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O'Donnell C, Crilly S, O'Mahony A, O'Riordan B, Traynor M, Gitau R, McDonald K, Ledwidge M, O'Shea D, Murphy DJ, Dodd JD, Ryan S. Continuous Positive Airway Pressure but Not GLP1-mediated Weight Loss Improves Early Cardiovascular Disease in Obstructive Sleep Apnea: A Randomized Proof-of-Concept Study. Ann Am Thorac Soc 2024; 21:464-473. [PMID: 38096106 DOI: 10.1513/annalsats.202309-821oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/08/2023] [Indexed: 03/02/2024] Open
Abstract
Rationale: Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular (CV) morbidity and mortality, but the benefit of continuous positive airway pressure (CPAP) is uncertain. However, most randomized controlled trials have focused on the role of CPAP in secondary prevention, although there is growing evidence of a potential benefit on early CV disease. Weight loss in combination with CPAP may be superior but is difficult to achieve and maintain with conventional measures alone. Objectives: The aim of this study was to gain insights into the effect of CPAP on early atherosclerotic processes and to compare it with a glucagon-like peptide (GLP)-1-mediated weight loss regimen in patients with OSA. Methods: We performed a randomized proof-of-concept study comparing CPAP, a GLP1-mediated weight-loss regimen (liraglutide [Lir]), and both in combination for 24 weeks in 30 consecutive patients with OSA (apnea-hypopnea index >15 events/h; body mass index 30-40 kg/m2; and no history of diabetes, heart failure, or unstable CV disease). In addition to extensive evaluation for CV risk factors and endothelial function at baseline and end of study, subjects underwent 18F-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography (18F-FDG PET-CT) for the measurement of aortic wall inflammation (target-to-background ratio) and coronary computed tomography angiography for semiautomated coronary plaque analysis. Results: Baseline characteristics were similar between groups. CPAP alone and in combination resulted in greater reduction in apnea-hypopnea index than Lir alone (mean difference, -45 and -43 events/h, respectively, vs. -12 events/h; P < 0.05). Both Lir and combination treatment led to significant weight loss, but only CPAP alone resulted in significant decrease in vascular inflammation (aortic wall target-to-background ratio from 2.03 ± 0.34 to 1.84 ± 0.43; P = 0.010), associated with an improvement in endothelial function and a decrease in C-reactive protein. Low-attenuation coronary artery plaque volume as a marker of unstable plaque also decreased with CPAP (from 571 ± 490 to 334 ± 185 mm3) and with combination therapy (from 401 ± 145 to 278 ± 126 mm3) but not with Lir. Conclusions: These data suggest that CPAP therapy, but not GLP1-mediated weight loss, improves vascular inflammation and reduces unstable plaque volume in patients with OSA. Further large randomized controlled studies are warranted to assess the benefit of CPAP therapy in modifying early CV disease. Clinical trial registered with www.clinicaltrials.gov (NCT04186494).
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Affiliation(s)
- Cliona O'Donnell
- Pulmonary and Sleep Disorders Unit
- School of Medicine, University College Dublin, Dublin, Ireland
| | | | | | | | | | - Rachael Gitau
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Kenneth McDonald
- Department of Cardiology, and
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Mark Ledwidge
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Donal O'Shea
- Department of Endocrinology, St. Vincent's University Hospital, Dublin, Ireland; and
- School of Medicine, University College Dublin, Dublin, Ireland
| | - David J Murphy
- Department of Radiology
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Jonathan D Dodd
- Department of Radiology
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Silke Ryan
- Pulmonary and Sleep Disorders Unit
- School of Medicine, University College Dublin, Dublin, Ireland
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2
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Lv N, Zhang Y, Wang L, Suo Y, Zeng W, Yu Q, Yu B, Jiang X. LncRNA/CircRNA-miRNA-mRNA Axis in Atherosclerotic Inflammation: Research Progress. Curr Pharm Biotechnol 2024; 25:1021-1040. [PMID: 37842894 DOI: 10.2174/0113892010267577231005102901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/09/2023] [Accepted: 08/21/2023] [Indexed: 10/17/2023]
Abstract
Atherosclerosis is characterized by chronic inflammation of the arterial wall. However, the exact mechanism underlying atherosclerosis-related inflammation has not been fully elucidated. To gain insight into the mechanisms underlying the inflammatory process that leads to atherosclerosis, there is need to identify novel molecular markers. Non-coding RNAs (ncRNAs), including microRNAs (miRNAs), long non-protein-coding RNAs (lncRNAs) and circular RNAs (circRNAs) have gained prominence in recent years. LncRNAs/circRNAs act as competing endogenous RNAs (ceRNAs) that bind to miRNAs via microRNA response elements (MREs), thereby inhibiting the silencing of miRNA target mRNAs. Inflammatory mediators and inflammatory signaling pathways are closely regulated by ceRNA regulatory networks in atherosclerosis. In this review, we discuss the role of LncRNA/CircRNA-miRNA-mRNA axis in atherosclerotic inflammation and how it can be targeted for early clinical detection and treatment.
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Affiliation(s)
- Nuan Lv
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yilin Zhang
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Luming Wang
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yanrong Suo
- Traditional Chinese Medicine Department, Ganzhou People's Hospital, Ganzhou, China
| | - Wenyun Zeng
- Oncology Department, Ganzhou People's Hospital, Ganzhou, China
| | - Qun Yu
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Bin Yu
- School of Medical Technology, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xijuan Jiang
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Weber BN, Paik JJ, Aghayev A, Klein AL, Mavrogeni SI, Yu PB, Mukherjee M. Novel Imaging Approaches to Cardiac Manifestations of Systemic Inflammatory Diseases: JACC Scientific Statement. J Am Coll Cardiol 2023; 82:2128-2151. [PMID: 37993205 PMCID: PMC11238243 DOI: 10.1016/j.jacc.2023.09.819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 11/24/2023]
Abstract
Derangements in the innate and adaptive immune responses observed in systemic inflammatory syndromes contributes to unique elevated atherosclerotic risk and incident cardiovascular disease. Novel multimodality imaging techniques may improve diagnostic precision for the screening and monitoring of disease activity. The integrated application of these technologies lead to earlier diagnosis and noninvasive monitoring of cardiac involvement in systemic inflammatory diseases that will aid in preclinical studies, enhance patient selection, and provide surrogate endpoints in clinical trials, thereby improving clinical outcomes. We review the common cardiovascular manifestations of immune-mediated systemic inflammatory diseases and address the clinical and investigational role of advanced multimodality cardiac imaging.
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Affiliation(s)
- Brittany N Weber
- Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, USA
| | - Julie J Paik
- Division of Rheumatology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ayaz Aghayev
- Department of Radiology, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, USA
| | - Allan L Klein
- Division of Cardiology, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Paul B Yu
- Division of Cardiology, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA
| | - Monica Mukherjee
- Division of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA.
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Yarahmadi P, Nguyen PK. PET-FDG for vascular imaging: a "visual barometer" for inflammatory risk? J Nucl Cardiol 2023; 30:1653-1655. [PMID: 37127724 DOI: 10.1007/s12350-023-03250-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 05/03/2023]
Affiliation(s)
- Pourya Yarahmadi
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA, USA
- Stanford Cardiovascular Institute, Stanford, CA, USA
| | - Patricia K Nguyen
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA, USA.
- Stanford Cardiovascular Institute, Stanford, CA, USA.
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5
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Yeh CB, Yeh LT, Yang SF, Wang BY, Wang YH, Chan CH. Association between psoriasis and peripheral artery occlusive disease: a population-based retrospective cohort study. Front Cardiovasc Med 2023; 10:1136540. [PMID: 37378400 PMCID: PMC10291070 DOI: 10.3389/fcvm.2023.1136540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Introduction Psoriasis (PSO) is a chronic skin condition that affects a variety of disorders, especially the cardiovascular system. This study investigated the association between PSO and peripheral arterial disease (PAOD). Methods A retrospective cohort study design was carried out between 2000 and 2018. The exposure subject was a newly diagnosed PSO. The diagnosis of PSO was never elaborated as a comparison subject. Balanced heterogeneity of the two groups was used by propensity score matching. The cumulative incidence of PAOD between the two groups was performed using Kaplan-Meier analysis. The Cox proportional hazard model was used to measure the risk of PAOD risk hazard ratio. Results After matching the 1: 1 propensity score, 15,696 subjects with PSO and the same number of subjects without the diagnosis of PSO were recruited. The PSO subject had a higher risk of PAOD than the non-PSO subject (adjusted HR = 1.25; 95% CI = 1.03-1.50). In the 40-64-year-old subgroup, the subject of PSO exhibited an increased risk of PAOD than the subject without PSO. Conclusion Psoriasis is associated with an increased risk of peripheral arterial disease and curative care is necessary to reduce the risk of PAOD..
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Affiliation(s)
- Chao-Bin Yeh
- Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Liang-Tsai Yeh
- Department of Anesthesiology, Changhua Christian Hospital, Changhua, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Bo-Yuan Wang
- Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chi-Ho Chan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
- Department of Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
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Liu J, Chen L, Zheng X, Guo C. Identification of immune-related genes in acute myocardial infarction based on integrated bioinformatical methods and experimental verification. PeerJ 2023; 11:e15058. [PMID: 37214088 PMCID: PMC10198157 DOI: 10.7717/peerj.15058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/22/2023] [Indexed: 05/24/2023] Open
Abstract
Background Acute myocardial infarction (AMI) is one of the leading causes of death worldwide. The etiology of AMI is complex and has not been fully defined. In recent years, the role of immune response in the development, progression and prognosis of AMI has received increasing attention. The aim of this study was to identify key genes associated with the immune response in AMI and to analyze their immune infiltration. Methods The study included a total of two GEO databases, containing 83 patients with AMI and 54 healthy individuals. We used the linear model of microarray data (limma) package to find the differentially expressed genes associated with AMI, performing weighted gene co-expression analysis (WGCNA) to further identify the genes associated with inflammatory response to AMI. We found the final hub genes through the protein-protein interaction (PPI) network and least absolute shrinkage and selection operator (LASSO) regression model. To verify the above conclusions, we constructed mice AMI model, extracting myocardial tissue to perform qRT-PCR. Furthermore, the CIBERSORT tool for immune cells infiltration analysis was also carried out. Results A total of 5,425 significant up-regulated and 2,126 down-regulated genes were found in GSE66360 and GSE24519. A total of 116 immune-related genes in close association with AMI were screened by WGCNA analysis. These genes were mostly clustered in the immune response on the basis of GO and KEGG enrichment. With construction of PPI network and LASSO regression analysis, this research found three hub genes (SOCS2, FFAR2, MYO10) among these differentially expressed genes. The immune cell infiltration results revealed that significant differences could be found on T cells CD4 memory activated, Tregs (regulatory T cells), macrophages M2, neutrophils, T cells CD8, T cells CD4 naive, eosinophils between controls and AMI patients.
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Affiliation(s)
- Jian Liu
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Lu Chen
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiang Zheng
- Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Caixia Guo
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Senders ML, Calcagno C, Tawakol A, Nahrendorf M, Mulder WJM, Fayad ZA. PET/MR imaging of inflammation in atherosclerosis. Nat Biomed Eng 2023; 7:202-220. [PMID: 36522465 DOI: 10.1038/s41551-022-00970-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/25/2022] [Indexed: 12/23/2022]
Abstract
Myocardial infarction, stroke, mental disorders, neurodegenerative processes, autoimmune diseases, cancer and the human immunodeficiency virus impact the haematopoietic system, which through immunity and inflammation may aggravate pre-existing atherosclerosis. The interplay between the haematopoietic system and its modulation of atherosclerosis has been studied by imaging the cardiovascular system and the activation of haematopoietic organs via scanners integrating positron emission tomography and resonance imaging (PET/MRI). In this Perspective, we review the applicability of integrated whole-body PET/MRI for the study of immune-mediated phenomena associated with haematopoietic activity and cardiovascular disease, and discuss the translational opportunities and challenges of the technology.
