Can pregnancy-associated plasma protein-A be a marker for the assessment of atherosclerosis risk in patients with chronic plaque psoriasis?

Large-scale serum analysis identifies unique systemic biomarkers in psoriasis and hidradenitis suppurativa

BACKGROUND

Hidradenitis suppurativa (HS) is now recognized as a systemic inflammatory disease, sharing molecular similarities with psoriasis. Direct comparison of the systemic inflammation in HS with psoriasis is lacking.

OBJECTIVES

To evaluate the serum proteome of HS and psoriasis, and to identify biomarkers associated with disease severity.

METHODS

In this cross-sectional study, 1536 serum proteins were assessed using the Olink Explore (Proximity Extension Assay) high-throughput panel in patients with moderate-to-severe HS (n = 11), patients with psoriasis (n = 10) and age- and body mass index-matched healthy controls (n = 10).

RESULTS

HS displayed an overall greater dysregulation of circulating proteins, with 434 differentially expressed proteins (absolute fold change ≥ 1·2; P ≤ 0·05) in patients with HS vs. controls, 138 in patients with psoriasis vs. controls and 503 between patients with HS and patients with psoriasis. Interleukin (IL)-17A levels and T helper (Th)1/Th17 pathway enrichment were comparable between diseases, while HS presented greater tumour necrosis factor- and IL-1β-related signalling. The Th17-associated markers peptidase inhibitor 3 (PI3) and lipocalin 2 (LCN2) were able to differentiate psoriasis from HS accurately. Both diseases presented increases of atherosclerosis-related proteins. Robust correlations between clinical severity scores and immune and atherosclerosis-related proteins were observed across both diseases.

CONCLUSIONS

HS and psoriasis share significant Th1/Th17 enrichment and upregulation of atherosclerosis-related proteins. Despite the greater body surface area involved in psoriasis, HS presents a greater serum inflammatory burden.

Evaluation of pregnancy-associated plasma protein-A and some inflammation markers for atherosclerosis in psoriasis patients

Introduction

Psoriasis is a common, chronic inflammatory disease of the skin. Although its relationship with cardiovascular risk factors is one of the main causes of mortality, the association between psoriasis and cardiovascular events is controversial.

Aim

The aim of this study is to measure the levels of hs-CRP and pregnancy-associated plasma protein-A (PAPP-A) related to atherosclerosis in patients with moderate-severe psoriasis and to evaluate their possible association with disease severity.

Material and methods

This study included 45 moderate-severe psoriasis patients without additional risk factors for cardiovascular disease and 45 healthy individuals as a control group.

Results

Serum PAPP-A levels in both groups were given as two different variables, detectable and non- detectable, based on a value of 0.004 U/lL. When PAPP-A levels were compared, there was no statistically significant difference between the groups.

Conclusions

The use of the PAPP-A test in the evaluation of early-stage atherosclerosis in moderate-severe psoriasis patients who do not have additional risk factors for cardiovascular diseases may not be sufficient.