1
|
Zhou Q, Shi R. Shared Genetic Features of Psoriasis and Myocardial Infarction: Insights From a Weighted Gene Coexpression Network Analysis. J Am Heart Assoc 2024; 13:e033893. [PMID: 38533976 PMCID: PMC11179746 DOI: 10.1161/jaha.123.033893] [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: 12/08/2023] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Increasing evidence suggests a higher propensity for acute myocardial infarction (MI) in patients with psoriasis. However, the shared mechanisms underlying this comorbidity in these patients remain unclear. This study aimed to explore the shared genetic features of psoriasis and MI and to identify potential biomarkers indicating their coexistence. METHODS AND RESULTS Data sets obtained from the gene expression omnibus were examined using a weighted gene coexpression network analysis approach. Hub genes were identified using coexpression modules and validated in other data sets and through in vitro cellular experiments. Bioinformatics tools, including the Human microRNA Disease Database, StarBase, and miRNet databases, were used to construct a ceRNA network and predict potential regulatory mechanisms. By applying weighted gene coexpression network analysis, we identified 2 distinct modules that were significant for both MI and psoriasis. Inflammatory and immune pathways were highlighted by gene ontology enrichment analysis of the overlapping genes. Three pivotal genes-Src homology and collagen 1, disruptor of telomeric silencing 1-like, and feline leukemia virus subgroup C cellular receptor family member 2-were identified as potential biomarkers. We constructed a ceRNA network that suggested the upstream regulatory roles of these genes in the coexistence of psoriasis and MI. CONCLUSIONS As potential therapeutic targets, Src homology and collagen 1, feline leukemia virus subgroup C cellular receptor family member 2, and disruptor of telomeric silencing 1-like provide novel insights into the shared genetic features between psoriasis and MI. This study paves the way for future studies focusing on the prevention of MI in patients with psoriasis.
Collapse
Affiliation(s)
- Qiaoyu Zhou
- Department of Cardiovascular MedicineThird Xiangya Hospital of Central South UniversityChangshaHunanChina
| | - Ruizheng Shi
- Department of Cardiovascular MedicineXiangya Hospital, Central South UniversityChangshaHunanChina
| |
Collapse
|
2
|
Siddiquee N, Waller JL, Baer SL, Mohammed A, Tran S, Padala S, Young L, Kheda M, Bollag WB. Association of psoriasis and stroke in end-stage renal disease patients. Am J Med Sci 2023; 366:413-420. [PMID: 37716600 DOI: 10.1016/j.amjms.2023.09.014] [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: 12/08/2022] [Revised: 08/18/2023] [Accepted: 09/07/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Previous research in the general population suggests that the inflammatory skin disease psoriasis is associated with an increased risk of vascular events, such as stroke. Thus, psoriasis may also represent a risk factor for stroke in end-stage renal disease (ESRD) patients. METHODS We queried the United States Renal Data System for incident dialysis patients between 2004 and 2015. Psoriasis was defined as having at least two international classification of disease (ICD)-9 or ICD-10 diagnosis codes. ICD codes were also used to query the outcome of interest, stroke, as well as other clinical risk factors. Logistic regression was used to examine the association of psoriasis and other risk factors with stroke. RESULTS Of 966,399 ESRD patients, we identified 89,700 (9.3%) subjects with stroke and 6,286 (0.7%) with psoriasis. Of these psoriasis patients, 796 (0.9%) also had a stroke. Psoriasis was associated with an increased risk of stroke in an unadjusted model [odds ratio (OR)=1.16; 95% confidence interval (CI)=1.08-1.25]. However, after controlling for demographic and clinical risk factors, the final adjusted model showed that psoriasis was not associated with stroke (OR=0.96, CI=0.88-1.04). Congestive heart failure [adjusted OR of 1.79 (CI=1.75-1.83)] was a confounder of the association of psoriasis with stroke. CONCLUSIONS Contrary to prior research in the general population, psoriasis in ESRD patients was not associated with the risk of stroke after controlling for various demographic and clinical parameters. Our finding emphasizes the importance of controlling for a variety of factors in population studies examining associations of diseases and risk factors.
Collapse
Affiliation(s)
- Naomi Siddiquee
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Jennifer L Waller
- Department of Population Health Sciences, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Stephanie L Baer
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA; Charlie Norwood VA Medical Center, Augusta, GA, USA
| | - Azeem Mohammed
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Sarah Tran
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Sandeep Padala
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Lufei Young
- Department of Physiological and Technological Nursing, Augusta University, Augusta, GA, USA
| | | | - Wendy B Bollag
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA; Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, USA; Charlie Norwood VA Medical Center, Augusta, GA, USA.
| |
Collapse
|
3
|
Husein-ElAhmed H, Steinhoff M. Hidradenitis Suppurativa and Risk of Myocardial Infarction: A Plausible Association? Dermatol Pract Concept 2023; 13:dpc.1304a201. [PMID: 37992351 PMCID: PMC10656150 DOI: 10.5826/dpc.1304a201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 11/24/2023] Open
Affiliation(s)
- Husein Husein-ElAhmed
- Department of Dermatology and Venereology, Hospital de Baza, Granada, Spain
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Martin Steinhoff
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine-Qatar, College of Medicine, Doha, Qatar
- Qatar University, Medical School, Doha, Qatar
- Deptartment of Dermatology, Weill Cornell Medicine, New York, NY, USA
| |
Collapse
|
4
|
Liang H, Li J, Zhang K. Pathogenic role of S100 proteins in psoriasis. Front Immunol 2023; 14:1191645. [PMID: 37346040 PMCID: PMC10279876 DOI: 10.3389/fimmu.2023.1191645] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/22/2023] [Indexed: 06/23/2023] Open
Abstract
Psoriasis is a chronic inflammatory skin disease. The histopathological features of psoriasis include excessive proliferation of keratinocytes and infiltration of immune cells. The S100 proteins are a group of EF-hand Ca2+-binding proteins, including S100A2, -A7, -A8/A9, -A12, -A15, which expression levels are markedly upregulated in psoriatic skin. These proteins exert numerous functions such as serving as intracellular Ca2+ sensors, transduction of Ca2+ signaling, response to extracellular stimuli, energy metabolism, and regulating cell proliferation and apoptosis. Evidence shows a crucial role of S100 proteins in the development and progress of inflammatory diseases, including psoriasis. S100 proteins can possibly be used as potential therapeutic target and diagnostic biomarkers. This review focuses on the pathogenic role of S100 proteins in psoriasis.
Collapse
Affiliation(s)
- Huifang Liang
- ShanXi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, Taiyuan, China
- State Key Breeding Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, Taiyuan, China
| | - Junqin Li
- ShanXi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, Taiyuan, China
- State Key Breeding Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, Taiyuan, China
| | - Kaiming Zhang
- ShanXi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, Taiyuan, China
- State Key Breeding Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, Taiyuan, China
| |
Collapse
|
5
|
Chi CC, Wu YW, Chao TH, Chen CC, Chen YJ, Cheng HM, Chiu HY, Chiu YW, Chung WH, Hsieh TY, Huang PH, Huang YH, Lin SH, Lin TH, Ueng KC, Wang CC, Wang YC, Wu NL, Jia-Yin Hou C, Tsai TF. 2022 Taiwanese Dermatological Association (TDA), Taiwanese Association for Psoriasis and Skin Immunology (TAPSI), and Taiwan Society of cardiology (TSOC) joint consensus recommendations for the management of psoriatic disease with attention to cardiovascular comorbidities. J Formos Med Assoc 2023; 122:442-457. [PMID: 36347733 DOI: 10.1016/j.jfma.2022.10.010] [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: 03/08/2022] [Revised: 08/09/2022] [Accepted: 10/20/2022] [Indexed: 11/08/2022] Open
Abstract
Psoriatic disease is a chronic inflammatory disorder with skin and joint manifestations. Due to the persistent inflammatory state exhibited by patients with psoriasis, multiple systemic comorbidities occur more frequently in patients with psoriasis than in the general population, and the risk of cardiovascular (CV) diseases is significantly increased. As the pathophysiology of psoriatic disease is becoming better understood, the sharing of underlying pathogenic mechanisms between psoriatic and CV diseases is becoming increasingly apparent. Consequently, careful attention to CV comorbidities that already exist or may potentially develop is needed in the management of patients with psoriasis, particularly in the screening and primary prevention of CV disease and in treatment selection due to potential drug-drug and drug-disease interactions. Furthermore, as the use of effective biologic therapy and more aggressive oral systemic treatment for psoriatic disease is increasing, consideration of the potential positive and negative effects of oral and biologic treatment on CV disease is warranted. To improve outcomes and quality of care for patients with psoriasis, the Taiwanese Dermatological Association, the Taiwanese Association for Psoriasis and Skin Immunology, and the Taiwan Society of Cardiology established a Task Force of 20 clinicians from the fields of dermatology, cardiology, and rheumatology to jointly develop consensus expert recommendations for the management of patients with psoriatic disease with attention to CV comorbidities.
Collapse
Affiliation(s)
- Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yen-Wen Wu
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ting-Hsing Chao
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Chiang Chen
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Ju Chen
- Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan; College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Hao-Min Cheng
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Center for Evidence-Based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsien-Yi Chiu
- Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Wei Chiu
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Computer Science and Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Wen-Hung Chung
- Department of Dermatology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tsu-Yi Hsieh
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Po-Hsun Huang
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Huei Huang
- Department of Dermatology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shang-Hung Lin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Tsung-Hsien Lin
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kwo-Chang Ueng
- Division of Cardiology, Department of Internal Medicine, Chung-Shan Medical University Hospital, Taichung, Taiwan; College of Medicine, Chung-Shan Medical University, Taichung, Taiwan
| | - Chun-Chieh Wang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan
| | - Yu-Chen Wang
- Division of Cardiology, Department of Internal Medicine, Asia University Hospital, Taichung, Taiwan; Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan
| | - Nan-Lin Wu
- Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Charles Jia-Yin Hou
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.
| | - Tsen-Fang Tsai
- College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan.
| |
Collapse
|
6
|
Siddiquee N, Waller JL, Baer SL, Mohammed A, Tran S, Siddiqui B, Padala S, Young L, Kheda M, Bollag WB. Association of psoriasis with myocardial infarction in end-stage renal disease patients. Am J Med Sci 2023; 365:329-336. [PMID: 36030899 DOI: 10.1016/j.amjms.2022.08.003] [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: 01/26/2022] [Revised: 04/29/2022] [Accepted: 08/09/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Previous research in non-dialysis patients suggests that the inflammatory skin disease psoriasis is associated with an increased risk of severe vascular events like myocardial infarction (MI). Thus, we determined whether psoriasis represents a significant risk factor for MI in end-stage renal disease (ESRD) patients. METHODS We queried the United States Renal Data System for ESRD patients starting dialysis between 2004 and 2015. ICD-9 and ICD-10 codes were used to identify those with at least two diagnoses of psoriasis, a diagnosis of MI, and other clinical risk factors. Logistic regression was used to examine the association of psoriasis and various risk factors with MI. RESULTS Of a cohort of 1,062,693, we identified 6823 (0.6%) subjects with psoriasis and 181,960 (17.1%) with MI. Of the 6823 patients with psoriasis, 1671 (24%) developed an MI. Psoriasis was associated with an increased risk of MI in an unadjusted model [odds ratio (OR) = 1.34; confidence interval (CI) = 1.26-1.42]. However, after controlling for demographics, dialysis modality, access type, and various conditions related to the Charlson Comorbidity Index, psoriasis was not associated with MI (OR = 0.95, CI = 0.89-1.01). Confounders of the association of psoriasis with MI included congestive heart failure (OR = 5.26, CI = 5.17-5.36), pulmonary disease (OR = 1.25, CI = 1.23-1.26), and diabetes with complications (OR = 1.82, CI = 1.79-1.85). CONCLUSIONS Contrary to prior research in the general population, in the ESRD population psoriasis was not associated with an increased risk of MI after controlling for various demographic and clinical parameters. These data emphasize the importance of an integrated approach since comorbidities may influence the choice of therapy for psoriasis and outcomes.