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Affiliation(s)
- Max L Senders
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Claudia Calcagno
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ahmed Tawakol
- Cardiology Division and Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Matthias Nahrendorf
- Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Willem J M Mulder
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
- Department of Internal Medicine, Radboud Institute of Molecular Life Sciences (RIMLS) and Radboud Center for Infectious Diseases (RCI), Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
- Laboratory of Chemical Biology, Department of Biochemical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
| | - Zahi A Fayad
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Huang S, Bai Y. Knowledge Mapping and Research Hotspots of Comorbidities in Psoriasis: A Bibliometric Analysis from 2004 to 2022. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020393. [PMID: 36837593 PMCID: PMC9961708 DOI: 10.3390/medicina59020393] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/02/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023]
Abstract
Background and Objectives: Psoriasis is a chronic inflammatory disease whose impact on health is not only limited to the skin, but is also associated with multiple comorbidities. Early screening for comorbidities along with appropriate treatment plans can provide a positive prognosis for patients. This study aimed to summarize the knowledge structure in the field of psoriasis comorbidities and further explore its research hotspots and trends through bibliometrics. Materials and Methods: A search was conducted in the core collection of the Web of Science for literature on comorbidities of psoriasis from 2004 to 2022. VOSviewer and CiteSpace software were used for collaborative network analysis, co-citation analysis of references, and keyword co-occurrence analysis on these publications. Results: A total of 1803 papers written by 6741 authors from 81 countries was included. The publications have shown a progressive increase since 2004. The United States and Europe were at the forefront of this field. The most prolific institution was the University of California, and the most productive author was A. Armstrong. Research has focused on "psoriatic arthritis", "metabolic syndrome", "cardiovascular disease", "psychosomatic disease", "inflammatory bowel disease", "prevalence", "quality of life", and "risk factor" in the past 18 years. Keywords such as "biologics" and "systemic inflammation", have been widely used recently, suggesting current research hotspots and trends. Conclusions: Over the past 18 years, tremendous progress has been made in research on psoriasis comorbidity. However, collaborations among countries, institutions, and investigators are inadequate, and the study of the mechanisms of interaction between psoriasis and comorbidities and management of comorbidities is insufficient. The treatment of comorbidities with biologic agents, screening of comorbidities, and multidisciplinary co-management are predicted to be the focus of future research.
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Affiliation(s)
- Shan Huang
- Graduate School, Beijing University of Chinese Medicine, Beijing 100105, China
| | - Yanping Bai
- Department of Dermatology, China-Japan Friendship Hospital, Beijing 100029, China
- Correspondence: ; Tel.: +86-13910758509
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Sammartino AM, Falco R, Drera A, Dondi F, Bellini P, Bertagna F, Vizzardi E. "Vascular inflammation and cardiovascular disease: review about the role of PET imaging". Int J Cardiovasc Imaging 2023; 39:433-440. [PMID: 36255543 PMCID: PMC9870832 DOI: 10.1007/s10554-022-02730-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/09/2022] [Indexed: 01/27/2023]
Abstract
Inflammation characterizes all stages of atherothrombosis and provides a critical pathophysiological link between plaque formation and its acute rupture, leading to coronary occlusion and heart attack. In the last 20 years the possibility of quantifying the degree of inflammation of atherosclerotic plaques and, therefore, also of vascular inflammation aroused much interest. 18Fluoro-deoxy-glucose photon-emissions-tomography (18F-FDG-PET) is widely used in oncology for staging and searching metastases; in cardiology, the absorption of 18F-FDG into the arterial wall was observed for the first time incidentally in the aorta of patients undergoing PET imaging for cancer staging. PET/CT imaging with 18F-FDG and 18F-sodium fluoride (18F-NaF) has been shown to assess atherosclerotic disease in its molecular phase, when the process may still be reversible. This approach has several limitations in the clinical practice, due to lack of prospective data to justify their use routinely, but it's desirable to develop further scientific evidence to confirm this technique to detect high-risk patients for cardiovascular events.
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Affiliation(s)
- Antonio Maria Sammartino
- Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili, University of Brescia, Brescia, Italy.
| | - Raffaele Falco
- Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Andrea Drera
- Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Francesco Dondi
- Nuclear Medicine, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili Di Brescia, University of Brescia, Brescia, Italy
| | - Pietro Bellini
- Nuclear Medicine, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili Di Brescia, University of Brescia, Brescia, Italy
| | - Francesco Bertagna
- Nuclear Medicine, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili Di Brescia, University of Brescia, Brescia, Italy
| | - Enrico Vizzardi
- Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili, University of Brescia, Brescia, Italy.
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10
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Berg AR, Petrole RF, Li H, Sorokin AV, Gonzalez-Cantero A, Playford MP, Mehta NN, Teague HL. Cholesterol efflux capacity is associated with lipoprotein size and vascular health in mild to moderate psoriasis. Front Cardiovasc Med 2023; 10:1041457. [PMID: 36891247 PMCID: PMC9986595 DOI: 10.3389/fcvm.2023.1041457] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/24/2023] [Indexed: 02/22/2023] Open
Abstract
Background and objective Psoriasis is a systemic inflammatory condition with poor cholesterol transport measured by cholesterol efflux capacity (CEC) that is associated with a heightened risk of cardiovascular disease (CVD). In psoriasis patients, we sought to characterize the lipoprotein profile by size using a novel nuclear magnetic resonance algorithm in patients with low CEC compared to normal CEC. Methods Lipoprotein profile was assessed using the novel nuclear magnetic resonance LipoProfile-4 deconvolution algorithm. Aortic vascular inflammation (VI) and non-calcified burden (NCB) were characterized via positron emission tomography-computed tomography and coronary computed tomography angiography. To understand the relationship between lipoprotein size and markers of subclinical atherosclerosis, linear regression models controlling for confounders were constructed. Results Psoriasis patients with low CEC had higher more severe psoriasis (p = 0.04), VI (p = 0.04) and NCB (p = 0.001), concomitant with smaller high-density lipoprotein (HDL) (p < 0.001) and low-density lipoprotein (LDL) particles (p < 0.001). In adjusted models HDL size (β = -0.19; p = 0.02) and LDL size (β = -0.31; p < 0.001) associated with VI and NCB. Lastly, HDL size strongly associated with LDL size in fully adjusted models (β = -0.27; p < 0.001). Conclusion These findings demonstrate that in psoriasis, low CEC associates with a lipoprotein profile comprised of smaller HDL and LDL particles which correlates with vascular health and may be driving early onset atherogenesis. Further, these results demonstrate a relationship between HDL and LDL size and provide novel insights into the complexities of HDL and LDL as biomarkers of vascular health.
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Affiliation(s)
- Alexander R Berg
- National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, United States
| | - Rylee F Petrole
- National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, United States
| | - Haiou Li
- National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, United States
| | | | - Alvaro Gonzalez-Cantero
- Dermatology Service, Hospital Universitario Ramón y Cajal, Medicine Department, Faculty of Medicine, Universidad de Alcalá, IRYCIS, Madrid, Spain.,Faculty of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - Martin P Playford
- National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, United States
| | - Nehal N Mehta
- National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, United States
| | - Heather L Teague
- National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, United States
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11
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Munnur RK, Cheng K, Laggoune J, Talman A, Muthalaly R, Nerlekar N, Baey YW, Nogic J, Lin A, Cameron JD, Seneviratne S, Wong DTL. Quantitative plaque characterisation and association with acute coronary syndrome on medium to long term follow up: insights from computed tomography coronary angiography. Cardiovasc Diagn Ther 2022; 12:415-425. [PMID: 36033222 PMCID: PMC9412217 DOI: 10.21037/cdt-21-763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/25/2022] [Indexed: 11/09/2022]
Abstract
Background Computed tomography coronary angiography (CTCA) is an established imaging modality widely used for diagnosing coronary artery stenosis with expanding potential for comprehensive assessment of coronary artery disease (CAD). Lesion-based analyses of high-risk plaques (HRP) on CTCA may aid further in prognostication presenting with stable chest pain. We conduct qualitative and quantitative assessments to identify HRPs that are associated with acute coronary syndrome (ACS) on a medium to long term follow-up. Methods Retrospective cohort study of patients who underwent CTCA for suspected CAD. Obstructive stenosis (OS) is defined as ≥50% and the presence of HRP and its constituents: positive-remodelling (PR), low-attenuation-plaque (LAP; <56 HU), very-low-attenuation-plaque (vLAP; <30 HU) and spotty-calcification (SC) were recorded. A cross-sectional quantitative analysis of HRP was performed at the site of minimum-luminal-area (MLA). The primary endpoint was fatal or non-fatal ACS on follow-up. Results A total of 1,257 patients were included (mean age 61±14 years old and 51% male) with a median follow-up of 7.24 years (interquartile range 5.5 to 7.7 years). The occurrence of ACS was significantly higher in HRP (+) patients compared to HRP (−) patients and patients with no plaques (20.5% vs. 1.6% vs. 0.4%, log-rank test P<0.001). ACS was more frequent in HRP (+)/OS (+) patients (20.7%) compared to HRP (+)/OS (−) patients (8.6%), HRP (−)/OS (+) patients (1.8%) and HRP (−)/OS (−) patients (1.0%). OS, cross-sectional plaque area (PA) and the presence of vLAP identified those HRP lesions that were more likely to cause future ACS. Cross-sectional LAP area (<56 HU) in HRP lesions added incremental prognostic value to OS in predicting ACS (P=0.008). Conclusions The presence of OS and the LAP area at the site of MLA identify the HRP lesions that have the greatest association with development of future ACS.
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Affiliation(s)
- Ravi K Munnur
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, Clayton, VIC, Australia
| | - Kevin Cheng
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, Clayton, VIC, Australia
| | - Jordan Laggoune
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, Clayton, VIC, Australia
| | - Andrew Talman
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, Clayton, VIC, Australia
| | - Rahul Muthalaly
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, Clayton, VIC, Australia
| | - Nitesh Nerlekar
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, Clayton, VIC, Australia
| | - Yi-Wei Baey
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, Clayton, VIC, Australia
| | - Jason Nogic
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, Clayton, VIC, Australia
| | - Andrew Lin
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, Clayton, VIC, Australia
| | - James D Cameron
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, Clayton, VIC, Australia
| | - Sujith Seneviratne
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, Clayton, VIC, Australia
| | - Dennis T L Wong
- Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, Clayton, VIC, Australia.,South Australian Health Medical Research Institute (SAHMRI), Adelaide, Australia
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12
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Teklu M, Mehta NN. FDG-PET in ischemic strokes of unknown origin: Have we found the needle in the haystack? J Nucl Cardiol 2022; 29:1337-1338. [PMID: 33825138 DOI: 10.1007/s12350-021-02598-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Meron Teklu
- National Institutes of Health, National Heart, Lung and Blood Institute, Bethesda, MD, USA
| | - Nehal N Mehta
- Lab of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, Bethesda, MD, 20892, USA.
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13
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Parel PM, Berg AR, Hong CG, Florida EM, O'Hagan R, Sorokin AV, Mehta NN. Updates in the Impact of Chronic Systemic Inflammation on Vascular Inflammation by Positron Emission Tomography (PET). Curr Cardiol Rep 2022; 24:317-326. [PMID: 35171444 DOI: 10.1007/s11886-022-01651-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW In this review, we focus on the clinical and epidemiological studies pertaining to systemic and vascular inflammation by positron emission tomography (PET) in patients with chronic inflammatory conditions such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), human immunodeficiency virus (HIV), and psoriasis to highlight the importance of chronic systemic inflammation on vascular inflammation by PET in these disease states. RECENT FINDINGS Recent clinical and translation advancements have demonstrated the durable relationship between chronic systemic inflammation and cardiovascular disease (CVD). In chronic inflammatory states, this relationship is robustly evident in the form of increased vascular inflammation, yet traditional risk estimates often underestimate the subclinical cardiovascular risk conferred by chronic inflammation. PET has emerged as a novel, non-invasive imaging modality capable of both quantifying the degree of systemic and vascular inflammation and detecting residual inflammation prior to cardiovascular events. We begin by demonstrating the role of inflammation in the pathogenesis of atherosclerosis, discussing how PET has been utilized to measure systemic and vascular inflammation and their effect on subclinical atherosclerosis, and finally reviewing recent applications of PET in constructing improved risk stratification for patients at high risk for stroke and CVD.
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Affiliation(s)
- Philip M Parel
- Inflammation and Cardiometabolic Diseases, Clinical Research Center, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, USA
| | - Alexander R Berg
- Inflammation and Cardiometabolic Diseases, Clinical Research Center, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, USA
| | - Christin G Hong
- Inflammation and Cardiometabolic Diseases, Clinical Research Center, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, USA
| | - Elizabeth M Florida
- Inflammation and Cardiometabolic Diseases, Clinical Research Center, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, USA
| | - Ross O'Hagan
- Inflammation and Cardiometabolic Diseases, Clinical Research Center, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, USA
| | - Alexander V Sorokin
- Inflammation and Cardiometabolic Diseases, Clinical Research Center, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, USA
| | - Nehal N Mehta
- Inflammation and Cardiometabolic Diseases, Clinical Research Center, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, USA.
