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Nguyen TTB, Jin YY, Chung HJ, Hong ST. Pharmabiotics as an Emerging Medication for Metabolic Syndrome and Its Related Diseases. Molecules 2017; 22:E1795. [PMID: 29064399 PMCID: PMC6151620 DOI: 10.3390/molecules22101795] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/17/2017] [Accepted: 10/20/2017] [Indexed: 12/15/2022] Open
Abstract
Metabolic syndrome (MetS) is a cluster of metabolic risk factors associated with central obesity, hyperglycemia, insulin resistance, dyslipidemia and high blood pressure. In recent decades, because of the remarkable increase in both prevalence and severity, MetS and its related diseases such as cardiovascular diseases (CVDs), obesity, hypertension and diabetes have become the main global burden and challenge in strategic management involving prevention and treatment. However, currently, the preventions and treatments based on pharmaceutical interventions do not provide a solution for MetS and its related diseases. Recently, gut microbiota showed clear evidence of preventing and/or treating MetS, shedding light on treating MetS and its related diseases through a completely different approach. In this review, we will interpret the effects of current pharmaceutical drugs used in preventing and treating MetS and its related diseases to understand remaining issues of those interventions. We will explore the possibility of developing gut microbiota as pharmabiotics in a completely new medication option for treating MetS and its related diseases.
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Affiliation(s)
- Thi Thanh Binh Nguyen
- Department of Biomedical Sciences and Institute for Medical Science, Chonbuk National University Medical School, Jeonju, Chonbuk 54907, Korea.
| | - Yan Yan Jin
- Department of Biomedical Sciences and Institute for Medical Science, Chonbuk National University Medical School, Jeonju, Chonbuk 54907, Korea.
| | - Hea-Jong Chung
- Department of Microbiology, Seonam University Medical School, Namwon, Chonbuk 55321, Korea.
| | - Seong-Tschool Hong
- Department of Biomedical Sciences and Institute for Medical Science, Chonbuk National University Medical School, Jeonju, Chonbuk 54907, Korea.
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202
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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: 125] [Impact Index Per Article: 15.6] [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.
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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.
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203
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Rivers JP, Powell-Wiley TM, Dey AK, Rodante JA, Chung JH, Joshi AA, Natarajan B, Sajja AP, Chaturvedi A, Rana A, Harrington CL, Teague HL, Lockshin BN, Ahlman MA, Yao J, Playford MP, Gelfand JM, Mehta NN. Visceral Adiposity in Psoriasis is Associated With Vascular Inflammation by 18F-Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography Beyond Cardiometabolic Disease Risk Factors in an Observational Cohort Study. JACC Cardiovasc Imaging 2017; 11:349-357. [PMID: 29055628 DOI: 10.1016/j.jcmg.2017.08.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/15/2017] [Accepted: 08/16/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The authors sought to examine the relationship between visceral adipose tissue (VAT) and vascular inflammation (VI) by 18F-Fluorodeoxyglucose (18F-FDG) positron-emission tomography (PET)/computed tomography (CT) in psoriasis (PSO). Furthermore, we evaluated whether treatment of PSO modulated VAT and VI. BACKGROUND PSO, a chronic inflammatory skin disease, is associated with VI by 18F-FDG PET/CT and increased cardiometabolic risk including adipose tissue dysregulation. Recently, VI was associated with future cardiovascular events; however, the relationship of visceral and subcutaneous adiposity with VI in PSO has yet to be evaluated. METHODS Consecutive PSO patients (N = 77) underwent 18F-FDG PET/CT scans to measure VI and abdominal adiposity. A subset of PSO patients with severe skin disease was scanned at 1 year following PSO treatment (N = 13). RESULTS The cohort was middle aged (51.8 ± 12.6 years), predominantly male (n = 44, 57%), had low cardiovascular risk by Framingham 10-year risk (median 4 years [interquartile range (IQR): 2 to 7 years]), and mild-to-moderate skin disease (5.2 [IQR: 3.0 to 8.5]). PSO disease severity associated with VAT (β = 0.33; p = 0.004) beyond SAT (β = 0.30; p = 0.005). VAT (β = 0.55; p < 0.001), but not SAT (β = 0.15; p = 0.11), associated with VI beyond cardiovascular risk factors. We followed a subset of severe PSO patients treated aggressively for PSO and observed improvement in PSO severity and VAT, which was associated with an improvement in VI at 1 year beyond cardiovascular risk factors (β = 0.53; p = 0.049). CONCLUSIONS Volume-based CT measurement of VAT may capture metabolic risk associated with VI compared to subcutaneous adipose tissue in PSO. PSO treatment associated with a decrease in VAT as well as decrease in VI suggesting VAT as a relevant biomarker related to VI in PSO.
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Affiliation(s)
- Joshua P Rivers
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Tiffany M Powell-Wiley
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Amit K Dey
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Justin A Rodante
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Jonathan H Chung
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Aditya A Joshi
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Balaji Natarajan
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Aparna P Sajja
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Abhishek Chaturvedi
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Anshuma Rana
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Charlotte L Harrington
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Heather L Teague
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | | | - Mark A Ahlman
- Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, Maryland
| | - Jianhua Yao
- Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, Maryland
| | - Martin P Playford
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Joel M Gelfand
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nehal N Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
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204
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Milčić D, Janković S, Vesić S, Milinković M, Marinković J, Ćirković A, Janković J. Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based cross-sectional study. An Bras Dermatol 2017; 92:46-51. [PMID: 28225956 PMCID: PMC5312178 DOI: 10.1590/abd1806-4841.20175178] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 03/06/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND: Emerging epidemiological evidence suggests independent associations between psoriasis and metabolic syndrome. Objectives: The aim of the study was to examine the prevalence of metabolic syndrome and its components in patients with psoriasis, and to assess which factors may predict metabolic syndrome in these patients. METHODS: A hospital-based, cross-sectional study with 244 psoriatic patients and 163 control subjects with skin diseases other than psoriasis was conducted at the Clinic of Dermatovenerology, Clinical Center of Serbia, Belgrade, from October 2011 to October 2012. Metabolic syndrome was defined using the revised National Cholesterol Education Program Adult Treatment Panel III. Severity of psoriasis was measured by Psoriasis Area and Severity Index and Body Surface Area. RESULTS: The adjusted odds ratios (ORs) and 95% confidence intervals (CI) for psoriasis patients vs. non-psoriasis patients were 2.66 (95% CI, 1.58-4.42) for metabolic syndrome, 3.81 (95% CI, 2.30-6.31) for hypertension, 2.29 (95% CI, 1.39-3.78) for central obesity, 1.92 (95% CI, 1.08-3.41) for hyperglycemia, 1.87 (95% CI 1.18-2.96) for low high-density lipoprotein cholesterol level, and 1.42 (95% CI, 0.87-1.04) for hypertrigliceridemia. We failed to find any statistically significant association between the metabolic syndrome and clinical severity of psoriasis. Later onset and longer duration of psoriasis were predicting factors for metabolic syndrome in our patients. Study limitations: The cross-sectional design of the study does not allow us to draw directional causal inferences concerning the association between psoriasis and metabolic syndrome. Factors such as diet, alcohol consumption or mental health, which have not been evaluated in this study, may be confounders in this relation. CONCLUSION: A higher prevalence of metabolic syndrome and its components in patients with psoriasis than in controls, regardless of disease severity, emphasizes the need for early treatment and follow-up of all psoriatic patients with respect to metabolic diseases.
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Affiliation(s)
- Danijela Milčić
- Department of Dermatovenereology, Faculty of Medicine, University of Belgrade - Belgrade, Serbia.,Clinic of Dermatovenereology, Clinical Center of Serbia - Belgrade, Serbia
| | - Slavenka Janković
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade - Belgrade, Serbia
| | - Sonja Vesić
- Department of Dermatovenereology, Faculty of Medicine, University of Belgrade - Belgrade, Serbia.,Clinic of Dermatovenereology, Clinical Center of Serbia - Belgrade, Serbia
| | - Mirjana Milinković
- Department of Dermatovenereology, Faculty of Medicine, University of Belgrade - Belgrade, Serbia.,Clinic of Dermatovenereology, Clinical Center of Serbia - Belgrade, Serbia
| | - Jelena Marinković
- Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade - Belgrade, Serbia
| | - Andja Ćirković
- Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade - Belgrade, Serbia
| | - Janko Janković
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade - Belgrade, Serbia
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205
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Rodríguez-Zúñiga MJM, García-Perdomo HA. Systematic review and meta-analysis of the association between psoriasis and metabolic syndrome. J Am Acad Dermatol 2017; 77:657-666.e8. [DOI: 10.1016/j.jaad.2017.04.1133] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 04/28/2017] [Accepted: 04/30/2017] [Indexed: 02/06/2023]
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206
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Paiva-Lopes MJ, Delgado Alves J. Psoriasis-associated vascular disease: the role of HDL. J Biomed Sci 2017; 24:73. [PMID: 28911329 PMCID: PMC5598036 DOI: 10.1186/s12929-017-0382-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 09/12/2017] [Indexed: 12/30/2022] Open
Abstract
Psoriasis is a chronic inflammatory systemic disease with a prevalence of 2-3%. Overwhelming evidence show an epidemiological association between psoriasis, cardiovascular disease and atherosclerosis. Cardiovascular disease is the most frequent cause of death in patients with severe psoriasis. Several cardiovascular disease classical risk factors are also increased in psoriasis but the psoriasis-associated risk persists after adjusting for other risk factors.Investigation has focused on finding explanations for these epidemiological data. Several studies have demonstrated significant lipid metabolism and HDL composition and function alterations in psoriatic patients. Altered HDL function is clearly one of the mechanisms involved, as these particles are of the utmost importance in atherosclerosis defense. Recent data indicate that biologic therapy can reverse both structural and functional HDL alterations in psoriasis, reinforcing their therapeutic potential.
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Affiliation(s)
- Maria Joao Paiva-Lopes
- Serviço de Dermatologia, Hospital dos Capuchos CHLC, Alameda de Santo António dos Capuchos, 1169-050, Lisboa, Portugal.
