co-occuring disorders in psoriasis during routine practice is often difficult due to their great diversity, different incidence and pronouncement of associations with the main disease. Objective. To study the structure of comorbid disorders in patients with psoriasis. Material and methods. A number of patients with the established diagnosis of «psoriasis» equal 509 was investigated from 2018 to 2021. All patients underwent examination with an assessment of the clinical course of psoriasis, the data of medical history were taken into account. The detection and analysis of comorbid disorders was carried out by patient’s clinical examination with further study of medical documentation. Results. Comorbid disorders have been noted in 224 (44%) patients. Psoriatic arthritis (143/63.8%), arterial hypertension (113/50.4%) and ischemic heart disease (27/12.5%) were the most common impairments. In addition, type II diabetes mellitus (17/7.6%), nephrolithiasis (16/7.1%), chronic glomerulonephritis (16/7.1%) and digestive system lesions with signs of chronic pancreatitis (23/10%) have been registered. Conclusion. The study and analysis of comorbid disorders in patients with psoriasis plays an important role in maintaining health and quality of life of patients. Clinicians should pay attention to the patient’s overall health status, in addition to the pathological process on the skin, with emphasis on possible lesions of the osteoarticular, cardiovascular and other systems.

Comparison of metabolic and neurological comorbidities in Asian patients with psoriasis and atopic dermatitis

Although various comorbidities have been noted to be associated with atopic dermatitis (AD) and psoriasis, few studies have compared comorbidities between the two diseases, and little is known about whether these comorbidities vary by the subtypes of psoriasis. In this study of 1:1 age- and sex-matched pair analysis between patients diagnosed with either psoriasis or AD at Asan Medical Center between 1991 and 2020, comorbidities, as determined by the International Classification of Diseases-10 codes, and likelihood ratios of metabolic and neurologic comorbidities in psoriasis compared with AD were studied using a logistic regression model. Among a total of 14,128 patients, the psoriasis group had higher odds of obesity (odds ratio [95% confidence interval]: 1.49 [1.34-1.66]), hypertension (1.14 [1.03-1.26]), diabetes mellitus (1.46 [1.29-1.66]), chronic kidney disease (1.59 [1.22-2.08]), and Parkinson's disease (2.1 [1.15-3.83]) than the AD group. Subgroup analysis revealed that patients with plaque psoriasis had higher odds of obesity (1.18 [1.05-1.33]), hypertension (1.18 [1.06-1.32]), diabetes mellitus (1.53 [1.34-1.75]), chronic kidney disease (1.66 [1.26-2.17]), and Parkinson's disease (2.12 [1.16-3.88]) compared with AD. Meanwhile, guttate psoriasis was associated with higher odds of dementia (3.63 [1.06-12.40]) and patients with generalized pustular psoriasis showed higher odds of diabetes mellitus (5.42 [1.56-18.83]) compared with AD. In conclusion, Asian patients with all types of psoriasis should be closely monitored for the development of metabolic and neurologic diseases, especially men and those aged ≥ 40 years.

Literature Overview of the Relation Between Psoriasis and Alzheimer

The most common type of dementia disease is Alzheimer, which placing a heavy burden on the healthcare system all over the world. At the same time, psoriasis is also one of the most common health problems, as a skin disease. Alzheimer's disease (AD) is more often in patients with psoriasis than in the general people. Several evidence has proved the relation between AD and psoriasis through immune-mediated pathophysiologic processes. This review aims to summary the potential relation between AD and psoriasis, and provide suggestions based on the relationship at the same time. Neurologists, dermatologists should pay attention to the relationship between Alzheimer's disease and psoriasis. Dermatology and neurology need referral each other when it is necessary.

Anti-Inflammatory Effect of Traditional Chinese Medicine on the Concept of Mind-Body Interface

In this chapter, we conducted a systemic literature review for the anti-inflammatory effects of Traditional Chinese Medicine (TCM) applying molecular mechanisms focusing on the neuroinflammation and gut-brain axis in three neuropsychiatric disorders: major depressive disorder, Alzheimer's disease, and Parkinson's disease. We demonstrated the anti-inflammation or immunomodulation effects of TCM, including acupuncture, from basic and clinical research, including cellular and molecular approaches. In conclusion, inflammation plays a critical role in the neuropsychopathological process. At the same time, anti-inflammation seems to be the common biological pathway for the effects of TCM and acupuncture in depression, Alzheimer's disease, and Parkinson's disease.

