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Lee WH, Kim W. Self-assembled hyaluronic acid nanoparticles for the topical treatment of inflammatory skin diseases: Beyond drug carriers. J Control Release 2024; 366:114-127. [PMID: 38145664 DOI: 10.1016/j.jconrel.2023.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/10/2023] [Accepted: 12/17/2023] [Indexed: 12/27/2023]
Abstract
Inflammatory skin diseases represent a significant health concern, affecting approximately 20-25% of the global population. These conditions not only reduce an individual's quality of life but also impose a huge burden on both humanity and society. However, addressing these challenges is hindered by their chronic nature, insufficient therapeutic effectiveness, and the propensity for recurrence and adverse side effects. Hyaluronic acid (HA) has emerged as a potential solution to these barriers, owing to its excellent attributes such as biocompatibility, non-toxicity, and targeted drug delivery. However, its practical application has been limited because endogenous hyaluronidase (HYAL) rapidly degrades HA in inflamed skin thus reducing its ability to penetrate deep into the skin. Interestingly, recent research has expanded the role of self-assembled HA-nanoparticles (HA-NPs) beyond drug carriers; they are resistant to HYAL, thereby enabling deep skin penetration, and possess inherent anti-inflammatory properties. Moreover, these abilities can be fine-tuned depending on the conditions during particle synthesis. Additionally, their role as a drug delivery system holds potential for use as a multi-target drug or hybrid drug. In conclusion, this review aims to specifically introduce and highlight the emerging potential of HA-NPs as a topical treatment for inflammatory skin conditions.
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Affiliation(s)
- Wang Hee Lee
- Department of Molecular Science & Technology, Ajou University, Suwon 16499, Republic of Korea
| | - Wook Kim
- Department of Molecular Science & Technology, Ajou University, Suwon 16499, Republic of Korea.
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Shani U, Ben-Shabat N, Qassem R, Lahat A, Omar M, Savin E, Dotan A, Patt YS, Fisher L, Zacay G, Amital H, Watad A, Sharif K. The association between psoriasis, psoriasis severity, and inflammatory bowel disease: a population-based analysis. Therap Adv Gastroenterol 2024; 17:17562848241227037. [PMID: 38282955 PMCID: PMC10822082 DOI: 10.1177/17562848241227037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Background The skin-gut axis, characterized by bidirectional communication between the skin and gut, plays a crucial role in the pathogenesis of psoriasis and inflammatory bowel diseases (IBD). Objectives We aimed to explore the association between psoriasis and IBD and identify predictors associated with IBD development among patients with psoriasis. Design Retrospective cohort study. Methods A retrospective study which utilized an electronic database from the Meuhedet Health Maintenance Organization (MHMO) in Israel. Psoriasis was categorized as severe if any systemic agent or phototherapy was administered. Univariate and multivariate logistic regressions were used to identify specific predictors for IBD, with adjustments made for potential confounders. The study received approval from the Ethical Committee of the MHMO. Results In total, 61,003 adult patients who were diagnosed with psoriasis between 2000 and 2022 were included. Among them, 1495/61,003 patients (2.4%) were diagnosed with IBD, as compared to 3834/244,012 patients (1.6%) in the non-psoriasis group [adjusted odds ratio (OR): 1.47; 95% confidence interval (CI): 1.37-1.56; p < 0.001]. Increased age (OR: 1.01; 95% CI: 1.01-1.02; p < 0.001), male gender (OR: 1.22; 95% CI: 1.03-1.45; p = 0.024), and Jewish ethnicity (OR: 2.5; 95% CI: 1.2-4.1; p < 0.001) were identified as significant risk factors for IBD. Spondyloarthropathies, including psoriatic arthritis (OR: 2.27; 95% CI: 1.86-2.77; p < 0.001) and ankylosing spondylitis (OR: 2.82; 95% CI: 1.5-5.32; p < 0.05), were associated with a higher prevalence of IBD. Furthermore, severe psoriasis was significantly associated with a higher likelihood of IBD, compared to mild psoriasis (OR: 16.03; 95% CI: 11.02-23.34; p < 0.001). Conclusion A significant association between psoriasis and IBD was demonstrated, including its subtypes: Crohn's disease and ulcerative colitis. Moreover, such association may depend on psoriasis severity as determined by the treatment used. This association warrants further investigation and implies a potential need for closer monitoring of patients with severe psoriasis.
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Affiliation(s)
- Uria Shani
- Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Israel
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Niv Ben-Shabat
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roula Qassem
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Emergency Medicine, Sheba Medical Center, Tel Aviv, Israel
| | - Adi Lahat
- Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mahmud Omar
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Einat Savin
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arad Dotan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yonatan Shneor Patt
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lior Fisher
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Galia Zacay
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Family Medicine, Meuhedet Health Maintenance Organization, Tel Aviv, Israel
| | - Howard Amital
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abdulla Watad
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Molecular Medicine, Chapel Allerton Hospital, University of Leeds, Leeds, UK
| | - Kassem Sharif
- Department of Gastroenterology, Sheba Medical Centre, Ramat Gan, 52621, Israel
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel ashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Guo J, Zhang H, Lin W, Lu L, Su J, Chen X. Signaling pathways and targeted therapies for psoriasis. Signal Transduct Target Ther 2023; 8:437. [PMID: 38008779 PMCID: PMC10679229 DOI: 10.1038/s41392-023-01655-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/10/2023] [Accepted: 09/14/2023] [Indexed: 11/28/2023] Open
Abstract
Psoriasis is a common, chronic, and inflammatory skin disease with a high burden on individuals, health systems, and society worldwide. With the immunological pathologies and pathogenesis of psoriasis becoming gradually revealed, the therapeutic approaches for this disease have gained revolutionary progress. Nevertheless, the mechanisms of less common forms of psoriasis remain elusive. Furthermore, severe adverse effects and the recurrence of disease upon treatment cessation should be noted and addressed during the treatment, which, however, has been rarely explored with the integration of preliminary findings. Therefore, it is crucial to have a comprehensive understanding of the mechanisms behind psoriasis pathogenesis, which might offer new insights for research and lead to more substantive progress in therapeutic approaches and expand clinical options for psoriasis treatment. In this review, we looked to briefly introduce the epidemiology, clinical subtypes, pathophysiology, and comorbidities of psoriasis and systematically discuss the signaling pathways involving extracellular cytokines and intracellular transmission, as well as the cross-talk between them. In the discussion, we also paid more attention to the potential metabolic and epigenetic mechanisms of psoriasis and the molecular mechanistic cascades related to its comorbidities. This review also outlined current treatment for psoriasis, especially targeted therapies and novel therapeutic strategies, as well as the potential mechanism of disease recurrence.