Collapse
Affiliation(s)
- Naomi Siddiquee
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Jennifer L Waller
- Population Health Sciences, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Stephanie L Baer
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States; Charlie Norwood VA Medical Center, Augusta, GA, United States
| | - Azeem Mohammed
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Sarah Tran
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Budder Siddiqui
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Sandeep Padala
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Lufei Young
- Department of Physiological and Technological Nursing, Augusta University, Augusta, GA, United States
| | | | - Wendy B Bollag
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States; Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States; Charlie Norwood VA Medical Center, Augusta, GA, United States.
| |
Collapse
|
7
|
Li AH, Qi MM, Li WW, Yu XQ, Yang LL, Wang J, Li D. Prediction and verification of the effect of psoriasis on coronary heart disease based on artificial neural network. Heliyon 2022; 8:e10677. [PMID: 36164531 PMCID: PMC9508559 DOI: 10.1016/j.heliyon.2022.e10677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/12/2022] [Accepted: 09/13/2022] [Indexed: 11/03/2022] Open
Abstract
Background and objectives Psoriasis is an independent risk factor for coronary heart disease. It is important for predicting the complications of coronary heart disease in patients with psoriasis. Methods In this study, related cases were collected from the case system of Qingdao University, and commonly used laboratory indicators were extracted. Artificial neural network (ANN) and logistics regression analysis were used to learn to distinguish psoriasis patients, coronary heart disease patients, and psoriasis patients with coronary heart disease. We identified independent risk factors for coronary heart disease in psoriasis patients that exacerbate coronary heart disease symptoms in patients with psoriasis. Findings Analysis shows that the accuracy of the ANN model was higher than 79%. It was determined that age, chlorinated, phosphorus, magnesium, low-density lipoprotein, triglycerides, high density lipoprotein and total cholesterol are independent risk factors for coronary heart disease in patients with psoriasis. Similarly, gender, age, chlorinated, magnesium, triglycerides, and high density lipoprotein are risk factors that exacerbate coronary heart disease symptoms in patients with psoriasis. Interpretation The presented approach is a valuable tool for identifying psoriasis patients, coronary heart disease patients, and psoriasis patients with coronary heart disease. It can also serve as a support tool clinicians in the diagnostic process, by providing an outstanding support in the diagnostics prevention of coronary heart disease in psoriasis.
Collapse
Affiliation(s)
- An-Hai Li
- Department of Dermatology, Qingdao Huangdao District Central Hospital, Qingdao, Shandong, China
| | - Meng-Meng Qi
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Wen-Wen Li
- Department of Hematology, Qingdao Women and Children's Hospital, Qingdao, Shandong, China
| | - Xiao-Qian Yu
- Department of Dermatology, Qingdao Haici Hospital (Qingdao Traditional Chinese Medicine Hospital), Qingdao, Shandong, China
| | - Li-Li Yang
- Department of Traditional Chinese Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Jun Wang
- Department of Clinical Laboratory, Weifang Maternal and Child Health Hospital Affiliated to Weifang Medical University, Weifang, Shandong, China
| | - Ding Li
- Department of Dermatology, Qingdao Huangdao District Central Hospital, Qingdao, Shandong, China.,Department of Traditional Chinese Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| |
Collapse
|
8
|
Orlando G, Molon B, Viola A, Alaibac M, Angioni R, Piaserico S. Psoriasis and Cardiovascular Diseases: An Immune-Mediated Cross Talk? Front Immunol 2022; 13:868277. [PMID: 35686132 PMCID: PMC9170986 DOI: 10.3389/fimmu.2022.868277] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/19/2022] [Indexed: 01/27/2023] Open
Abstract
Psoriasis is a chronic immune-mediated inflammatory skin disease, characterized by well-demarcated scaly, erythematous, infiltrated plaques. The cutaneous-to-systemic expansion of the inflammation in psoriasis leads to the concept of “psoriatic march” or “inflammatory skin march”. Accordingly, psoriasis is thought to be a systemic inflammatory disease associated with numerous comorbidities. Indeed, it’s currently considered an independent risk factor for cardiovascular diseases. Here, we discuss the current knowledge on TNF-α and IL-23/IL-17 mediated pathways linking the psoriatic plaque to the cardiovascular compartment. We further argue the possible involvement of the endothelial compartment in the psoriatic plaque- cardiovascular system crosstalk.
Collapse
Affiliation(s)
- Gloria Orlando
- Unit of Dermatology, Department of Medicine - DIMED, University of Padova, Padova, Italy.,Department of Biomedical Sciences - DSB, University of Padova, Padova, Italy
| | - Barbara Molon
- Department of Biomedical Sciences - DSB, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica, Città della Speranza - IRP, Padova, Italy
| | - Antonella Viola
- Department of Biomedical Sciences - DSB, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica, Città della Speranza - IRP, Padova, Italy
| | - Mauro Alaibac
- Unit of Dermatology, Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Roberta Angioni
- Department of Biomedical Sciences - DSB, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica, Città della Speranza - IRP, Padova, Italy
| | - Stefano Piaserico
- Unit of Dermatology, Department of Medicine - DIMED, University of Padova, Padova, Italy
| |
Collapse
|
9
|
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.
Collapse
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
| |
Collapse
|
10
|
Atherosclerosis attacks in patients with psoriasis vulgaris but without a relationship with the severity and course of the disease. Postepy Dermatol Alergol 2021; 38:673-681. [PMID: 34658712 PMCID: PMC8501432 DOI: 10.5114/ada.2021.108908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/08/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction In recent years numerous research studies have indicated that chronic inflammation in psoriasis can be associated with an increased risk of developing atherosclerosis. Aim The presented study was aimed at demonstrating whether patients suffering from psoriasis vulgaris are at a greater risk of developing atherosclerosis depending on the presence of selected cardiovascular risk factors and the course and severity of the disease. Material and methods Sixty-two patients with diagnosed psoriasis vulgaris and 42 healthy volunteers were included in the study. All the patients underwent carotid ultrasound with the assessment of the common carotid artery intima-media thickness (IMT) and the computed tomography with determination of coronary artery calcification (CAC). Results The IMT was significantly higher in the study group (1.030 ±0.303 mm vs. 0.838 ±0.151 mm, p < 0.0001). We also found a significantly increased severity of Calcium Score (CS) in Agatston units (168.20 ±309.63 vs. 24.52 ±43.21, p = 0.0207) of CAC in patients with psoriasis. There was no significant correlation between the degree of atherosclerosis and psoriasis severity determined in the PASI (Psoriasis Area and Severity Index) scale, duration of the disease, number of exacerbations per year or C-reactive protein values. Conclusions The study showed an increased risk of developing atherosclerosis in patients diagnosed with psoriasis vulgaris, but no correlation was found between the degree of atherosclerosis and the severity of the disease.
Collapse
|
11
|
Psoriasis and Atherosclerosis-Skin, Joints, and Cardiovascular Story of Two Plaques in Relation to the Treatment with Biologics. Int J Mol Sci 2021; 22:ijms221910402. [PMID: 34638740 PMCID: PMC8508744 DOI: 10.3390/ijms221910402] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 02/06/2023] Open
Abstract
It is known that both psoriasis (PSO) limited to the skin and psoriatic arthritis (PSA) increase the risk of cardiovascular complications and atherosclerosis progression by inducing systemic inflammatory response. In recent decades, the introduction of biological medications directed initially against TNF-α and, later, different targets in the inflammatory cascade brought a significant breakthrough in the efficacy of PSO/PSA treatment. In this review, we present and discuss the most recent findings related to the interplay between the genetics and immunology mechanisms involved in PSO and PSA, atherosclerosis and the development of cardiac dysfunction, as well as the current PSO/PSA treatment in view of cardiovascular safety and prognosis.
Collapse
|
12
|
Lin D, Fan D, Chen G, Luo C, Guo X, Liu Z. Association of antenatal corticosteroids with morbidity and mortality among preterm multiple gestations: meta-analysis of observational studies. BMJ Open 2021; 11:e047651. [PMID: 34580092 PMCID: PMC8477320 DOI: 10.1136/bmjopen-2020-047651] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 09/07/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE This meta-analysis aimed to assess the efficacy of antenatal corticosteroids (ACS) on morbidity and mortality among preterm multiple pregnancies. METHODS The PubMed, Embase, Web of Science and Cochrane Library databases were searched for studies investigating the outcomes among preterm multiple gestations following to ACS, from their inception to 1 November 2020. Two authors independently performed the study selection, risk of bias assessment and data extraction. The primary outcomes were respiratory distress syndrome (RDS) and mortality and secondary outcomes included intraventricular haemorrhage (IVH), periventricular leukomalacia (PVL), necrotising enterocolitis, retinopathy of prematurity and bronchopulmonary dysplasia. Pooled ORs were obtained using random effects models. Subgroup analyses were performed to explain heterogeneity by ACS completeness, administration-to-delivery intervals (≤7 days) and single or multicentre. RESULTS A total of 16 observational studies with 36 973 newborns were included in the meta-analysis. ACS treatment was associated with a reduction in RDS (OR 0.66; 95% CI 0.54 to 0.82; I2=91.4%; p<0.001), mortality (OR 0.64; 95% CI 0.50 to 0.81; I2=85.9%; p<0.001), IVH (OR 0.67; 95% CI 0.54 to 0.83; I2=77.4%; p<0.001) and PVL (OR 0.65; 95% CI 0.47 to 0.92; I2=75.5%; p<0.001). Subgroup analyses showed ACS completeness, administration-to-delivery interval and multicentre study affected these associations. DISCUSSION ACS may be beneficial for reducing the risks of RDS, mortality, IVH and PVL among preterm multiple gestations. The efficacy of ACS could be affected by ACS completeness and administration-to-delivery. More robust evidence on the efficacy of ACS treatment among multiple gestations is warranted.
Collapse
Affiliation(s)
- Dongxin Lin
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, Guangdong, China
- Department of Obsterics, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, Guangdong, China
| | - Dazhi Fan
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, Guangdong, China
- Department of Obsterics, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, Guangdong, China
| | - Gengdong Chen
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, Guangdong, China
- Department of Obsterics, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, Guangdong, China
| | - Caihong Luo
- Department of Obsterics, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, Guangdong, China
| | - Xiaoling Guo
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, Guangdong, China
- Department of Obsterics, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, Guangdong, China
| | - Zhengping Liu
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, Guangdong, China
- Department of Obsterics, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, Guangdong, China
| |
Collapse
|
13
|
Cardiovascular Safety of Biologics Targeting Interleukin (IL)-12 and/or IL-23: What Does the Evidence Say? Am J Clin Dermatol 2021; 22:587-601. [PMID: 34292509 DOI: 10.1007/s40257-021-00612-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 12/13/2022]
Abstract
There is substantial evidence regarding the association between psoriasis and the elevated risk of cardiovascular (CV) disease. Many patients with psoriasis may also be concerned that their treatments may be associated with a further increase in the risk of CV disease. In this article, we summarize the data regarding the biological role of interleukin (IL)-12/23 in atherogenesis. We performed a literature search for currently known CV safety data from trials and observational studies of treatments targeting IL-12/23 in psoriasis, i.e. the p40 inhibitors ustekinumab and briakinumab, and the p19 inhibitors guselkumab, risankizumab, and tildrakizumab. On balance, extensive evidence supports the CV safety of ustekinumab, with over 14 years of follow-up data in multiple cohort studies and randomized controlled trials (RCTs). One self-controlled study concluded ustekinumab may precipitate short-term raised CV risk, but the study had limitations hindering interpretation. The safety evidence from RCTs on the p19 inhibitors are reassuring thus far, but these studies may not detect rare CV events in real-world patients. We concluded that the overall evidence does not show that ustekinumab is associated with an increase in the risk of CV disease in patients with psoriasis, but further data are awaited to assess the CV safety of p19 inhibitors for the treatment of psoriasis.