Identification of Drugs Associated with Lower Risk of Parkinson's Disease Using a Systematic Screening Approach in a Nationwide Nested Case-Control Study

Introduction

Drugs for other indications may be repurposable as disease-modifying drugs for Parkinson's disease (PD). A systematic hypothesis-free approach can enable identification of candidates for repurposing. We applied a hypothesis-free systematic approach to identify drugs associated with lower risk of PD to discover candidates with potential for repurposing as disease-modifying drugs for PD and to illustrate challenges in observational studies that simultaneously investigate multiple repurposing candidates.

Methods

The Finnish Parkinson's disease study (FINPARK), a nationwide nested case-control study, was randomized to screening (10,183 cases, 67,849 controls) and replication (10,184 cases, 67,754 controls) samples, including cases diagnosed in 1998-2015. After screening all univariable associations of register-derived exposure to individual-drug, group- and subgroup level since 1995 (exposure ≥3 years before outcome, threshold P = 0.1), different exposure periods were used in confounder-adjusted replication analyses.

Results

In screening stage, the group-level (antipsoriatics and antigout preparations) and subgroup-level (cicatrizants, topical antipsoriatics, antigout preparations and mydriatics and cycloplegics) associations were mainly due to individual drugs. Seven other drugs (eg methotrexate, drugs for chronic obstructive pulmonary disease, COPD and/or asthma) were associated with lower risk. Associations of antigout preparations and antipsoriatics were replicated. COPD/asthma drugs, methotrexate and diabetes drugs were studied in separate, indication-restricted designs.

Discussion

The results reflect the known risk factors and the implied role of the immune system in PD pathogenesis and spurious associations. They underline the importance of controlling for confounding by indication, which is challenging to apply to systematic screening.

Psoriasis and neurodegenerative diseases—a review

Psoriasis is a chronic skin disease with underlying genetic, inflammatory and immunological background, which is a great medical problem, currently regarded as a systemic condition. Neurodegenerative diseases (NDs) are characterized by a progressive loss of nervous tissue, which affects elderly people more frequently; therefore, it is suspected that, due to society's aging, morbidity is going to increase. We performed a thorough review in order to investigate for the first time whether psoriasis may predispose to different particular neurodegenerative diseases—Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS). PubMed search resulted in the retrieval of 833 records, of which 77 eligible were included in the review. Our thorough analysis revealed there are some potential links between psoriasis and NDs (inflammation, oxidative stress, genetics, cardiometabolic disorders), but there is no strong evidence that psoriasis may predispose to NDs. Based on the evidence, it seems that the risk of PD in psoriatics is not increased, and the evidence for increased risk of AD slightly prevails the data that state the opposite. ALS risk does not seem to be increased in psoriatics. The paucity of original studies does not allow for the formulation of definitive conclusions but encourages to perform further investigations.

Epidemiology of Psoriasis and Comorbid Diseases: A Narrative Review

Psoriasis is a chronic autoimmune inflammatory disease that remains active for a long period, even for life in most patients. The impact of psoriasis on health is not only limited to the skin, but also influences multiple systems of the body, even mental health. With the increasing of literature on the association between psoriasis and extracutaneous systems, a better understanding of psoriasis as an autoimmune disease with systemic inflammation is created. Except for cardiometabolic diseases, gastrointestinal diseases, chronic kidney diseases, malignancy, and infections that have received much attention, the association between psoriasis and more systemic diseases, including the skin system, reproductive system, and oral and ocular systems has also been revealed, and mental health diseases draw more attention not just because of the negative mental and mood influence caused by skin lesions, but a common immune-inflammatory mechanism identified of the two systemic diseases. This review summarizes the epidemiological evidence supporting the association between psoriasis and important and/or newly reported systemic diseases in the past 5 years, and may help to comprehensively recognize the comorbidity burden related to psoriasis, further to improve the management of people with psoriasis.

Immunosuppressants contribute to a reduced risk of Parkinson's disease in rheumatoid arthritis

BACKGROUND

Observational studies have suggested a decreased risk of Parkinson's disease (PD) in patients with rheumatoid arthritis (RA). However, the results are controversial and the biological mechanism underlying this effect remains largely unknown.

METHODS

The effect sizes of five observational studies were summarized to determine the association between RA and PD. A two-step Mendelian randomization (TSMR) analysis was conducted using genome-wide association studies data sets of RA, PD and prescription of non-steroidal anti-inflammatory drugs (NSAIDs), immunosuppressants (IS) and glucocorticoids (GC). A multivariable MR (MVMR) was also performed to verify the impact of prescription history on PD risk.