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14
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Weber B, Perez-Chada LM, Divakaran S, Brown JM, Taqueti V, Dorbala S, Blankstein R, Liao K, Merola JF, Di Carli M. Coronary microvascular dysfunction in patients with psoriasis. J Nucl Cardiol 2022; 29:37-42. [PMID: 32419071 PMCID: PMC9202505 DOI: 10.1007/s12350-020-02166-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/17/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Psoriasis is a common chronic inflammatory skin disorder that is associated with excess cardiovascular risk. Inflammation is a key mediator in the onset and progression of these cardiometabolic abnormalities; however, the excess cardiovascular risk conferred by psoriatic disease remains understudied. We investigated the prevalence and severity of CMD in patients with psoriasis and determined whether CMD is a result of CV risk factors and atherosclerotic burden. METHODS This was a consecutive retrospective cohort study of patients with psoriasis, normal myocardial perfusion, and LV ejection fraction (EF) > 50% (N = 62) and matched controls without psoriasis (N = 112). Myocardial perfusion and myocardial flow reserve (MFR) were quantified using PET imaging. Atherosclerotic burden was determined by semi-quantitative computed tomography (CT) coronary calcium assessment. RESULTS The prevalence of CMD (defined as MFR < 2) was 61.3% in patients with psoriatic disease, compared to 38.4% in a matched control population (P = .004). Furthermore, patients with psoriasis had a more severe reduction in adjusted MFR (2.3 ± .81 vs 1.92 ± .65, respectively, P = .001). The degree of atherosclerotic burden, as assessed by qualitative calcium score, was similar between psoriasis and controls. CONCLUSIONS Patients with psoriasis without overt CAD demonstrated a high prevalence of coronary vasomotor abnormalities that are not entirely accounted for by the commonly associated coronary risk factors or the burden of atherosclerosis.
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Affiliation(s)
- Brittany Weber
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, USA
| | - Lourdes M Perez-Chada
- Department of Dermatology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, ASB-L1 037C, Boston, MA, 02115, USA
| | - Sanjay Divakaran
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, USA
| | - Jenifer M Brown
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, USA
| | - Viviany Taqueti
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, USA
| | - Sharmila Dorbala
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, USA
| | - Ron Blankstein
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, USA
| | - Katherine Liao
- Division of Rheumatology, Department of Medicine, Brigham and Women's Hospital, Boston, USA
| | - Joseph F Merola
- Department of Dermatology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, ASB-L1 037C, Boston, MA, 02115, USA
| | - Marcelo Di Carli
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, USA.
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15
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Heightened splenic and bone marrow uptake of 18F-FDG PET/CT is associated with systemic inflammation and subclinical atherosclerosis by CCTA in psoriasis: An observational study. Atherosclerosis 2021; 339:20-26. [PMID: 34808541 DOI: 10.1016/j.atherosclerosis.2021.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/14/2021] [Accepted: 11/04/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Psoriasis is an immune-mediated inflammatory disease with increased risk of myocardial infarction. Preclinical studies in psoriasis models show an association between chronic inflammation and immune cell proliferation in the spleen and bone marrow (BM). We sought to test the hypothesis that splenic and BM 18F-fluorodeoxyglucose (18F-FDG) uptake is heightened in psoriasis and that higher uptake associates with systemic inflammation and subclinical atherosclerotic disease measures in this cohort. METHODS Multimodality imaging and biomarker assays were performed in 240 participants (210 with psoriasis and 30 healthy). Splenic and BM uptake was obtained using 18F-FDG positron emission tomography/computed tomography (PET/CT). Coronary artery plaque characteristics including non-calcified burden (NCB) and lipid rich necrotic core (LRNC) were quantified using a dedicated software for CT angiography. All analyses were performed with StataIC 16 (Stata Corp., College Station, TX, USA). RESULTS Splenic and BM 18F-FDG uptake was increased in psoriasis (vs. healthy volunteers) and significantly associated with proatherogenic lipids, immune cells and systemic inflammation. Higher splenic 18F-FDG uptake associated with higher total coronary burden (β = 0.37; p<0.001), NCB (β = 0.39; p<0.001), and LRNC (β = 0.32; p<0.001) in fully adjusted models. Similar associations were seen for BM 18F-FDG uptake in adjusted models (β = 0.38; β = 0.41; β = 0.24; respectively, all p<0.001). CONCLUSIONS Heightened splenic and BM uptake of 18F-FDG is associated with proatherogenic lipids, immune cells, inflammatory markers and coronary artery disease. These findings provide insights into atherogenic mechanisms in psoriasis and suggest that immune cell proliferation in the spleen and BM is associated with subclinical atherosclerosis.
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16
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Kaiser H, Wang X, Kvist-Hansen A, Krakauer M, Gørtz PM, McCauley BD, Skov L, Becker C, Hansen PR. Biomarkers of subclinical atherosclerosis in patients with psoriasis. Sci Rep 2021; 11:21438. [PMID: 34728734 PMCID: PMC8564536 DOI: 10.1038/s41598-021-00999-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022] Open
Abstract
Psoriasis is linked with increased risk of cardiovascular disease (CVD) that is underestimated by traditional risk stratification. We conducted a large-scale plasma proteomic analysis by use of a proximity extension assay in 85 patients with a history of moderate-to-severe psoriasis with or without established atherosclerotic CVD. Differentially expressed proteins associated with CVD were correlated with subclinical atherosclerotic markers including vascular inflammation determined by 18F-fluorodeoxyglucose positron emission tomography/computed tomography, carotid intima-media thickness (CIMT), carotid artery plaques, and coronary artery calcium score (CCS) in the patients without CVD and statin treatment. We also examined the association between the neutrophil-to-lymphocyte ratio (NLR) and subclinical atherosclerosis. In unadjusted analyses, growth differentiation factor-15 (GDF-15) levels and NLR were increased, while tumor necrosis factor (TNF)-related activation-inducing ligand (TRANCE) and TNF-related apoptosis-induced ligand (TRAIL) levels were decreased in patients with established CVD compared to those without CVD. Among patients with psoriasis without CVD and statin treatment, GDF-15 levels were negatively associated with vascular inflammation in the ascending aorta and entire aorta, and positively associated with CIMT and CCS. NLR was positively associated with vascular inflammation in the carotid arteries. Our data suggest that circulating GDF-15 levels and NLR might serve as biomarkers of subclinical atherosclerosis in patients with psoriasis.
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Affiliation(s)
- Hannah Kaiser
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Xing Wang
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amanda Kvist-Hansen
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Martin Krakauer
- Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, Hellerup, Denmark
- Department of Clinical Physiology and Nuclear Medicine, Bispebjerg and Frederiksberg Hospital, University Hospital, Copenhagen, Denmark
| | - Peter Michael Gørtz
- Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Benjamin D McCauley
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lone Skov
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christine Becker
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Peter Riis Hansen
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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17
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Villani AP, Pavel AB, Wu J, Fernandes M, Maari C, Saint‐Cyr Proulx E, Jack C, Glickman J, Choi S, He H, Ungar B, Estrada Y, Kameyama N, Zhang N, Gonzales J, Tardif J, Krueger JG, Bissonnette R, Guttman‐Yassky E. Vascular inflammation in moderate-to-severe atopic dermatitis is associated with enhanced Th2 response. Allergy 2021; 76:3107-3121. [PMID: 33866573 DOI: 10.1111/all.14859] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/15/2021] [Accepted: 03/04/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND In atopic dermatitis (AD), some studies have shown an association with increased cardiovascular disease in certain populations. However, other investigations found modest or no association. Despite conflicting results, molecular profiling studies in both AD skin and blood have demonstrated upregulation of atherosclerosis and cardiovascular risk-related markers. However, the underlying mechanisms connecting AD to vascular inflammation/atherosclerosis are unknown. In this study, we aim to determine factors associated with vascular inflammation/atherosclerosis in AD patients. METHODS We used 18-FDG PET-CT to characterize vascular inflammation in AD patients and healthy subjects. In parallel, we assessed their skin and blood immune profiles to determine AD-related immune biomarkers associated with vascular inflammation. We also assessed levels of circulating microparticles, which are known to be associated with increased cardiovascular risk. RESULTS We found significant correlations between vascular inflammation and Th2-related products in skin and blood of AD patients as well as atherosclerosis-related markers that were modulated by dupilumab. Circulating levels of endothelial microparticles were significantly higher in severe AD patients and tended to correlate with vascular inflammation assessed by PET-CT. CONCLUSION Vascular inflammation in AD is associated with enhanced Th2 response and clinical severity, which may explain cardiovascular comorbidities observed in select AD populations. Larger prospective studies are needed to further evaluate vascular inflammation and cardiovascular events and mortality in AD patients. Finally, as dupilumab treatment demonstrated significant modulation of atherosclerosis-related genes in AD patients compared to placebo, these data suggest that modulation of vascular inflammation with systemic treatment should be explored in patients with AD.
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Affiliation(s)
- Axel P. Villani
- Department of Dermatology and the Immunology Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - Ana B. Pavel
- Department of Dermatology and the Immunology Institute Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Biomedical Engineering University of Mississippi University MS USA
| | - Jianni Wu
- Department of Dermatology and the Immunology Institute Icahn School of Medicine at Mount Sinai New York NY USA
- College of Medicine State University of New York Downstate Medical Center Brooklyn New York USA
| | - Marie Fernandes
- Department of Dermatology and the Immunology Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | | | | | | | - Jacob Glickman
- Department of Dermatology and the Immunology Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - Seulah Choi
- Department of Dermatology and the Immunology Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - Helen He
- Department of Dermatology and the Immunology Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - Benjamin Ungar
- Department of Dermatology and the Immunology Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - Yeriel Estrada
- Department of Dermatology and the Immunology Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - Naoya Kameyama
- Department of Dermatology and the Immunology Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - Ning Zhang
- Department of Dermatology and the Immunology Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - Juana Gonzales
- Department of Dermatology and the Immunology Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - Jean‐Claude Tardif
- Montreal Heart Institute Faculty of Medicine Université de Montréal Montreal QC Canada
| | - James G. Krueger
- Laboratory for Investigative Dermatology The Rockefeller University New York NY USA
| | | | - Emma Guttman‐Yassky
- Department of Dermatology and the Immunology Institute Icahn School of Medicine at Mount Sinai New York NY USA
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18
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Zhou W, Dey A, Manyak G, Teklu M, Patel N, Teague H, Mehta NN. The application of molecular imaging to advance translational research in chronic inflammation. J Nucl Cardiol 2021; 28:2033-2045. [PMID: 33244675 PMCID: PMC8149483 DOI: 10.1007/s12350-020-02439-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/17/2020] [Indexed: 01/23/2023]
Abstract
Over the past several decades, molecular imaging techniques to assess cellular processes in vivo have been integral in advancing our understanding of disease pathogenesis. 18F-fluorodeoxyglucose (18-FDG) positron emission tomography (PET) imaging in particular has shaped the field of atherosclerosis research by highlighting the importance of underlying inflammatory processes that are responsible for driving disease progression. The ability to assess physiology using molecular imaging, combining it with anatomic delineation using cardiac coronary angiography (CCTA) and magnetic resonance imaging (MRI) and lab-based techniques, provides a powerful combination to advance both research and ultimately clinical care. In this review, we demonstrate how molecular imaging studies, specifically using 18-FDG PET, have revealed that early vascular disease is a systemic process with multiple, concurrent biological mechanisms using inflammatory diseases as a basis to understand early atherosclerotic mechanisms in humans.
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Affiliation(s)
- Wunan Zhou
- National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
- Cardiovascular Branch, NHLBI, 10 Center Drive, CRC, Room 5-5140, Bethesda, MD, 20892, USA
| | - Amit Dey
- National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Grigory Manyak
- National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Meron Teklu
- National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Nidhi Patel
- National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Heather Teague
- National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Nehal N Mehta
- National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA.
- Cardiovascular Branch, NHLBI, 10 Center Drive, CRC, Room 5-5140, Bethesda, MD, 20892, USA.
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19
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Yan D, Blauvelt A, Dey AK, Golpanian RS, Hwang ST, Mehta NN, Myers B, Shi ZR, Yosipovitch G, Bell S, Liao W. New Frontiers in Psoriatic Disease Research, Part II: Comorbidities and Targeted Therapies. J Invest Dermatol 2021; 141:2328-2337. [PMID: 33888321 PMCID: PMC8464483 DOI: 10.1016/j.jid.2021.02.743] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 01/27/2021] [Accepted: 02/09/2021] [Indexed: 12/12/2022]
Abstract
Although psoriasis and psoriatic arthritis (PsA) have been classically considered to be diseases of the skin and joints, respectively, emerging evidence suggests that a combination of innate and environmental factors creates widespread immune dysfunction, affecting multiple organ systems. A greater understanding of the pathogenesis of psoriasis and the systemic effects of psoriatic inflammation has allowed for the development of new, more effective treatments. The second portion of this two-part review series examines the comorbidities associated with psoriasis and PsA as well as the most recent advances in targeted systemic therapies for these conditions.
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Affiliation(s)
- Di Yan
- The Ronald O. Perelman Department of Dermatology, NYU Langone Medical Center, New York, New York, USA
| | | | - Amit K Dey
- Cardiopulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - Rachel S Golpanian
- Itch Center, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Samuel T Hwang
- Department of Dermatology, UC Davis Medical Center, Sacramento, California
| | - Nehal N Mehta
- Cardiopulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - Bridget Myers
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Zhen-Rui Shi
- Department of Dermatology, UC Davis Medical Center, Sacramento, California
| | - Gil Yosipovitch
- Itch Center, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Stacie Bell
- National Psoriasis Foundation, Portland, Oregon, USA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, San Francisco, California.