- CEDOC, NOVA Medical School | Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisboa, Portugal.
| | - José Delgado Alves
- CEDOC, NOVA Medical School | Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisboa, Portugal
- Immunomediated Systemic Diseases Unit (UDIMS), Fernando Fonseca Hospital, Amadora, Portugal
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207
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Abstract
The association of the metabolic syndrome (MetS) and its components with immune-mediated chronic inflammatory disorders has attracted much interest within the last two decades. In addition to the well-established association of psoriasis with MetS, recent data point to an association between MetS and hidradenitis suppurativa, as well. The association of hidradenitis suppurativa with MetS and its components, such as diabetes, obesity, and dyslipidemia, has been consistently identified in controlled studies. This relationship is not only limited to older individuals but also applicable to younger patients and those with mild disease. This review documents the link between these disorders and discusses its practical implications, mainly highlighting the importance of prevention and routine screening for early diagnosis to prevent cardiovascular-related morbidity.
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Affiliation(s)
- Tulin Ergun
- Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey.
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208
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Abstract
Originally coined as "syndrome X" in 1988 by Gerald Reaven (1928), the metabolic syndrome (MetS) encompasses a constellation of risk factors, the coincidence of which amounts to an increased cardiovascular and diabetic risk. Rising numbers of dermatoses are being recognized as cutaneous markers of MetS. Dermatologists should look beyond treating the cutaneous condition and quantify the associated increase in cardiovascular risk. The original dermatosis associated with obesity was acanthosis nigricans-described in 1889 by Paul Gerson Unna (1850-1929) and Sigmund Pollitzer (1859-1937). Over the last 20 years, clear associations between psoriasis, hidradenitis suppurativa, and MetS have also emerged. Several studies have shown synergistic improvement in the cutaneous pathology after treatment of components of MetS. This suggests common causalities and is a burgeoning area of research. We review the available evidence about the genetics underlying psoriasis, hidradenitis suppurativa, and acanthosis nigricans. Despite the strong clinical associations, the underlying genetic basis for a link to MetS remains unclear.
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Affiliation(s)
- Emma Fanning
- Department of Medicine, St James Hospital, Trinity College Dublin, Dublin, Ireland
| | - Donal O'Shea
- Department of Endocrinology, St Vincent's University Hospital, University College Dublin, Dublin, Ireland.
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209
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Abstract
Chronic plaque psoriasis is an immune-mediated inflammatory skin disease that is strongly associated with the clinical features of the metabolic syndrome (MetS), including abdominal obesity, hypertension, atherogenic dyslipidemia, type 2 diabetes, insulin resistance, and nonalcoholic fatty liver disease. The strength of these associations has been repeatedly confirmed by several observational studies. In particular, the prevalence of MetS in patients with psoriasis ranges from 20% to 50%, with a risk of having MetS is at least double in psoriatic patients compared with nonpsoriatic control individuals. MetS is also more common in patients with severe psoriasis than in those with mild skin disease. Emerging evidence now suggests that psoriasis and MetS share multiple metabolic risk factors, genetic background, and pathogenic pathways. The association between psoriasis and MetS has important clinical implications. Systemic conventional treatments should be used with caution in psoriatic patients with MetS, because they could adversely affect the coexisting metabolic disorders, especially in the case of their chronic use. Biologics appear to have a different safety profile compared with conventional treatments, and so they are usually tolerated. Collectively, dermatologists should pay close attention to the early recognition of coexisting metabolic disorders and give appropriate pharmacologic and nonpharmacologic (hypocaloric diet and regular exercise) recommendations to their patients.
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Affiliation(s)
- Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.
| | - Anna Chiara Fostini
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Irene Fossà
- Section of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Verona, Verona, Italy
| | - Giampiero Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Giovanni Targher
- Section of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Verona, Verona, Italy
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210
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Psoriasis and Cardiovascular Risk-Do Promising New Biomarkers Have Clinical Impact? Mediators Inflamm 2017; 2017:7279818. [PMID: 28947858 PMCID: PMC5602647 DOI: 10.1155/2017/7279818] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 08/01/2017] [Accepted: 08/07/2017] [Indexed: 12/14/2022] Open
Abstract
Epidemiological studies suggest an increased prevalence of cardiovascular disease (CVD) in patients with psoriasis (PS). Therefore, emphasis has lately been laid on the necessity for clinical evaluation of the risk of CVD in these patients. The systemic inflammatory markers C-reactive protein (CRP) and interleukin- (IL-) 6, which have long been used to predict future CVD in the general population, are increased manyfold in patients with PS. Lipid abnormalities characterized by elevated triglycerides, low HDL cholesterol, and higher concentrations of LDL cholesterol and its oxidized form are also prevalent in patients. There is a need for additional laboratory markers for the assessment of cardiovascular status of patients with PS. Due to frequent comorbid overweight and obesity, biologically active compounds produced by adipocytes may have an impact on monitoring the status of the cardiovascular system of patients with PS. For this purpose, two adipokines, adiponectin and leptin, have been most extensively studied. The review focuses on some inflammatory and oxidative stress aspects in patients with PS through the analysis of the impact of prominent adipokines and oxidized low-density lipoprotein (oxLDL) to assess their eligibility for clinical practice as markers of CVD risk in patients with PS.
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211
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Wang H, Wang Z, Rani PL, Fu X, Yu W, Bao F, Yu G, Li J, Li L, Sun L, Yue Z, Zhao Q, Pan Q, Cao J, Wang C, Chi X, Wang Y, Yang Q, Mi Z, Liu H, Zhang F. Identification of PTPN22
,ST6GAL1
and JAZF1
as psoriasis risk genes demonstrates shared pathogenesis between psoriasis and diabetes. Exp Dermatol 2017; 26:1112-1117. [DOI: 10.1111/exd.13393] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2017] [Indexed: 01/02/2023]
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212
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Llamas-Velasco M, de la Cueva P, Notario J, Martínez-Pilar L, Martorell A, Moreno-Ramírez D. Moderate Psoriasis: A Proposed Definition. ACTAS DERMO-SIFILIOGRAFICAS 2017; 108:911-917. [PMID: 28823420 DOI: 10.1016/j.ad.2017.07.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 06/17/2017] [Accepted: 07/02/2017] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION The Psoriasis Area Severity Index (PASI) is the most widely used scale for assessing the severity of psoriasis and for therapeutic decision making. On the basis of the PASI score, patients have been stratified into 2 groups: mild disease and moderate-to-severe disease. OBJECTIVE To draft a proposal for the definition and characterization of moderate psoriasis based on PASI and Dermatology Life Quality Index (DLQI) scores. MATERIAL AND METHODS A group of 6 dermatologists with experience in the treatment of psoriasis undertook a critical review of the literature and a discussion of cases to draft a proposal. RESULTS In order of priority, PASI, DLQI, and body surface area (BSA) are the parameters to be used in daily practice to classify psoriasis as mild, moderate, or severe. Severity should be assessed on the basis of a combined evaluation and interpretation of the PASI and DLQI. And 3, PASI and DLQI should carry equal weight in the determination of disease severity. On this basis, psoriasis severity was defined using the following criteria: mild, PASI<7 and DLQI<7; moderate, PASI=7-15 and DLQI=5-15 (classified as severe when difficult-to-treat sites are affected or when there is a significant psychosocial impact); severe, PASI >15, independently of the DLQI score. CONCLUSIONS A more precise classification of psoriasis according to disease severity will improve the risk-benefit assessment essential to therapeutic decision making in these patients.
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Affiliation(s)
- M Llamas-Velasco
- Departamento Dermatología, Hospital Universitario la Princesa, Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, España.
| | - P de la Cueva
- Departamento Dermatología, Hospital Universitario Infanta Leonor, Madrid, España
| | - J Notario
- Departamento Dermatología, Hospital de Bellvitge, Barcelona, España
| | - L Martínez-Pilar
- Departamento Dermatología, Hospital Regional Universitario Carlos Haya, Málaga, España
| | - A Martorell
- Departamento Dermatología, Hospital de Manises, Valencia, España
| | - D Moreno-Ramírez
- Departamento Dermatología, Hospital Universitario Virgen de la Macarena, Sevilla, España
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213
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Potts J, Maybury C, Salam A, Barker J, Agarwal K, Smith C. Diagnosing liver fibrosis: a narrative review of current literature for dermatologists. Br J Dermatol 2017; 177:637-644. [DOI: 10.1111/bjd.15246] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2016] [Indexed: 12/14/2022]
Affiliation(s)
- J.R. Potts
- Institute of Liver Studies King's College Hospital NHS Foundation Trust London U.K
| | - C.M. Maybury
- St John's Institute of Dermatology Division of Genetics and Molecular Medicine Faculty of Life Sciences and Medicine King's College London London U.K
| | - A. Salam
- St John's Institute of Dermatology Guy's and St Thomas' NHS Foundation Trust London U.K
| | - J.N. Barker
- St John's Institute of Dermatology Division of Genetics and Molecular Medicine Faculty of Life Sciences and Medicine King's College London London U.K
| | - K. Agarwal
- Institute of Liver Studies King's College Hospital NHS Foundation Trust London U.K
| | - C.H. Smith
- St John's Institute of Dermatology Guy's and St Thomas' NHS Foundation Trust London U.K
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214
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Hägg D, Sundström A, Eriksson M, Schmitt-Egenolf M. Severity of Psoriasis Differs Between Men and Women: A Study of the Clinical Outcome Measure Psoriasis Area and Severity Index (PASI) in 5438 Swedish Register Patients. Am J Clin Dermatol 2017; 18:583-590. [PMID: 28342016 PMCID: PMC5506504 DOI: 10.1007/s40257-017-0274-0] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Psoriasis is a common skin disease and moderate to severe psoriasis is associated with a dose-dependent risk for metabolic and cardiovascular morbidity. It has previously been speculated that women have less severe psoriasis, as men are overrepresented in psoriasis registers and consume more care. Objective The objective of this study was to investigate, for the first time, the sex differences in the severity of psoriasis using the gold standard of severity measurement, the Psoriasis Area and Severity Index (PASI), and the distinct elements of the PASI score. Design, Setting and Participants This was a cross-sectional study based on the national registry for systemic treatment of psoriasis in Sweden (PsoReg), with 5438 patients experiencing moderate to severe psoriasis. Differences in the PASI score and its elements at enrolment were tested by multivariable ordinal logistic regressions. Main Outcome Measures The different components of the PASI score were used to analyze the assessment of disease severity. For each body area (head, arms, trunk, and legs), the score of the plaque characteristics and degree of skin involvement were used as outcomes. Results Women had statistically significantly lower median PASI scores (5.4) than men (7.3) [p < 0.001], which was consistent across all ages. The difference remained statistically significant in a multivariable linear regression. The itemized PASI analyses from the Mann–Whitney–Wilcoxon tests and the adjusted ordinal logistic regressions confirmed that women had significantly lower scores than men in all areas of the body, except for the head. No differences in the use of medications prior to enrolment could be found that may cause this difference between the sexes. Conclusions As the PsoReg contains the detailed disease measurement PASI, which was traditionally used for selected participants in clinical studies only, a nationwide unselected population could be investigated. The fact that women have less severe psoriasis can explain the dominance of males in the systemic treatment of psoriasis. These findings motivate a gender perspective in the management of psoriasis and in the prevention and management of its comorbidities.