RESULTS

Integrated data from observational studies showed that RA was associated with a decreased risk of PD in the European population (effect size = -0.38, P = 0.004). We found that genetically predicted RA was correlated with a decreased risk of PD [odds ratio (OR) = 0.91, P = 0.007]. In the TSMR, RA patients tended to have an increased prescription of GC (OR = 1.16, P = 2.96e - 07) and IS (OR = 1.77, P = 5.58e - 64), which reduced the risk of PD (GC: OR = 0.86, P = 0.0270; IS: OR = 0.82, P = 0.0277), respectively. Further MVMR analysis demonstrated that only IS was linked to a decreased risk of PD (OR = 0.86, P = 0.004).

CONCLUSION

This work clarified that patients with RA had a decreased risk of PD, which was partially attributed to the use of IS in RA patients but not GC or NSAIDs.

Neurological Complications of Biological Treatment of Psoriasis

In the available literature, little attention has been paid to the assessment of psoriasis and the biological therapy used for it and the nervous system. The purpose of this article is to discuss the relationship between psoriasis and the nervous system as well as to analyze the mechanisms that lead to neurological complications during anticytokine therapies in psoriasis. However, this connection requires further analysis. The use of biological drugs in psoriasis, although it yields positive therapeutic results, is not without numerous side effects. Serious neurological side effects of the therapy are most often visible with the use of anti-TNF-alpha, which is why patients should be monitored for their potential occurrence. Early detection of complications and rapid discontinuation of treatment with the drug may potentially increase the patient’s chances of a full recovery or improvement of his/her neurological condition. It also seems reasonable that, in the case of complications occurring during anti-TNF-alpha therapy, some of the drugs from other groups should be included in the therapy.

Increased risk of Alzheimer's disease in patients with psoriasis: a nationwide population-based cohort study

Although the pathogenesis of Alzheimer’s disease (AD) is unclear, neuroinflammation appears to play a role in its development. Psoriasis is a chronic inflammatory skin disease that has recently been found to genetically overlap with AD. We aimed to investigate the risk of AD in patients with psoriasis. Subjects with psoriasis (n = 535,927) and age- and sex-matched controls without psoriasis (at a 5:1 ratio; n = 2,679,635) who underwent ≥3 health examinations between 2008 and 2014 were included, drawn from the Korean National Health Insurance System database. There were 50,209 cases of AD (1.87%) in controls without psoriasis and 11,311 cases (2.11%) in patients with psoriasis, and the median follow-up was 3.35 years. In a multivariable-adjusted model, patients with psoriasis showed a significantly increased risk of AD (hazard ratio, 1.09; 95% CI, 1.07–1.12, p < 0.0001) compared to controls without psoriasis. Among patients with psoriasis, the risk of AD was significantly increased in psoriasis patients not receiving systemic therapy compared to those receiving systemic therapy (hazard ratio, 1.10; 95% CI, 1.08–1.12 vs. hazard ratio, 0.99; 95% CI: 0.90–1.09, p < 0.0001). The incidence of AD was significantly increased in patients with psoriasis compared to control subjects without psoriasis. Of note, systemic treatment for psoriasis was associated with a reduced risk of AD.

Risk of End-Stage Renal Disease in Psoriatic Patients: Real-World Data from a Nationwide Population-Based Cohort Study

Psoriasis is a chronic inflammatory skin disorder mediated by the T-cell–related immune response. Psoriatic patients may have a variety of comorbidities, but their risk of end-stage renal disease (ESRD), particularly according to the subtype of psoriasis, is unclear. We investigated the risk of ESRD in patients with psoriasis according to the subtype of psoriasis and history of systemic therapy for psoriasis. A total of 2,121,228 adults (1,590,921 in the control group and 530,307 in the psoriasis group) were enrolled in this nationwide population-based cohort study until 2015. During follow-up, 1,434 of the subjects in the psoriasis group developed ESRD. After adjusting for confounding factors, psoriasis was associated with the risk of ESRD (hazard ratio (HR) 1.58, 95% confidence interval [95% CI] 1.47–1.68). The psoriatic arthritis group (HR 7.60, 95% CI 1.90–30.41) had a higher risk of ESRD than the control group. Interestingly, no such association was detected in the systemically treated group (HR 1.07, 95% CI 0.80–1.41). Moreover, the acitretin-treated group had a lower risk of ESRD (HR 0.658, 95% CI, 0.494–0.875) than the non-systemically treated group. In conclusion, the risk of developing ESRD in patients with psoriasis differed according to the type of treatment and the presence of arthritis.