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20
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Bao W, Yang M, Xu Z, Yan F, Yang Q, Li X, Yang W. Coronary Inflammation Assessed by Perivascular Fat Attenuation Index in Patients with Psoriasis: A Propensity Score-Matched Study. Dermatology 2021; 238:562-570. [PMID: 34535598 DOI: 10.1159/000518771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/29/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate coronary inflammation by measuring the perivascular fat attenuation index (FAI) and quantify the atherosclerosis burden in patients with psoriasis and control individuals without psoriasis based on coronary computed tomography angiography (CCTA) images. METHODS A total of 98 consecutive patients with psoriasis (76 male [77.6%], aged 56.5 years, range 45.5-65.0) were recruited, and 196 patients (157 male [80.1%]; aged 54.6 ± 14.1 years) without established cardiovascular disease (CVD) who underwent CCTA within the same period were enrolled in the control group. Coronary plaque burden was quantified using the computed tomography-adapted Leaman score (CT-LeSc), and the FAI surrounding the proximal of three main epicardial vessels was measured to represent coronary inflammation. RESULTS Patients with psoriasis and the control subjects were well matched in CVD risk factors (all p > 0.05). Psoriasis patients had a greater overall CT-LeSc (5.86 vs. 4.69, p = 0.030) and lower perivascular FAI (-80.19 ± 7.48 vs. -78.14 ± 7.81 HU, p < 0.001). A similar result was found upon comparing psoriasis patients without biological or statin therapy with non-psoriasis individuals without statin treatments. Furthermore, the psoriasis group had a higher prevalence of non-calcified plaques (30.3% in the psoriasis group vs. 20.1% in the control subjects, p = 0.001). No difference in perivascular FAI on either calcified and mixed plaques or non-calcified plaques between the two groups was found. CONCLUSION Patients with psoriasis have a higher atherosclerotic burden as quantified by CT-LeSc and less coronary inflammation as detected by perivascular FAI around the most proximal of the three major epicardial vessels. The usefulness of perivascular FAI for evaluating coronary inflammation in patients with chronic low-grade inflammatory disease such as psoriasis should be verified.
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Affiliation(s)
- Wenrui Bao
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Yang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhihan Xu
- Siemens Healthineers CT Collaboration, Shanghai, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Yang
- Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xia Li
- Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjie Yang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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21
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Mosca M, Hong J, Hadeler E, Hakimi M, Brownstone N, Liao W, Bhutani T. Psoriasis and Cardiometabolic Comorbidities: An Evaluation of the Impact of Systemic Treatments in Randomized Clinical Trials. Dermatol Ther (Heidelb) 2021; 11:1497-1520. [PMID: 34505985 PMCID: PMC8484473 DOI: 10.1007/s13555-021-00590-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/06/2021] [Indexed: 02/07/2023] Open
Abstract
The association between psoriasis, metabolic syndrome, and cardiovascular disease is well established. The shared pathways between psoriasis, metabolic syndrome, and atherosclerosis suggest that treatments targeting the inflammatory pathways of psoriasis may also be beneficial in the treatment of associated cardiometabolic comorbidities. This paper reviews the most recent data regarding the impact of systemic psoriasis treatments on comorbid cardiovascular and metabolic disease. Data from randomized clinical trials with systemic and biologic agents are presented. Overall, studies demonstrate beneficial effects on several cardiometabolic markers and risk factors in psoriasis patients; however, longer randomized controlled trials to characterize the direct benefit for cardiovascular outcomes are needed.
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Affiliation(s)
- Megan Mosca
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center, 515 Spruce Street, San Francisco, CA, 94118, USA.
| | - Julie Hong
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Edward Hadeler
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Marwa Hakimi
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Nicholas Brownstone
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center, 515 Spruce Street, San Francisco, CA, 94118, USA
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22
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Teklu M, Parel PM, Mehta NN. Psoriasis and Cardiometabolic Diseases: The Impact of Inflammation on Vascular Health. PSORIASIS-TARGETS AND THERAPY 2021; 11:99-108. [PMID: 34322373 PMCID: PMC8312325 DOI: 10.2147/ptt.s320016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/06/2021] [Indexed: 12/24/2022]
Abstract
Psoriasis is a common chronic inflammatory condition associated with a higher risk of cardiovascular disease. Psoriasis confers a dose-dependent increase in risk for the metabolic syndrome and its components. The metabolic syndrome and its components have been associated with higher coronary atherosclerosis in psoriasis and cardiovascular events in the general population. In this review, we discuss the role of inflammation and psoriasis in cardiometabolic diseases with a focus on the metabolic syndrome and its components. We highlight the relationship between psoriasis and important cardiovascular risk factors encompassed by obesity, dyslipidemia, insulin resistance and hypertension. Furthermore, we briefly highlight literature on anti-inflammatory therapies and their impact on the components of the metabolic syndrome as well as directly quantified coronary atherosclerosis burden.
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Affiliation(s)
- Meron Teklu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Philip M Parel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nehal N Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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Boussoussou M, Vattay B, Szilveszter B, Kolossváry M, Simon J, Vecsey-Nagy M, Merkely B, Maurovich-Horvat P. Functional assessment of coronary plaques using CT based hemodynamic simulations: Current status, technical principles and clinical value. IMAGING 2021. [DOI: 10.1556/1647.2020.00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
AbstractIn recent years, coronary computed tomography angiography (CCTA) has emerged as an accurate and safe non-invasive imaging modality in terms of detecting and excluding coronary artery disease (CAD). In the latest European Society of Cardiology Guidelines CCTA received Class I recommendation for the evaluation of patients with stable chest pain with low to intermediate clinical likelihood of CAD. Despite its high negative predictive value, the diagnostic performance of CCTA is limited by the relatively low specificity, especially in patients with heavily calcified lesions. The discrepancy between the degree of stenosis and ischemia is well established based on both invasive and non-invasive tests. The rapid evolution of computational flow dynamics has allowed the simulation of CCTA derived fractional flow reserve (FFR-CT), which improves specificity by combining anatomic and functional information regarding coronary atherosclerosis. FFR-CT has been extensively validated against invasively measured FFR as the reference standard. Due to recent technological advancements FFR-CT values can also be calculated locally, without offsite processing. Wall shear stress (WSS) and axial plaque stress (APS) are additional key hemodynamic elements of atherosclerotic plaque characteristics, which can also be measured using CCTA images. Current evidence suggests that WSS and APS are important hemodynamic features of adverse coronary plaques. CCTA based hemodynamic calculations could therefore improve prognostication and the management of patients with stable CAD.
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Affiliation(s)
- Melinda Boussoussou
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Borbála Vattay
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Bálint Szilveszter
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Márton Kolossváry
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Judit Simon
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Milán Vecsey-Nagy
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Béla Merkely
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
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Poizeau F, Nowak E, Kerbrat S, Le Nautout B, Droitcourt C, Drici MD, Sbidian E, Guillot B, Bachelez H, Ait-Oufella H, Happe A, Oger E, Dupuy A. Association Between Early Severe Cardiovascular Events and the Initiation of Treatment With the Anti-Interleukin 12/23p40 Antibody Ustekinumab. JAMA Dermatol 2021; 156:1208-1215. [PMID: 32902568 DOI: 10.1001/jamadermatol.2020.2977] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Importance Ustekinumab, a monoclonal antibody targeting interleukin 12/23p40 (IL-12/23p40), is effective in the treatment of moderate to severe psoriasis, psoriatic arthritis, and Crohn disease. In 2011, a meta-analysis of randomized clinical trials reported a potential risk of severe cardiovascular events (SCEs) within the first few months after the initiation of anti-IL-12/23p40 antibodies. Objective To assess whether the initiation of ustekinumab treatment is associated with increased risk of SCEs. Design, Setting, and Participants This case-time-control study used data from the French national health insurance database, covering 66 million individuals, on all patients exposed to ustekinumab between April 1, 2010, and December 31, 2016, classified according to their cardiovascular risk level (high- and low-risk strata). The risk period was the 6 months before the SCE, defined as acute coronary syndrome or stroke, and the reference period was the 6 months before the risk period. Statistical analysis was performed from September 20, 2017, to July 6, 2018. Exposure The initiation of ustekinumab treatment was screened during the risk and reference periods. Main Outcomes and Measures Odds ratios for the risk of SCE after the initiation of ustekinumab treatment were calculated. Results Of the 9290 patients exposed to ustekinumab (4847 men [52%]; mean [SD] age, 43 [14] years), 179 experienced SCEs (65 cases of acute coronary syndrome, 68 cases of unstable angina, and 46 cases of stroke). Among patients with a high cardiovascular risk, a statisically significant association between initiaton of ustekinumab treatment and SCE occurrence was identified (odds ratio, 4.17; 95% CI, 1.19-14.59). Conversely, no statistically significant association was found among patients with a low cardiovascular risk (odds ratio, 0.30; 95% CI, 0.03-3.13). Conclusions and Relevance This study suggests that the initiation of ustekinumab treatment may trigger SCEs among patients at high cardiovascular risk. In line with the current mechanistic models for atherosclerotic disease, the period after the initiation of anti-IL-12/23p40 may be associated with atherosclerotic plaque destabilization via the inhibition of helper T cell subtype 17. Although the study interpretation is limited by its observational design, these results suggest that caution may be needed in the prescription of ustekinumab to patients at high cardiovascular risk.
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Affiliation(s)
- Florence Poizeau
- EA 7449 REPERES (Pharmacoepidemiology and Health Services Research), University of Rennes 1, Rennes, France.,PEPS Research Consortium (Pharmacoepidemiology for Health Product Safety), Rennes, France.,Department of Dermatology, CHU Rennes, Rennes, France
| | - Emmanuel Nowak
- PEPS Research Consortium (Pharmacoepidemiology for Health Product Safety), Rennes, France.,University of Bretagne Occidentale, Brest University, Brest, France.,INSERM CIC 1412, CHRU Brest, Brest, France
| | - Sandrine Kerbrat
- EA 7449 REPERES (Pharmacoepidemiology and Health Services Research), University of Rennes 1, Rennes, France.,PEPS Research Consortium (Pharmacoepidemiology for Health Product Safety), Rennes, France
| | - Béranger Le Nautout
- EA 7449 REPERES (Pharmacoepidemiology and Health Services Research), University of Rennes 1, Rennes, France.,PEPS Research Consortium (Pharmacoepidemiology for Health Product Safety), Rennes, France
| | - Catherine Droitcourt
- EA 7449 REPERES (Pharmacoepidemiology and Health Services Research), University of Rennes 1, Rennes, France.,PEPS Research Consortium (Pharmacoepidemiology for Health Product Safety), Rennes, France.,Department of Dermatology, CHU Rennes, Rennes, France
| | | | - Emilie Sbidian
- Department of Dermatology, Henri Mondor Hospital, APHP, Créteil, France.,EA EpiDermE 7379, Paris Est Créteil University, Créteil, France
| | - Bernard Guillot
- Department of Dermatology, CHU Montpellier, Montpellier, France
| | - Hervé Bachelez
- Université de Paris, Paris, France.,INSERM UMR1163, Institut Imagine, Paris, France.,Department of Dermatology, Saint-Louis Hospital, APHP, Paris, France
| | - Hafid Ait-Oufella
- INSERM U970, Paris Cardiovascular Research Centre, Université de Paris, Paris, France.,Department of Intensive Care, Saint-Antoine Hospital, APHP, Paris, France
| | - André Happe
- EA 7449 REPERES (Pharmacoepidemiology and Health Services Research), University of Rennes 1, Rennes, France.,PEPS Research Consortium (Pharmacoepidemiology for Health Product Safety), Rennes, France
| | - Emmanuel Oger
- EA 7449 REPERES (Pharmacoepidemiology and Health Services Research), University of Rennes 1, Rennes, France.,PEPS Research Consortium (Pharmacoepidemiology for Health Product Safety), Rennes, France
| | - Alain Dupuy
- EA 7449 REPERES (Pharmacoepidemiology and Health Services Research), University of Rennes 1, Rennes, France.,PEPS Research Consortium (Pharmacoepidemiology for Health Product Safety), Rennes, France.,Department of Dermatology, CHU Rennes, Rennes, France
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Yuvaraj J, Cheng K, Lin A, Psaltis PJ, Nicholls SJ, Wong DTL. The Emerging Role of CT-Based Imaging in Adipose Tissue and Coronary Inflammation. Cells 2021; 10:1196. [PMID: 34068406 PMCID: PMC8153638 DOI: 10.3390/cells10051196] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/30/2021] [Accepted: 05/07/2021] [Indexed: 12/15/2022] Open
Abstract
A large body of evidence arising from recent randomized clinical trials demonstrate the association of vascular inflammatory mediators with coronary artery disease (CAD). Vascular inflammation localized in the coronary arteries leads to an increased risk of CAD-related events, and produces unique biological alterations to local cardiac adipose tissue depots. Coronary computed tomography angiography (CTA) provides a means of mapping inflammatory changes to both epicardial adipose tissue (EAT) and pericoronary adipose tissue (PCAT) as independent markers of coronary risk. Radiodensity or attenuation of PCAT on coronary CTA, notably, provides indirect quantification of coronary inflammation and is emerging as a promising non-invasive imaging implement. An increasing number of observational studies have shown robust associations between PCAT attenuation and major coronary events, including acute coronary syndrome, and 'vulnerable' atherosclerotic plaque phenotypes that are associated with an increased risk of the said events. This review outlines the biological characteristics of both EAT and PCAT and provides an overview of the current literature on PCAT attenuation as a surrogate marker of coronary inflammation.