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Affiliation(s)
- David Hägg
- Dermatology, Department of Public Health and Clinical Medicine, Umea University, 901 85, Umeå, Sweden
- Centre for Pharmacoepidemiology (CPE), Karolinska Institutet, Karolinska University Hospital, T2, 171 76, Stockholm, Sweden
| | - Anders Sundström
- Centre for Pharmacoepidemiology (CPE), Karolinska Institutet, Karolinska University Hospital, T2, 171 76, Stockholm, Sweden
| | - Marie Eriksson
- Department of Statistics, Umeå School of Business and Economics (USBE), Umea University, 901 87, Umeå, Sweden
| | - Marcus Schmitt-Egenolf
- Dermatology, Department of Public Health and Clinical Medicine, Umea University, 901 85, Umeå, Sweden.
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215
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An update on psoriasis and metabolic syndrome: A meta-analysis of observational studies. PLoS One 2017; 12:e0181039. [PMID: 28719618 PMCID: PMC5515416 DOI: 10.1371/journal.pone.0181039] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/26/2017] [Indexed: 02/06/2023] Open
Abstract
The relationship between psoriasis and metabolic syndrome is not well understood. Though multiple epidemiologic studies have suggested a link between psoriasis and metabolic syndrome, there is a lack of a comprehensive meta-analysis synthesizing the results of all available observational studies to date. In this meta-analysis, we examined global data on the relationship between psoriasis and odds of metabolic syndrome by searching for studies published between 1946–2016. Specifically, we analyzed the results from 35 observational studies from 20 countries with 1,450,188 total participants, of which 46,714 were psoriasis patients. The pooled odds ratio based on random effects analysis was 2.14 (95% CI 1.84–2.48). Publication bias was present, as evidenced by an Egger test and graphical visualization through a funnel plot (p = 0.001). Based on this comprehensive meta-analysis, psoriasis patients have higher odds of having metabolic syndrome when compared with the general population.
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TNF Inhibitors for Psoriasis and Psoriatic Arthritis. CURRENT DERMATOLOGY REPORTS 2017. [DOI: 10.1007/s13671-017-0174-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Carvalho AVED, Romiti R, Souza CDS, Paschoal RS, Milman LDM, Meneghello LP. Psoriasis comorbidities: complications and benefits of immunobiological treatment. An Bras Dermatol 2017; 91:781-789. [PMID: 28099601 PMCID: PMC5193190 DOI: 10.1590/abd1806-4841.20165080] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 10/02/2015] [Indexed: 01/04/2023] Open
Abstract
During the last decade, different studies have converged to evidence the high
prevalence of comorbidities in subjects with psoriasis. Although a causal
relation has not been fully elucidated, genetic relation, inflammatory pathways
and/or common environmental factors appear to be underlying the development of
psoriasis and the metabolic comorbidities. The concept of psoriasis as a
systemic disease directed the attention of the scientific community in order to
investigate the extent to which therapeutic interventions influence the onset
and evolution of the most prevalent comorbidities in patients with psoriasis.
This study presents scientific evidence of the influence of immunobiological
treatments for psoriasis available in Brazil (infliximab, adalimumab, etanercept
and ustekinumab) on the main comorbidities related to psoriasis. It highlights
the importance of the inflammatory burden on the clinical outcome of patients,
not only on disease activity, but also on the comorbidities. In this sense,
systemic treatments, whether immunobiologicals or classic, can play a critical
role to effectively control the inflammatory burden in psoriatic patients.
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Affiliation(s)
| | - Ricardo Romiti
- Universidade de São Paulo (USP) - São Paulo (SP), Brazil
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219
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Kim ES, Han K, Kim MK, Park YM, Baek KH, Moon SD, Han JH, Song KH, Kwon HS. Impact of metabolic status on the incidence of psoriasis: a Korean nationwide cohort study. Sci Rep 2017; 7:1989. [PMID: 28512338 PMCID: PMC5434014 DOI: 10.1038/s41598-017-01983-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 04/05/2017] [Indexed: 12/14/2022] Open
Abstract
Growing evidence suggests that obesity is a risk factor for incident psoriasis. This study was aimed to evaluate the association of obesity and metabolic status with the incidence of psoriasis. A total of 418,057 adults were followed-up using a nationwide prospective cohort study in Korea. Participants were stratified based on the body mass index categories and metabolic condition. During the follow-up visit, 11054 (2.6%) cases were found to have psoriasis. Diabetes, hypertension, hyperlipidemia, and obesity were all found to be risk factors for incident psoriasis. The metabolically unhealthy non-obese (MUNO) subjects (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.22-1.37) and metabolically unhealthy obese subjects (MUO; HR, 1.33; 95% CI, 1. 26-1.41) had a significantly higher risk of psoriasis incidence as compared to metabolically healthy non-obese subjects. The risk of psoriasis development was found to be high among the MUNO and MUO subjects in both sexes and all age groups. In conclusion, the metabolic health status was significantly associated with an increased risk of psoriasis in both obese and non-obese individuals. However, further studies are needed to evaluate whether the control of metabolic parameters can lower the incidence of psoriasis.
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Affiliation(s)
- Eun Sook Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, 06591, Korea.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary's hospital, Incheon, 21431, Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, 06591, Korea
| | - Mee Kyoung Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, 06591, Korea.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's hospital, Seoul, 07345, Korea
| | - Yong-Moon Park
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, 27709, USA
| | - Ki-Hyun Baek
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, 06591, Korea.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's hospital, Seoul, 07345, Korea
| | - Sung Dae Moon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, 06591, Korea.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary's hospital, Incheon, 21431, Korea
| | - Je-Ho Han
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, 06591, Korea.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary's hospital, Incheon, 21431, Korea
| | - Ki-Ho Song
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, 06591, Korea.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's hospital, Seoul, 07345, Korea
| | - Hyuk-Sang Kwon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, 06591, Korea. .,Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's hospital, Seoul, 07345, Korea.
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Economic burden of comorbidities in psoriasis patients in the United States: results from a retrospective U.S. database. BMC Health Serv Res 2017; 17:337. [PMID: 28482887 PMCID: PMC5422993 DOI: 10.1186/s12913-017-2278-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 04/27/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Psoriasis is a multifactorial, inflammatory, skin disease associated with various comorbidities. The cost of those comorbidities is not well characterized. The present study assesses the incremental burden of comorbidities on healthcare resource utilization, direct costs and indirect costs associated with short-term disabilities among patients with psoriasis in the United States. METHODS A retrospective, U.S. cohort analysis was conducted using a large claims database. Adult psoriasis patients with at least two diagnoses of psoriasis during the years 2010 and 2011 (one psoriasis diagnosis had to happen in the year 2010) and with continuous enrollment of medical and pharmacy benefits in the years 2010 and 2011 were included. Psoriasis patients were categorized and compared according to the presence or absence of pre-selected comorbidities in the year 2010. Adjusted annual direct (costs associated with outpatient, emergency room, and inpatient claims, and outpatient pharmacy claims) and indirect costs (short-term disabilities) was assessed in patients with and without comorbidities using a regression analysis, controlling for age, gender, and psoriasis severity in year 2010. RESULTS In total, 56,406 patients (mean [SD]) age, 51.6 [14.6] years) were included in the analysis. The most prevalent comorbidities were hypertension (34.3%), hyperlipidemia (33.5%), cardiovascular disease (17.7%), diabetes (14.2%), and psoriatic arthritis (9.9%). Psoriasis patients with comorbidities used more healthcare resources than those without comorbidities. The incidence rate ratio (IRR) (95% CI) for patients with cardiovascular disease was 1.5 (1.4 - 1.5) for outpatient visits, 2.6 (2.4 - 2.8) for hospitalizations, and 2.3 (2.2 - 2.5) for ER visits, showing higher IRRs across all three types of resource use. The mean annual adjusted direct cost differences (i.e., incremental adjusted costs) in psoriasis patients with and without comorbidities were $9914.3, $8386.5, and $8275.1 for psoriatic arthritis, peripheral vascular disease, and cardiovascular disease, respectively. The mean annual incremental adjusted indirect costs of short-term disabilities were $1333, $1195, $994.9, and $996.6 for cerebrovascular disease, obesity, peripheral vascular disease, and depression, respectively. CONCLUSION The presence of comorbidities was associated with higher healthcare resource utilization and costs among patients with psoriasis.