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Affiliation(s)
- Jia Guo
- Department of Dermatology, Xiangya Hospital, Central South University, No.87 Xiangya Road, Changsha, 410008, Hunan, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, 410008, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, 410008, Hunan, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, 410008, Hunan, China
| | - Hanyi Zhang
- Department of Dermatology, Xiangya Hospital, Central South University, No.87 Xiangya Road, Changsha, 410008, Hunan, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, 410008, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, 410008, Hunan, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, 410008, Hunan, China
| | - Wenrui Lin
- Department of Dermatology, Xiangya Hospital, Central South University, No.87 Xiangya Road, Changsha, 410008, Hunan, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, 410008, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, 410008, Hunan, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, 410008, Hunan, China
| | - Lixia Lu
- Department of Dermatology, Xiangya Hospital, Central South University, No.87 Xiangya Road, Changsha, 410008, Hunan, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, 410008, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, 410008, Hunan, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, 410008, Hunan, China
| | - Juan Su
- Department of Dermatology, Xiangya Hospital, Central South University, No.87 Xiangya Road, Changsha, 410008, Hunan, China.
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, 410008, Hunan, China.
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, 410008, Hunan, China.
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, 410008, Hunan, China.
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, No.87 Xiangya Road, Changsha, 410008, Hunan, China.
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, 410008, Hunan, China.
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, 410008, Hunan, China.
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, 410008, Hunan, China.
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4
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Cai Y, Xie S, Jia X, Chen D, Wu D, Bao W, Cai J, Mao J, Ye J. Integrated analysis of Mendelian Randomization and Bayesian colocalization reveals bidirectional causal association between inflammatory bowel disease and psoriasis. Ann Med 2023; 55:2281658. [PMID: 37988718 PMCID: PMC10836255 DOI: 10.1080/07853890.2023.2281658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/03/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Observational studies have suggested an association between inflammatory bowel disease [IBD] and psoriasis. However, the detailed genetic basis, causality, and direction of this association remain unclear. METHODS Bidirectional two-sample Mendelian Randomization [MR] analysis was conducted using summary statistics from published genome-wide association studies. Bayesian Colocalization and multivariable MR [MVMR] analyses were performed to identify candidate variants and risk genes involved in the shared genetic basis between IBD, psoriasis, and their subtypes. RESULTS Genetically predicted IBD and Crohn's disease [CD] were associated with an increased risk of psoriasis, psoriasis vulgaris [PsV], and psoriatic arthritis [PsA] (IBD on psoriasis: pooled odds ratio [OR] 1.09, 95% confidence interval [CI] 1.04-1.14, p = .0001; CD on psoriasis: pooled OR 1.10, 95% CI 1.06-1.15, p < .0001) and vice versa (psoriasis on IBD: pooled OR 1.11, 95%CI 1.02-1.21), whereas CD only exhibited a unidirectional association with psoriasis. Colocalization analysis revealed eight candidate genetic variants and risk genes (including LINC00824, CDKAL1, IL10, IL23R, DNAJC27, LPP, RUNX3, and RGS14) associated with a shared genetic basis. Among these, IL23R, DNAJC27, LPP, and RGS14 were further validated by MVMR analysis. CONCLUSION Our findings indicated bidirectional causal associations between IBD and psoriasis (including PsV and PsA), which were attributed primarily to CD rather than Ulcerative colitis [UC]. Furthermore, we identified several candidate variants and risk genes involved in the shared genetic basis of IBD and psoriasis. Acquiring a better understanding of the shared genetic architecture underlying IBD and psoriasis would help improve clinical strategies.
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Affiliation(s)
- Yangke Cai
- Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Siyuan Xie
- Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Xuan Jia
- Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Delong Chen
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Dehao Wu
- Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Wenwen Bao
- Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Jianting Cai
- Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Jianshan Mao
- Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Jun Ye
- Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
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Zapata-Cobo P, Salvador-Martín S, Velasco M, Palomino LM, Clemente S, Segarra O, Moreno-Álvarez A, Fernández-Lorenzo A, Pérez-Moneo B, Montraveta M, Sánchez C, Tolín M, Loverdos I, Fobelo MJ, Navas-López VM, Magallares L, García-Romero R, Sánchez-Hernández JG, Rodríguez A, Bossacoma F, Balboa MJ, Salcedo E, Sanjurjo-Sáez M, López-Fernández LA. Polymorphisms indicating risk of inflammatory bowel disease or antigenicity to anti-TNF drugs as biomarkers of response in children. Pharmacol Res 2023; 194:106859. [PMID: 37473877 DOI: 10.1016/j.phrs.2023.106859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/17/2023] [Accepted: 07/17/2023] [Indexed: 07/22/2023]
Abstract
Few genetic polymorphisms predict early response to anti-TNF drugs in inflammatory bowel disease (IBD), and even fewer have been identified in the pediatric population. However, it would be of considerable clinical interest to identify and validate genetic biomarkers of long-term response. Therefore, the aim of the study was to analyze the usefulness of biomarkers of response to anti-TNFs in pediatric IBD (pIBD) as long-term biomarkers and to find differences by type of IBD and type of anti-TNF drug. The study population comprised 340 children diagnosed with IBD who were treated with infliximab or adalimumab. Genotyping of 9 selected SNPs for their association with early response and/or immunogenicity to anti-TNFs was performed using real-time PCR. Variants C rs10508884 (CXCL12), A rs2241880 (ATG16L1), and T rs6100556 (PHACTR3) (p value 0.049; p value 0.03; p value 0.031) were associated with worse long-term response to anti-TNFs in pIBD. DNA variants specific to disease type and anti-TNF type were identified in the pediatric population. Genotyping of these genetic variants before initiation of anti-TNFs would enable, if validated in a prospective cohort, the identification of pediatric patients who are long-term responders to this therapy.