Collapse
|
14
|
Gundogan B, Dowlut N, Rajmohan S, Borrelli MR, Millip M, Iosifidis C, Udeaja YZ, Mathew G, Fowler A, Agha R. Assessing the compliance of systematic review articles published in leading dermatology journals with the PRISMA statement guidelines: A systematic review. JAAD Int 2021; 1:157-174. [PMID: 34409336 PMCID: PMC8361930 DOI: 10.1016/j.jdin.2020.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2020] [Indexed: 11/24/2022] Open
Abstract
Background Reporting quality of systematic reviews and meta-analyses is of critical importance in dermatology because of their key role in informing health care decisions. Objective To assess the compliance of systematic reviews and meta-analyses in leading dermatology journals with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines. Methods This review was carried out in accordance with PRISMA guidelines. Included studies were reviews published across 6 years in the top 4 highest-impact-factor dermatology journals of 2017. Records and full texts were screened independently. Data analysis was conducted with univariate multivariable linear regression. The primary outcome was to assess the compliance of systematic reviews and meta-analyses in leading dermatology journals with the PRISMA statement. Results A total of 166 studies were included and mean PRISMA compliance across all articles was 73%. Compliance significantly improved over time (β = .016; P = <.001). The worst reported checklist item was item 5 (reporting on protocol existence), with a compliance of 15% of articles. Conclusion PRISMA compliance within leading dermatology journals could be improved; however, it is steadily improving.
Collapse
Affiliation(s)
- Buket Gundogan
- University College London Hospital, London, United Kingdom
| | - Naeem Dowlut
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | | | - Mimi R Borrelli
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Mirabel Millip
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Christos Iosifidis
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Yagazie Z Udeaja
- Luton and Dunstable University Hospital NHS Foundation Trust, Luton, United Kingdom
| | - Ginimol Mathew
- University College London Medical School, Gower Street, London, United Kingdom
| | | | - Riaz Agha
- Bart's Health NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
15
|
Patrushev AV, Samtsov AV, Soukharev AV. Features of the cytokine profile and the effectiveness of radical treatment of focal infection in patients with psoriasis. VESTNIK DERMATOLOGII I VENEROLOGII 2021. [DOI: 10.25208/vdv1200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background. Focal infection (FI) are important trigger factors for the development of psoriasis, which means they can aggravate the course of dermatosis, including due to an increase in certain pro-inflammatory cytokines in the blood.
Aim. To study the cytokine profile of patients with psoriasis in the progressive period of the disease, as well as to assess the effect radical treatment of focal infection on the course of dermatosis.
Material and methods. Prospective comparative non-randomized study included 52 patients with psoriasis vulgaris, aged 18 to 65 years, who signed a informed consent. The first group consisted of patients who underwent radical treatment FI (16 people), the second those who did not treat FI (16 people), and the third group consisted of patients in whom FI was not detected (20 people).
Cytokine concentrations were measured in the progressive stage of the disease in 52 patients with psoriasis and 20 individuals in the control group (healthy individuals).The spectrum of detected cytokines included: IL-1, IL-2, IL-4, IL-6, IL-8, IL-10, IL-17A, as well as INF- and INF-. For the detection of all cytokines, except for IL-17A, reagents from Vector-Best, Russia were used. The Human ELISA MAX Deluxe Set (BioLegend, USA) was used to determine the concentration of IL-17A.
During the main course of treatment (0, 2 and 4 weeks), as well as the follow-up of patients (12, 24 and 52 weeks), the severity of psoriasis was assessed with the calculation of the PASI index. At the end of the study (week 52), the number of relapses and the total duration of remission were recorded.
Results. The level of IL-8 was increased in 90,6% of psoriasis patients with FI. In this case, significant differences were obtained in comparison with the group of patients with psoriasis without diagnosed FI and with the control group, in which an increase in the concentration of IL-8 was noted, respectively, in 65% and 30% of cases. A moderate positive correlation was found between the IL-8 level and the PASI index (rs = 0,48; p = 3,6 104). The levels of INF- and IL-6 in psoriasis patients with FI were increased, respectively, in 15,6% and 21,9% of cases and significantly differed from the group of practically healthy individuals (p 0,05), differences from the group of patients with psoriasis without FI was not identified. The concentration of TNF- did not differ in all three groups. The level of IL-17A was significantly increased in comparison with practically healthy individuals both in the group of psoriasis patients with FI and in the group of patients without FI (Me = 3,3 and 4,3 pg/ml versus 0,2 pg/ml). The concentrations of five interleukin cytokines, namely IL-1, IL-2, IL-4, IL-10 and INF-, did not exceed the upper limit of the reference range in all patients of the experimental (patients with psoriasis) and control groups.
Evaluation of the PASI index during the observation of patients in the first and second groups showed significantly lower values of this indicator for weeks 24 and 52 in the first group (0,2 vs. 7,0; p = 0,02 and 0,1 vs. 7,2; p = 0,002). The relative risk of disease recurrence in the absence of radical treatment for FI was 2,6 (CI 1,1 to 5,2).
Conclusion. Data were obtained showing the role of IL-8 and focal infection, with the presence of which its increased production is associated, in the worsening of the course of psoriasis with the frequent development of relapses. Important preventive measures leading to a decrease in the number of relapses of psoriasis are timely diagnosis and radical treatment of focal infection.
Collapse
|
16
|
Abstract
Psoriasis has long been known as a disease with many complications, but was attributed to diet and obesity. However, in recent years, psoriasis itself has been recognized as a series of systemic inflammatory diseases, and that the cytokines involved can induce a variety of other diseases. Individuals with psoriasis were also found to have higher incidences of cerebral and cardiovascular diseases and a younger age at death compared to healthy individuals. However, no clear guidelines have been defined regarding how much vascular lesion testing should be performed in patients with psoriasis. In this report, I attempt to unravel the objective data on psoriasis and its complications from various reviews and reports, and introduce the impact of biologics, which are currently the main treatment for psoriasis, on cardiac vascular disease.
Collapse
|
17
|
Kubanov AA, Bogdanova EV. Epidemiology of psoriasis in the Russian Federation according to the patient registry. VESTNIK DERMATOLOGII I VENEROLOGII 2021. [DOI: 10.25208/vdv1268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background. Psoriasis is a chronic skin disorder that impairs patients health-related quality of life. It is associated with patients need in specialized medical care and with essential medical costs. Psoriasis may be the reason for temporary or permanent disability. Patient registries are important sources of epidemiological and clinical data on patients with psoriasis and medical care provided.
Aims. To describe demographic characteristics, characteristics of the disease, prevalence of concomitant and past diseases in adult (18 years and older) patients with moderate and severe psoriasis included in the patient registry of the Russian Society of Dermatovenereologists and Cosmetologists.
Materials and methods. The data of 3,268 patients with psoriasis aged 18 years and older were analyzed as of inclusion in the registry. Data lock point was June 3, 2021. Descriptive statistics methods were applied in data analysis.
Results. The mean ( SD) age of adult patients at inclusion in the registry was 46.1 14.4 years. Male patients accounted for 60.5%. The mean age of onset of psoriasis is 31.1 16.1 years. Most of the patients (89.5%) have psoriasis vulgaris. The mean body surface area at inclusion was 43.3% 24.7%. 28.9% of patients had psoriatic arthritis at inclusion in the registry.
A high prevalence of cardiovascular diseases was revealed: arterial hypertension 28.5%, coronary heart disease 5.4%, myocardial infarction and acute cerebrovascular accident 0.9% each.
More than half of patients are pre-obese or obese according to the WHO body mass index classification. 2.2% of patients have impaired glucose tolerance, 6.7% of patients have type 2 diabetes mellitus. 3.8% of patients have diseases or dysfunction of the thyroid gland.
The prevalence of diseases of the digestive system is high: any disease of the esophagus, stomach and duodenum was noted in 10.2% of patients, any disease of the liver, gallbladder, biliary tract and pancreas in 11.8% of patients.
The prevalence of viral hepatitis C among patients with psoriasis was 2.6%.
Conclusions. The prevalence of comorbidities is high among Russian patients with moderate and severe psoriasis.
Collapse
|
18
|
The Risk of Systemic Diseases in Those with Psoriasis and Psoriatic Arthritis: From Mechanisms to Clinic. Int J Mol Sci 2020; 21:ijms21197041. [PMID: 32987907 PMCID: PMC7583918 DOI: 10.3390/ijms21197041] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/15/2020] [Accepted: 09/21/2020] [Indexed: 02/08/2023] Open
Abstract
Psoriasis and psoriatic arthritis (PsA) have been recently considered as chronic systemic inflammatory disorders. Over the past decades, enormous evidence indicates that patients with psoriasis and PsA have a higher risk of developing various comorbidities including cardiovascular disease, metabolic disease, cancers, infections, autoimmune disease, and psychiatric diseases. However, reported risks of some comorbidities in those with psoriasis and PsA are somewhat different according to the research design. Moreover, pathomechanisms underlying comorbidities of those with psoriasis and PsA remain poorly elucidated. The purpose of this review is to provide the most updated comprehensive view of the risk of systemic comorbidities in those with psoriasis and PsA. Molecular mechanisms associated with the development of various comorbidities in those with psoriasis and PsA are also reviewed based on recent laboratory and clinical investigations. Identifying the risk of systemic comorbidities and its associated pathomechanisms in those with psoriasis and PsA could provide a sufficient basis to use a multi-disciplinary approach for treating patients with psoriasis and PsA.
Collapse
|
19
|
Karbach S, Hobohm L, Wild J, Münzel T, Gori T, Wegner J, Steinbrink K, Wenzel P, Keller K. Impact of Psoriasis on Mortality Rate and Outcome in Myocardial Infarction. J Am Heart Assoc 2020; 9:e016956. [PMID: 32914667 PMCID: PMC7726965 DOI: 10.1161/jaha.120.016956] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Psoriasis is a frequent chronic inflammatory cytokine‐mediated skin disease and was identified to be an independent risk factor for the occurrence of myocardial infarction (MI). However, data about the impact of psoriasis on mortality and other in‐hospital adverse events in the setting of MI are sparse and inconsistent. Methods and Results The nationwide German inpatient sample of the years 2005 to 2016 was used for statistical analysis. Hospitalized patients with MI were stratified for the presence of psoriasis and the impact of psoriasis on in‐hospital events was investigated. Overall, 3 307 703 patients with MI (37.6% females, 56.8% aged ≥70 years) were treated in Germany (2005–2016); among them 9028 (0.3%) were diagnosed with psoriasis. Patients with MI with psoriasis were significantly younger (68.0 [58.0–76.0] versus 73.0 [62.0–81.0] years; P<0.001) and showed significant lower in‐hospital case‐fatality rate (7.1% versus 12.4%; P<0.001), confirmed in the regression (odds ratio, 0.68; 95% CI, 0.63–0.74; P<0.001) adjusted for age, sex, and comorbidities. They more frequently revealed cardiovascular risk factors such as arterial hypertension (58.9% versus 55.0%; P<0.001), hyperlipidemia (44.4% versus 38.6%; P<0.001), smoking (14.3% versus 7.4%; P<0.001), diabetes mellitus (34.8% versus 30.4%; P<0.001) or obesity (17.9% versus 9.3%; P<0.001). While the rate of percutaneous coronary intervention (41.4 versus 42.0%; P=0.223) was comparable between both groups, coronary bypass surgery was more often performed in patients with MI with psoriasis (7.7% versus 4.7%; P<0.001). Conclusions Overall, only 0.3% of all MI cases were diagnosed with psoriasis, and patients with MI with psoriasis were in median 5 years younger than patients with MI without psoriasis. Psoriasis seems to enhance the prevalence of classical cardiovascular risk factors and might therefore explain the earlier time point for MI. Our data also showed in turn a lower in‐hospital mortality rate in patients with MI with psoriasis, presumably driven by younger age.