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Rodríguez-Zúñiga M, Cortez-Franco F, Quijano-Gomero E. Association of Psoriasis and Metabolic Syndrome in Latin America: A Systematic Review and Meta-Analysis. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2017.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Al-Harbi NO, Nadeem A, Ansari MA, Al-Harbi MM, Alotaibi MR, AlSaad AM, Ahmad SF. Psoriasis-like inflammation leads to renal dysfunction via upregulation of NADPH oxidases and inducible nitric oxide synthase. Int Immunopharmacol 2017; 46:1-8. [DOI: 10.1016/j.intimp.2017.02.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 02/16/2017] [Accepted: 02/16/2017] [Indexed: 02/07/2023]
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Rodríguez-Zúñiga M, Cortez-Franco F, Quijano-Gomero E. Relación entre psoriasis y síndrome metabólico en Latinoamérica. Revisión sistemática y metaanálisis. ACTAS DERMO-SIFILIOGRAFICAS 2017; 108:326-334. [DOI: 10.1016/j.ad.2016.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 09/02/2016] [Accepted: 11/06/2016] [Indexed: 01/30/2023] Open
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Psoriatic Arthritis Is an Indicator of Significant Renal Damage in Patients with Psoriasis: An Observational and Epidemiological Study. Int J Inflam 2017; 2017:5217687. [PMID: 28421157 PMCID: PMC5380854 DOI: 10.1155/2017/5217687] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/02/2017] [Accepted: 03/07/2017] [Indexed: 11/17/2022] Open
Abstract
Background. Psoriasis affects joints in around 30% of the patients. Recent studies have demonstrated an increased risk of essential hypertension, ischemic heart disease, and stroke in psoriatic patients. However, the prevalence of renal disease in patients with psoriasis has not been evaluated properly. Objectives. Objectives were to evaluate renal functions in patients with psoriasis and to assess any possible relationship of renal failure with psoriasis and psoriatic arthritis. Methods. In this cross-sectional study, 30 participants were recruited into the following three groups: group-A, psoriatic arthritis; group-B, psoriasis without arthritis; and group-C, healthy subjects. Renal function tests were performed for every participant of each group. The data was analyzed by using SPSS version 16. Chi-squared and one-way ANOVA tests were applied, considering a P value of less than 0.05 as a standard criterion. Results. Serum creatinine, urea, and phosphate were the highest in group-A, higher in group-B, and normal in group-C, P < 0.05. Similarly, GFR was the lowest in group-A, lower in group-B, and normal in group-C. The difference in mean GFR values was statistically significant, F(2) = 355, P < 0.001. Moreover, proteinuria (gm/day) was seen in 96.7% of the patients with psoriatic arthritis, (M = 1.18 ± 0.55, P < 0.05) against 10% of the psoriatic patients without arthritis (M = 0.41 ± 0.10, P < 0.05). Conclusion. Derangement of renal function is more prevalent in psoriatic patients, especially in those with concomitant psoriatic arthritis. Therefore, each psoriatic patient must be routinely screened for an underlying renal failure.
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Papp KA, Blauvelt A, Bukhalo M, Gooderham M, Krueger JG, Lacour JP, Menter A, Philipp S, Sofen H, Tyring S, Berner BR, Visvanathan S, Pamulapati C, Bennett N, Flack M, Scholl P, Padula SJ. Risankizumab versus Ustekinumab for Moderate-to-Severe Plaque Psoriasis. N Engl J Med 2017; 376:1551-1560. [PMID: 28423301 DOI: 10.1056/nejmoa1607017] [Citation(s) in RCA: 393] [Impact Index Per Article: 49.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Interleukin-23 is thought to be critical to the pathogenesis of psoriasis. We compared risankizumab (BI 655066), a humanized IgG1 monoclonal antibody that inhibits interleukin-23 by specifically targeting the p19 subunit and thus prevents interleukin-23 signaling, and ustekinumab, an interleukin-12 and interleukin-23 inhibitor, in patients with moderate-to-severe plaque psoriasis. METHODS We randomly assigned a total of 166 patients to receive subcutaneous injections of risankizumab (a single 18-mg dose at week 0 or 90-mg or 180-mg doses at weeks 0, 4, and 16) or ustekinumab (45 or 90 mg, according to body weight, at weeks 0, 4, and 16). The primary end point was a 90% or greater reduction from baseline in the Psoriasis Area and Severity Index (PASI) score at week 12. RESULTS At week 12, the percentage of patients with a 90% or greater reduction in the PASI score was 77% (64 of 83 patients) for risankizumab (90-mg and 180-mg groups, pooled), as compared with 40% (16 of 40 patients) for ustekinumab (P<0.001); the percentage of patients with a 100% reduction in the PASI score was 45% in the pooled 90-mg and 180-mg risankizumab groups, as compared with 18% in the ustekinumab group. Efficacy was generally maintained up to 20 weeks after the final dose of 90 or 180 mg of risankizumab. In the 18-mg and 90-mg risankizumab groups and the ustekinumab group, 5 patients (12%), 6 patients (15%), and 3 patients (8%), respectively, had serious adverse events, including two basal-cell carcinomas and one major cardiovascular adverse event; there were no serious adverse events in the 180-mg risankizumab group. CONCLUSIONS In this phase 2 trial, selective blockade of interleukin-23 with risankizumab was associated with clinical responses superior to those associated with ustekinumab. This trial was not large enough or of long enough duration to draw conclusions about safety. (Funded by Boehringer Ingelheim; ClinicalTrials.gov number, NCT02054481 ).
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Affiliation(s)
- Kim A Papp
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Andrew Blauvelt
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Michael Bukhalo
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Melinda Gooderham
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - James G Krueger
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Jean-Philippe Lacour
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Alan Menter
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Sandra Philipp
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Howard Sofen
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Stephen Tyring
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Beate R Berner
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Sudha Visvanathan
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Chandrasena Pamulapati
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Nathan Bennett
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Mary Flack
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Paul Scholl
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
| | - Steven J Padula
- From K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), School of Medicine, Queen's University, Kingston, ON (M.G.), and Centre for Dermatology and Probity Medical Research, Peterborough, ON (M.G.) - all in Canada; Oregon Medical Research Center, Portland (A.B.); Altman Dermatology Associates, Arlington Heights, IL (M.B.); Rockefeller University, New York (J.K.); Hôpital de l'Archet, University of Nice-Sophia Antipolis, Nice, France (J.-P.L.); Baylor Research Institute, Dallas (A.M.); Charité Universitätsmedizin Berlin, Berlin (S.P.), Boehringer Ingelheim Pharma, Biberach (B.R.B.), and Boehringer Ingelheim Pharma, Ingelheim, (S.J.P.) - all in Germany; University of Texas Health Science Center, Houston (S.T.); University of California, Los Angeles, School of Medicine, Los Angeles (H.S.); and Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT (S.V., C.P., N.B., M.F., P.S.)
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226
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Hillary T, Gutermuth J. Should psoriasis be considered a risk factor for hypogonadism in male patients? A monocentric, prospective, observational pilot study. J Eur Acad Dermatol Venereol 2017; 31:e197-e198. [PMID: 27556231 DOI: 10.1111/jdv.13944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- T Hillary
- Department of Dermatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - J Gutermuth
- Department of Dermatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Shetty A, Cho W, Alazawi W, Syn WK. Methotrexate Hepatotoxicity and the Impact of Nonalcoholic Fatty Liver Disease. Am J Med Sci 2017; 354:172-181. [PMID: 28864376 DOI: 10.1016/j.amjms.2017.03.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 02/10/2017] [Accepted: 03/08/2017] [Indexed: 01/01/2023]
Abstract
Methotrexate (MTX) is commonly used to treat individuals with rheumatological and dermatologic disorders. Current American College of Rheumatology (ACR) and American Association of Dermatology (AAD) guidelines identify diabetes and obesity as risk factors for MTX-induced liver injury. Both diabetes and obesity are components of the metabolic syndrome, and are also risk factors for nonalcoholic fatty liver disease (NAFLD). NAFLD affects approximately 40% of the U.S. population, and those with more advanced NAFLD (i.e., nonalcoholic steatohepatitis with or without fibrosis) are likely to develop progressive liver disease. As such, individuals who are treated with MTX may need to be screened for advanced NAFLD, as this may put them at an increased risk of MTX-induced liver injury. In this mini-review, we review the current ACR and AAD guidelines on MTX hepatotoxicity, discuss the evidence (or lack thereof) of the impact of metabolic risk factors on MTX-induced liver injury and highlight the areas that need further research.
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Affiliation(s)
- Akshay Shetty
- Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, South Carolina
| | - WonKyung Cho
- Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, South Carolina
| | - William Alazawi
- Department of Hepatology, Barts Health NHS Trust, London, United Kingdom; Centre for Immunobiology, Blizzard Institute, Queen Mary University of London, London, United Kingdom
| | - Wing-Kin Syn
- Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, South Carolina; Section of Gastroenterology, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina.
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228
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Classical rather than genetic risk factors account for high cardiovascular disease prevalence in Lithuania: A cross-sectional population study. Adv Med Sci 2017; 62:121-128. [PMID: 28242483 DOI: 10.1016/j.advms.2016.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 08/24/2016] [Accepted: 08/25/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Cardiovascular disease (CVD) mortality accounts for 54% of all deaths in Lithuania, making it the highest among all of the European Union countries. We evaluated the prevalence of several CVD risk factors, including lifestyle, blood biochemistry and genetic predisposition to determine the reasons behind significantly increased CVD prevalence in Lithuania. MATERIALS AND METHODS In total 435 volunteers of Lithuanian ethnicity and stable geographic settlement for 3 generations, had their anthropometric, biochemical and behavioural risk factors measured. A randomly selected sample of 166 volunteers had their 60 CVD risk alleles genotyped. The prevalence of risk alleles and cumulative CVD genetic risk score were compared with population of North-West European origin (CEU) using data from the phase 3 HapMap project. RESULTS CVD was present in 33.8% of study volunteers, 84% of participants consumed alcohol, 21% were current smokers and only 30% of participants engaged in higher levels of physical activity. Also, the average BMI (males 28.3±4.3kg/m2, females 27.3±5.0kg/m2), total cholesterol (males 6.1±1.2mmol/L, females 6.2±1.0mmol/L) and LDL-cholesterol (males 4.1±1.1mmol/L, females 4.1±1.0mmol/L) were above the normal values. The cumulative genetic susceptibility to develop CVD in Lithuanians was only 1.4% higher than in CEU population. CONCLUSIONS High BMI and poor population plasma lipid profile are the major contributing factors to high CVD mortality and morbidity in Lithuania. Smoking, alcohol consumption and preliminary genetic predisposition results do not explain the difference in CVD mortality between the Lithuanian and wider European populations. CVD prevention programmes in Lithuania should primarily focus on weight loss and improving blood lipid control.
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229
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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: 727] [Impact Index Per Article: 90.9] [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.
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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
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Urbancek S, Sutka R, Kmecova Z, Salkovska J, Vano I, Pecova T, Rovensky J. Screening of Patients with Psoriasis for Psoriatic Arthritis in the Slovak Republic. ACTA MEDICA MARTINIANA 2017. [DOI: 10.1515/acm-2016-0015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Abstract
Global prevalence of psoriasis is ranging from 0.91 % to 8.5 % [1]. Exact numbers are missing for Slovakia. 1-5% range is the most probable while 2 % is also mentioned as an average prevalence for the European population. There is approximately 110 thousand patients suffering from psoriasis when extrapolating from total population of 5.5 million [2]. Extracutaneous manifestation is observed in 11–30 % of patients after years of solely skin symptoms presentation [3, 4, 5, 6].