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Affiliation(s)
- Jeremy Yuvaraj
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University and Monash Heart, Monash Health, Clayton, VIC 3168, Australia; (J.Y.); (K.C.); (S.J.N.)
| | - Kevin Cheng
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University and Monash Heart, Monash Health, Clayton, VIC 3168, Australia; (J.Y.); (K.C.); (S.J.N.)
| | - Andrew Lin
- Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA 90048, USA;
| | - Peter J. Psaltis
- Department of Medicine, University of Adelaide, Adelaide, SA 5005, Australia;
- South Australian Health Medical Research Institute, Adelaide, SA 5000, Australia
| | - Stephen J. Nicholls
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University and Monash Heart, Monash Health, Clayton, VIC 3168, Australia; (J.Y.); (K.C.); (S.J.N.)
| | - Dennis T. L. Wong
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University and Monash Heart, Monash Health, Clayton, VIC 3168, Australia; (J.Y.); (K.C.); (S.J.N.)
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Association between Vascular Inflammation and Inflammation in Adipose Tissue, Spleen, and Bone Marrow in Patients with Psoriasis. Life (Basel) 2021; 11:life11040305. [PMID: 33915972 PMCID: PMC8065955 DOI: 10.3390/life11040305] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/22/2021] [Accepted: 03/29/2021] [Indexed: 12/29/2022] Open
Abstract
Psoriasis is associated with atherosclerotic cardiovascular disease (CVD) with significant overlap of inflammatory pathways. A link between vascular inflammation and inflammation in multiple adipose tissue types, spleen, and bone marrow may exist. Therefore, we investigated these associations using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in patients with psoriasis (n = 83) where half had established CVD. Carotid ultrasound imaging was also performed. Inflammation was measured by FDG uptake in the aorta, visceral- (VAT), subcutaneous- (SAT), and pericardial (PAT) adipose tissues, and spleen and bone marrow, respectively. Vascular inflammation was associated with FDG uptakes in all adipose tissues, including VAT (β = 0.26; p < 0.001), SAT (β = 0.28; p < 0.001), PAT (β = 0.24; p < 0.001), spleen (β = 1.35; p = 0.001), and bone marrow (β = 1.14; p < 0.001). Adjustments for age, sex, body mass index, and high sensitivity C-reactive protein did not change the results. These associations were generally preserved in the patients without prior CVD. No associations were observed between vascular inflammation and carotid intima-media thickness or presence of carotid plaques, respectively. The results suggest an inflammatory link between vascular and adipose tissues, spleen, and bone marrow in patients with psoriasis.
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Jung R, Wild J, Ringen J, Karbach S, Wenzel P. Innate Immune Mechanisms of Arterial Hypertension and Autoimmune Disease. Am J Hypertens 2021; 34:143-153. [PMID: 32930786 DOI: 10.1093/ajh/hpaa145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/15/2020] [Accepted: 09/14/2020] [Indexed: 12/16/2022] Open
Abstract
The immune system is indispensable in the development of vascular dysfunction and hypertension. The interplay between immune cells and the vasculature, kidneys, heart, and blood pressure regulating nuclei in the central nervous system results in a complex and closely interwoven relationship of the immune system with arterial hypertension. A better understanding of this interplay is necessary for optimized and individualized antihypertensive therapy. Our review article focuses on innate cells in hypertension and to what extent they impact on development and preservation of elevated blood pressure. Moreover, we address the association of hypertension with chronic autoimmune diseases. The latter are ideally suited to learn about immune-mediated mechanisms in cardiovascular disease leading to high blood pressure.
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Affiliation(s)
- Rebecca Jung
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
| | - Johannes Wild
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- Department of Cardiology, University Medical Center Mainz, Mainz, Germany
| | - Julia Ringen
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
| | - Susanne Karbach
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- Department of Cardiology, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Germany
| | - Philip Wenzel
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- Department of Cardiology, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Germany
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Srivastava AK, Chand Yadav T, Khera HK, Mishra P, Raghuwanshi N, Pruthi V, Prasad R. Insights into interplay of immunopathophysiological events and molecular mechanistic cascades in psoriasis and its associated comorbidities. J Autoimmun 2021; 118:102614. [PMID: 33578119 DOI: 10.1016/j.jaut.2021.102614] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023]
Abstract
Psoriasis is an inflammatory skin disease with complex pathogenesis and multiple etiological factors. Besides the essential role of autoreactive T cells and constellation of cytokines, the discovery of IL-23/Th17 axis as a central signaling pathway has unraveled the mechanism of accelerated inflammation in psoriasis. This has provided insights into psoriasis pathogenesis and revolutionized the development of effective biological therapies. Moreover, genome-wide association studies have identified several candidate genes and susceptibility loci associated with this disease. Although involvement of cellular innate and adaptive immune responses and dysregulation of immune cells have been implicated in psoriasis initiation and maintenance, there is still a lack of unifying mechanism for understanding the pathogenesis of this disease. Emerging evidence suggests that psoriasis is a high-mortality disease with additional burden of comorbidities, which adversely affects the treatment response and overall quality of life of patients. Furthermore, changing trends of psoriasis-associated comorbidities and shared patterns of genetic susceptibility, risk factors and pathophysiological mechanisms manifest psoriasis as a multifactorial systemic disease. This review highlights the recent progress in understanding the crucial role of different immune cells, proinflammatory cytokines and microRNAs in psoriasis pathogenesis. In addition, we comprehensively discuss the involvement of various complex signaling pathways and their interplay with immune cell markers to comprehend the underlying pathophysiological mechanism, which may lead to exploration of new therapeutic targets and development of novel treatment strategies to reduce the disastrous nature of psoriasis and associated comorbidities.
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Affiliation(s)
- Amit Kumar Srivastava
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India
| | - Tara Chand Yadav
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India
| | - Harvinder Kour Khera
- Tata Institute for Genetics and Society, Centre at InStem, Bangalore, 560065, Karnataka, India; Division of Biological Sciences, University of California, San Diego, La Jolla, CA, 92093, United States
| | - Purusottam Mishra
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India
| | - Navdeep Raghuwanshi
- Vaccine Formulation & Research Center, Gennova (Emcure) Biopharmaceuticals Limited, Pune, 411057, Maharashtra, India
| | - Vikas Pruthi
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India
| | - Ramasare Prasad
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India.
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Teklu M, Zhou W, Kapoor P, Patel N, Dey AK, Sorokin AV, Manyak GA, Teague HL, Erb-Alvarez JA, Sajja A, Abdelrahman KM, Reddy AS, Uceda DE, Lateef SS, Shanbhag SM, Scott C, Prakash N, Svirydava M, Parel P, Rodante JA, Keel A, Siegel EL, Chen MY, Bluemke DA, Playford MP, Gelfand JM, Mehta NN. Metabolic syndrome and its factors are associated with noncalcified coronary burden in psoriasis: An observational cohort study. J Am Acad Dermatol 2021; 84:1329-1338. [PMID: 33383084 DOI: 10.1016/j.jaad.2020.12.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/10/2020] [Accepted: 12/16/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Psoriasis is associated with a heightened risk of cardiovascular disease and higher prevalence of metabolic syndrome. OBJECTIVE Investigate the effect of metabolic syndrome and its factors on early coronary artery disease assessed as noncalcified coronary burden by coronary computed tomography angiography in psoriasis. METHODS This cross-sectional study consisted of 260 participants with psoriasis and coronary computed tomography angiography characterization. Metabolic syndrome was defined according to the harmonized International Diabetes Federation criteria. RESULTS Of the 260 participants, 80 had metabolic syndrome (31%). The metabolic syndrome group had a higher burden of cardiometabolic disease, systemic inflammation, noncalcified coronary burden, and high-risk coronary plaque. After adjusting for Framingham risk score, lipid-lowering therapy, and biologic use, metabolic syndrome (β = .31; P < .001) and its individual factors of waist circumference (β = .33; P < .001), triglyceride levels (β = .17; P = .005), blood pressure (β = .18; P = .005), and fasting glucose (β = .17; P = .009) were significantly associated with noncalcified coronary burden. After adjusting for all other metabolic syndrome factors, blood pressure and waist circumference remained significantly associated with noncalcified coronary burden. LIMITATIONS Observational nature with limited ability to control for confounders. CONCLUSIONS In psoriasis, individuals with metabolic syndrome had more cardiovascular disease risk factors, systemic inflammation, and noncalcified coronary burden. Efforts to increase metabolic syndrome awareness in psoriasis should be undertaken to reduce the heightened cardiovascular disease risk.
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Affiliation(s)
- Meron Teklu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Wunan Zhou
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Promita Kapoor
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Nidhi Patel
- 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
| | - Alexander V Sorokin
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Grigory A Manyak
- 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
| | - Julie A Erb-Alvarez
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Aparna Sajja
- Department of Internal Medicine, Johns Hopkins University Medical Center, Baltimore, Maryland
| | - Khaled M Abdelrahman
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Aarthi S Reddy
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Domingo E Uceda
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Sundus S Lateef
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Sujata M Shanbhag
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Colin Scott
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Nina Prakash
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Maryia Svirydava
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Philip Parel
- 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
| | - Andrew Keel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Evan L Siegel
- Department of Rheumatology, Arthritis and Rheumatism Associates, Rockville, Maryland
| | - Marcus Y Chen
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - David A Bluemke
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Martin P Playford
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Joel M Gelfand
- Department of Dermatology, Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Nehal N Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
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GlycA measured by NMR spectroscopy is associated with disease activity and cardiovascular disease risk in chronic inflammatory diseases. Am J Prev Cardiol 2020; 4:100120. [PMID: 34327480 PMCID: PMC8315361 DOI: 10.1016/j.ajpc.2020.100120] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 02/08/2023] Open
Abstract
GlycA is a biomarker of systemic inflammation, quantifying both the protein concentrations and glycosylation states of several acute phase proteins. GlycA has been shown to be associated with both subclinical atherosclerosis and with cardiovascular disease (CVD). GlycA levels are higher in acute and chronic inflammation. During ongoing systemic inflammatory processes, GlycA specific acute phase reactants and proteins undergo circulating concentration and glycosylation pattern changes, and these alterations are reflected in the GlycA NMR signal. Additionally, levels associate with ongoing disease severity in individuals with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and psoriasis thus capturing active inflammation. Furthermore, in these disease states, GlycA is associated with cardiovascular disease (CVD) independent of traditional risk factors including C-reactive protein (CRP). Finally, GlycA levels decrease with exercise, weight loss, and systemic anti-inflammatory agents. Therefore, GlycA appears to be a promising new composite biomarker of active systemic inflammation including assessing CVD risk in patients with inflammatory diseases. Patients with chronic inflammatory disorders are at increased risk for cardiovascular diseasenot captured by traditional risk factors. GlycA is a biomarker of acute phase reactants by NMR spectroscopy which captures disease activity in human inflammatory diseases. GlycA associates with cardiovascular disease and offers a tool to monitor primary disease activity and assess CVD risk in inflammatory diseases.
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Sorokin AV, Remaley AT, Mehta NN. Oxidized Lipids and Lipoprotein Dysfunction in Psoriasis. JOURNAL OF PSORIASIS AND PSORIATIC ARTHRITIS 2020; 5:139-146. [PMID: 33163854 PMCID: PMC7646705 DOI: 10.1177/2475530320950268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Psoriasis is a chronic immune-mediated inflammatory skin disease associated with increased development of metabolic abnormalities including obesity and dyslipidemia, as well as increased cardiovascular disease (CVD) risk. Shared pathophysiological mechanisms linking psoriasis to CVD include altered immune activation, elevated chronic systemic inflammation, and lipoprotein dysfunction characterized by oxidative damage to lipids and apolipoproteins. OBJECTIVE This review aims to provide evidence-based proof for existing relationships between psoriatic inflammation, lipid oxidation, and increased CVD risk. METHODS We included review articles and original research papers, published between 1980 and 2020, using the following key words: psoriasis, oxidized lipids, oxidation, dyslipidemia, and inflammation. RESULTS Systemic inflammation underlying psoriasis leads to increased skin accumulation of pro-inflammatory oxidized lipids, derived from the omega-6 fatty acids, along with counteracting anti-inflammatory lipid mediators, products of the omega-3 polyunsaturated fatty acids. Imbalance in these metabolites culminates in impaired inflammation resolution and results in multisystemic biological alterations. Sustained systemic inflammation results in excessive lipid oxidation, generating proatherogenic oxidized low- and high-density lipoproteins. Together, these pathophysiological mechanisms contribute to increased CVD risk associated with psoriasis disease. CONCLUSION Available anti-inflammatory treatment showed promising clinical results in treating psoriasis, although further research is warranted on managing associated dyslipidemia and establishing novel cardiometabolic markers specific for both skin and vascular pathology.