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Affiliation(s)
- Paula Zapata-Cobo
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Sara Salvador-Martín
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Marta Velasco
- Hospital Universitario Infantil Niño Jesús, Madrid, Spain
| | | | | | | | | | | | | | | | - Cesar Sánchez
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Mar Tolín
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - María Jesús Fobelo
- Hospital Universitario Virgen de Valme, Universidad de Sevilla, Sevilla, Spain
| | | | | | | | | | | | - Ferrán Bossacoma
- Servicio de Gastroenterología, Hepatología y Nutrición Pediátrica, Hospital Sant Joan de Dèu, Barcelona, Spain
| | | | | | - María Sanjurjo-Sáez
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Luis A López-Fernández
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
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Krušič M, Jezernik G, Potočnik U. Gene Ontology Analysis Highlights Biological Processes Influencing Responsiveness to Biological Therapy in Psoriasis. Pharmaceutics 2023; 15:2024. [PMID: 37631238 PMCID: PMC10459906 DOI: 10.3390/pharmaceutics15082024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/27/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
Psoriasis is a chronic, immune-mediated and inflammatory skin disease. Although various biological drugs are available for psoriasis treatment, some patients have poor responses or do not respond to treatment. The aim of the present study was to highlight the molecular mechanism of responsiveness to current biological drugs for psoriasis treatment. To this end, we reviewed previously published articles that reported genes associated with treatment response to biological drugs in psoriasis, and gene ontology analysis was subsequently performed using the Cytoscape platform. Herein, we revealed a statistically significant association between NF-kappaB signaling (p value = 3.37 × 10-9), regulation of granulocyte macrophage colony-stimulating factor production (p value = 6.20 × 10-6), glial cell proliferation (p value = 2.41 × 10-5) and treatment response in psoriatic patients. To the best of our knowledge, we are the first to directly associate glial cells with treatment response. Taken together, our study revealed gene ontology (GO) terms, some of which were previously shown to be implicated in the molecular pathway of psoriasis, as novel GO terms involved in responsiveness in psoriatic disease patients.
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Affiliation(s)
- Martina Krušič
- Center for Human Molecular Genetics and Pharmacogenomics, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia; (M.K.); (G.J.)
| | - Gregor Jezernik
- Center for Human Molecular Genetics and Pharmacogenomics, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia; (M.K.); (G.J.)
| | - Uroš Potočnik
- Center for Human Molecular Genetics and Pharmacogenomics, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia; (M.K.); (G.J.)
- Faculty of Chemistry and Chemical Engineering, University of Maribor, Smetanova ulica 17, 2000 Maribor, Slovenia
- Department for Science and Research, University Clinical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia
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Plasma Levels of Interleukins 36α, 36β, and 37 in Patients with Psoriasis and Their Correlation with Disease Activity Parameters. J Clin Med 2022; 11:jcm11185254. [PMID: 36142901 PMCID: PMC9501264 DOI: 10.3390/jcm11185254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/02/2022] [Accepted: 09/03/2022] [Indexed: 11/16/2022] Open
Abstract
Psoriasis is a chronic, proliferative, inflammatory skin disease characterised by skin lesions and systemic symptoms. Numerous cytokines are produced in psoriasis as a result of inflammation. The aim of this study was to examine the plasma concentrations of IL-36α, IL-36β, and IL-37 in psoriasis and their correlations with disease activity parameters. This study recruited 84 individuals, 53 with plaque-type psoriasis and 31 healthy controls. The plaque type of psoriasis is the most common type and is typically characterized by circular-to-oval red plaques distributed over body surfaces of the extremities and scalp. In patients with psoriasis, we observed statistically significantly decreased plasma concentrations of IL-36β and IL-37. The concentrations of IL-36α were increased in comparison with control group. The plasma concentrations of IL-36α and IL-36β were statistically significantly correlated with all tested parameters of disease activity: the Psoriasis Activity Severity Index, Dermatology Life Quality Index, and Body Surface Area Index. There were no statistically significant correlations between plasma levels of IL-37 and the tested parameters of disease activity. These results indicate a role of IL36α, IL-36β, and IL-37 in the pathogenesis of psoriasis.
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Psoriasis and Cardiometabolic Diseases: Shared Genetic and Molecular Pathways. Int J Mol Sci 2022; 23:ijms23169063. [PMID: 36012327 PMCID: PMC9409274 DOI: 10.3390/ijms23169063] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/26/2022] Open
Abstract
A convincing deal of evidence supports the fact that severe psoriasis is associated with cardiovascular diseases. However, the precise underlying mechanisms linking psoriasis and cardiovascular diseases are not well defined. Psoriasis shares common pathophysiologic mechanisms with atherosclerosis and cardiovascular (CV) risk factors. In particular, polymorphism in the IL-23R and IL-23 genes, as well as other genes involved in lipid and fatty-acid metabolism, renin–angiotensin system and endothelial function, have been described in patients with psoriasis and with cardiovascular risk factors. Moreover, systemic inflammation in patients with psoriasis, including elevated serum proinflammatory cytokines (e.g., TNF-α, IL-17, and IL-23) may contribute to an increased risk of atherosclerosis, hypertension, alteration of serum lipid composition, and insulin resistance. The nonlinear and intricate interplay among various factors, impacting the molecular pathways in different cell types, probably contributes to the development of psoriasis and cardiovascular disease (CVD). Future research should, therefore, aim to fully unravel shared and differential molecular pathways underpinning the association between psoriasis and CVD.
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9
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Yuan Z, Guo Y. Risk of incident type 2 diabetes in patients with psoriatic arthritis: A systematic review and meta-analysis of cohort studies. Int J Rheum Dis 2022; 25:1029-1037. [PMID: 35766111 DOI: 10.1111/1756-185x.14375] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 05/07/2022] [Accepted: 06/05/2022] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To determine the risk of type 2 diabetes among patients with psoriatic arthritis (PsA). METHODS Electronic database searches of PubMed, EMBASE and Cochrane Library were performed from inception to June 2020 and updated in May 2022. Cohort studies were included if they reported hazard ratios (HR) or relative risks with 95% confidence interval (CI) of incident diabetes in patients with PsA compared with non-rheumatic populations. Pooled HR and 95% CI were calculated using a DerSimonian and Laird method random-effects model. RESULTS A total of 5 studies comprising 37 811 PsA patients with 174 825 patient-years and 476 838 non-rheumatic controls with 2 945 358 patient-years were identified and included in our data analysis. During the follow-up, 2335 and 23 035 incident diabetes were observed in PsA and non-rheumatic control groups, corresponding to a crude incidence rate of 13.4 and 7.8 per 1000 patient-years, respectively. The pooled age- and gender-adjusted, and fully adjusted HR of incident diabetes in patients with PsA compared with non-rheumatic populations were 1.54 (95% CI: 1.43-1.67, I2 = 50.8%) and 1.38 (95% CI: 1.31-1.47, I2 = 0.0%), respectively. CONCLUSIONS Our study indicates a 38% increase in the risk of type 2 diabetes among patients with PsA, with an incidence rate of 13.4 per 1000 patients-years. These findings suggest the awareness of managing diabetes with careful screening of PsA patients in daily practice.