Collapse
Affiliation(s)
- Susanne Karbach
- Department of Cardiology Cardiology I University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Center for Thrombosis and Hemostasis (CTH) University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany
| | - Lukas Hobohm
- Department of Cardiology Cardiology I University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Center for Thrombosis and Hemostasis (CTH) University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany
| | - Johannes Wild
- Department of Cardiology Cardiology I University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Center for Thrombosis and Hemostasis (CTH) University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany
| | - Thomas Münzel
- Department of Cardiology Cardiology I University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main Mainz Germany
| | - Tommaso Gori
- Department of Cardiology Cardiology I University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Center for Thrombosis and Hemostasis (CTH) University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main Mainz Germany
| | - Joanna Wegner
- Department of Dermatology University Medical Center Mainz Mainz Germany
| | - Kerstin Steinbrink
- Center for Thrombosis and Hemostasis (CTH) University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Department of Dermatology University Medical Center Münster Westfälische Wilhelms-University Münster Münster Germany
| | - Philip Wenzel
- Department of Cardiology Cardiology I University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Center for Thrombosis and Hemostasis (CTH) University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main Mainz Germany
| | - Karsten Keller
- Department of Cardiology Cardiology I University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Center for Thrombosis and Hemostasis (CTH) University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Medical Clinic VII Department of Sports Medicine University Hospital Heidelberg Heidelberg Germany
| |
Collapse
|
20
|
Fan JM, Solomon DA, López GY, Hofmann JW, Colorado RA, Kim AS, Meisel K, Halabi C. Catastrophic stroke burden in a patient with uncontrolled psoriasis and psoriatic arthritis: a case report. BMC Neurol 2020; 20:106. [PMID: 32199449 PMCID: PMC7085172 DOI: 10.1186/s12883-020-01681-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 03/10/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Psoriasis is the most common chronic inflammatory condition involving the T helper cell system. Population studies have demonstrated that patients with psoriasis and/or psoriatic arthritis have an increased risk of developing vascular risk factors, including diabetes, hypertension, and obesity, and increased risk of adverse vascular events, including myocardial infarction and stroke. Population studies have generally investigated the individual contributions of psoriasis and psoriatic arthritis to development of vascular risk factors; fewer studies have investigated the additive contribution of comorbid inflammatory disorders. We present a case of a woman with psoriasis, psoriatic arthritis, and comorbid vascular risk factors. CASE PRESENTATION A 49 year-old Caucasian woman with a history of severe psoriasis and psoriatic arthritis since adolescence presented with bilateral lower extremity weakness. She was found to have acute bilateral watershed infarcts and multifocal subacute infarcts. Her evaluation revealed vascular risk factors and elevated non-specific systemic inflammatory markers; serum and cerebral spinal fluid did not reveal underlying infection, hypercoagulable state, or vasculitis. Over the course of days, she exhibited precipitous clinical deterioration related to multiple large vessel occlusions, including the bilateral anterior cerebral arteries and the left middle cerebral artery. Autopsy revealed acute thrombi and diffuse, severe atherosclerosis. CONCLUSION Patients with early onset inflammatory disease activity or comorbid inflammatory disorders may have an even higher risk of developing metabolic syndrome and adverse vascular events compared to patients with late-onset disease activity or with a single inflammatory condition. The described case illustrates the complex relationship between inflammatory disorders and vascular risk factors. The degree of systemic inflammation, as measured by severity of disease activity, has been shown to have a dose-response relationship with comorbid vascular risk factors and vascular events. Dysregulation of the Th1 and Th17 system has been implicated in the development of atherosclerosis and may explain the severe atherosclerosis seen in such chronic inflammatory conditions. Further research will help refine screening and management guidelines to account for comorbid inflammatory disorders and related disease severity.
Collapse
Affiliation(s)
- Joline M Fan
- Department of Neurology, University of California, San Francisco, California, USA.
| | - David A Solomon
- Division of Neuropathology, Department of Pathology, University of California, San Francisco, California, USA
| | - Giselle Y López
- Division of Neuropathology, Department of Pathology, Duke University, Durham, North Carolina, USA
| | - Jeffrey W Hofmann
- Division of Neuropathology, Department of Pathology, University of California, San Francisco, California, USA
| | - Rene A Colorado
- Department of Neurology, Salinas Valley Memorial Healthcare System, Salinas, California, USA
| | - Anthony S Kim
- Department of Neurology, University of California, San Francisco, California, USA
| | - Karl Meisel
- Department of Neurology, University of California, San Francisco, California, USA
| | - Cathra Halabi
- Department of Neurology, University of California, San Francisco, California, USA
- Weill Institute for Neurosciences, University of California, San Francisco, California, USA
| |
Collapse
|
21
|
Packer M. Epicardial Adipose Tissue Inflammation Can Cause the Distinctive Pattern of Cardiovascular Disorders Seen in Psoriasis. Am J Med 2020; 133:267-272. [PMID: 31520623 DOI: 10.1016/j.amjmed.2019.08.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 08/27/2019] [Accepted: 08/28/2019] [Indexed: 12/20/2022]
Abstract
Psoriasis is a systemic inflammatory disorder that can target adipose tissue; the resulting adipocyte dysfunction is manifest clinically as the metabolic syndrome, which is present in ≈20%-40% of patients. Epicardial adipose tissue inflammation is likely responsible for a distinctive pattern of cardiovascular disorders consisting of 1) accelerated coronary atherosclerosis leading to myocardial infarction, 2) atrial myopathy leading to atrial fibrillation and thromboembolic stroke, and 3) ventricular myopathy leading to heart failure with a preserved ejection fraction. If cardiovascular inflammation drives these risks, then treatments that focus on blood pressure, lipids, and glucose will not ameliorate the burden of cardiovascular disease in patients with psoriasis, especially in those who are young and have severe inflammation. Instead, interventions that alleviate systemic and adipose tissue inflammation may not only minimize the risks of atrial fibrillation and heart failure but may also have favorable effects on the severity of psoriasis. Viewed from this perspective, the known link between psoriasis and cardiovascular disease is not related to the influence of the individual diagnostic components of the metabolic syndrome.
Collapse
Affiliation(s)
- Milton Packer
- Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Tex; Imperial College, London.
| |
Collapse
|
22
|
Lee MP, Desai RJ, Jin Y, Brill G, Ogdie A, Kim SC. Association of Ustekinumab vs TNF Inhibitor Therapy With Risk of Atrial Fibrillation and Cardiovascular Events in Patients With Psoriasis or Psoriatic Arthritis. JAMA Dermatol 2020; 155:700-707. [PMID: 30916734 DOI: 10.1001/jamadermatol.2019.0001] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Accumulating evidence indicates that there is an increased risk of cardiovascular disease among patients with psoriatic disease. Although an emerging concern that the risk of atrial fibrillation (AF) may also be higher in this patient population adds to the growing support of initiating early interventions to control systemic inflammation, evidence on the comparative cardiovascular safety of current biologic treatments remains limited. Objective To evaluate the risk of AF and major adverse cardiovascular events (MACE) associated with use of ustekinumab vs tumor necrosis factor inhibitors (TNFi) in patients with psoriasis or psoriatic arthritis. Design, Setting, and Participants This cohort study included data from a nationwide sample of 78 162 commercially insured patients in 2 US commercial insurance databases (Optum and MarketScan) from September 25, 2009, through September 30, 2015. Patients were included if they were 18 years or older, had psoriasis or psoriatic arthritis, and initiated ustekinumab or a TNFi therapy. Exclusion criteria included history of AF or receipt of antiarrhythmic or anticoagulant therapy during the baseline period. Exposures Initiation of ustekinumab vs TNFi therapy. Main Outcomes and Measures Incident AF and MACE, including myocardial infarction, stroke, or coronary revascularization. Results A total of 60 028 patients with psoriasis or psoriatic arthritis (9071 ustekinumab initiators and 50 957 TNFi initiators) were included in the analyses. The mean (SD) age was 46 (13) years in Optum and 47 (13) in MarketScan, and 29 495 (49.1%) were male. Overall crude incidence rates (reported per 1000 person-years) for AF were 5.0 (95% CI, 3.8-6.5) for ustekinumab initiators and 4.7 (95% CI, 4.2-5.2) for TNFi initiators, and for MACE were 6.2 (95% CI, 4.9-7.8) for ustekinumab initiators and 6.1 (95% CI, 5.5-6.7) for TNFi initiators. The combined adjusted hazard ratio for incident AF among ustekinumab initiators was 1.08 (95% CI, 0.76-1.54) and for MACE among ustekinumab initiators was 1.10 (95% CI, 0.80-1.52) compared with TNFi initiators. Conclusions and Relevance No substantially different risk of incident AF or MACE after initiation of ustekinumab vs TNFi was observed in this study. This information may be helpful when weighing the risks and benefits of various systemic treatment strategies for psoriatic disease.
Collapse
Affiliation(s)
- Moa P Lee
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Department of Epidemiology, University of North Carolina, Chapel Hill
| | - Rishi J Desai
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Yinzhu Jin
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Gregory Brill
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Alexis Ogdie
- Center for Clinical Epidemiology and Biostatistics, Department of Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia.,Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Seoyoung C Kim
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
23
|
Sondermann W, Djeudeu Deudjui DA, Körber A, Slomiany U, Brinker TJ, Erbel R, Moebus S. Psoriasis, cardiovascular risk factors and metabolic disorders: sex-specific findings of a population-based study. J Eur Acad Dermatol Venereol 2019; 34:779-786. [PMID: 31797464 DOI: 10.1111/jdv.16029] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 10/01/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Scientific evidence suggests an association between psoriasis and cardiovascular and metabolic diseases. However, there are hardly any sex-specific results from population-based studies reporting the prevalence of cardiovascular risk factors in patients with psoriasis and point estimates of the association between psoriasis and cardiovascular and metabolic disorders. OBJECTIVE Aims are to evaluate the sex-specific prevalence of psoriasis and cardiovascular risk factors, and to estimate sex-specific associations between psoriasis and diabetes type 2 (DM) and metabolic syndrome (MetS). METHODS We used data of 3723 participants (45-75 years, 54.1% women) without coronary heart disease and missing data (psoriasis, DM, MetS) from the Heinz Nixdorf Recall study. Standardized information on health outcomes and risk factors was assessed. We performed descriptive statistics and multiple regression analyses to calculate prevalence rate ratios (PR) and 95% confidence intervals (95% CI). RESULTS The prevalence of psoriasis was 3.8% (n = 143), with no differences between sex. We observed more often metabolic and cardiovascular risk factors in women with psoriasis compared to women without psoriasis. Interestingly, in men, this pattern was partly reversed. Multiple regression analyses revealed distinctly elevated PRs for DM for both women and men with psoriasis (fully adjusted PR: 2.43; 95% CI: 1.17-5.07, resp. 2.09; 1.16-3.76). Regarding the MetS, the results were inconsistent, showing a positive association between psoriasis and MetS in women (1.84; 1.14-2.98), but a negative association in men, even though with a wide 95% CI (0.69; 0.42-1.12). CONCLUSION The results of our cross-sectional, population-based analysis show a distinct association between psoriasis and DM, whereas for the MetS the results contrasted between men and women, translating in women with MetS showing a higher and in men a lower chance to be psoriatic. Our results emphasize the urgent need for sex-specific research, studying the effects of psoriasis on metabolic disorders as well as effective sex tailored prevention measures.
Collapse
Affiliation(s)
- W Sondermann
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - D A Djeudeu Deudjui
- Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - A Körber
- Hautärzte RÜ 143, Essen, Germany
| | - U Slomiany
- Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - T J Brinker
- National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Dermatology, University Hospital of Heidelberg, Heidelberg, Germany
| | - R Erbel
- Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - S Moebus
- Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
24
|
Jung KJ, Kim TG, Lee JW, Lee M, Oh J, Lee SE, Chang HJ, Jee SH, Lee MG. Increased risk of atherosclerotic cardiovascular disease among patients with psoriasis in Korea: A 15-year nationwide population-based cohort study. J Dermatol 2019; 46:859-866. [PMID: 31432567 DOI: 10.1111/1346-8138.15052] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 07/25/2019] [Indexed: 12/18/2022]
Abstract
The association between psoriasis and risk of atherosclerotic cardiovascular disease has not been thoroughly evaluated in a large longitudinal cohort of an Asian population. We conducted a nationwide population-based retrospective cohort study encompassing more than 1.7 million Koreans with a 15-year follow-up period. The period prevalence of psoriasis was 0.33% among the baseline participants (1997-2000). In Cox proportional hazard analyses, the individuals with psoriasis had a higher adjusted hazard ratio (HR) for incidence of overall atherosclerotic cardiovascular disease (HR, 1.18; 95% confidence interval [CI], 1.09-1.27) compared with controls. Subgroup analyses revealed that the risk for myocardial infarction was commonly increased in both sexes with moderate to severe psoriasis (male: HR, 2.09; 95% CI, 1.35-3.24; female: HR, 3.23; 95% CI, 1.34-7.76), whereas the risk for ischemic stroke was specifically increased in female individuals with moderate to severe psoriasis (HR, 2.02; 95% CI, 1.24-3.30). Our data suggest that appropriate medical screening for possible cardiovascular comorbidities is warranted in Asian psoriatic patients according to disease severity and sex.