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Affiliation(s)
- Alexander V. Sorokin
- Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Alan T. Remaley
- Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nehal N. Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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Karbach S, Hobohm L, Wild J, Münzel T, Gori T, Wegner J, Steinbrink K, Wenzel P, Keller K. Impact of Psoriasis on Mortality Rate and Outcome in Myocardial Infarction. J Am Heart Assoc 2020; 9:e016956. [PMID: 32914667 PMCID: PMC7726965 DOI: 10.1161/jaha.120.016956] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Psoriasis is a frequent chronic inflammatory cytokine‐mediated skin disease and was identified to be an independent risk factor for the occurrence of myocardial infarction (MI). However, data about the impact of psoriasis on mortality and other in‐hospital adverse events in the setting of MI are sparse and inconsistent. Methods and Results The nationwide German inpatient sample of the years 2005 to 2016 was used for statistical analysis. Hospitalized patients with MI were stratified for the presence of psoriasis and the impact of psoriasis on in‐hospital events was investigated. Overall, 3 307 703 patients with MI (37.6% females, 56.8% aged ≥70 years) were treated in Germany (2005–2016); among them 9028 (0.3%) were diagnosed with psoriasis. Patients with MI with psoriasis were significantly younger (68.0 [58.0–76.0] versus 73.0 [62.0–81.0] years; P<0.001) and showed significant lower in‐hospital case‐fatality rate (7.1% versus 12.4%; P<0.001), confirmed in the regression (odds ratio, 0.68; 95% CI, 0.63–0.74; P<0.001) adjusted for age, sex, and comorbidities. They more frequently revealed cardiovascular risk factors such as arterial hypertension (58.9% versus 55.0%; P<0.001), hyperlipidemia (44.4% versus 38.6%; P<0.001), smoking (14.3% versus 7.4%; P<0.001), diabetes mellitus (34.8% versus 30.4%; P<0.001) or obesity (17.9% versus 9.3%; P<0.001). While the rate of percutaneous coronary intervention (41.4 versus 42.0%; P=0.223) was comparable between both groups, coronary bypass surgery was more often performed in patients with MI with psoriasis (7.7% versus 4.7%; P<0.001). Conclusions Overall, only 0.3% of all MI cases were diagnosed with psoriasis, and patients with MI with psoriasis were in median 5 years younger than patients with MI without psoriasis. Psoriasis seems to enhance the prevalence of classical cardiovascular risk factors and might therefore explain the earlier time point for MI. Our data also showed in turn a lower in‐hospital mortality rate in patients with MI with psoriasis, presumably driven by younger age.
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Affiliation(s)
- Susanne Karbach
- Department of Cardiology Cardiology I University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Center for Thrombosis and Hemostasis (CTH) University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany
| | - Lukas Hobohm
- Department of Cardiology Cardiology I University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Center for Thrombosis and Hemostasis (CTH) University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany
| | - Johannes Wild
- Department of Cardiology Cardiology I University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Center for Thrombosis and Hemostasis (CTH) University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany
| | - Thomas Münzel
- Department of Cardiology Cardiology I University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main Mainz Germany
| | - Tommaso Gori
- Department of Cardiology Cardiology I University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Center for Thrombosis and Hemostasis (CTH) University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main Mainz Germany
| | - Joanna Wegner
- Department of Dermatology University Medical Center Mainz Mainz Germany
| | - Kerstin Steinbrink
- Center for Thrombosis and Hemostasis (CTH) University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Department of Dermatology University Medical Center Münster Westfälische Wilhelms-University Münster Münster Germany
| | - Philip Wenzel
- Department of Cardiology Cardiology I University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Center for Thrombosis and Hemostasis (CTH) University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main Mainz Germany
| | - Karsten Keller
- Department of Cardiology Cardiology I University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Center for Thrombosis and Hemostasis (CTH) University Medical Center Mainz (Johannes Gutenberg-University Mainz) Mainz Germany.,Medical Clinic VII Department of Sports Medicine University Hospital Heidelberg Heidelberg Germany
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Baumer Y, Dey AK, Gutierrez-Huerta CA, Khalil NO, Sekine Y, Sanda GE, Zhuang J, Saxena A, Stempinski E, Elnabawi YA, Dagur PK, Ng Q, Teague HL, Keel A, Rodante JA, Boisvert WA, Tsoi LC, Gudjonsson JE, Bleck CKE, Chen MY, Bluemke DA, Gelfand JM, Schwartz DM, Kruth HS, Powell-Wiley TM, Playford MP, Mehta NN. Hyperlipidaemia and IFNgamma/TNFalpha Synergism are associated with cholesterol crystal formation in Endothelial cells partly through modulation of Lysosomal pH and Cholesterol homeostasis. EBioMedicine 2020; 59:102876. [PMID: 32646751 PMCID: PMC7502673 DOI: 10.1016/j.ebiom.2020.102876] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Inflammation plays an important role in the development of cardiovascular disease (CVD). Patients with chronic inflammation diseases have high levels of inflammation and early fatal myocardial infarction due to early, unstable coronary plaques. Cholesterol crystals (CC) play a key role in atherogenesis. However, the underlying mechanisms of endothelial cell (EC)-derived CC formation are not well understood in chronic inflammation. METHODS We utilized a combination of a mouse psoriasis model (K14-Rac1V12 mouse model) and human psoriasis patients to study the effect of inflammatory cytokines on CC formation in ECs. Lysosomal pH, alterations in lipid load and inflammatory proteins were evaluated as potential mechanisms linking inflammatory cytokines to CC formation. Coronary CT angiography was performed (n = 224) to characterize potential IFNγ and TNFα synergism on vascular diseases in vivo. FINDINGS We detected CC presence in the aorta of K14-Rac1V12 mice on chow diet. IFNγ and TNFα were found to synergistically increase LDL-induced CC formation by almost 2-fold. There was an increase in lysosomal pH accompanied by a 28% loss in pH-dependent lysosomal signal and altered vATPaseV1E1 expression patterns. In parallel, we found that LDL+IFNγ/TNFα treatments increased free cholesterol content within EC and led to a decrease in SOAT-1 expression, an enzyme critically involved cholesterol homeostasis. Finally, the product of IFNγ and TNFα positively associated with early non-calcified coronary burden in patients with psoriasis (n = 224; β = 0.28, p < 0.001). INTERPRETATION Our results provide evidence that IFNγ and TNFα accelerate CC formation in endothelial cells in part by altering lysosomal pH and free cholesterol load. These changes promote early atherogenesis and contribute to understanding the burden of CVD in psoriasis. FUNDING Funding was provided by the Intramural Research Program at NIH (NNM) and the National Psoriasis Foundation (NNM and YB).
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Affiliation(s)
- Yvonne Baumer
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA; Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Amit K Dey
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Cristhian A Gutierrez-Huerta
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Noor O Khalil
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Yusuke Sekine
- Center for Molecular Medicine, National Heart Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Gregory E Sanda
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Jie Zhuang
- Cardiovascular and Cancer Genetics Laboratory, National Heart Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Ankit Saxena
- Flow Cytometry Core, National Heart Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Erin Stempinski
- Electron Microscopy Core Facility, National Heart, Lung, and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Youssef A Elnabawi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Pradeep K Dagur
- Flow Cytometry Core, National Heart Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Qimin Ng
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Heather L Teague
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Andrew Keel
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Justin A Rodante
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - William A Boisvert
- Center for Cardiovascular Research, John A Burns School of Medicine, University of Hawaii, 651 Ilalo Street, Honolulu, HI 96813, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, 1301 E. Catherine Street, Ann Arbor, MI 48109, USA
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan, 1301 E. Catherine Street, Ann Arbor, MI 48109, USA
| | - Christopher K E Bleck
- Electron Microscopy Core Facility, National Heart, Lung, and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Marcus Y Chen
- Section of Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - David A Bluemke
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA
| | - Joel M Gelfand
- Department of Dermatology, Hospital of the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Daniella M Schwartz
- Genetics and Pathogenesis of Allergy Section, National Institute of Allergy and Infectious Diseases, 10 Center Drive, Bethesda, MD 20892, USA
| | - Howard S Kruth
- Section of Experimental Atherosclerosis, National Heart, Lung, and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Tiffany M Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Martin P Playford
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, USA.
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Ungar B, Pavel AB, Robson PM, Kaufman A, Pruzan A, Brunner P, Kaushik S, Krueger JG, Lebwohl MG, Mani V, Fayad ZA, Guttman-Yassky E. A Preliminary 18F-FDG-PET/MRI Study Shows Increased Vascular Inflammation in Moderate-to-Severe Atopic Dermatitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:3500-3506. [PMID: 32721606 DOI: 10.1016/j.jaip.2020.07.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/20/2020] [Accepted: 07/14/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Recent data suggest that patients with atopic dermatitis (AD) have increased systemic immune activation and cardiovascular risk. However, unlike psoriasis, evaluation of active vascular inflammation using state-of-the-art imaging is lacking in AD. OBJECTIVE To assess aortic and carotid vascular inflammation using 18F-fluorodeoxyglucose-positron emission tomography/magnetic resonance imaging (18F-FDG-PET/MRI) imaging in moderate-to-severe AD versus healthy individuals. METHODS A total of 27 patients with moderate-to-severe AD and 12 healthy controls were imaged using 18F-FDG-PET/MRI. Target-to-background ratio (TBR) values were calculated in multiple segments of the aorta and carotid vessels. RESULTS Patients with AD had elevated aortic max TBR (fold change [FCH] = 1.45, P = .057) versus healthy controls and significantly elevated mean TBR (FCH = 1.20; P < .05) in the right carotid (RC) arteries versus controls. When examining greatest focal inflammation (most diseased segment [MDS] TBR), patients with AD had higher aortic inflammation (FCH = 1.28; P = .052). AD clinical severity significantly correlated with C-reactive protein (ρ = 0.60, P < .01) and with RC mean TBR levels (ρ = 0.60, P = .04). Stratifying patients into moderate-to-severe and very severe AD showed greater RC mean TBR in patients with very severe AD versus controls (FCH = 1.31; P = .02) and versus patients with moderate/severe AD (FCH = 1.23, P = .05). Aortic inflammation was also significantly greater in patients with very severe AD versus controls (max TBR: FCH = 1.6, P = .04; MDS TBR: FCH = 1.73, P = .03). CONCLUSIONS This preliminary study is the first that establishes greater vascular (aorta and carotid) inflammation in moderate-to-severe AD versus healthy controls. Furthermore, very severe AD showed higher inflammation than both moderate/severe patients and healthy controls. Future studies with larger patient cohorts and evaluation before and after treatment are needed to determine the extent to which vascular inflammation in AD is modifiable.
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Affiliation(s)
- Benjamin Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ana B Pavel
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Philip M Robson
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY; The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Audrey Kaufman
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY; The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Alison Pruzan
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY; The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Patrick Brunner
- The Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY
| | - Shivani Kaushik
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - James G Krueger
- The Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY
| | - Mark G Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Venkatesh Mani
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY; The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Zahi A Fayad
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY; The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Emma Guttman-Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY; The Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY; Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
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Baccino D, Merlo G, Cozzani E, Rosa GM, Tini G, Burlando M, Parodi A. Cutaneous effects of antihypertensive drugs. GIORN ITAL DERMAT V 2020; 155:202-211. [DOI: 10.23736/s0392-0488.19.06360-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Reddy AS, Uceda DE, Al Najafi M, Dey AK, Mehta NN. PET Scan with Fludeoxyglucose/Computed Tomography in Low-Grade Vascular Inflammation. PET Clin 2020; 15:207-213. [PMID: 32145891 PMCID: PMC7668223 DOI: 10.1016/j.cpet.2019.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Fluorodeoxyglucose-PET/computed tomography combines the high sensitivity of PET with the excellent spatial resolution provided by computed tomography, making it a potentially powerful tool for capturing and quantifying early vascular diseases. Patients with chronic inflammatory states have an increased risk of cardiovascular events; there is also increased vascular fluorodeoxyglucose uptake seen compared with healthy controls. This review examines the use of fluorodeoxyglucose-PET/computed tomography in assessing low-grade vascular inflammation in chronic inflammation and then reviews fluorodeoxyglucose-PET/computed tomography as a tool in monitoring the efficacy of various treatments known to modulate cardiovascular disease.