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Affiliation(s)
- Ziqi Yuan
- Department of Rheumatology and Clinical Immunology, Changzhi Medical College Affiliated Heping Hospital, Changzhi, China
| | - Yan Guo
- Department of Obstetrics, Changzhi Medical College Affiliated Heping Hospital, Changzhi, China
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Shao J, Xu Z, Xu Y. Integrated Population Pharmacokinetic Analysis of Ustekinumab Across Multiple Immune-Mediated Inflammatory Disease Populations and Healthy Subjects. Eur J Drug Metab Pharmacokinet 2022; 47:537-548. [PMID: 35442011 DOI: 10.1007/s13318-022-00768-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Ustekinumab has been approved for the treatment of patients with plaque psoriasis (PSO), psoriatic arthritis (PSA), Crohn's disease (CD), and ulcerative colitis (UC). This study was performed to investigate whether the pharmacokinetics of ustekinumab differ across different disease populations. METHODS An integrated population pharmacokinetic analysis was conducted to characterize ustekinumab pharmacokinetics across four disease indications (i.e., PSO, PSA, CD, and UC) and healthy subjects. RESULTS The pooled ustekinumab pharmacokinetic data consisted of 46,970 serum concentrations from 3,217 subjects (n = 356 for PSO, 696 for PSA, 1196 for CD, 823 for UC, and 24 for healthy subjects) in 7 clinical trials following subcutaneous or intravenous ustekinumab administrations. The pharmacokinetics of ustekinumab were adequately described by a two-compartment linear model with first-order absorption and elimination. Ustekinumab clearance (CL) and volume of distribution parameters increased nonlinearly with body weight, and the CL was higher in subjects with lower serum albumin, non-Caucasians, and positive antibodies to ustekinumab. Although CL in subjects with PSO and PSA appeared to be slightly different (- 12.7% and + 8.87%, respectively) from CL in other populations (including CD, UC, and healthy subjects), the model-derived post-hoc pharmacokinetic parameters were generally comparable across the 4 disease populations. Simulations also suggested overall comparable ustekinumab exposure (i.e., trough concentration and AUC) at steady state across the disease populations following the same subcutaneous dose regimen. CONCLUSIONS Ustekinumab pharmacokinetics are generally comparable across all approved inflammatory-mediated indications and healthy subjects after accounting for the body weight-related pharmacokinetic difference.
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Affiliation(s)
- Jie Shao
- Clinical Pharmacology and Pharmacometrics, Janssen Research & Development LLC, 1400 McKean Rd, PA, 19477, Spring House, USA.
| | - Zhenhua Xu
- Clinical Pharmacology and Pharmacometrics, Janssen Research & Development LLC, 1400 McKean Rd, PA, 19477, Spring House, USA
| | - Yan Xu
- Clinical Pharmacology and Pharmacometrics, Janssen Research & Development LLC, 1400 McKean Rd, PA, 19477, Spring House, USA.,Clinical Pharmacology, Simcere Pharmaceuticals, MB, Cambridge, USA
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11
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CircOAS3 Regulates Keratinocyte Proliferation and Psoriatic Inflammation by Interacting with Hsc70 via the JNK/STAT3/NF-κB Signaling Pathway. Inflammation 2022; 45:1924-1935. [DOI: 10.1007/s10753-022-01664-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/02/2022] [Accepted: 03/14/2022] [Indexed: 02/07/2023]
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12
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Wu JJ, Kavanaugh A, Lebwohl MG, Gniadecki R, Merola JF. Psoriasis and metabolic syndrome: implications for the management and treatment of psoriasis. J Eur Acad Dermatol Venereol 2022; 36:797-806. [PMID: 35238067 PMCID: PMC9313585 DOI: 10.1111/jdv.18044] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 02/11/2022] [Indexed: 11/28/2022]
Abstract
Psoriasis is a chronic systemic inflammatory disorder associated with several comorbidities in addition to the characteristic skin lesions. Metabolic syndrome (MetS) is the most frequent comorbidity in psoriasis and a risk factor for cardiovascular disease, a major cause of death among patients with psoriasis. Although the exact causal relationship between these two disorders is not fully established, the underlying pathophysiology linking psoriasis and MetS seems to involve overlapping genetic predispositions and inflammatory pathways. Dysregulation of the IL‐23/Th‐17 immune signalling pathway is central to both pathologies and may be key to promoting susceptibility to metabolic and cardiovascular diseases in individuals with and without psoriasis. Thus, biological treatments for psoriasis that interrupt these signals could both reduce the psoriatic inflammatory burden and also lessen the risk of developing atherosclerosis and cardiometabolic diseases. In support of this hypothesis, improvement of skin lesions was associated with improvement in vascular inflammation in recent imaging studies, demonstrating that the beneficial effect of biological agents goes beyond the skin and could help to prevent cardiovascular disease. This review will summarize current knowledge on underlying inflammatory mechanisms shared between psoriasis and MetS and discuss the most recent clinical evidence for the potential for psoriasis treatment to reduce cardiovascular risk.
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Affiliation(s)
- J J Wu
- Dermatology Research and Education Foundation, Irvine, CA, USA
| | - A Kavanaugh
- University of California San Diego, San Diego, CA, USA
| | - M G Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - R Gniadecki
- Division of Dermatology, University of Alberta, Edmonton, AB, Canada
| | - J F Merola
- Department of Medicine, Division of Rheumatology and Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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13
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Gao J, Shen X, Ko R, Huang C, Shen C. Cognitive Process of Psoriasis and Its Comorbidities: From Epidemiology to Genetics. Front Genet 2021; 12:735124. [PMID: 34899832 PMCID: PMC8662384 DOI: 10.3389/fgene.2021.735124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/25/2021] [Indexed: 12/16/2022] Open
Abstract
Psoriasis (PsO) is a chronic inflammatory skin disease that affects approximately 2% of the population all over the world. Comorbidities of PsO have increasingly garnered more interest in the past decades. Compared with the normal population, the incidences of comorbidities are higher among patients with PsO. In the last 20 years, researchers have focused on studying the genetic components of PsO, and genetic associations between PsO and its comorbidities were elucidated. This review provides an in-depth understanding and summarization of the connection between PsO and its comorbidities from the perspectives of epidemiology and genetics. Further understanding of PsO and its comorbidities will promote research on the pathogenesis, drug development, novel therapy methods, and personalized and precision treatment of PsO and its comorbidities.