Objective: To estimate prevalence of psoriatic arthritis among psoriatic patients population visiting dermatology out-patient irrelevant of the disease duration and the treatment regimen. To compare the sensitivity of both tests (ToPAS and PASE) used, evaluate possible PsA risk factors.
Methods: This was a prospective, non-interventional, epidemiological, observational study conducted using a survey administered to psoriatic patients by their dermatologists. 10–20 consequent outpatients with psoriasis in each center in 43 regional dermatology officies were screened for the presence of extra-cutaneous symptoms (i.e. joint pain, enthesitis, dactylitis, nail involvement) using questionnaire, developed specificaly for this study, and by the PASE and ToPAS questionnaires. Patients without personal history of PsA and „positivity“ of PASE and/or ToPAS were sent to the center for confirmation / exclusion of the diagnosis by applying CASPAR criteria. Outcomes were statistically processed.
Results: 177 (21.8 %) of total of 831 psoriatic patients had PsA. 9 of 177 (5.35 %) has been newly diagnosed. There was almost equal number of men (50.5 %) and women (49.5 %).
Plaque psoriasis has been most frequent type – 76.9 %. 43.2 % of PsA patients reported the onset of the disease after 40 years of life. Time interval between onset of psoriasis and PsA has been less than 10 years in 20.2 %, 10–20 years in 20.8 % and more than 20 years in 16.1 %. Most frequent co-morbidity in the study population was hypertension 23.2 %, asthma 3 % and diabetes 2.4 %. Average value of BSA and PASI was higher in PsA vs. non-PsA group: 24 vs. 20 and 10 vs 9, respectively. The sensitivity (72.6 % vs 58.9 %, P=0.01) and specificity (81.3 % vs 80.5 %) of ToPAS was higher compared to PASE.
Conclusion: 21.8 % PsA prevalence in psoriatic population in Slovakia is within the range observed in other studies. ToPAS test showed comparable results in terms of specificity, but significantly better results in terms of sensitivity and its early application should be of major importance because of the diagnostic process acceleration. The effect of an early diagnosis on the total patient outcome should be an objective of further research. This project was supported from educational grant of Pfizer Inc.
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Affiliation(s)
| | - R Sutka
- Comenius University Jessenius Faculty of Medicine and University Hospital, Department of Dermatovenerology, Martin, Slovak Republic
| | - Z Kmecova
- Rheumatology F.D. Roosevelt Hospital, Banska Bystrica
| | | | - I Vano
- Internal Medicine, University Hospital, Nitra
| | - T Pecova
- Comenius University Jessenius Faculty of Medicine and University Hospital, Department of Dermatovenerology, Martin, Slovak Republic
| | - J Rovensky
- National Institute of Rheumatic Diseases, Piešťany, Slovakia
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Curcó N, Barriendos N, Barahona MJ, Arteaga C, García M, Yordanov S, De La Barrera O, Prat C, Vives P, Giménez N. Factors influencing cardiometabolic risk profile in patients with psoriasis. Australas J Dermatol 2017; 59:e93-e98. [DOI: 10.1111/ajd.12577] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 09/08/2016] [Indexed: 12/30/2022]
Affiliation(s)
- Neus Curcó
- Department of Dermatology; Hospital Universitari Mútua Terrassa; Barcelona Spain
| | - Nuria Barriendos
- Department of Dermatology; Hospital Universitari Mútua Terrassa; Barcelona Spain
| | - Maria José Barahona
- Department of Endocrinology; Hospital Universitari Mútua Terrassa; Barcelona Spain
| | - Carmen Arteaga
- Department of Dermatology; Hospital Universitari Mútua Terrassa; Barcelona Spain
| | - Mercedes García
- Department of Dermatology; Hospital Universitari Mútua Terrassa; Barcelona Spain
| | - Stanislav Yordanov
- Department of Dermatology; Hospital Universitari Mútua Terrassa; Barcelona Spain
| | | | - Carolina Prat
- Department of Dermatology; Hospital Universitari Mútua Terrassa; Barcelona Spain
| | - Pere Vives
- Department of Dermatology; Hospital Universitari Mútua Terrassa; Barcelona Spain
| | - Nuria Giménez
- Research Unit; Mútua Terrassa Research Foundation; University of Barcelona; Barcelona Spain
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Singh S, Dogra S, Shafiq N, Bhansali A, Malhotra S. Prevalence of Metabolic Syndrome in Psoriasis and Levels of Interleukin-6 and Tumor Necrosis Factor-α in Psoriasis Patients with Metabolic Syndrome: Indian Tertiary Care Hospital Study. Int J Appl Basic Med Res 2017; 7:169-175. [PMID: 28904916 PMCID: PMC5590379 DOI: 10.4103/ijabmr.ijabmr_330_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: Psoriasis is a chronic inflammatory multisystem disease, found to be associated with metabolic syndrome (MS) and increased levels of cytokines. To evaluate the prevalence of MS in psoriasis and to determine the levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in psoriasis patients with MS. Methods: Observational study on 334 psoriasis patients and 230 controls. MS was diagnosed by the presence of three or more criteria of original, revised, and modified National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATP III). Results: MS was significantly more common in psoriasis patients than in controls (multivariate odds ratio [95% confidence interval] of original NCEP ATP III = 5.73 [2.99–10.99], revised NCEP ATP III = 4.44 [2.43–8.10], and modified NCEP ATP III = 6.00 [3.43–10.52]). Higher prevalence of abdominal obesity (66.2% vs. 47%, P < 0.001), hypertriglyceridemia (40.4% vs. 29.6%, P = 0.009), systolic blood pressure (BP) ≥130 mmHg (25.1% vs. 7.4%, P < 0.001), diastolic BP ≥85 mmHg (30.2% vs. 12.2%, P < 0.001), and fasting plasma glucose ≥100 mg/dl (17.4% vs. 9.1%, P = 0.005) among psoriasis patients as compared to controls. Mean (standard deviation) values of IL-6 and TNF-α were 76.7 (73.9) pg/ml and 234.3 (273.9) in subgroup of psoriasis patients with MS (n = 42), significantly higher than the normal population (P < 0.0001). Conclusion: MS is more common in psoriasis. IL-6 and TNF-α is significantly higher in psoriasis patients with MS, signifying their role in pathogenesis of psoriasis and MS.
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Affiliation(s)
- Surjit Singh
- Department of Pharmacology, AIIMS, Jodhpur, Rajasthan, India
| | - Sunil Dogra
- Department of Dermatology Venereology Leprology, PGIMER, Chandigarh, India
| | - Nusrat Shafiq
- Department of Pharmacology, PGIMER, Chandigarh, India
| | - Anil Bhansali
- Department of Endocrinology, PGIMER, Chandigarh, India
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Lamb RC, Matcham F, Turner MA, Rayner L, Simpson A, Hotopf M, Barker JNWN, Jackson K, Smith CH. Screening for anxiety and depression in people with psoriasis: a cross-sectional study in a tertiary referral setting. Br J Dermatol 2016; 176:1028-1034. [PMID: 27363600 DOI: 10.1111/bjd.14833] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2016] [Indexed: 01/26/2023]
Abstract
BACKGROUND National Institute for Health and Care Excellence guidance recommends assessment of psychological and social well-being in people with psoriasis. OBJECTIVES To screen systematically for depression and anxiety in patients with psoriasis in routine clinical practice and to identify at-risk groups for psychiatric morbidity. METHODS Consecutive patients attending a single, tertiary centre over a 10-month period were invited to complete the Patient Health Questionnaire Depression Scale (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and Dermatology Life Quality Index (DLQI) as part of IMPARTS: Integrating Mental and Physical Healthcare: Research, Training and Services. Information on demographics, treatment and clinical disease severity was collated from electronic patient records. Regression models were used to identify at-risk groups for psychiatric morbidity. RESULTS Of 607 patients included (56·2% on biologics), 9·9% (95% confidence interval 7·5-12·3%) screened positive for major depressive disorder (MDD) and 13·1% (79/604) (95% confidence interval 10·4-15·8%) for generalized anxiety disorder (GAD; GAD-7 score > 9). Suicidal ideation was reported in 35% of those with MDD; DLQI was < 10 in 38·3% and 45·6% cases of MDD and GAD, respectively. After adjusting for covariates, the risk of MDD or GAD was significantly higher in women and those with severe clinical disease, psoriatic arthritis and previous depression/anxiety. The risk of GAD was significantly increased with Asian ethnicity and use of topical treatments only. CONCLUSIONS Systematic screening for anxiety and depression identifies clinically important levels of depression and anxiety that may be missed using DLQI data alone. Women and those with severe disease, psoriatic arthritis and/or a prior history of psychiatric morbidity may be at particular risk.
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Affiliation(s)
- R C Lamb
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, U.K
| | - F Matcham
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 9RJ, U.K
| | - M A Turner
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, U.K
| | - L Rayner
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 9RJ, U.K
| | - A Simpson
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 9RJ, U.K
| | - M Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 9RJ, U.K
| | - J N W N Barker
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, U.K
| | - K Jackson
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, U.K
| | - C H Smith
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, U.K
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González-Parra E, Daudén E, Carrascosa J, Olveira A, Botella R, Bonanad C, Rivera R. Kidney Disease and Psoriasis. A New Comorbidity? ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2016.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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González-Parra E, Daudén E, Carrascosa J, Olveira A, Botella R, Bonanad C, Rivera R. Enfermedad renal y psoriasis. ¿Una nueva comorbilidad? ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:823-829. [DOI: 10.1016/j.ad.2016.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 05/19/2016] [Accepted: 05/29/2016] [Indexed: 10/21/2022] Open
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Papadavid E, Diamanti K, Spathis A, Varoudi M, Andreadou I, Gravanis K, Theodoropoulos K, Karakitsos P, Lekakis J, Rigopoulos D, Ikonomidis I. Increased levels of circulating platelet-derived microparticles in psoriasis: Possible implications for the associated cardiovascular risk. World J Cardiol 2016; 8:667-675. [PMID: 27957253 PMCID: PMC5124725 DOI: 10.4330/wjc.v8.i11.667] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/20/2016] [Accepted: 09/08/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate platelet activation markers in psoriasis patients, compared to controls, and investigate their association with the inflammatory burden of psoriasis.