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Affiliation(s)
- Aarthi S Reddy
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, Clinical Research Center, 10 Center Drive, Room 5-5140, Bethesda, MD 20892, USA
| | - Domingo E Uceda
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, Clinical Research Center, 10 Center Drive, Room 5-5140, Bethesda, MD 20892, USA
| | - Mina Al Najafi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, Clinical Research Center, 10 Center Drive, Room 5-5140, Bethesda, MD 20892, USA
| | - Amit K Dey
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, Clinical Research Center, 10 Center Drive, Room 5-5140, Bethesda, MD 20892, USA
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, Clinical Research Center, 10 Center Drive, Room 5-5140, Bethesda, MD 20892, USA.
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Fernández-Friera L, Fuster V, López-Melgar B, Oliva B, Sánchez-González J, Macías A, Pérez-Asenjo B, Zamudio D, Alonso-Farto JC, España S, Mendiguren J, Bueno H, García-Ruiz JM, Ibañez B, Fernández-Ortiz A, Sanz J. Vascular Inflammation in Subclinical Atherosclerosis Detected by Hybrid PET/MRI. J Am Coll Cardiol 2020; 73:1371-1382. [PMID: 30922468 DOI: 10.1016/j.jacc.2018.12.075] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Atherosclerosis is a chronic inflammatory disease, but data on arterial inflammation at early stages is limited. OBJECTIVES The purpose of this study was to characterize vascular inflammation by hybrid 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/magnetic resonance imaging (PET/MRI). METHODS Carotid, aortic, and ilio-femoral 18F-FDG PET/MRI was performed in 755 individuals (age 40 to 54 years; 83.7% men) with known plaques detected by 2-/3-dimensional vascular ultrasound and/or coronary calcification in the PESA (Progression of Early Subclinical Atherosclerosis) study. The authors evaluated the presence, distribution, and number of arterial inflammatory foci (increased 18F-FDG uptake) and plaques with or without inflammation (coincident 18F-FDG uptake). RESULTS Arterial inflammation was present in 48.2% of individuals (24.4% femorals, 19.3% aorta, 15.8% carotids, and 9.3% iliacs) and plaques in 90.1% (73.9% femorals, 55.8% iliacs, and 53.1% carotids). 18F-FDG arterial uptakes and plaques significantly increased with cardiovascular risk factors (p < 0.01). Coincident 18F-FDG uptakes were present in 287 of 2,605 (11%) plaques, and most uptakes were detected in plaque-free arterial segments (459 of 746; 61.5%). Plaque burden, defined by plaque presence, number, and volume, was significantly higher in individuals with arterial inflammation than in those without (p < 0.01). The number of plaques and 18F-FDG uptakes showed a positive albeit weak correlation (r = 0.25; p < 0.001). CONCLUSIONS Arterial inflammation is highly prevalent in middle-aged individuals with known subclinical atherosclerosis. Large-scale multiterritorial PET/MRI allows characterization of atherosclerosis-related arterial inflammation and demonstrates 18F-FDG uptake in plaque-free arterial segments and, less frequently, within plaques. These findings suggest an arterial inflammatory state at early stages of atherosclerosis. (Progression of Early Subclinical Atherosclerosis [PESA]; NCT01410318).
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Affiliation(s)
- Leticia Fernández-Friera
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Hospital Universitario HM Montepríncipe-CIEC, Madrid, Spain; CIBERV, Madrid, Spain; Universidad CEU San Pablo, Madrid, Spain
| | - Valentín Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Beatriz López-Melgar
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Hospital Universitario HM Montepríncipe-CIEC, Madrid, Spain; Universidad CEU San Pablo, Madrid, Spain
| | - Belén Oliva
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Javier Sánchez-González
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Philips Healthcare, Iberia, Spain
| | - Angel Macías
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | | | - Daniel Zamudio
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Juan C Alonso-Farto
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Samuel España
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | | | - Héctor Bueno
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Jose M García-Ruiz
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBERV, Madrid, Spain; Hospital Universitario de Cabueñes Gijón, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Borja Ibañez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBERV, Madrid, Spain; IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Antonio Fernández-Ortiz
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBERV, Madrid, Spain; Hospital Clínico San Carlos, Universidad Complutense, IdISSC, Madrid, Spain
| | - Javier Sanz
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Icahn School of Medicine at Mount Sinai, New York, New York
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Verhoeven F, Prati C, Demougeot C, Wendling D. Cardiovascular risk in psoriatic arthritis, a narrative review. Joint Bone Spine 2020; 87:413-418. [PMID: 31958573 DOI: 10.1016/j.jbspin.2019.12.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 12/03/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Psoriatic arthritis (PsA) is a chronic inflammatory rheumatism characterized for a long time by a high degree of cardiovascular risk. Chronic inflammation is one of the mechanisms that explain this cardiovascular excess of risk through direct and indirect pathways. In recent years, epidemiological data have changed somewhat since the increasing use of bio-drugs that are effective in reducing this inflammation. The purpose of this review is to assess the current state of cardiovascular morbidity and mortality in PsA and thus to assess the cardiovascular risk in case of PsA. METHOD We conducted a literature review using Pubmed and Medline databases with the following keywords "Psoriatic Arthritis" AND "cardiovascular" including articles from the last three years. RESULTS It appears that in case of PsA, there is an increased prevalence of high blood pressure, diabetes, obesity and dyslipidemia, and therefore of metabolic syndrome. Insulin resistance is closely linked to PsA. On the other hand, the data are more contrasted for active smoking. There is also arterial inflammation specific to PsA. Finally, at the therapeutic level, the impact of NSAIDs remains controversial, while methotrexate and bio-drugs are beneficial at the cardiovascular level. CONCLUSION PsA is characterized by an increase in cardiovascular morbidity in relation with insulin resistance. Current treatments seem to improve this risk with a decrease in cardiovascular mortality in comparison with patients with plaque psoriasis but this requires confirmation in larger prospective studies.
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Affiliation(s)
- Frank Verhoeven
- Service de rhumatologie, CHRU de Besanço, 25030 Besançon cedex, France; EA 4267 « PEPITE », université de Bourgogne Franche-Comté, 25000 Besançon, France.
| | - Clément Prati
- Service de rhumatologie, CHRU de Besanço, 25030 Besançon cedex, France; EA 4267 « PEPITE », université de Bourgogne Franche-Comté, 25000 Besançon, France
| | - Céline Demougeot
- EA 4267 « PEPITE », université de Bourgogne Franche-Comté, 25000 Besançon, France
| | - Daniel Wendling
- Service de rhumatologie, CHRU de Besanço, 25030 Besançon cedex, France; EA 4266 «EPILAB », université de Bourgogne Franche-Comté, 25000 Besançon,France
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Inflammatory Biomarkers for Cardiovascular Risk Stratification in Familial Hypercholesterolemia. Rev Physiol Biochem Pharmacol 2020; 177:25-52. [PMID: 32691159 DOI: 10.1007/112_2020_26] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Familial hypercholesterolemia (FH) is a frequent autosomal genetic disease characterized by elevated concentrations of low-density lipoprotein cholesterol (LDL) from birth with increased risk of premature atherosclerotic complications. Accumulating evidence has shown enhanced inflammation in patients with FH. In vessels, the deposition of modified cholesterol lipoproteins triggers local inflammation. Then, inflammation facilitates fatty streak formation by activating the endothelium to produce chemokines and adhesion molecules. This process eventually results in the uptake of vascular oxidized LDL (OxLDL) by scavenger receptors in monocyte-derived macrophages and formation of foam cells. Further leukocyte recruitment into the sub-endothelial space leads to plaque progression and activation of smooth muscle cells proliferation. Several inflammatory biomarkers have been reported in this setting which can be directly synthetized by activated inflammatory/vascular cells or can be indirectly produced by organs other than vessels, e.g., liver. Of note, inflammation is boosted in FH patients. Inflammatory biomarkers might improve the risk stratification for coronary heart disease and predict atherosclerotic events in FH patients. This review aims at summarizing the current knowledge about the role of inflammation in FH and the potential application of inflammatory biomarkers for cardiovascular risk estimation in these patients.
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Gelfand JM, Shin DB, Alavi A, Torigian DA, Werner T, Papadopoulos M, Takeshita J, Noe MH, Dey AK, Playford MP, Mehta NN. A Phase IV, Randomized, Double-Blind, Placebo-Controlled Crossover Study of the Effects of Ustekinumab on Vascular Inflammation in Psoriasis (the VIP-U Trial). J Invest Dermatol 2020; 140:85-93.e2. [PMID: 31326395 PMCID: PMC6926160 DOI: 10.1016/j.jid.2019.07.679] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/06/2019] [Accepted: 07/03/2019] [Indexed: 02/08/2023]
Abstract
Psoriasis is a T helper type 17 autoimmune disease associated with an increased risk cardiovascular events and mortality. Ustekinumab, an antibody to p40, blocks cytokines IL-12 and IL-23, and is a highly effective and safe treatment for psoriasis. We conducted a randomized double-blinded placebo-controlled trial to determine the effect of ustekinumab on aortic vascular inflammation (AVI) measured by imaging, and key biomarkers of inflammation, lipid, and glucose metabolism in the blood of patients with moderate-to-severe psoriasis. A total of 43 patients were randomized, and at week 12, ustekinumab-treated patients had a -18.65% (95% confidence interval = -29.45% to -7.85%) reduction in AVI, a reduction in inflammatory biomarkers, and an increase in apolipoprotein B lipoproteins compared with placebo. At week 12, placebo patients were crossed over such that all patients received ustekinumab for 52 weeks. At the end of 52 weeks of ustekinumab treatment, there was no change in AVI compared with baseline, inflammatory markers were reduced, and there were increases in selected measures of lipids and leptin. These results show that blockade of IL-12 and/or IL-23 may transiently reduce AVI, with more durable reduction in inflammatory cytokines associated with cardiovascular disease.
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Affiliation(s)
- Joel M Gelfand
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
| | - Daniel B Shin
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Abass Alavi
- Department of Radiology (Nuclear Medicine), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Drew A Torigian
- Department of Radiology (Nuclear Medicine), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tom Werner
- Department of Radiology (Nuclear Medicine), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Maryte Papadopoulos
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Junko Takeshita
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Megan H Noe
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Amit K Dey
- Section of Inflammation and Cardiometabolic Diseases, National Heart Lung Blood Institute, Bethesda, Maryland, USA
| | - Martin P Playford
- Section of Inflammation and Cardiometabolic Diseases, National Heart Lung Blood Institute, Bethesda, Maryland, USA
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart Lung Blood Institute, Bethesda, Maryland, USA
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Tarkin JM, Mason JC, Fayad ZA. Imaging at the inter-face of inflammation and angiogenesis by 18F-fluciclatide PET. Heart 2019; 105:1845-1847. [PMID: 31471464 DOI: 10.1136/heartjnl-2019-315487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Jason M Tarkin
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK .,Vascular Sciences, National Heart & Lung Institute, Imperial College London, London, UK
| | - Justin C Mason
- Vascular Sciences, National Heart & Lung Institute, Imperial College London, London, UK
| | - Zahi A Fayad
- Translational & Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Playford MP, Dey AK, Zierold C, Joshi AA, Blocki F, Bonelli F, Rodante JA, Harrington CL, Rivers JP, Elnabawi YA, Chen MY, Ahlman MA, Teague HL, Mehta NN. Serum active 1,25(OH) 2D, but not inactive 25(OH)D vitamin D levels are associated with cardiometabolic and cardiovascular disease risk in psoriasis. Atherosclerosis 2019; 289:44-50. [PMID: 31450013 DOI: 10.1016/j.atherosclerosis.2019.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/09/2019] [Accepted: 08/16/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Vitamin D exists as an inactive 25-hydroxyvitamin D (25(OH)D) in the bloodstream, which is converted to active 1,25-dihydroxyvitaminD (1,25(OH)2D) in target tissues. Cohort studies reporting cardiovascular disease among individuals with low vitamin D are inconsistent and solely measure 25(OH)D. Psoriasis, a chronic inflammatory disease, is a vitamin D deficient state and is associated with increased cardiovascular disease risk. While serum 25(OH)D is routinely measured, we hypothesized that measurement of 1,25(OH)2D in psoriasis may perform better than 25(OH)D in capturing cardiovascular risk. METHODS Consecutive psoriasis patients (N = 122) at baseline underwent FDG PET/CT and CCTA scans to measure visceral adipose volume, aortic vascular uptake of FDG, and coronary plaque burden respectively. Blood levels of both 1,25(OH)2D and 25(OH)D were measured by chemiluminescence (LIAISON XL DIaSorin, Stillwater, MN). RESULTS The psoriasis cohort was middle-aged (mean ± SD: 49.6 ± 13.0), predominantly male (n = 71, 58%), in majority Caucasians (n = 98, 80%), and had moderate-to-severe skin disease [psoriasis area severity index score, PASI score, med. (IQR) 5.5 (3.2-10.7)], with almost one-fourth of the cohort on biologic psoriasis therapy for skin disease management (n = 32, 27%) at baseline. Interestingly, serum levels of 1,25(OH)2D but not 25(OH)D were found to be inversely associated with visceral adipose, a marker of cardiometabolic risk in fully adjusted models (β = - 0.43, p = 0.026 and β = -0.26 p = 0.13). Similarly, we found an inverse relationship between 1,25(OH)2D, but not 25(OH)D, and aortic vascular uptake of FDG independent of traditional risk factors (β = -0.19, p = 0.01). Finally, we found that serum 1,25(OH)2D, but not 25(OH)D, was inversely associated with non-calcified coronary plaque burden, as measured by CCTA independent of traditional risk factors (β = -0.18, p = 0.03). CONCLUSIONS In conclusion, we demonstrate that low 1,25(OH)2D levels were associated with visceral adipose volume, vascular uptake of FDG and coronary plaque burden independent of traditional risk factors, suggesting that 1,25(OH)2D may better capture the cardiometabolic risk associated with vitamin D deficient states.