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Affiliation(s)
- Jing Gao
- Department of Dermatology, the Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Xue Shen
- Department of Dermatology, Chengdu Second People's Hospital, Chengdu, China
| | - Randy Ko
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Cong Huang
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, China.,Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen Peking University-the Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Changbing Shen
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, China.,Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen Peking University-the Hong Kong University of Science and Technology Medical Center, Shenzhen, China
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14
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Cai J, Cui L, Wang Y, Li Y, Zhang X, Shi Y. Cardiometabolic Comorbidities in Patients With Psoriasis: Focusing on Risk, Biological Therapy, and Pathogenesis. Front Pharmacol 2021; 12:774808. [PMID: 34803716 PMCID: PMC8600112 DOI: 10.3389/fphar.2021.774808] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/14/2021] [Indexed: 12/23/2022] Open
Abstract
Psoriasis is a chronic inflammatory disease characterized by erythematous scaly plaques, accompanied by systemic damage that leads to the development of multiple comorbidities. In particular, the association between psoriasis and cardiometabolic comorbidities, including cardiovascular diseases (CVDs), obesity, diabetes mellitus, and metabolic syndrome, has been verified in a considerable number of clinical trials. Moreover, the increased risk of cardiometabolic comorbidities positively correlates with psoriasis severity. Biologic therapy targeting inflammatory pathways or cytokines substantially improves the life quality of psoriasis patients and may affect cardiometabolic comorbidities by reducing their incidences. In this review, we focus on exploring the association between cardiometabolic comorbidities and psoriasis, and emphasize the benefits and precautions of biologic therapy in the management of psoriasis with cardiometabolic comorbidities. The pathogenic mechanisms of cardiometabolic comorbidities in psoriasis patients involve common genetic factors, lipid metabolism, insulin resistance, and shared inflammatory pathways such as tumor necrosis factor-α and interleukin-23/Th-17 pathways.
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Affiliation(s)
- Jiangluyi Cai
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Lian Cui
- Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China.,Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yu Wang
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Ying Li
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Xilin Zhang
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Yuling Shi
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
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15
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Psoriasis and Atherosclerosis-Skin, Joints, and Cardiovascular Story of Two Plaques in Relation to the Treatment with Biologics. Int J Mol Sci 2021; 22:ijms221910402. [PMID: 34638740 PMCID: PMC8508744 DOI: 10.3390/ijms221910402] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 02/06/2023] Open
Abstract
It is known that both psoriasis (PSO) limited to the skin and psoriatic arthritis (PSA) increase the risk of cardiovascular complications and atherosclerosis progression by inducing systemic inflammatory response. In recent decades, the introduction of biological medications directed initially against TNF-α and, later, different targets in the inflammatory cascade brought a significant breakthrough in the efficacy of PSO/PSA treatment. In this review, we present and discuss the most recent findings related to the interplay between the genetics and immunology mechanisms involved in PSO and PSA, atherosclerosis and the development of cardiac dysfunction, as well as the current PSO/PSA treatment in view of cardiovascular safety and prognosis.
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16
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Analysis of the Potential Genetic Links between Psoriasis and Cardiovascular Risk Factors. Int J Mol Sci 2021; 22:ijms22169063. [PMID: 34445769 PMCID: PMC8396451 DOI: 10.3390/ijms22169063] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 01/07/2023] Open
Abstract
Cardiovascular risk factors are one of the most common comorbidities in psoriasis. A higher prevalence of hypertension, insulin resistance and type 2 diabetes, dyslipidemia, obesity, metabolic syndrome, depression, as well as cardiovascular disease was confirmed in psoriatic patients in comparison to the general population. Data suggest that psoriasis and systemic inflammatory disorders may originate from the pleiotropic interactions with many genetic pathways. In this review, the authors present the current state of knowledge on the potential genetic links between psoriasis and cardiovascular risk factors. The understanding of the processes linking psoriasis with cardiovascular risk factors can lead to improvement of psoriasis management in the future.
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17
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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: 19] [Impact Index Per Article: 6.3] [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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18
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Antonelli E, Bassotti G, Tramontana M, Hansel K, Stingeni L, Ardizzone S, Genovese G, Marzano AV, Maconi G. Dermatological Manifestations in Inflammatory Bowel Diseases. J Clin Med 2021; 10:jcm10020364. [PMID: 33477990 PMCID: PMC7835974 DOI: 10.3390/jcm10020364] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel diseases (IBDs) may be associated with extra-intestinal manifestations. Among these, mucocutaneous manifestations are relatively frequent, often difficult to diagnose and treat, and may complicate the course of the underlying disease. In the present review, a summary of the most relevant literature on the dermatologic manifestations occurring in patients with inflammatory bowel diseases has been reviewed. The following dermatological manifestations associated with IBDs have been identified: (i) specific manifestations with the same histological features of the underlying IBD (occurring only in Crohn's disease); (ii) cutaneous disorders associated with IBDs (such as aphthous stomatitis, erythema nodosum, psoriasis, epidermolysis bullosa acquisita); (iii) reactive mucocutaneous manifestations of IBDs (such as pyoderma gangrenosum, Sweet's syndrome, bowel-associated dermatosis-arthritis syndrome, aseptic abscess ulcers, pyodermatitis-pyostomatitis vegetans, etc.); (iv) mucocutaneous conditions secondary to treatment (including injection site reactions, infusion reactions, paradoxical reactions, eczematous and psoriasis-like reactions, cutaneous infections, and cutaneous malignancies); (v) manifestations due to nutritional malabsorption (such as stomatitis, glossitis, angular cheilitis, pellagra, scurvy, purpura, acrodermatitis enteropathica, phrynoderma, seborrheic-type dermatitis, hair and nail abnormalities). An accurate dermatological examination is essential in all IBD patients, especially in candidates to biologic therapies, in whom drug-induced cutaneous reactions may assume marked clinical relevance.