METHODS Forty psoriatic patients without cardiovascular disease, and 12 healthy controls were subjected to measurement of baseline platelet CD62P, CD63 and CD42b expression, platelet-leukocyte complexes, i.e., platelet-monocyte complexes (PMC), platelet-neutrophil complexes (PNC) and platelet-lymphocyte complexes, and concentrations of platelet-derived microparticles (PMPs) using flow cytometry. Both larger-size (0.5-0.9 μm) and smaller-size (< 0.5 μm) PMPs were determined. Serum interleukin (IL)-12 and IL-17 levels were also measured by enzyme-linked immunosorbent assay. The severity of psoriasis was evaluated by the Psoriasis Area Severity Index (PASI).
RESULTS PMP concentrations were significantly higher in psoriasis patients than controls [mean ± standard error of mean (SEM): 22 ± 5/μL vs 11 ± 6/μL; P = 0.018), for both smaller-size (10 ± 2/μL vs 4 ± 2/μL; P = 0.033) and larger-size (12 ± 3/μL vs 6 ± 4/μL; P = 0.014) PMPs. Platelet CD62P, CD63 and CD42b expression and circulating PMC and PNC were similar between the two groups. Lower circulating PLC were observed in psoriasis patients compared to controls (mean ± SEM: 16% ± 3% vs 23% ± 6%; P = 0.047). Larger-size PMPs were related with IL-12 levels (P < 0.001) and smaller-size PMPs with both IL-12 and IL-17 levels (P < 0.001). Total PMPs also correlated with IL-12 (P < 0.001). CD63 expression was positively correlated with both IL-12 and IL-17 (P < 0.05). Increased PASI score was associated with increased levels of larger-size PMPs (r = 0.45; P = 0.011) and increased CD63 expression (r = 0.47; P < 0.01).
CONCLUSION PMPs, known to be predictive of cardiovascular outcomes, are increased in psoriasis patients, and associated with high inflammatory disease burden. Enhanced platelet activation may be the missing link leading to cardiovascular events in psoriatic patients.
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Galluzzo M, Talamonti M, Perino F, Servoli S, Giordano D, Chimenti S, De Simone C, Peris K. Bioelectrical impedance analysis to define an excess of body fat: evaluation in patients with psoriasis. J DERMATOL TREAT 2016; 28:299-303. [DOI: 10.1080/09546634.2016.1254326] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M. Galluzzo
- Department of Dermatology, University of Rome “Tor Vergata”, Rome, Italy
| | - M. Talamonti
- Department of Dermatology, University of Rome “Tor Vergata”, Rome, Italy
| | - F. Perino
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - S. Servoli
- Department of Dermatology, University of Rome “Tor Vergata”, Rome, Italy
| | - D. Giordano
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - S. Chimenti
- Department of Dermatology, University of Rome “Tor Vergata”, Rome, Italy
| | - C. De Simone
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - K. Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
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Kim J, Bissonnette R, Lee J, Correa da Rosa J, Suárez-Fariñas M, Lowes MA, Krueger JG. The Spectrum of Mild to Severe Psoriasis Vulgaris Is Defined by a Common Activation of IL-17 Pathway Genes, but with Key Differences in Immune Regulatory Genes. J Invest Dermatol 2016; 136:2173-2182. [DOI: 10.1016/j.jid.2016.04.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 04/19/2016] [Accepted: 04/26/2016] [Indexed: 01/07/2023]
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239
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Duarte GV, de Oliveira MDFSP, Follador I, Silva TS, de Carvalho Filho EM. Diagnosis and underdiagnosis of comorbidities in psoriasis patients - need for a multidisciplinary approach. An Bras Dermatol 2016; 91:743-747. [PMID: 28099594 PMCID: PMC5198231 DOI: 10.1590/abd1806-4841.20164716] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 01/11/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND: Psoriasis is an immune-mediated disease that manifests predominantly in the skin, although systemic involvement may also occur. Although associated comorbidities have long been recognized and despite several studies indicating psoriasis as an independent risk factor for cardiovascular events, little has been done in general medical practice regardind screening. In the United States, less than 50% of clinicians are aware of these recommendations. OBJECTIVE: To identify the prevalence of these comorbidities in 296 patients followed up at a university dermatology clinic. METHODS: Systematically investigated comorbidity frequencies were compared with general practitioners' registry frequencies. Clinical features correlated with comorbidities were also investigated. RESULTS: High prevalences of systematically investigated comorbidities such as hypertension (30%) and dyslipidemia (26.5%) were documented. Conversely, data from general practitioners' records showed that 33% of dyslipidemia cases were undiagnosed and indicated possible underdiagnosis of some comorbidities. Furthermore, an association was found between: the number of comorbidities and psoriasis duration, age and high body mass index an association was found between the number of comorbidities and psoriasis duration, age, high body mass index, waist circumference or waist-to-hip ratio. (p<0.05). CONCLUSION: Disease duration, age and high body mass index, waist circumference or waist-to-hip ratio are possible criteria for choosing which patients should be screened for comorbidities. Underdiagnosis of comorbidities by general practitioners highlights the need for a multidisciplinary approach in psoriasis management.
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Al-Harbi NO, Nadeem A, Al-Harbi MM, Zoheir KMA, Ansari MA, El-Sherbeeny AM, Alanazi KM, Alotaibi MR, Ahmad SF. Psoriatic inflammation causes hepatic inflammation with concomitant dysregulation in hepatic metabolism via IL-17A/IL-17 receptor signaling in a murine model. Immunobiology 2016; 222:128-136. [PMID: 27773660 DOI: 10.1016/j.imbio.2016.10.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 10/15/2016] [Indexed: 02/07/2023]
Abstract
Psoriatic inflammation has been shown to be associated with cardiovascular dysfunction and systemic inflammation. Recently, psoriasis has also been linked to hepatic disorders, however underlying mechanism connecting the two are unknown. IL-17A being a central pro-inflammatory cytokine in the pathogenesis of psoriasis may be involved in hepatic inflammation through its receptor and downward signaling; however so far no study has investigated IL-17A related signaling in the liver during psoriasis in a murine model. Therefore, this study explored psoriasis-induced hepatic inflammation and concurrent metabolic changes. Mice were applied topically imiquimod (IMQ) to develop psoriatic inflammation. Additionally mice were also treated either with IL-17A or anti-IL17A antibody to explore the role of IL-17 related signaling in liver. Mice were then assessed for hepatic inflammation through assessment of inflammatory/oxidative stress markers (IL-17RC, NFκB, IL-6, MCP-1, IL-1β, GM-CSF, ICAM-1, iNOS, lipid peroxides and myeloperoxidase activity) as well as hepatic injury (alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase) and protein/lipid metabolic biomarkers (total proteins, albumin, total bilirubin, triglycerides, HDL cholesterol, and total cholesterol). IMQ treatment led to hepatic inflammation as evidenced by increased pro-inflammatory cytokines and oxidative stress with concomitant dysregulation in hepatic protein/lipid metabolism. Treatment with IL-17A further aggravated, whereas treatment with anti-IL17A antibody ameliorated IMQ-induced changes in hepatic injury/inflammation and protein/lipid metabolism. Our study shows for the first time that psoriatic inflammation leads to hepatic inflammation which results in dysregulated protein/lipid metabolism through IL-17RC/NFκB signaling. This could result in increased risk of cardiovascular dysfunction in patients with psoriasis.
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Affiliation(s)
- Naif O Al-Harbi
- Department of Pharmacology & Toxicology, College of Pharmacy, Riyadh, Saudi Arabia
| | - Ahmed Nadeem
- Department of Pharmacology & Toxicology, College of Pharmacy, Riyadh, Saudi Arabia.
| | - Mohammed M Al-Harbi
- Department of Pharmacology & Toxicology, College of Pharmacy, Riyadh, Saudi Arabia
| | - Khairy M A Zoheir
- Department of Pharmacology & Toxicology, College of Pharmacy, Riyadh, Saudi Arabia
| | - Mushtaq A Ansari
- Department of Pharmacology & Toxicology, College of Pharmacy, Riyadh, Saudi Arabia
| | | | - Khalid M Alanazi
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Moureq R Alotaibi
- Department of Pharmacology & Toxicology, College of Pharmacy, Riyadh, Saudi Arabia
| | - Sheikh F Ahmad
- Department of Pharmacology & Toxicology, College of Pharmacy, Riyadh, Saudi Arabia
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241
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Dowlatshahi EA, Hollestein LM, Herings RMC, Nijsten T, Wakkee M. Increased overall drug utilization in patients with psoriasis: a case-control study based on Dutch general practitioner data. Br J Dermatol 2016; 176:634-642. [PMID: 27203361 DOI: 10.1111/bjd.14754] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Medication use in patients with psoriasis has been studied mostly in the context of psoriasis comorbidities. OBJECTIVES To investigate detailed drug utilization in patients with psoriasis compared with controls in a population-based sample. METHODS This was a case-control study based on drug prescriptions derived from a Dutch general practitioner database where patients with psoriasis and controls without psoriasis were matched 1 : 1 for age, sex, general practitioner and duration of follow-up, between 2002 and 2012. We calculated Mantel-Haenszel odds ratios (ORs) and 95% confidence intervals (CIs) for all therapeutic groups and chemical substances. RESULTS In total 17 627 patients with psoriasis and 17 627 controls were followed for > 4 years. Overall 20% of patients with psoriasis received no psoriasis treatment and 8% had moderate-to-severe disease. During the entire follow-up a mean of nine unique drugs were prescribed in patients with psoriasis; this was significantly higher than in controls (mean of seven). Drug use did not peak around the date of diagnosis for psoriasis, but remained constant over time. All of the most commonly prescribed therapeutic groups were significantly more often prescribed in patients with psoriasis than in controls. These included drugs associated with psoriasis symptoms and treatment (OR 2·17, 95% CI 2·07-2·28 and OR 22, 95% CI 21-25, respectively), drugs related to psoriasis comorbidities (1·46, 95% CI 1·39-1·53) and a proportion of drugs that were a priori not expected to be increased in patients with psoriasis, such as nasal preparations and laxatives. CONCLUSIONS Patients with psoriasis received more prescriptions for all drugs, regardless of associated comorbidities. This overall increased use of drugs suggests an increased healthcare utilization in patients with psoriasis identified in routine databases.
