Killing Two Birds with One Stone: Potential Therapies Targeting Psoriasis and Atherosclerosis at the Same Time

Association of psoriasis disease with physical activity and exercise: systematic review and meta-analysis

Introduction

Psoriasis (Pso) is an inflammatory autoimmune skin disease. High BMI, and elevated body fat and body weight is associated with risk of Pso development. People with Pso have lower physical activity than people without Pso, so they are at higher risk for comorbidities and underlying disease. Exercise has been shown to improve disease outcomes and inflammation in people with psoriasis.

Aim

Meta-analysis study to investigate the physical activity in psoriasis patients.

Methods

We designed this study according to the Systematic Reviews and Meta-Analyses (PRISMA) statement. The ISI, Scopus, PubMed, Cochrane Library, and Google Scholar have been used to search articles up to the end of May 2024.

Results

A total of 1319 articles were extracted from the databases, and 7 articles were selected for analysis. High-intensity exercise levels were significantly lower in Pso patients than in healthy people (RR = 0.75; 95% CI: 0.60-0.93; p = 0.010). But there was no significant difference between the 2 groups regarding moderate-intensity exercise (RR = 0.80; 95% CI: 0.57-1.12; p = 0.20) and low-intensity exercise (RR = 1.42; 95% CI: 0.36-5.60; p = 0.62). Also, the number of metabolic equivalent task (MET) minutes in the Pso group was significantly lower than in healthy controls (SMD = -0.71; 95% CI: -0.86-0.56; p < 000001). Finally, the post-exercise PASI score decreased significantly in psoriatic patients (SMD = 3.98; 95% CI: 0.48-7.48; p = 0.03).

Conclusions

High-intensity physical activity is significantly lower in Pso patients than in healthy people, MET in the Pso group was significantly lower than in healthy controls, and the post-exercise PASI score decreased significantly in psoriatic patients, which means physical activity intervention can be suggested as a therapeutic method for Pso patients.

Management of psoriatic arthritis: a consensus opinion by expert rheumatologists

Background

Psoriatic arthritis (PsA) is a chronic inflammatory musculoskeletal disease involving several articular and extra-articular structures. Despite the important progresses recently made in all of the aspects of this disease, its management is still burdened by unresolved issues. The aim of this exercise was to provide a set of statements that may be helpful for the management of PsA.

Methods

A group of 38 Italian rheumatologists with recognized expertise in PsA selected and addressed the following four topics: "early PsA," "axial-PsA," "extra-articular manifestations and comorbidities," "therapeutic goals." Relevant articles from the literature (2016-2022) were selected by the experts based on a PubMed search. A number of statements for each topic were elaborated.

Results

Ninety-four articles were selected and evaluated, 68 out of the 1,114 yielded by the literature search and 26 added by the Authors. Each of the four topic was subdivided in themes as follows: transition from psoriasis to PsA, imaging vs. CASPAR criteria in early diagnosis, early treatment for "early PsA"; axial-PsA vs. axialspondyloarthritis, diagnosis, clinical evaluation, treatment, standard radiography vs. magnetic resonance imaging for "axial PsA"; influence of inflammatory bowel disease on the therapeutic choice, cardiovascular comorbidity, bone damage, risk of infection for "comorbidities and extra-articular manifestations"; target and tools, treat-to-target strategy, role of imaging for "therapeutic goals." The final document consisted of 49 statements.

Discussion

The final product of this exercise is a set of statements concerning the main issues of PsA management offering an expert opinion for some unmet needs of this complex disease.

The Impact of Diet and Physical Activity on Psoriasis: A Narrative Review of the Current Evidence

Psoriasis is an inflammatory disease with strong genetic links and numerous features of autoimmunity that are also influenced by environment and lifestyle, including nutritional factors and physical activity (PA), with regards to the condition of patients. Recent reports in the field of nutrigenomics indicate a significant impact of nutrients in modulating microRNAs. However, few studies have evaluated the effect of nutritional systems and PA on treating psoriasis. This narrative review updates information regarding the current dietary recommendations for individuals with psoriasis and discusses the role of diet and PA in psoriasis prevention and treatment. Application of nutrigenetics in psoriasis therapy is also discussed. The PubMed and Google Scholar databases were searched using the MeSH terms for "nutrigenomics", "dietetics", "diet therapy", "diet", "physical activity", and "exercise" in conjunction with the MeSH terms for "psoriasis" and "dermatology". Evidence has shown that patients with psoriasis should have a personalized anti-inflammatory diet. Psoriasis patients are less physically active; most performed exercises of low-to-moderate intensity and were less likely to undertake regular exercise. Identifying nutrigenomic discoveries and the current lifestyle interventions associated with psoriasis can help physicians and physical therapists develop educational programs to manage and protect against the disease.