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Affiliation(s)
| | - Gabrio Bassotti
- Gastroenterology Section, Perugia General Hospital, 06156 Perugia, Italy;
- Gastroenterology & Hepatology Section, Department of Medicine, University of Perugia, 06156 Perugia, Italy
- Correspondence:
| | - Marta Tramontana
- Dermatology Section, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (M.T.); (K.H.); (L.S.)
| | - Katharina Hansel
- Dermatology Section, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (M.T.); (K.H.); (L.S.)
| | - Luca Stingeni
- Dermatology Section, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (M.T.); (K.H.); (L.S.)
| | - Sandro Ardizzone
- Gastroenterology Unit, Department of Biomedical and Clinical Sciences, “L.Sacco” Hospital, 20157 Milano, Italy; (S.A.); (G.M.)
| | - Giovanni Genovese
- Dermatology Unit, Fondazione IRCSS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy; (G.G.); (A.V.M.)
- Department of Pathophysiology and Transplantation, University of Milano, 20122 Milano, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCSS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy; (G.G.); (A.V.M.)
- Department of Pathophysiology and Transplantation, University of Milano, 20122 Milano, Italy
| | - Giovanni Maconi
- Gastroenterology Unit, Department of Biomedical and Clinical Sciences, “L.Sacco” Hospital, 20157 Milano, Italy; (S.A.); (G.M.)
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19
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Adami R, Bottai D. S-adenosylmethionine tRNA modification: unexpected/unsuspected implications of former/new players. Int J Biol Sci 2020; 16:3018-3027. [PMID: 33061813 PMCID: PMC7545696 DOI: 10.7150/ijbs.49302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/10/2020] [Indexed: 12/13/2022] Open
Abstract
S-adenosylmethionine supplies methyl groups to many acceptors, including lipids, proteins, RNA, DNA, and a wide range of small molecules. It acts as the precursor in the biosynthesis of metal ion chelating compounds, such as nicotianamine and phytosiderophores, of the polyamines spermidine and spermine and of some plant hormones. Finally, it is the source of catalytic 5′-deoxyadenosyl radicals. Radical S-adenosylmethionine (SAM) enzymes (RS) represent one of the most abundant groups (more than 100,000) of enzymes, exerting a plethora of biological functions, some of which are still unknown. In this work, we will focus on two RS: CDK5RAP1 and CDKAL1, both of which are involved in tRNA modifications that result in important tRNA folding and stability and in maintaining high translational fidelity. Based on this crucial role, their impairment can be important in the development of different human diseases.
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Affiliation(s)
- Raffaella Adami
- Department of Health Science University of Milan via A. di Rudinì 8 20142 Milan
| | - Daniele Bottai
- Department of Health Science University of Milan via A. di Rudinì 8 20142 Milan
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20
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Warren RB, Blauvelt A, Poulin Y, Beeck S, Kelly M, Wu T, Geng Z, Paul C. Efficacy and safety of risankizumab vs. secukinumab in patients with moderate-to-severe plaque psoriasis (IMMerge): results from a phase III, randomized, open-label, efficacy-assessor-blinded clinical trial. Br J Dermatol 2020; 184:50-59. [PMID: 32594522 PMCID: PMC7983954 DOI: 10.1111/bjd.19341] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2020] [Indexed: 12/25/2022]
Abstract
Background Patients with plaque psoriasis treated with biologic therapies need more efficacious, safe and convenient treatments to improve quality of life. Risankizumab and secukinumab inhibit interleukin‐23 and interleukin‐17A, respectively, and are effective in adult patients with moderate‐to‐severe plaque psoriasis but have different dosing regimens. Objectives To compare directly the efficacy and safety of risankizumab vs. secukinumab over 52 weeks. Methods IMMerge was an international, phase III, multicentre, open‐label, efficacy–assessor‐blinded, active‐comparator study, in which adult patients with chronic, moderate‐to‐severe plaque psoriasis were randomized in a 1 : 1 ratio to treatment with risankizumab 150 mg or secukinumab 300 mg. Primary efficacy endpoints were the proportions of patients achieving ≥ 90% improvement from baseline in Psoriasis Area and Severity Index (PASI 90) at week 16 (noninferiority comparison with margin of 12%) and week 52 (superiority comparison). Results In total 327 patients from nine countries were treated with risankizumab (n = 164) or secukinumab (n = 163). Risankizumab was noninferior to secukinumab in the proportion of patients achieving PASI 90 at week 16 [73·8% vs. 65·6%; difference of 8·2%, 96·25% confidence interval (CI)−2·2 to 18·6; within the 12% noninferiority margin] and superior to secukinumab at week 52 (86·6% vs. 57·1%; difference of 29·8%, 95% CI 20·8–38·8; P < 0·001), thus meeting both primary endpoints. All secondary endpoints (PASI 100, static Physician's Global Assessment 0 or 1, and PASI 75) at week 52 demonstrated superiority for risankizumab vs. secukinumab (P < 0·001). No new safety concerns were identified. Conclusions At week 52, risankizumab demonstrated superior efficacy and similar safety with less frequent dosing compared with secukinumab. What is already known about this topic? The need remains for treatments with sustained efficacy and a more convenient dosing schedule in moderate‐to‐severe psoriasis. Risankizumab and secukinumab are indicated for the treatment of adults with moderate‐to‐severe plaque psoriasis and target interleukin‐23 and interleukin‐17, respectively. To date, risankizumab and secukinumab have not been directly compared.
What does this study add? IMMerge directly compared the safety and efficacy of risankizumab and secukinumab in patients with moderate‐to‐severe plaque psoriasis using ≥ 90% improvement in Psoriasis Area and Severity Index at weeks 16 (noninferiority) and 52 (superiority) as primary endpoints. In terms of efficacy risankizumab was noninferior to secukinumab at week 16 and superior to secukinumab at week 52 of treatment based on primary endpoint analyses. The two medications had a similar safety profile.