Collapse
Affiliation(s)
- Keum Ji Jung
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Tae-Gyun Kim
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Won Lee
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Minseok Lee
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jongwook Oh
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Sang-Eun Lee
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea.,Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea
| | - Hyuk-Jae Chang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea.,Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Min-Geol Lee
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.,Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
25
|
Abstract
Research on psoriasis pathogenesis has largely increased knowledge on skin biology in general. In the past 15 years, breakthroughs in the understanding of the pathogenesis of psoriasis have been translated into targeted and highly effective therapies providing fundamental insights into the pathogenesis of chronic inflammatory diseases with a dominant IL-23/Th17 axis. This review discusses the mechanisms involved in the initiation and development of the disease, as well as the therapeutic options that have arisen from the dissection of the inflammatory psoriatic pathways. Our discussion begins by addressing the inflammatory pathways and key cell types initiating and perpetuating psoriatic inflammation. Next, we describe the role of genetics, associated epigenetic mechanisms, and the interaction of the skin flora in the pathophysiology of psoriasis. Finally, we include a comprehensive review of well-established widely available therapies and novel targeted drugs.
Collapse
|
26
|
Yuan M, Cao WF, Xie XF, Zhou HY, Wu XM. Relationship of atopic dermatitis with stroke and myocardial infarction: A meta-analysis. Medicine (Baltimore) 2018; 97:e13512. [PMID: 30544450 PMCID: PMC6310567 DOI: 10.1097/md.0000000000013512] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 11/07/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Lots of previous reports have suggested a potential association of atopic dermatitis (AD) with stroke and myocardial infarction (MI). However, the result is still controversial, Consequently, we conducted this meta-analysis to estimate the relationship of AD with Stroke and MI. METHODS PubMed, Embase, and Web of Science databases were searched from inception to June 2018. Stroke and MI were considered as a composite endpoint. We calculated pooled hazard ratios (HRs) with 95% confidence intervals (CIs). Subgroup and sensitivity analysis were performed to assess the potential sources of heterogeneity of the pooled estimation. RESULTS A total of 12 articles with 15 studies involving 3,701,199 participants were included in this meta-analysis. Of these, 14 studies on stroke and 12 on MI. Pooled analysis showed participants with AD experienced a significant increased risk of stroke (combined HR, 1.15; 95% CI, 1.08-1.22; P = .000) and MI (combined HR, 1.13; 95% CI, 1.02-1.24; P = .014), compared with participants without AD. The risk of stroke and MI was significant both in male subjects (stroke: HR: 1.33, 95% CI: 1.14-1.56; MI: HR: 2.01, 95% CI: 1.31-3.08), but not in female subjects (HR: 1.02, 95% CI: 0.77-1.35; MI: HR: 0.98, 95% CI: 0.72-1.32). The results were more pronounced for ischemic stroke (HR: 1.16, 95% CI: 1.13-1.19) in the stratified with stroke type. Stratifying by AD type, the risk of stroke was significant in severe AD (HR: 1.29, 95% CI: 1.08-1.54) and moderate AD (HR: 1.11, 95% CI: 1.01-1.22) for MI. CONCLUSIONS AD is independently associated with an increased risk of stroke and MI, especially in male subjects and ischemic stroke and the risk is associated with the severity of AD.
Collapse
Affiliation(s)
- Min Yuan
- Department of Neurology, Jiangxi Provincial People's Hospital
| | - Wen-Feng Cao
- Department of Neurology, Jiangxi Provincial People's Hospital
| | - Xu-Fang Xie
- Department of Neurology, Jiangxi Provincial People's Hospital
| | - Huang-Yan Zhou
- Department of Blood Transfusion, Jiangxi Provincial Tumor Hospital, Nanchang, Jiangxi Province, China
| | - Xiao-Mu Wu
- Department of Neurology, Jiangxi Provincial People's Hospital
| |
Collapse
|
27
|
Manolis AA, Manolis TA, Melita H, Manolis AS. Psoriasis and cardiovascular disease: the elusive link. Int Rev Immunol 2018; 38:33-54. [PMID: 30457023 DOI: 10.1080/08830185.2018.1539084] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Psoriasis, an autoimmune inflammatory disease, with its most common coexisting condition, psoriatic arthritis, seem to be more than just a local skin or joint disease, as evidence has accumulated over the years that it is associated with cardiovascular disease (CVD), which may confer an increased cardiovascular event and death rate. The data come mostly from observational studies and meta-analyses and indicate a potential pathogenetic link between these two systemic diseases, however definite proof of this detrimental relationship awaits further prospective studies. Newer anti-psoriatic biologic therapies seem to confer a cardiovascular benefit, but this needs future randomized controlled studies to confirm. All these intricate issues of a potential link between psoriasis and CVD are discussed and elaborated in this overview, in an attempt to shed further light on pivotal aspects of the association between psoriasis and CVD.
Collapse
Affiliation(s)
| | | | - Helen Melita
- c Onassis Cardiac Surgery Center , Athens , Greece
| | - Antonis S Manolis
- d Third Department of Cardiology , Athens University School of Medicine , Athens , Greece
| |
Collapse
|
28
|
Dattilo G, Borgia F, Guarneri C, Casale M, Bitto R, Morabito C, Signorelli S, Katsiki N, Cannavò SP. Cardiovascular Risk in Psoriasis: Current State of the Art. Curr Vasc Pharmacol 2018; 17:85-91. [DOI: 10.2174/1570161115666171116163816] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 10/23/2017] [Accepted: 10/23/2017] [Indexed: 02/07/2023]
Abstract
Psoriasis (Pso) is a chronic inflammatory immune-mediated skin disease associated with
several comorbidities. Despite the growing number of studies providing evidence for the link between
Pso and Cardiovascular (CV) disorders, there are still many unsolved questions, dealing with the role of
the skin disease as an independent risk factor for CV events, the influence of Pso severity and duration
on CV damage, the presence of Psoriatic Arthritis (PsA) as a predictor of increased CV mortality and
morbidity and the detection of reliable clinical, laboratory and/or instrumental parameters to stratify CV
risk in psoriatic patients. Moreover, it remains to clarify if the early treatment of the dermatosis may
lower CV risk. In this paper we will try to provide answers to these queries in the light of the updated
data of the literature.
Collapse
Affiliation(s)
- Giuseppe Dattilo
- Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, Messina, Italy
| | - Francesco Borgia
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy
| | - Claudio Guarneri
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy
| | - Matteo Casale
- Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, Messina, Italy
| | - Roberto Bitto
- Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, Messina, Italy
| | - Claudia Morabito
- Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, Messina, Italy
| | - Salvatore Signorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Niki Katsiki
- Second Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Serafinello P. Cannavò
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy
| |
Collapse
|
29
|
Gottlieb A, Gratacos J, Dikranian A, van Tubergen A, Fallon L, Emir B, Aikman L, Smith T, Chen L. Treatment patterns, unmet need, and impact on patient-reported outcomes of psoriatic arthritis in the United States and Europe. Rheumatol Int 2018; 39:121-130. [PMID: 30426237 PMCID: PMC6329738 DOI: 10.1007/s00296-018-4195-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 11/02/2018] [Indexed: 01/01/2023]
Abstract
Psoriatic arthritis (PsA) is a chronic, inflammatory disease. The effects of PsA real-world treatment patterns on patient-reported outcomes in the US and 5 European countries (EU5; France, Germany, Italy, Spain, UK) were evaluated. Respondents from the 2016 National Health and Wellness Survey received advanced therapies (e.g., biologic disease-modifying antirheumatic drugs [DMARDs]), other therapies, (e.g., conventional synthetic DMARDs), or no treatment. Assessments included demographics, disease severity (patient-reported), comorbidities (Charlson Comorbidity Index), health status (Short Form-36 Health Survey), depression (Patient Health Questionnaire-9), work productivity (Work Productivity and Activity Index), and treatment adherence (Morisky Medication Adherence Scale-8). Overall, 1037 respondents from the US and 947 respondents from the EU5 were included. Of these, 21.7% US and 7.3% EU5 respondents received advanced therapies; 16.6% and 28.5%, other therapies; and 61.7% and 64.2%, no treatment, respectively. During treatment with advanced or other therapies, 40.8-54.7% US and 57.7-58.9% EU5 respondents self-reported moderate or severe PsA. Respondents receiving advanced therapies had the highest Charlson Comorbidity Index score (US, 1.25; EU5, 1.42); the lowest scores were with no treatment (0.52 and 0.49, respectively). Employment was lowest with other therapies (US, 47.7%; EU5, 41.1%). Overall work impairment was reported by 57.9% US and 62.6% EU5 respondents receiving advanced therapies. Medication adherence was generally low in the US and medium in the EU5 (Morisky Medication Adherence Scale-8: low, US 40.1-46.7%, EU5, 29.0-35.2%; medium, US 29.3-36.1%, EU5 37.8-49.3%; high, US 23.8-24.0%; EU5, 21.7-27.0%). Advanced and other therapies reduced PsA severity; however, > 40% of respondents reported moderate or severe PsA during treatment. Better management and adherence may reduce unmet need and disease burden. Further work is required to improve PsA diagnosis and time to treatment initiation.
Collapse
Affiliation(s)
- Alice Gottlieb
- Department of Dermatology, New York Medical College at Metropolitan Hospital, 1901 First Avenue, Floor 14B, New York, NY, 10021, USA.
| | - Jordi Gratacos
- Department of Rheumatology, University Hospìtal Parc Taulí Sabadell, Barcelona, Spain
| | - Ara Dikranian
- Cabrillo Center for Rheumatic Disease, San Diego, CA, USA
| | - Astrid van Tubergen
- Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, Netherlands
| | | | | | | | | | | |
Collapse
|
30
|
Niu F, Wei B, Yan M, Li J, Ouyang Y, Jin T. Matrix metalloproteinase-2 gene polymorphisms are associated with ischemic stroke in a Hainan population. Medicine (Baltimore) 2018; 97:e12302. [PMID: 30278505 PMCID: PMC6181616 DOI: 10.1097/md.0000000000012302] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/16/2018] [Indexed: 02/04/2023] Open
Abstract
Ischemic stroke is a complex vascular disease, which has become 1 of the major causes of morbidity and mortality worldwide. More and more data showed that matrix metalloproteinases (MMPs), in particular, MMP-2 are deleterious after ischaemic stroke. This study investigated the relationship between MMP-2 and stroke risk in the Southern Chinese population.We evaluated single nucleotide polymorphisms (SNP) of MMP-2 in stroke patients in an association study using a case-control design. Six SNPs of MMP2 were selected and genotyped by Agena MassARRAY. SNPStats, Haploview was used to analyze genetic data.Two SNPs in the MMP-2 gene were significantly associated with stroke risk.For rs1132896 (C versus G allele), the C allele was significantly reduced stroke risk (OR = 0.56, 95% confidence intervals [95% CI] = 0.39-0.81, P = .002). The effect of the T allele of rs243849 was IS risk according to an additive genetic model (OR = 0.67, 95% CI = 0.47-0.96, P = .028). We did not found any strong linkage between the six SNPs (rs1132896, rs1053605, rs243849, rs243847, rs243832, rs7201)The results presented strongly indicate that MMP-2 genetic variants are an important mediator of stroke risk.