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Affiliation(s)
- E A Dowlatshahi
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - L M Hollestein
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - R M C Herings
- PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands
| | - T Nijsten
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - M Wakkee
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
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242
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Joshi AA, Lerman JB, Aberra TM, Afshar M, Teague HL, Rodante JA, Krishnamoorthy P, Ng Q, Aridi TZ, Salahuddin T, Natarajan B, Lockshin BN, Ahlman MA, Chen MY, Rader DJ, Reilly MP, Remaley AT, Bluemke DA, Playford MP, Gelfand JM, Mehta NN. GlycA Is a Novel Biomarker of Inflammation and Subclinical Cardiovascular Disease in Psoriasis. Circ Res 2016; 119:1242-1253. [PMID: 27654120 DOI: 10.1161/circresaha.116.309637] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 09/08/2016] [Accepted: 09/21/2016] [Indexed: 01/26/2023]
Abstract
RATIONALE GlycA, an emerging inflammatory biomarker, predicted cardiovascular events in population-based studies. Psoriasis, an inflammatory disease associated with increased cardiovascular risk, provides a model to study inflammatory biomarkers in cardiovascular disease (CVD). Whether GlycA associates with psoriasis and how it predicts subclinical CVD beyond high-sensitivity C-reactive protein in psoriasis is unknown. OBJECTIVE To investigate the relationships between GlycA and psoriasis and between GlycA and subclinical CVD. METHODS AND RESULTS Patients with psoriasis and controls (n=412) participated in a 2-stage study. We measured GlycA by nuclear magnetic resonance spectroscopy. National Institutes of Health (NIH) participants underwent 18-F Fluorodeoxyglucose Positron Emission Tomography Computed Tomography (18-FDG PET/CT) scans to assess vascular inflammation (VI) and coronary computed tomographic angiography to quantify coronary artery disease burden. Psoriasis cohorts were young (mean age=47.9), with low cardiovascular risk and moderate skin disease. high-sensitivity C-reactive protein and GlycA were increased in psoriasis compared with controls (GlycA: [PENN: 408.8±75.4 versus 289.4±60.2, P<0.0001; NIH: 415.8±63.2 versus 346.2±46, P<0.0001]) and demonstrated a dose-response with psoriasis severity. In stage 2, VI (β=0.36, P<0.001) and coronary artery disease (β=0.29, P=0.004) associated with GlycA beyond CV risk factors in psoriasis. In receiver operating characteristic analysis, GlycA added value in predicting VI (P=0.01) and coronary artery disease (P<0.01). Finally, initiating anti-tumor necrosis factor therapy (n=16) reduced psoriasis severity (P<0.001), GlycA (463.7±92.5 versus 370.1±78.5, P<0.001) and VI (1.93±0.36 versus 1.76±0.19, P<0.001), whereas GlycA remained associated with VI (β=0.56, P<0.001) post treatment. CONCLUSIONS GlycA associated with psoriasis severity and subclinical CVD beyond traditional CV risk and high-sensitivity C-reactive protein. Moreover, psoriasis treatment reduced GlycA and VI. These findings support the potential use of GlycA in subclinical CVD risk assessment in psoriasis and potentially other inflammatory diseases.
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Affiliation(s)
- Aditya A Joshi
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Joseph B Lerman
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Tsion M Aberra
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Mehdi Afshar
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Heather L Teague
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Justin A Rodante
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Parasuram Krishnamoorthy
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Qimin Ng
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Tarek Z Aridi
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Taufiq Salahuddin
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Balaji Natarajan
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Benjamin N Lockshin
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Mark A Ahlman
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Marcus Y Chen
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Daniel J Rader
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Muredach P Reilly
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Alan T Remaley
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - David A Bluemke
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Martin P Playford
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Joel M Gelfand
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.)
| | - Nehal N Mehta
- From the Cardiovascular and Pulmonary Branch (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., M.Y.C., A.T.R., D.A.B., M.P.P., N.N.M.), Section of Inflammation and Cardiometabolic Diseases (A.A.J., J.B.L., T.M.A., H.L.T., J.A.R., Q.N., T.Z.A., T.S., B.N., A.T.R., M.P.P., N.N.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA (A.A.J.); Department of Medicine, McGill University, Montreal, QC, Canada (M.A.); Department of Cardiology, Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, Philadelphia, PA (P.K.); Department of Internal Medicine, University of Colorado, Denver (T.S.); Department of Internal Medicine, University of Arizona College of Medicine at South Campus, Tucson (B.N.); Derm Associates, Silver Spring, MD (B.N.L.); Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, MD (M.A.A.); Perelman School of Medicine (D.J.R.), Department of Dermatology (J.M.G.), and The Center for Clinical Epidemiology and Biostatistics (J.M.G.), University of Pennsylvania, Philadelphia; and Division of Cardiology, Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University, New York (M.P.R.).
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Brito-Luna MJ, Villanueva-Quintero DG, Sandoval-Talamantes AK, Fafutis-Morris M, Graciano-Machuca O, Sanchez-Hernandez PE, Alvarado-Navarro A. Correlation of IL-12, IL-22, and IL-23 in patients with psoriasis and metabolic syndrome. Preliminary report. Cytokine 2016; 85:130-6. [PMID: 27344023 DOI: 10.1016/j.cyto.2016.06.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/20/2016] [Accepted: 06/15/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND Psoriasis is an autoimmune skin disease characterised by proliferation of keratinocytes, primarily due to cytokines Th1 and Th17. This profile is involved in pathogenesis of metabolic syndrome, a frequently found comorbidity in patients with psoriasis. OBJECTIVE In this study we determine the correlation of levels of pro-inflammatory cytokines TNF-α, IL-23, IL-12, and IL-22 in patients with psoriasis with and without metabolic syndrome and clinically healthy controls. METHODS We included 55 patients with plaque psoriasis: 30 with metabolic syndrome (PPMS), 25 without metabolic syndrome (PP), 15 healthy subjects (HS) and 15 with metabolic syndrome (MS). Quantification of serum levels of IL-12, TNF-α, IL-22, and IL-23 was done by ELISA. RESULTS We observed that serum levels of IL-12 were more elevated in PP group, while the lowest levels of TNF-α were seen in HS group. IL-22 was found to be higher in PP than in PPMS (p<0.05). PP patients with PASI scores rating as severe showed higher levels of IL-12. TNF-α level analysis showed significant differences in HS group compared with the others; levels of this cytokine were lower in patients with PP and moderate PASI scores than in MS group (p<0.05). We found no correlation between cytokine levels and psoriasis or between cytokines and PASI scores. In PP group, a positive correlation was observed between IL-23 and fasting glucose (r=0.432, p<0.05), as well as a negative correlation between IL-23, IL-22, and IL-12 versus waist circumference (r=-0.504, r=-0.556 and r=-0.511, respectively; p<0.05). CONCLUSIONS Psoriasis is not just a skin disorder, but rather a condition with systemic implications, with intervention of pro-inflammatory cytokines that contribute to metabolic syndrome and other comorbidities, which in turn increases the risk of developing cardiovascular disease.
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Affiliation(s)
- M J Brito-Luna
- Jalisco Dermatology Institute "Dr. José Barba Rubio", Secretary of Health, Jalisco, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - D G Villanueva-Quintero
- Jalisco Dermatology Institute "Dr. José Barba Rubio", Secretary of Health, Jalisco, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - A K Sandoval-Talamantes
- Centre for Research in Immunology and Dermatology, Health Sciences University Centre, University of Guadalajara, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - M Fafutis-Morris
- Centre for Research in Immunology and Dermatology, Health Sciences University Centre, University of Guadalajara, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - O Graciano-Machuca
- Centre for Research in Immunology and Dermatology, Health Sciences University Centre, University of Guadalajara, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - P E Sanchez-Hernandez
- Immunology Laboratory, Department of Physiology, Health Sciences University Centre, University of Guadalajara, México, Sierra Mojada 950, Col. Independencia, CP 44340 Guadalajara, Jalisco, Mexico.
| | - A Alvarado-Navarro
- Centre for Research in Immunology and Dermatology, Health Sciences University Centre, University of Guadalajara, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
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244
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Martin G, Strober BE, Leonardi CL, Gelfand JM, Blauvelt A, Kavanaugh A, Stein Gold L, Berman B, Rosen T, Stockfleth E. Updates on Psoriasis and Cutaneous Oncology: Proceedings from the 2016 MauiDerm Meeting based on presentations by. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2016; 9:S5-S29. [PMID: 27800119 PMCID: PMC5077303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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245
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Wolk K, Sabat R. Adipokines in psoriasis: An important link between skin inflammation and metabolic alterations. Rev Endocr Metab Disord 2016; 17:305-317. [PMID: 27554109 DOI: 10.1007/s11154-016-9381-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Psoriasis is a chronic inflammatory skin disease most common in Europe, North America, and Australia. The etiology and pathomechanisms underlying the evolution and persistence of the skin alterations are increasingly being understood and have led to the development of effective anti-psoriatic therapies. Apart from the skin manifestations, psoriasis is associated with the metabolic syndrome (MetS), known to increase the risk of type 2 diabetes mellitus and cardiovascular disorders. Research of the last years demonstrated a dysregulated adipokine balance as an important link between inflammation, MetS, and consequential disorders. This article describes selected adipokines and their potential role in both metabolic comorbidity and skin inflammation in psoriasis.
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Affiliation(s)
- Kerstin Wolk
- Psoriasis Research and Treatment Center, Department of Dermatology and Allergy & Institute of Medical Immunology, University Medicine Charité, Charitéplatz 1, 10117, Berlin, Germany.