Linked Comment:Schmitt-Egenolf. Br J Dermatol 2021; 184:
3–4. Plain language summary available online
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Affiliation(s)
- R B Warren
- The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, Manchester, UK
| | - A Blauvelt
- Oregon Medical Research Centre, Portland, OR, USA
| | - Y Poulin
- Laval University and Centre de Recherche Dermatologique du Québec Métropolitain, Québec City, QC, Canada
| | - S Beeck
- AbbVie Inc., North Chicago, IL, USA
| | - M Kelly
- AbbVie Inc., North Chicago, IL, USA
| | - T Wu
- AbbVie Inc., North Chicago, IL, USA
| | - Z Geng
- AbbVie Inc., North Chicago, IL, USA
| | - C Paul
- Paul Sabatier University and Larrey Hospital, Toulouse, France
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21
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Aydin B, Arga KY, Karadag AS. Omics-Driven Biomarkers of Psoriasis: Recent Insights, Current Challenges, and Future Prospects. Clin Cosmet Investig Dermatol 2020; 13:611-625. [PMID: 32922059 PMCID: PMC7456337 DOI: 10.2147/ccid.s227896] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022]
Abstract
Advances in omics technologies have made it possible to unravel biomarkers from different biological levels. Intensive studies have been carried out to uncover the dysregulations in psoriasis and to identify molecular signatures associated with the pathogenesis of psoriasis. In this review, we presented an overview of the current status of the omics-driven biomarker research and emphasized the transcriptomic, epigenomic, proteomic, metabolomic, and glycomic signatures proposed as psoriasis biomarkers. Furthermore, insights on the limitations and future directions of the current biomarker discovery strategies were discussed, which will continue to comprehend broader visions of psoriasis research, diagnosis, and therapy especially in the context of personalized medicine.
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Affiliation(s)
- Busra Aydin
- Department of Bioengineering, Faculty of Engineering, Marmara University, Istanbul, Turkey
| | - Kazim Yalcin Arga
- Department of Bioengineering, Faculty of Engineering, Marmara University, Istanbul, Turkey
| | - Ayse Serap Karadag
- Department of Dermatology, Istanbul Medeniyet University, School of Medicine, Goztepe Research and Training Hospital, Istanbul, Turkey
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22
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Billi AC, Gudjonsson JE, Voorhees JJ. Psoriasis: Past, Present, and Future. J Invest Dermatol 2020; 139:e133-e142. [PMID: 31648690 DOI: 10.1016/j.jid.2019.08.437] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/09/2019] [Indexed: 01/02/2023]
Affiliation(s)
- Allison C Billi
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan
| | | | - John J Voorhees
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan
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23
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Genkel VV, Shaposhnik II. Conceptualization of Heterogeneity of Chronic Diseases and Atherosclerosis as a Pathway to Precision Medicine: Endophenotype, Endotype, and Residual Cardiovascular Risk. Int J Chronic Dis 2020; 2020:5950813. [PMID: 32099839 PMCID: PMC7038435 DOI: 10.1155/2020/5950813] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 12/30/2019] [Accepted: 02/05/2020] [Indexed: 12/22/2022] Open
Abstract
The article discusses modern approaches to the conceptualization of pathogenetic heterogeneity in various branches of medical science. The concepts of endophenotype, endotype, and residual cardiovascular risk and the scope of their application in internal medicine and cardiology are considered. Based on the latest results of studies of the genetic architecture of atherosclerosis, five endotypes of atherosclerosis have been proposed. Each of the presented endotypes represents one or another pathophysiological mechanism of atherogenesis, having an established genetic substrate, a characteristic panel of biomarkers, and a number of clinical features. Clinical implications and perspectives for the study of endotypes of atherosclerosis are briefly reviewed.
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Affiliation(s)
- Vadim V. Genkel
- Department of Internal Medicine, Federal State Budgetary Educational Institution of Higher Education “South-Ural State Medical University” of the Ministry of Healthcare of the Russian Federation, Vorovskogo St. 64, 454092 Chelyabinsk, Russia
| | - Igor I. Shaposhnik
- Department of Internal Medicine, Federal State Budgetary Educational Institution of Higher Education “South-Ural State Medical University” of the Ministry of Healthcare of the Russian Federation, Vorovskogo St. 64, 454092 Chelyabinsk, Russia
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24
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Reich K, Gooderham M, Thaçi D, Crowley JJ, Ryan C, Krueger JG, Tsai TF, Flack M, Gu Y, Williams DA, Thompson EHZ, Paul C. Risankizumab compared with adalimumab in patients with moderate-to-severe plaque psoriasis (IMMvent): a randomised, double-blind, active-comparator-controlled phase 3 trial. Lancet 2019; 394:576-586. [PMID: 31280967 DOI: 10.1016/s0140-6736(19)30952-3] [Citation(s) in RCA: 174] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/12/2019] [Accepted: 04/02/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Psoriasis is an autoimmune disease that affects approximately 100 million people worldwide, and is a disease that can be ameliorated by anti-cytokine treatment. We aimed to compare the efficacy and safety of risankizumab with adalimumab in patients with moderate-to-severe plaque psoriasis. METHODS IMMvent was a phase 3, randomised, double-blind, active-comparator-controlled trial completed at 66 clinics in 11 countries. Eligible patients were aged 18 years or older with moderate-to-severe chronic plaque psoriasis. Patients were randomly assigned 1:1 using interactive response technology to receive 150 mg risankizumab subcutaneously at weeks 0 and 4 or 80 mg adalimumab subcutaneously at randomisation, then 40 mg at weeks 1, 3, 5, and every other week thereafter during a 16-week double-blind treatment period (part A). For weeks 16-44 (part B), adalimumab intermediate responders were re-randomised 1:1 to continue 40 mg adalimumab or switch to 150 mg risankizumab. In part A, participants and investigators were masked to study treatment. Randomisation was stratified by weight and previous tumour necrosis factor inhibitor exposure. Co-primary endpoints in part A were a 90% improvement from baseline (PASI 90) and a static Physician's Global Assessment (sPGA) score of 0 or 1 at week 16, and for part B was PASI 90 at week 44 (non-responder imputation). Efficacy analyses were done in the intention-to-treat population and safety analyses were done in the safety population (all patients who received at least one dose of study drug or placebo). This study is registered with ClinicalTrials.gov, number NCT02694523. FINDINGS Between March 31, 2016, and Aug 24, 2017, 605 patients were randomly assigned to receive either risankizumab (n=301, 50%) or adalimumab (n=304, 50%). 294 (98%) of patients in the risankizumab group and 291 (96%) in the adalimumab group completed part A, and 51 (96%) of 53 patients re-randomised to risankizumab and 51 (91%) of 56 patients re-randomised to continue adalimumab completed part B. At week 16, PASI 90 was achieved in 218 (72%) of 301 patients given risankizumab and 144 (47%) of 304 patients given adalimumab (adjusted absolute difference 24·9% [95% CI 17·5-32·4]; p<0·0001), and sPGA scores of 0 or 1 were achieved in 252 (84%) patients given risankizumab and 252 (60%) patients given adalimumab (adjusted absolute difference 23·3% [16·6-30·1]; p<0·0001). In part B, among adalimumab intermediate responders, PASI 90 was achieved by 35 (66%) of 53 patients switched to risankizumab and 12 (21%) of 56 patients continuing adalimumab (adjusted absolute difference 45·0% [28·9-61·1]; p<0·0001) at week 44. Adverse events were reported in 168 (56%) of 301 patients given risankizumab and 179 (57%) of 304 patients given adalimumab in part A, and among adalimumab intermediate responders, adverse events were reported in 40 (75%) of 53 patients who switched to risankizumab and 37 (66%) of 56 patients who continued adalimumab in part B. INTERPRETATION Risankizumab showed significantly greater efficacy than adalimumab in providing skin clearance in patients with moderate-to-severe plaque psoriasis. No additional safety concerns were identified for patients who switched from adalimumab to risankizumab. Treatment with risankizumab provides flexibility in the long-term treatment of psoriasis. FUNDING AbbVie and Boehringer Ingelheim.