Collapse
Affiliation(s)
- Fanglin Niu
- Key Laboratory of Resource Biology and Biotechnology in Western China, Northwest University, Ministry of Education, Xi’an, Shaanxi
| | - Boping Wei
- Qingdao Jimo People Hospital, Qingdao, China
| | - Mengdan Yan
- Key Laboratory of Resource Biology and Biotechnology in Western China, Northwest University, Ministry of Education, Xi’an, Shaanxi
| | - Jing Li
- Key Laboratory of Resource Biology and Biotechnology in Western China, Northwest University, Ministry of Education, Xi’an, Shaanxi
| | - Yongri Ouyang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Northwest University, Ministry of Education, Xi’an, Shaanxi
| | - Tianbo Jin
- Key Laboratory of Resource Biology and Biotechnology in Western China, Northwest University, Ministry of Education, Xi’an, Shaanxi
| |
Collapse
|
31
|
Nakao M, Nakamura K, Fukasawa T, Shida R, Ito A, Ichimura Y, Takahashi T, Mitsui A, Yoshizaki A, Shibata S, Kamata M, Araki M, Watanabe R, Sato S, Asano Y. Assessment of endothelial function during the loading phase of infliximab in psoriasis: a potential predictor of its drug survival. Int J Dermatol 2018; 58:54-59. [PMID: 30168849 DOI: 10.1111/ijd.14200] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 08/06/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Tumor necrosis factor inhibitors decrease the risk of cardiovascular events in moderate to severe psoriasis, but the association between their effects on endothelial function and those on skin lesions has not been well studied. We investigated the association between infliximab effects on endothelial function during the loading phase and those on skin lesions in patients with psoriasis. METHODS We evaluated endothelial function with reactive hyperemia-peripheral arterial tonometry index (RHI) in 15 patients with psoriasis before the first and third infusions of infliximab. Patients were stratified into two groups; those who maintained Psoriasis Area and Severity Index (PASI) 75 response for more than 6 months (defined as responders) and the others (defined as nonresponders). RESULTS Six weeks after the initiation of infliximab (before the third infusion), PASI scores were significantly improved compared with baseline, while RHI values were not altered in the whole patient group. However, when the responders and the nonresponders were analyzed separately, RHI values tended to be decreased before the third infusion compared with baseline in the nonresponders, while being unchanged in the responders. Importantly, the difference in ∆RHI reached a statistical significance between the two groups, and the cutoff value (mean - 2 standard deviation of RHI values in the responders) identified the nonresponders with 67% of sensitivity and 100% of specificity. CONCLUSIONS The decrease in RHI values before the third infusion may serve as a predictor for the long-term unfavorable effect of infliximab on psoriatic skin lesions.
Collapse
Affiliation(s)
- Momoko Nakao
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Kouki Nakamura
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Takemichi Fukasawa
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Rino Shida
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Arisa Ito
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yohei Ichimura
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Takehiro Takahashi
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Aya Mitsui
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Ayumi Yoshizaki
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Sayaka Shibata
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Masahiro Kamata
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Mayuko Araki
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Rei Watanabe
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Shinichi Sato
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yoshihide Asano
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| |
Collapse
|
32
|
Wang Y, Xiong J, Niu M, Xu W, Xu K, Zhong H. Hepatitis B virus and the risk of coronary heart disease: A comprehensive systematic review and meta-analyses of observational studies. Int J Cardiol 2018; 265:204-209. [PMID: 29706430 DOI: 10.1016/j.ijcard.2018.04.059] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 02/27/2018] [Accepted: 04/13/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Several studies have reported that hepatitis B virus (HBV) infection affects the risk of coronary heart disease. However, its association is controversial. Thus, we conducted a systematic review and meta-analysis to better understand it. METHODS Relevant studies published before October 2017 were identified by searching PubMed, EMBASE, and ISI Web of Science. The relationships between HBV and the risk of coronary heart disease were assessed using Relative risk (RR) values and the corresponding 95% confidence intervals (CIs). We used the random effects model proposed by DerSimonian and Laird to quantify the relationship. RESULTS Nine articles, including 65,058 HBV-infected patients and 534,998 uninfected controls, were included in the meta-analysis. The present study does not support that HBV infection is associated with the risk of coronary heart disease (RR = 0.99, CI = 0.76-1.22; I2 = 68.9%). Sensitivity analysis and 'trim and fill' method yielded similar results. No evidence of publication bias was observed. CONCLUSIONS HBV infection does not increase the risk of coronary heart disease. The associations were not significant both in cohort studies and in case-control studies.
Collapse
Affiliation(s)
- Yaqin Wang
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jianping Xiong
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing 100730, China
| | - Meng Niu
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Weiyu Xu
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing 100730, China
| | - Ke Xu
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China..
| | - Hongshan Zhong
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China..
| |
Collapse
|
33
|
Boehncke WH. Systemic Inflammation and Cardiovascular Comorbidity in Psoriasis Patients: Causes and Consequences. Front Immunol 2018; 9:579. [PMID: 29675020 PMCID: PMC5895645 DOI: 10.3389/fimmu.2018.00579] [Citation(s) in RCA: 179] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 03/07/2018] [Indexed: 11/26/2022] Open
Abstract
Psoriasis is a common inflammatory skin disease characterized by the appearance of red scaly plaques that can affect any part of the body. High prevalence, chronicity, disfiguration, disability, and associated comorbidity make it a challenge for clinicians of multiple specialties. Likewise, its complex pathogenesis, comprising inflammation, hyperproliferation, and angioneogenesis, intrigues numerous scientific disciplines, namely, immunology. From a clinical perspective, the severity of psoriasis is highlighted by its increased mortality, with cardiovascular diseases contributing the highest excess risk. From a scientific point of view, psoriasis has to be considered a systemic inflammatory condition, as blood biomarkers of inflammation are elevated and imaging techniques document sites of inflammation beyond the skin. While the association of psoriasis with cardiovascular diseases is now widely accepted, causes and consequences of this association are controversially discussed. This review comments on epidemiologic, genetic, and mechanistic studies that analyzed the relation between psoriasis and cardiovascular comorbidity. The hypothesis of psoriasis potentially being an independent cardiovascular risk factor, driving atherosclerosis via inflammation-induced endothelial dysfunction, will be discussed. Finally, consequences for the management of psoriasis with the objective to reduce the patients’ excess cardiovascular risk will be pointed out.
Collapse
Affiliation(s)
- Wolf-Henning Boehncke
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
34
|
Hu SCS, Lan CCE. Psoriasis and Cardiovascular Comorbidities: Focusing on Severe Vascular Events, Cardiovascular Risk Factors and Implications for Treatment. Int J Mol Sci 2017; 18:ijms18102211. [PMID: 29065479 PMCID: PMC5666891 DOI: 10.3390/ijms18102211] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 10/16/2017] [Accepted: 10/16/2017] [Indexed: 12/19/2022] Open
Abstract
Psoriasis is a common and chronic inflammatory disease of the skin. It may impair the physical and psychosocial function of patients and lead to decreased quality of life. Traditionally, psoriasis has been regarded as a disease affecting only the skin and joints. More recently, studies have shown that psoriasis is a systemic inflammatory disorder which can be associated with various comorbidities. In particular, psoriasis is associated with an increased risk of developing severe vascular events such as myocardial infarction and stroke. In addition, the prevalence rates of cardiovascular risk factors are increased, including hypertension, diabetes mellitus, dyslipidemia, obesity, and metabolic syndrome. Consequently, mortality rates have been found to be increased and life expectancy decreased in patients with psoriasis, as compared to the general population. Various studies have also shown that systemic treatments for psoriasis, including methotrexate and tumor necrosis factor-α inhibitors, may significantly decrease cardiovascular risk. Mechanistically, the presence of common inflammatory pathways, secretion of adipokines, insulin resistance, angiogenesis, oxidative stress, microparticles, and hypercoagulability may explain the association between psoriasis and cardiometabolic disorders. In this article, we review the evidence regarding the association between psoriasis and cardiovascular comorbidities, focusing on severe vascular events, cardiovascular risk factors and implications for treatment.
Collapse
Affiliation(s)
- Stephen Chu-Sung Hu
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
| | - Cheng-Che E Lan
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
| |
Collapse
|
35
|
Zhang Y, Liu H, Li L, Ai M, Gong Z, He Y, Dong Y, Xu S, Wang J, Jin B, Liu J, Teng Z. Cholecystectomy can increase the risk of colorectal cancer: A meta-analysis of 10 cohort studies. PLoS One 2017; 12:e0181852. [PMID: 28771518 PMCID: PMC5542607 DOI: 10.1371/journal.pone.0181852] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 07/07/2017] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE This study aimed to elucidate the effects of cholecystectomy on the risk of colorectal cancer (CRC) by conducting a meta-analysis of 10 cohort studies. METHODS The eligible cohort studies were selected by searching the PubMed and EMBASE databases from their origination to June 30, 2016, as well as by consulting the reference lists of the selected articles. Two authors individually collected the data from the 10 papers. When the data showed marked heterogeneity, we used a random-effects model to estimate the overall pooled risk; otherwise, a fixed effects model was employed. RESULTS The final analysis included ten cohort studies. According to the Newcastle-Ottawa Scale (NOS), nine papers were considered high quality. After the data of these 9 studies were combined, an increased risk of CRC was found among the individuals who had undergone cholecystectomy (risk ratio (RR) 1.22; 95% confidence interval (CI) 1.08-1.38). In addition, we also found a promising increased risk for colon cancer (CC) (RR 1.30, 95% CI 1.07-1.58), but no relationship between cholecystectomy and rectum cancer (RC) (RR 1.09; 95% CI 0.89-1.34) was observed. Additionally, in the sub-group analysis of the tumor location in the colon, a positive risk for ascending colon cancer (ACC) was found (RR 1.18, 95% CI 1.11-1.26). After combining the ACC, transverse colon cancer (TCC), sigmoid colon cancer (SCC) and descending colon cancer (DCC) patients, we found a positive relationship with cholecystectomy (RR 1.18, 95% CI 1.11-1.26). Furthermore, after combining the ACC and DCC patients, we also found a positive relationship with cholecystectomy (RR 1.28; 95% CI 1.11-1.26) in the sub-group analysis. In an additional sub-group analysis of patients from Western countries, there was a positive relationship between cholecystectomy and the risk of CRC (RR 1.20; 95% CI 1.05-1.36). Furthermore, a positive relationship between female gender and CRC was also found (RR 1.17; 95% CI 1.03-1.34). However, there was no relationship between gender and CC or RC. Furthermore, no publication bias was observed, and the sensitivity analysis indicated stable results. CONCLUSIONS This meta-analysis of 10 cohort studies revealed that cholecystectomy is associated with an increased risk for CRC, CC and ACC, particularly in Western countries. No relationship between cholecystectomy and RC was observed. There was no relationship between gender and either CC or RC, but a positive relationship between female gender and CRC was observed.
Collapse
Affiliation(s)
- Yong Zhang
- Department of General Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi, Yunnan, China
| | - Hao Liu
- Department of General Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi, Yunnan, China
| | - Li Li
- Department of General Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi, Yunnan, China
| | - Min Ai
- School of Public Health, Dali University, Dali, Yunnan, China
| | - Zheng Gong
- Department of General Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi, Yunnan, China
| | - Yong He
- Department of General Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi, Yunnan, China
| | - Yunlong Dong
- Department of General Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi, Yunnan, China
| | - Shuanglan Xu
- Department of Respiratory Medicine, The Affiliated Yanan Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Jun Wang
- Department of General Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi, Yunnan, China
| | - Bo Jin
- Department of General Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi, Yunnan, China
| | - Jianping Liu
- Department of Science and Education, The 6th Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi, Yunnan, China
| | - Zhaowei Teng
- Department of Orthopedic Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi, Yunnan, China
| |
Collapse
|
36
|
Yeh ML, Ko SH, Wang MH, Chi CC, Chung YC. Acupuncture-Related Techniques for Psoriasis: A Systematic Review with Pairwise and Network Meta-Analyses of Randomized Controlled Trials. J Altern Complement Med 2017. [PMID: 28628749 DOI: 10.1089/acm.2016.0158] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE There has be a large body of evidence on the pharmacological treatments for psoriasis, but whether nonpharmacological interventions are effective in managing psoriasis remains largely unclear. This systematic review conducted pairwise and network meta-analyses to determine the effects of acupuncture-related techniques on acupoint stimulation for the treatment of psoriasis and to determine the order of effectiveness of these remedies. METHODS This study searched the following databases from inception to March 15, 2016: Medline, PubMed, Cochrane Central Register of Controlled Trials, EBSCO (including Academic Search Premier, American Doctoral Dissertations, and CINAHL), Airiti Library, and China National Knowledge Infrastructure. Randomized controlled trials (RCTs) on the effects of acupuncture-related techniques on acupoint stimulation as intervention for psoriasis were independently reviewed by two researchers. RESULTS A total of 13 RCTs with 1,060 participants were included. The methodological quality of included studies was not rigorous. Acupoint stimulation, compared with nonacupoint stimulation, had a significant treatment for psoriasis. However, the most common adverse events were thirst and dry mouth. Subgroup analysis was further done to confirm that the short-term treatment effect was superior to that of the long-term effect in treating psoriasis. Network meta-analysis identified acupressure or acupoint catgut embedding, compared with medication, and had a significant effect for improving psoriasis. It was noted that acupressure was the most effective treatment. CONCLUSIONS Acupuncture-related techniques could be considered as an alternative or adjuvant therapy for psoriasis in short term, especially of acupressure and acupoint catgut embedding. This study recommends further well-designed, methodologically rigorous, and more head-to-head randomized trials to explore the effects of acupuncture-related techniques for treating psoriasis.