- Berlin-Brandenburg Center of Regenerative Therapies, University Medicine Charité, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Robert Sabat
- Psoriasis Research and Treatment Center, Department of Dermatology and Allergy & Institute of Medical Immunology, University Medicine Charité, Charitéplatz 1, 10117, Berlin, Germany
- Research Center Immunosciences, University Medicine Charité, Charitéplatz 1, 10117, Berlin, Germany
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246
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Rutter MK, Kane K, Lunt M, Cordingley L, Littlewood A, Young HS, Chew-Graham CA, Hilton R, Symmons DPM, Griffiths CEM. Primary care-based screening for cardiovascular risk factors in patients with psoriasis. Br J Dermatol 2016; 175:348-56. [PMID: 26990294 PMCID: PMC5113692 DOI: 10.1111/bjd.14557] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2016] [Indexed: 01/05/2023]
Abstract
Background Studies assessing cardiovascular disease (CVD) risk factors in patients with psoriasis have been limited by selection bias, inappropriate controls or a reliance on data collected for clinical reasons. Objectives To investigate whether screening for CVD risk factors in patients with psoriasis in primary care augments the known prevalence of CVD risk factors in a cross‐sectional study. Methods Patients listed as having psoriasis in primary care were recruited, screened and risk assessed by QRISK2. Results In total, 287 patients attended (mean age 53 years, 57% women, 94% white British, 22% severe disease, 33% self‐reported psoriatic arthritis). The proportion with known and screen‐detected (previously unknown) risk factors was as follows: hypertension 35% known and 13% screen‐detected; hypercholesterolaemia 32% and 37%; diabetes 6·6% and 3·1% and chronic kidney disease 1·1% and 4·5%. At least one screen‐detected risk factor was found in 48% and two or more risk factors were found in 21% of patients. One in three patients (37%) not previously known to be at high risk were found to have a high (> 10%) 10‐year CVD risk. Among the participants receiving treatment for known CVD risk factors, nearly half had suboptimal levels for blood pressure (46%) and cholesterol (46%). Conclusions Cardiovascular risk factor screening of primary care‐based adults with psoriasis identified a high proportion of patients (i) at high CVD risk, (ii) with screen‐detected risk factors and (iii) with suboptimally managed known risk factors. These findings need to be considered alongside reports that detected limited responses of clinicians to identified risk factors before universal CVD screening can be recommended. What's already known about this topic? Several studies have suggested that patients with psoriasis have a greater number of risk factors for cardiovascular disease (CVD) and a higher risk for vascular events compared with the general population. However, the prevalence data used to support systematic CVD risk factor screening in psoriasis have been limited by selection bias, inappropriate choice of control groups or reliance on risk factors measured for other clinical reasons.
What does this study add? Cardiovascular risk factor screening of primary care‐based adults with psoriasis identified a high proportion of patients (i) at high CVD risk, (ii) with screen‐detected risk factors and (iii) with suboptimally managed known risk factors. These findings need to be considered alongside reports that detected limited responses of clinicians to identified risk factors before universal CVD screening can be recommended.
Plain language summary available online
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Affiliation(s)
- M K Rutter
- The Endocrinology and Diabetes Research Group, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.,Manchester Diabetes Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
| | - K Kane
- Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K
| | - M Lunt
- Arthritis Research U.K. Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.,NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester, U.K
| | - L Cordingley
- Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.,Manchester Centre for Health Psychology, School of Psychological Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K
| | - A Littlewood
- Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K
| | - H S Young
- Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.,Centre for Dermatology Research, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
| | - C A Chew-Graham
- Research Institute, Primary Care and Health Sciences, Keele University, Keele, U.K.,South Staffordshire and Shropshire Healthcare NHS Foundation Trust, Stafford, U.K
| | - R Hilton
- Bridgewater Community Healthcare NHS Trust, Wigan, U.K
| | - D P M Symmons
- Arthritis Research U.K. Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.,NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester, U.K
| | - C E M Griffiths
- Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.,Centre for Dermatology Research, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
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Abstract
There has been a surge of new data regarding the pathophysiology of skin diseases. We are appreciating the sophisticated interplay among the skin, the immune system, and the environment. More elegant and highly specific medicines have been designed to target certain immune mediators of the adaptive immune system. In parallel fashion, we are learning more about the elegance of the innate immune system and how nutrition as early as the prenatal period can affect the priming of other immune cells. Concerns about the long-term impact of new immune-modulating medicines-especially in the pediatric population-have patients asking their dermatologists for nutritional alternatives to medical therapies. Nutrients and nutritional therapies appear to play a role at different ages for different dermatoses. Probiotics are showing promise as a therapeutic option for patients older than 1 year for atopic dermatitis. Systemic contact allergens appear to be a bigger burden on the adult population with atopic dermatitis. Obesity is a growing concern for both children and adults with psoriasis. Milk and high glycemic foods have a strong impact on the teenage acne population. Vitamins A and D are addressed as piece of the alopecia areata puzzle. Zinc and homeopathy are presented finally as possible treatments to the everlasting wart.
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Affiliation(s)
- Meagen McCusker
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT.
| | - Robert Sidbury
- Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA
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Roberts JL, Moreau R. Functional properties of spinach (Spinacia oleracea L.) phytochemicals and bioactives. Food Funct 2016; 7:3337-53. [PMID: 27353735 DOI: 10.1039/c6fo00051g] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Overwhelming evidence indicates that diets rich in fruits and vegetables are protective against common chronic diseases, such as cancer, obesity and cardiovascular disease. Leafy green vegetables, in particular, are recognized as having substantial health-promoting activities that are attributed to the functional properties of their nutrients and non-essential chemical compounds. Spinach (Spinacia oleracea L.) is widely regarded as a functional food due to its diverse nutritional composition, which includes vitamins and minerals, and to its phytochemicals and bioactives that promote health beyond basic nutrition. Spinach-derived phytochemicals and bioactives are able to (i) scavenge reactive oxygen species and prevent macromolecular oxidative damage, (ii) modulate expression and activity of genes involved in metabolism, proliferation, inflammation, and antioxidant defence, and (iii) curb food intake by inducing secretion of satiety hormones. These biological activities contribute to the anti-cancer, anti-obesity, hypoglycemic, and hypolipidemic properties of spinach. Despite these valuable attributes, spinach consumption remains low in comparison to other leafy green vegetables. This review examines the functional properties of spinach in cell culture, animals and humans with a focus on the molecular mechanisms by which spinach-derived non-essential phytochemicals and bioactives, such as glycolipids and thylakoids, impart their health benefits.
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Affiliation(s)
- Joseph L Roberts
- Department of Nutrition & Health Sciences, University of Nebraska-Lincoln, Lincoln, NE 68583, USA
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Jabbar-Lopez ZK, Weatherhead SC, Reynolds NJ. Kidney disease in moderate-to-severe psoriasis: a critical appraisal. Br J Dermatol 2016; 174:267-70. [PMID: 26871922 DOI: 10.1111/bjd.14302] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Using a population-based cohort, Wan et al. examined the risk of moderate-to-advanced (stage 3-5) chronic kidney disease (CKD) in patients with psoriasis. SETTING AND DESIGN A population-based cohort was constructed using The Health Improvement Network (THIN) database. THIN is an electronic primary healthcare records database containing routinely collected medical diagnosis and drug prescribing data on > 9 million patients in the U.K. Data were collected prospectively on 143 883 adults (aged 18-90 years) with psoriasis. Of these, 7354 had severe psoriasis, as defined by prescription codes for systemic medication or treatment codes for phototherapy. Patients with psoriasis were matched with up to five nonpsoriasis age- and practice-matched controls. Patients with a diagnosis of CKD before study entry were excluded. In addition, baseline data from the Incident Health Outcomes and Psoriasis Events (iHOPE) study, a cohort of 8731 primary care patients aged 25-64 years with psoriasis, was included. Psoriasis severity was categorized according to body surface area (BSA) involvement as estimated by general practitioners. A similar method using a patient-reported BSA assessment tool was previously validated by the same group. Patients were matched by age and practice with 10 nonpsoriasis controls. STUDY EXPOSURE Psoriasis, identified on the basis of a recorded diagnostic code for psoriasis. OUTCOMES Incident CKD was defined as the presence of a recorded diagnostic code consistent with moderate-to-advanced (stage 3-5) CKD or laboratory parameters consistent with the diagnosis (estimated glomerular filtration rate < 60 mL min(-1) 1·73 m(-2) ) during follow-up. Prevalent CKD (as defined above) in the cross-sectional data from the iHOPE study. RESULTS The adjusted hazard ratios for incident CKD were 1·05 [95% confidence interval (CI) 1·02-1·07], 0·99 (95% CI 0·97-1·02) and 1·93 (95% CI 1·79-2·08) in the overall, mild and severe psoriasis groups, respectively. In the nested cross-sectional study (iHOPE) the adjusted prevalence odds ratios for CKD were 0·89 (95% CI 0·72-1·10), 1·36 (95% CI 1·06-1·74) and 1·58 (95% CI 1·07-2·34) in the mild, moderate and severe psoriasis groups, respectively. CONCLUSIONS Moderate-to-severe psoriasis is associated with an increased risk of moderate-to-advanced CKD, independently of traditional risk factors.
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Affiliation(s)
- Z K Jabbar-Lopez
- Dermatological Sciences, Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, U.K.,Department of Dermatology, Royal Victoria Infirmary, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, U.K
| | - S C Weatherhead
- Dermatological Sciences, Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, U.K.,Department of Dermatology, Royal Victoria Infirmary, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, U.K
| | - N J Reynolds
- Dermatological Sciences, Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, U.K.,Department of Dermatology, Royal Victoria Infirmary, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, U.K
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Age and gender differences in Framingham risk score and metabolic syndrome in psoriasis patients: A cross-sectional study in the Turkish population. Anatol J Cardiol 2016; 17:66-72. [PMID: 27271475 PMCID: PMC5324866 DOI: 10.14744/anatoljcardiol.2016.6679] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective: Psoriasis is associated with an increased frequency of cardiovascular risk factors. Metabolic syndrome (MS) and the Framingham risk score (FRS) are two different algorithms for evaluating cardiovascular risk. They include different features: waist circumference measurement is included in the MS criteria, whereas smoking, age, and gender are questioned in FRS. This study aimed to evaluate the frequency of MS and FRS in psoriasis patients compared with a control group and investigate the differences between MS and FRS. Methods: This was a cross-sectional study involving 300 psoriasis patients and 177 controls. MS, FRS, and disease severity were evaluated. Results: The frequency of MS was higher in females with psoriasis than in those in the control group (p=0.019). Females in the psoriasis group were more obese than those in the control group (p=0.036). FRS significantly differed between the patients and controls of age >60 years (p=0.006). The risk of hypertension in current and past smokers was higher in the psoriasis patients (OR=2.07 and 2.32–2.48, respectively) than in the control group. There was no statistically significant relationship among MS, FRS, and psoriasis severity (p>0.05). Conclusion: The results of this study support the evaluation of cardiovascular risk assessment in female psoriasis patients with MS and in male and elderly psoriasis patients with FRS.
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