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Affiliation(s)
- Martin P Playford
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Amit K Dey
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Aditya A Joshi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Frank Blocki
- DIaSorin Inc, 1951 Northwestern Avenue, Stillwater, MN, USA
| | | | - Justin A Rodante
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Charlotte L Harrington
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Joshua P Rivers
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Youssef A Elnabawi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marcus Y Chen
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mark A Ahlman
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Heather L Teague
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
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Groenendyk JW, Shukla P, Dey AK, Elnabawi YA, Aksentijevich M, Choi H, Genovese LD, Harrington CL, Natarajan B, Goyal A, Reddy AS, Rodante J, Kabbany MT, Sadek A, Al Najafi M, Playford MP, Joshi AA, Ahlman MA, Gelfand JM, Bluemke DA, Mehta NN. Association of aortic vascular uptake of 18FDG by PET/CT and aortic wall thickness by MRI in psoriasis: a prospective observational study. Eur J Nucl Med Mol Imaging 2019; 46:2488-2495. [PMID: 31385013 DOI: 10.1007/s00259-019-04454-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/18/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND The contribution of inflammation to the incidence of cardiovascular disease (CVD) has been increasingly recognized in recent years. We investigated the relationship of aortic vascular uptake of 18F-FDG by PET/CT and aortic wall thickness (AWT) by MRI in psoriasis, a chronic inflammatory disease with increased incidence of CVD. One hundred sixty-five patients with plaque psoriasis participated in an ongoing longitudinal cohort study. Subclinical atherosclerosis was assessed as aortic uptake of 18F-FDG by PET/CT reported as target-to-background ratio (TBR) and AWT by MRI reported as maximal thickness. RESULTS Patients with psoriasis were middle aged, predominantly male, and had mild CV risk by traditional risk factors. Psoriasis severity as measured by PASI score was a notable determinant of AWT (ρ = 0.20, p = 0.01). Moreover, aortic vascular uptake of 18F-FDG associated with AWT by MRI at baseline in unadjusted analysis (β = 0.27 p = 0.001) and following adjustment for traditional cardiovascular risk factors, waist-to-hip ratio, and statin use (β = 0.21 p = 0.01). Finally, following 1 year of psoriasis treatment, a decrease in aortic vascular uptake of 18F-FDG was associated with a reduction in AWT in fully adjusted models (β = 0.33, p = 0.02). CONCLUSION In conclusion, we demonstrate that psoriasis severity and aortic vascular uptake of 18F-FDG in the aorta were associated with AWT. Following treatment of psoriasis, a decrease in aortic vascular uptake of 18F-FDG was associated with a reduction in AWT at 1 year. These findings suggest that aortic vascular uptake of 18F-FDG is associated with early evidence of vascular disease assessed by aortic wall thickness. Prospective studies in larger populations including other inflammatory diseases are warranted.
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Affiliation(s)
- Jacob W Groenendyk
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Parag Shukla
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Amit K Dey
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Youssef A Elnabawi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Milena Aksentijevich
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Harry Choi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Leonard D Genovese
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Charlotte L Harrington
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Balaji Natarajan
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Aditya Goyal
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Aarthi S Reddy
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Justin Rodante
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Mohammad Tarek Kabbany
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Ahmed Sadek
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Mina Al Najafi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Martin P Playford
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Aditya A Joshi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Mark A Ahlman
- National Institutes of Health Clinical Center, 10 Center Drive, Clinical Research Center, Bethesda, MD, 20892, USA
| | - Joel M Gelfand
- University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - David A Bluemke
- University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI, 53792, USA
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA.
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Yang EJ, Smith MP, Ly K, Bhutani T. Evaluating guselkumab: an anti-IL-23 antibody for the treatment of plaque psoriasis. DRUG DESIGN DEVELOPMENT AND THERAPY 2019; 13:1993-2000. [PMID: 31354244 PMCID: PMC6587972 DOI: 10.2147/dddt.s137588] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The approval of guselkumab marks the entry of the IL-23 inhibitor class into the therapeutic armamentarium for patients with moderate-to-severe plaque psoriasis. This class specifically targets the upstream portion of the type 17 helper T (Th17) axis, which has been implicated as a key driver of the abnormal inflammatory state observed in psoriasis. Guselkumab is highly efficacious, with over 85% of the patients achieving ≥75% reduction in Psoriasis Area and Severity Index from baseline (PASI 75) and over 70% of the patients achieving PASI 90 response in its Phase III clinical trials. Additionally, this medication is well-tolerated, with non-serious infections such as nasopharyngitis and upper respiratory infections (URIs) being the most common adverse events (AEs) reported in its clinical trials. Guselkumab offers yet another effective treatment option in the rapidly growing list of available biological therapies for moderate-to-severe plaque psoriasis.
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Affiliation(s)
- Eric J Yang
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA; .,Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA;
| | - Mary Patricia Smith
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA; .,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Karen Ly
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA; .,School of Medicine, Wayne State University, Detroit, MI, USA
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA;
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Hoffmann U, Lu MT, Olalere D, Adami EC, Osborne MT, Ivanov A, Aluru JS, Lee S, Arifovic N, Overton ET, Fichtenbaum CJ, Aberg JA, Alston-Smith B, Klingman KL, Waclawiw M, Burdo TH, Williams KC, Zanni MV, Desvigne-Nickens P, Cooper-Arnold K, Fitch KV, Ribaudo H, Douglas PS, Grinspoon SK. Rationale and design of the Mechanistic Substudy of the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE): Effects of pitavastatin on coronary artery disease and inflammatory biomarkers. Am Heart J 2019; 212:1-12. [PMID: 30928823 PMCID: PMC6596304 DOI: 10.1016/j.ahj.2019.02.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 02/23/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND People with HIV (PWH) have increased cardiovascular events, inflammation, and high-risk coronary atherosclerosis. Statin therapy has been shown to lower the risk of cardiovascular disease (CVD) in the general population, but whether this results from reductions in coronary atherosclerosis and is mediated by decreased inflammation remains unknown. METHODS REPRIEVE is a randomized, placebo-controlled trial of pitavastatin calcium (4 mg/day) vs. placebo enrolling at least 7500 PWH between 40-75 years, on antiretroviral therapy (ART), with low to moderate traditional CVD risk. The Mechanistic Substudy of REPRIEVE (A5333s) is co-enrolling 800 participants from 31 US sites. These participants undergo serial contrast enhanced coronary computed tomography angiography (CCTA) and measurements of biomarkers of inflammation and immune activation at baseline and after 2 years of follow-up. The primary objectives are to determine the effects of pitavastatin on noncalcified coronary atherosclerotic plaque (NCP) volume, low attenuation plaque, and positive remodeling and on changes in immune activation and inflammation and to assess relationships between the two. Changes in CAD will be assessed in a standardized fashion by a core lab with expert readers blinded to time points and participant information; immune activation and inflammation assessment is also performed centrally. RESULTS To date the Mechanistic Substudy has completed planned enrollment, with 805 participants. CONCLUSION This study represents the first large, randomized, CCTA-based assessment of the effects of a primary prevention strategy for CVD on high-risk CAD, immune activation and inflammation among PWH. The study will assess pitavastatin's effects on coronary plaque, and the interrelationship of these changes with biomarkers of immune activation and inflammation in PWH to determine mechanisms of CVD prevention and improved outcomes in this population.
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Affiliation(s)
- Udo Hoffmann
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA.
| | - Michael T Lu
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Devvora Olalere
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Elizabeth C Adami
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Michael T Osborne
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Alex Ivanov
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - John Sukumar Aluru
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Saeyun Lee
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Nadja Arifovic
- Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Edgar Turner Overton
- Division of Infectious Diseases, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | - Carl J Fichtenbaum
- Division of Infectious Diseases, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Judith A Aberg
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | - Myron Waclawiw
- National Institutes of Health/National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Tricia H Burdo
- Department of Neuroscience, Temple University School of Medicine, Philadelphia, PA
| | | | - Markella V Zanni
- MGH Program in Nutritional Metabolism and Harvard Medical School, Boston, MA
| | | | | | - Kathleen V Fitch
- MGH Program in Nutritional Metabolism and Harvard Medical School, Boston, MA
| | - Heather Ribaudo
- Center for Biostatistics in AIDS Research, Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA
| | - Pamela S Douglas
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | - Steven K Grinspoon
- MGH Program in Nutritional Metabolism and Harvard Medical School, Boston, MA
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Roldan PC, Greene ER, Qualls CR, Sibbitt WL, Roldan CA. Progression of atherosclerosis versus arterial stiffness with age within and between arteries in systemic lupus erythematosus. Rheumatol Int 2019; 39:1027-1036. [PMID: 30877372 DOI: 10.1007/s00296-019-04267-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 02/26/2019] [Indexed: 12/31/2022]
Abstract
The progression of atherosclerosis versus arterial stiffness with age within and between arteries has not been defined. Systemic lupus erythematosus (SLE) is a human model of accelerated arterial disease that may permit this determination. 76 SLE patients (69 women, age 37 ± 12 years) and 26 age-and-sex-matched controls (22 women, age 34 ± 11 years) underwent transesophageal echocardiography and carotid ultrasonography for assessment of atherosclerosis [plaques and intima-media thickening (IMT)] and arterial stiffness [increased pressure-strain elastic modulus (PSEM)] of the descending thoracic aorta and carotid arteries. Since IMT is highly associated with plaques, IMT was used as a marker of atherosclerosis to assess its progression in relation with age and PSEM. Aortic and carotid plaques, IMT, and PSEM were greater in patients than in controls (all p ≤ 0.05). Within the aorta and within the carotid arteries, the average percent increases per decade of age for IMT versus PSEM were similar in patients (8.55% versus 9.33% and 3.39% versus 2.46%, respectively) and controls (5.53% versus 6.60% and 4.75% versus 3.49%, respectively) (all p ≥ 0.58). However, in SLE patients, the average percent increases per decade of age for IMT and PSEM were higher in the aorta than in the carotid arteries (8.55% and 9.33% versus 3.39% and 2.46%, respectively, both p ≤ 0.03). In patients with SLE, atherosclerosis and arterial stiffness progress with age parallel to each other within arteries, but divergently between arteries with different anatomy and hemodynamics.
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Affiliation(s)
- Paola C Roldan
- Divisions of Cardiology and Rheumatology, Department of Medicine, University of New Mexico School of Medicine, Cardiology 5-ACC, MSC 10-5550, University of New Mexico, Albuquerque, NM, 87131-0001, USA
| | - Ernest R Greene
- Divisions of Cardiology and Rheumatology, Department of Medicine, University of New Mexico School of Medicine, Cardiology 5-ACC, MSC 10-5550, University of New Mexico, Albuquerque, NM, 87131-0001, USA
| | - Clifford R Qualls
- Divisions of Cardiology and Rheumatology, Department of Medicine, University of New Mexico School of Medicine, Cardiology 5-ACC, MSC 10-5550, University of New Mexico, Albuquerque, NM, 87131-0001, USA
| | - Wilmer L Sibbitt
- Divisions of Cardiology and Rheumatology, Department of Medicine, University of New Mexico School of Medicine, Cardiology 5-ACC, MSC 10-5550, University of New Mexico, Albuquerque, NM, 87131-0001, USA
| | - Carlos A Roldan
- Divisions of Cardiology and Rheumatology, Department of Medicine, University of New Mexico School of Medicine, Cardiology 5-ACC, MSC 10-5550, University of New Mexico, Albuquerque, NM, 87131-0001, USA.
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