Collapse
Affiliation(s)
- Mei-Ling Yeh
- 1 Graduate Institute of Integration of Traditional Chinese Medicine with Western Nursing, National Taipei University of Nursing and Health Sciences , Taipei, Taiwan, Republic of China
| | - Shu-Hua Ko
- 2 Chong-Ren Hospital , Miaoli, Taiwan, Republic of China
| | - Mei-Hua Wang
- 3 School of Nursing, National Taipei University of Nursing and Health Sciences , Taipei, Taiwan, Republic of China
| | - Ching-Chi Chi
- 4 Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine , Taoyuan, Taiwan, Republic of China
| | - Yu-Chu Chung
- 5 Department of Nursing, Yuanpei University of Medical Technology , Hsinchu, Taiwan, Republic of China
| |
Collapse
|
37
|
Long-term treatment of chronic plaque psoriasis with biological drugs can control platelet activation: targeting the bridge between inflammation and atherothrombosis. Postepy Dermatol Alergol 2017; 34:131-137. [PMID: 28507492 PMCID: PMC5420605 DOI: 10.5114/ada.2017.67077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 04/18/2016] [Indexed: 01/17/2023] Open
Abstract
Introduction Platelet activation is elevated in moderate to severe psoriasis, and the reduction in platelet activation during short-term treatment has already been demonstrated. Soluble P-selectin is a well-established marker of platelet activation. Aim To show whether the long-term treatment of psoriasis with biological drugs can reduce elevated platelet activation. Material and methods An observational study of 27 patients with chronic plaque psoriasis, treated with infliximab, adalimumab, etanercept, or ustekinumab for up to 12 months was conducted. Psoriasis area and severity index (PASI), serum P-selectin and interleukin (IL)-6 were monitored throughout the treatment. Results There was no significant correlation between PASI and platelet activation in our patients. After 3 months of treatment, a significant reduction in PASI and IL-6 was found, while P-selectin was not significantly reduced. When a cohort of patients who had shown elevated P-selectin prior to the treatment was evaluated, a significant reduction in P-selectin was observed in all 8 patients following 3 months; a reduction that was sustained after 6 and 12 months of therapy. Conclusions We conclude that PASI is not a good predictor of platelet activity in patients with PASI near to 10. Biological drugs reduce platelet activation in patients who have increased platelet activation prior to treatment, and this effect is stable during chronic therapy.
Collapse
|
38
|
Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, Van Voorhees AS, Gelfand JM. Psoriasis and comorbid diseases: Epidemiology. J Am Acad Dermatol 2017; 76:377-390. [PMID: 28212759 PMCID: PMC5731650 DOI: 10.1016/j.jaad.2016.07.064] [Citation(s) in RCA: 625] [Impact Index Per Article: 89.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/17/2016] [Accepted: 07/01/2016] [Indexed: 02/08/2023]
Abstract
Psoriasis is a common chronic inflammatory disease of the skin that is increasingly being recognized as a systemic inflammatory disorder. Psoriatic arthritis is a well-known comorbidity of psoriasis. A rapidly expanding body of literature in various populations and settings supports additional associations between psoriasis and cardiometabolic diseases, gastrointestinal diseases, kidney disease, malignancy, infection, and mood disorders. The pathogenesis of comorbid disease in patients with psoriasis remains unknown; however, shared inflammatory pathways, cellular mediators, genetic susceptibility, and common risk factors are hypothesized to be contributing elements. As additional psoriasis comorbidities continue to emerge, education of health care providers is essential to ensuring comprehensive medical care for patients with psoriasis.
Collapse
Affiliation(s)
- Junko Takeshita
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
| | - Sungat Grewal
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Sinéad M Langan
- London School of Hygiene and Tropical Medicine and St. John's Institute of Dermatology, London, United Kingdom
| | - Nehal N Mehta
- National Heart, Lung and Blood Institute, Bethesda, Maryland
| | - Alexis Ogdie
- Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Abby S Van Voorhees
- Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia
| | - Joel M Gelfand
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| |
Collapse
|
39
|
Chang WL, Hsu MH, Lin CL, Chan PC, Chang KS, Lee CH, Hsu CY, Tsai MT, Yeh CH, Sung FC. Increased risk of stroke in contact dermatitis patients: A nationwide population-based retrospective cohort study. Medicine (Baltimore) 2017; 96:e5650. [PMID: 28272195 PMCID: PMC5348143 DOI: 10.1097/md.0000000000005650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Dermatologic diseases are not traditional risk factors of stroke, but recent studies show atopic dermatitis, psoriasis, and bullous skin disease may increase the risk of stroke and other cardiovascular diseases. No previous studies have focused on the association between contact dermatitis and stroke.We established a cohort comprised of 48,169 contact dermatitis patients newly diagnosed in 2000-2003 and 96,338 randomly selected subjects without the disorder, frequency matched by sex, age, and diagnosis year, as the comparison cohort. None of them had a history of stroke. Stroke incidence was assessed by the end of 2011 for both cohorts.The incidence stroke was 1.1-fold higher in the contact dermatitis cohort than in the comparison cohort (5.93 vs 5.37 per 1000 person-years, P < 0.01). The multivariable Cox method analyzed adjusted hazard ratios (aHRs) were 1.12 (95% confidence interval [CI], 1.05-1.19) for all stroke types and 1.12 (95% CI, 1.05-1.20) for ischemic stroke and 1.11 (95% CI, 0.94-1.30) for hemorrhagic stroke. The age-specific aHR of stroke for contact dermatitis cohort increased with age, from 1.14 (95% CI, 1.03-1.27) for 65 to 74 years; to 1.27 (95% CI, 1.15-1.42) for 75 years and older. The aHR of stroke were 1.16 (95% CI, 1.07-1.27) and 1.09 (95% CI, 1.00-1.18) for men and women, respectively.This study suggests that patients with contact dermatitis were at a modestly increased risk of stroke, significant for ischemic stroke but not for hemorrhagic stroke. Comorbidity, particularly hypertension, increased the hazard of stroke further.
Collapse
Affiliation(s)
- Wei-Lun Chang
- Department of Neurology, Show-Chwan Memorial Hospital, Changhua, Taiwan, R.O.C
- Department of Medical Technology, Jen-The Junior College of Medicine, Nursing and Management, Miaoli, Taiwan, R.O.C
| | - Min-Hsien Hsu
- Department of Neurology, Show-Chwan Memorial Hospital, Changhua, Taiwan, R.O.C
- Department of Medical Technology, Jen-The Junior College of Medicine, Nursing and Management, Miaoli, Taiwan, R.O.C
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Po-Chi Chan
- Department of Neurology, Show-Chwan Memorial Hospital, Changhua, Taiwan, R.O.C
- Department of Medical Technology, Jen-The Junior College of Medicine, Nursing and Management, Miaoli, Taiwan, R.O.C
| | - Ko-Shih Chang
- Department of Cardiology, Yuan Rung Hospital, Changhua, Taiwan, R.O.C
| | - Ching-Hsiao Lee
- Department of Medical Technology, Jen-The Junior College of Medicine, Nursing and Management, Miaoli, Taiwan, R.O.C
| | - Chung-Yi Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C
| | - Min-Tein Tsai
- Department of Neurology, Yuan Rung Hospital, Taiwan, R.O.C
| | - Chung-Hsin Yeh
- Department of Neurology, Yuan Rung Hospital, Taiwan, R.O.C
- Department of Sport and Health Management, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan, R.O.C
- Department of Nursing, College of Medicine & Nursing, HungKuang University, Taichung, Taiwan, R.O.C
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, R.O.C
- Department of Health Services Administration, College of Public Health, China Medical University, Taichung, Taiwan, R.O.C
| |
Collapse
|
40
|
Polachek A, Touma Z, Anderson M, Eder L. Risk of Cardiovascular Morbidity in Patients With Psoriatic Arthritis: A Meta-Analysis of Observational Studies. Arthritis Care Res (Hoboken) 2016; 69:67-74. [DOI: 10.1002/acr.22926] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 04/04/2016] [Accepted: 04/19/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Ari Polachek
- University of Toronto, Toronto Western Hospital; Toronto Ontario Canada
| | - Zahi Touma
- University of Toronto, Toronto Western Hospital, Centre for Prognosis Studies in the Rheumatic Diseases; Toronto Ontario Canada
| | | | - Lihi Eder
- University of Toronto, Women's College Research Institute, Women's College Hospital; Toronto Ontario Canada
| |
Collapse
|
41
|
Metabolic Syndrome and Selective Inflammatory Markers in Psoriatic Patients. J Immunol Res 2016; 2016:5380792. [PMID: 28097156 PMCID: PMC5209622 DOI: 10.1155/2016/5380792] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/11/2016] [Accepted: 11/30/2016] [Indexed: 12/26/2022] Open
Abstract
The presented article studies the role of selected inflammatory and anti-inflammatory serum markers of psoriatic patients in the pathogenesis of metabolic syndrome (MS) and psoriasis. The study is based on the comparison between the group of psoriatic patients (74) and the control group (65). We found significantly higher BMI (p < 0.05) and diastolic blood pressure (p < 0.05) in the psoriatic patients. The values of waist circumference and BMI were significantly higher (p < 0.05) in the male patients compared to the men in the control group. The analysis revealed significantly higher CRP (p < 0.001), Lp-PLA2 (p < 0.001), leptin (p < 0.01), and resistin (p < 0.01) levels in the psoriatic patients. Significantly higher levels of CRP (p < 0.01), Lp-PLA2 (p < 0.001), leptin (p < 0.01), and resistin (p < 0.05) were found in the patients with MS compared to the controls with MS. The level of adiponectin was significantly lower (p < 0.01) in the patients with MS. Finally, we found significantly higher level of Lp-PLA2 (p < 0.001) in the group of patients without MS compared to the controls without MS. In conclusion, observed inflammatory and anti-inflammatory markers (CRP, adiponectin, leptin, resistin, and Lp-PLA2) are involved in both pathogenesis of MS and pathogenesis of psoriasis. The level of Lp-PLA2 indicates the presence of subclinical atherosclerosis (cardiovascular risk) in psoriatic patients.
Collapse
|
42
|
Liu H, Zhang Y, Ai M, Wang J, Jin B, Teng Z, Wang Y, Li L. Body Mass Index Can Increase the Risk of Gallbladder Cancer: A Meta-Analysis of 14 Cohort Studies. Med Sci Monit Basic Res 2016; 22:146-155. [PMID: 27899789 PMCID: PMC5134363 DOI: 10.12659/msmbr.901651] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND This study sought to appraise the association between raised body mass index (BMI) and the risk of gallbladder cancer (GBC) by performing a meta-analysis of 14 cohort studies. MATERIAL AND METHODS Eligible cohort studies were selected by searching PubMed and EMBASE from their inception to May 26, 2016, and the reference lists of retrieved articles were also consulted. The information was screened by two authors separately. We used a fixed-effects model to calculate the overall pooled risk estimates. A random-effects model was used to identify heterogeneity. RESULTS The meta-analysis incorporated 14 cohort studies. Nine papers were deemed to be of high quality based on the Newcastle-Ottawa Scale (NOS). Compared with normal weight (BMI 18.5-24.9 kg/m²), the overall pooled relative risks (RR) of GBC was 1.45 (95% CI 1.30-1.61) for excess body weight individuals (BMI ≥25 kg/m²); 1.10 (95% CI 1.02-1.18) for overweight persons (BMI 25-29.9 kg/m²) and 1.69(95% CI 1.54-1.86) for obese folks (BMI ≥30 kg/m²). A higher risk of GBC was presented in obese women (women: RR 1.78, 95% CI 1.59-1.99; men: RR 1.50, 95% CI 1.25-1.79). And a positive relationship between overweight and GBC risk was also displayed in female (RR 1.25, 95% CI 1.11-1.40), but not in male (RR 1.01, 95% CI 0.93-1.11). The sensitivity analysis indicated stable results, and no publication bias was observed. CONCLUSIONS This meta-analysis of 14 cohort studies demonstrated that raised BMI has a dramatic association with risk of GBC, especially in women. But, no association between overweight and GBC in men was found.
Collapse
Affiliation(s)
- Hao Liu
- Department of General Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People's Hospital of Yuxi City, Yuxi, Yunan, China (mainland)
| | - Yong Zhang
- Department of General Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People's Hospital of Yuxi City, Yuxi, Yunan, China (mainland)
| | - Min Ai
- Department of Health Statistics and Epidemiology, Dali University, Dali, Yunnan, China (mainland)
| | - Jun Wang
- Department of General Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People's Hospital of Yuxi City, Yuxi, Yunan, China (mainland)
| | - Bo Jin
- Department of General Surgery, The 6th Affiliated Hospital of Kunming Medical University, Yuxi, Yunan, China (mainland)
| | - Zhaowei Teng
- Department of Orthopedic Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People's Hospital of Yuxi City, Yuxi, Yunan, China (mainland)
| | - Yansheng Wang
- Department of General Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People's Hospital of Yuxi City, Yuxi, Yunan, China (mainland)
| | - Li Li
- Department of General Surgery, The 6th Affiliated Hospital of Kunming Medical University, The People's Hospital of Yuxi City, Yuxi, Yunan, China (mainland)
| |
Collapse
|
43
|
Cardiovascular event risk assessment in psoriasis patients treated with tumor necrosis factor-α inhibitors versus methotrexate. J Am Acad Dermatol 2016; 76:81-90. [PMID: 27894789 DOI: 10.1016/j.jaad.2016.07.042] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 07/07/2016] [Accepted: 07/20/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Psoriasis is associated with increased risk for cardiovascular disease. OBJECTIVE To compare major cardiovascular event risk in psoriasis patients receiving methotrexate or tumor necrosis factor-α inhibitor (TNFi) and to assess TNFi treatment duration impact on major cardiovascular event risk. METHODS Adult psoriasis patients with ≥2 TNFi or methotrexate prescriptions in the Truven MarketScan Databases (Q1 2000-Q3 2011) were classified as TNFi or methotrexate users. The index date for each of these drugs was the TNFi initiation date or a randomly selected methotrexate dispensing date, respectively. Cardiovascular event risks and cumulative TNFi effect were analyzed by using multivariate Cox proportional-hazards models. RESULTS By 12 months, TNFi users (N = 9148) had fewer cardiovascular events than methotrexate users (N = 8581) (Kaplan-Meier rates: 1.45% vs 4.09%: P < .01). TNFi users had overall lower cardiovascular event hazards than methotrexate users (hazard ratio = 0.55; P < .01). Over 24 months' median follow-up, every 6 months of cumulative exposure to TNFis were associated with an 11% cardiovascular event risk reduction (P = .02). LIMITATIONS Lack of clinical assessment measures. CONCLUSIONS Psoriasis patients receiving TNFis had a lower major cardiovascular event risk compared to those receiving methotrexate. Cumulative exposure to TNFis was associated with a reduced risk for major cardiovascular events.
Collapse
|
44
|
Potenza C, Raimondi G, Pampena R, Proietti I, Viola GL, Bernardini N, Tolino E, Zuber S, Balduzzi V, Scordamaglia B, Skroza N. Cardiovascular risk evaluation through heart rate variability analysis in psoriatic patients before and after 24 weeks of etanercept therapy: Prospective study. J Int Med Res 2016; 44:43-47. [PMID: 27683138 PMCID: PMC5536535 DOI: 10.1177/0300060515593242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Objective To assess the influence of etanercept, an anti-tumour necrosis factor (TNF)-α agent, on autonomic cardiovascular regulation in young patients with moderate-to-severe psoriasis without cardiovascular risk factors. Methods Patients with psoriasis underwent 5-min electrocardiogram (ECG) recordings before and after 24 weeks of etanercept therapy. Linear heart rate variability (HRV) analysis was performed. Results The study recruited 19 patients. Frequency-domain analysis showed a significant decrease in oscillatory components attributable to sympathetic activity (LF%) and a significant decrease in low frequency/high frequency (LF/HF) ratio following etanercept therapy. Conclusion Treatment with etanercept in patients with moderate-to-severe psoriasis could affect cardiovascular autonomic regulation, and subsequently reduce cardiovascular risk.
Collapse
Affiliation(s)
- Concetta Potenza
- Department of Medical and Surgical Sciences and Biotechnologies, Division of Dermatology "Daniele Innocenzi", University of Rome "La Sapienza", Polo Pontino, Italy
| | - Gianfranco Raimondi
- Department of Medical and Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome "Sapienz'', Italy
| | - Riccardo Pampena
- Department of Medical and Surgical Sciences and Biotechnologies, Division of Dermatology "Daniele Innocenzi", University of Rome "La Sapienza", Polo Pontino, Italy
| | - Ilaria Proietti
- Department of Medical and Surgical Sciences and Biotechnologies, Division of Dermatology "Daniele Innocenzi", University of Rome "La Sapienza", Polo Pontino, Italy
| | - Giorgio La Viola
- Department of Medical and Surgical Sciences and Biotechnologies, Division of Dermatology "Daniele Innocenzi", University of Rome "La Sapienza", Polo Pontino, Italy
| | - Nicoletta Bernardini
- Department of Medical and Surgical Sciences and Biotechnologies, Division of Dermatology "Daniele Innocenzi", University of Rome "La Sapienza", Polo Pontino, Italy
| | - Ersilia Tolino
- Department of Medical and Surgical Sciences and Biotechnologies, Division of Dermatology "Daniele Innocenzi", University of Rome "La Sapienza", Polo Pontino, Italy
| | - Sara Zuber
- Department of Medical and Surgical Sciences and Biotechnologies, Division of Dermatology "Daniele Innocenzi", University of Rome "La Sapienza", Polo Pontino, Italy
| | - Veronica Balduzzi
- Department of Medical and Surgical Sciences and Biotechnologies, Division of Dermatology "Daniele Innocenzi", University of Rome "La Sapienza", Polo Pontino, Italy
| | - Beatrice Scordamaglia
- Department of Medical and Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome "Sapienz'', Italy
| | - Nevena Skroza
- Department of Medical and Surgical Sciences and Biotechnologies, Division of Dermatology "Daniele Innocenzi", University of Rome "La Sapienza", Polo Pontino, Italy
| |
Collapse
|
45
|
Zhou ZX, Chen JK, Hong YY, Zhou R, Zhou DM, Sun LY, Qin WL, Wang TC. Relationship Between the Serum Total Bilirubin and Inflammation in Patients With Psoriasis Vulgaris. J Clin Lab Anal 2016; 30:768-75. [PMID: 27061381 DOI: 10.1002/jcla.21936] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 12/02/2015] [Accepted: 12/09/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Psoriasis is a chronic and recurrent inflammatory skin disease. Previous studies have shown that bilirubin has anti-inflammation and antioxidant effects. However, the various roles of bilirubin in psoriasis patients are still unclear. OBJECTIVE To investigate the serum total bilirubin (TB) level in the individuals with psoriasis vulgaris and further evaluate the relationship between serum TB concentration and C-reactive protein (CRP) to clarify the effect of bilirubin on inflammation. METHODS A total of 214 patients with psoriasis vulgaris and 165 age- and gender-matched healthy control subjects were recruited. The peripheral leukocyte count (white blood cell, WBC) and differential, serum biochemical and immunologic indexes including serum TB, immunoglobulin (Ig) G, IgA, IgM, complement C3 and C4 , as well as serum CRP concentrations were measured. RESULTS Results showed that the serum TB level decreased significantly and peripheral WBC, neutrophil, and serum CRP concentrations increased significantly in patients with psoriasis vulgaris. Meanwhile, the serum CRP was negatively correlated with serum TB levels but positively correlated with peripheral WBC and the Psoriasis Area and Severity Index (PASI). Logistic regression analysis showed that the serum TB was a protective factor for psoriasis vulgaris. CONCLUSION The present study suggests that lower serum TB is associated with the enhancement of the inflammatory response in psoriasis vulgaris. Therefore, lower serum TB has a prognostic significance for worsening psoriasis vulgaris. Bilirubin may play a crucial role in inflammation by contributing to the inhibition of the inflammatory response.
Collapse
Affiliation(s)
- Zhen-Xing Zhou
- Department of Clinical Laboratory, Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical University, Beijing, P. R. China
| | - Jian-Kui Chen
- Department of Clinical Laboratory, Hospital Affiliated to Academy of Military Medical Science, Beijing, P. R. China
| | - Yan-Ying Hong
- Department of Clinical Laboratory, Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical University, Beijing, P. R. China
| | - Ru Zhou
- Department of Clinical Laboratory, Beijing Ditan Hospital Affiliated to Capital Medical University, Beijing, P. R. China
| | - Dong-Mei Zhou
- Department of Dermatology, Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical University, Beijing, P. R. China
| | - Li-Yun Sun
- Department of Dermatology, Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical University, Beijing, P. R. China
| | - Wen-Li Qin
- Department of Clinical Laboratory, Jingxi Hospital of General Hospital of Beijing Military Region, Beijing, P. R. China
| | - Tian-Cheng Wang
- Department of Clinical Laboratory, Third Hospital of Peking University, Beijing, P. R. China.
| |
Collapse
|
46
|
Abstract
Psoriasis is a 'pacemaker' in dermatology. Substantial progress has been made regarding our understanding of its pathophysiology and genetic background, fuelling developments in cutaneous biology in general. Besides, the clinical perspective on psoriasis is currently changing, taking into consideration comorbidity and the systemic dimensions of this seemingly organ-specific inflammation. The availability of drugs exhibiting fewer contraindications and improved long-term safety opened a discussion around replacing a relatively limited (regarding both objectives and duration) 'therapeutic' by a much broader 'management' approach when it comes to treating psoriasis as a systemic disease. The question arises whether this 'upgrade' is warranted.
Collapse
Affiliation(s)
- Sandra Boehncke
- Department of Diabetology, Endocrinology, Hypertension and Nutrition, Geneva University Hospital, Geneva, Switzerland
| | | |
Collapse
|
47
|
Increased risk of migraine in patients with psoriasis: A Danish nationwide cohort study. J Am Acad Dermatol 2015; 73:829-35. [DOI: 10.1016/j.jaad.2015.08.039] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 08/15/2015] [Accepted: 08/20/2015] [Indexed: 11/22/2022]
|
48
|
Cohen-Barak E, Sah M, Kerner M, Rozenman D, Ziv M. Impact of antipsoriatic therapy on endothelial function. Br J Dermatol 2015; 173:1440-6. [DOI: 10.1111/bjd.14076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2015] [Indexed: 02/02/2023]
Affiliation(s)
- E. Cohen-Barak
- Department of Dermatology; Haemek Medical Center; Afula 18101 Israel
| | - M. Sah
- Department of Dermatology; Haemek Medical Center; Afula 18101 Israel
| | - M. Kerner
- Department of Dermatology; Haemek Medical Center; Afula 18101 Israel
| | - D. Rozenman
- Department of Dermatology; Haemek Medical Center; Afula 18101 Israel
| | - M. Ziv
- Department of Dermatology; Haemek Medical Center; Afula 18101 Israel
| |
Collapse
|
49
|
Abstract
Psoriasis is a systemic inflammatory disease that confers significant risk of metabolic derangements and adverse cardiovascular outcomes. Early detection and treatment of modifiable risk factors and modulation of the systemic inflammatory response are important treatment goals. Studies have shown that there is a significant lack of awareness of the relationship between psoriasis and cardiovascular disease, so future considerations should focus on education of and collaboration with health care providers, especially those in primary care, and development of updated, rigorous screening guidelines. In addition, targeted biologic therapies such as TNF-a inhibitors have shown immense promise in targeting the systemic inflammation associated with psoriatic disease, but whether they will impact long-term cardiovascular outcomes remains to be seen.
Collapse
Affiliation(s)
- Kathryn T Shahwan
- Clinical Unit for Research Trials and Outcomes in Skin (CURTIS), Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 50 Staniford Street, Suite 240, Boston, MA 02114, USA
| | - Alexa B Kimball
- Clinical Unit for Research Trials and Outcomes in Skin (CURTIS), Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 50 Staniford Street, Suite 240, Boston, MA 02114, USA.
| |
Collapse
|
50
|
|