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Affiliation(s)
- Kristian Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf and Skinflammation Center, Hamburg, Germany.
| | - Melinda Gooderham
- School of Medicine, Queen's University, Kingston, Ontario, Canada; Centre for Dermatology and Probity Medical Research, Peterborough, ON, Canada
| | - Diamant Thaçi
- Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - Jeffrey J Crowley
- Bakersfield Dermatology and Skin Cancer Medical Group, Bakersfield, CA, USA
| | - Caitriona Ryan
- Charles Institute of Dermatology, University College Dublin, Ireland
| | - James G Krueger
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - Tsen-Fang Tsai
- National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Mary Flack
- Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, CT, USA
| | - Yihua Gu
- AbbVie Inc, North Chicago, IL, USA
| | | | | | - Carle Paul
- Paul Sabatier University and Larrey Hospital, Toulouse, France
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Peluso R, Caso F, Tasso M, Sabbatino V, Lupoli R, Dario Di Minno MN, Ursini F, Costa L, Scarpa R. Biomarkers of subclinical atherosclerosis in patients with psoriatic arthritis. Open Access Rheumatol 2019; 11:143-156. [PMID: 31388317 PMCID: PMC6607207 DOI: 10.2147/oarrr.s206931] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/15/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Psoriatic arthritis (PsA) is a chronic immune-mediated disease. It is associated with an increase in cardiovascular risk factors (obesity, hypertension, diabetes, and dyslipidemia), giving a higher risk of major adverse cardiovascular events. Patients with PsA have an increased incidence of subclinical atherosclerosis and endothelial dysfunction. The aim of this study is to perform a review of the biomarkers of subclinical atherosclerosis in patients with PsA. Methods: A search was performed in the electronic databases (PubMed, Web of Science, Scopus, and Embase) up until July 2017. Studies were considered if they included data on biomarkers of subclinical atherosclerosis in PsA, and each article was then reviewed for quality and clinical relevance. After completing the literature search, all screened literature was summarized and discussed in our study group (CaRRDs study group). Results: The initial search produced 532 abstracts, which were limited to 258 potentially relevant articles by preliminary review of the titles and by excluding review articles and case reports (n=274). A further 102 articles were deemed ineligible after examining the abstracts. Full texts of the remaining 156 articles were retrieved. Most articles were excluded because they were not relevant to the biomarkers of subclinical atherosclerosis in psoriasis and/or PsA. In the end, 54 articles were deemed eligible for this review. Conclusion: Patients with PsA showed more severe atherosclerotic disease compared with patients with only psoriasis. This may have been due to the higher systemic inflammatory burden from the combination of both diseases. In patients with PsA some molecules may be considered as markers of atherosclerotic disease, and their detection may be a prognostic marker, in addition to imaging procedures, for the development of atherosclerotic disease, and could be suitable for the management of patients with PsA.
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Affiliation(s)
- Rosario Peluso
- Department of Clinical Medicine and Surgery, Rheumatology Research Unit, Federico II University, Naples, Italy
| | - Francesco Caso
- Department of Clinical Medicine and Surgery, Rheumatology Research Unit, Federico II University, Naples, Italy
| | - Marco Tasso
- Department of Clinical Medicine and Surgery, Rheumatology Research Unit, Federico II University, Naples, Italy
| | - Vincenzo Sabbatino
- Department of Clinical Medicine and Surgery, Rheumatology Research Unit, Federico II University, Naples, Italy
| | - Roberta Lupoli
- Department of Clinical Medicine and Surgery, Division of Internal Medicine, Federico II University, Naples, Italy
| | | | - Francesco Ursini
- Internal Medicine Unit, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Luisa Costa
- Department of Clinical Medicine and Surgery, Rheumatology Research Unit, Federico II University, Naples, Italy
| | - Raffaele Scarpa
- Department of Clinical Medicine and Surgery, Rheumatology Research Unit, Federico II University, Naples, Italy
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Schreiber S, Colombel JF, Feagan BG, Reich K, Deodhar AA, McInnes IB, Porter B, Das Gupta A, Pricop L, Fox T. Incidence rates of inflammatory bowel disease in patients with psoriasis, psoriatic arthritis and ankylosing spondylitis treated with secukinumab: a retrospective analysis of pooled data from 21 clinical trials. Ann Rheum Dis 2019; 78:473-479. [PMID: 30674475 PMCID: PMC6530077 DOI: 10.1136/annrheumdis-2018-214273] [Citation(s) in RCA: 121] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 12/13/2018] [Accepted: 12/19/2018] [Indexed: 12/14/2022]
Abstract
Objectives Here, we present the reported incidence rates of inflammatory bowel disease (IBD) in patients receiving treatment with secukinumab for psoriasis (PsO), psoriatic arthritis (PsA) or ankylosing spondylitis (AS), in a pooled analysis of 21 clinical trials. Methods Data from all patients who had received at least one dose of secukinumab were included. Safety analyses were conducted to evaluate cumulative IBD rates as well as per-year rates, by indication. Crohn’s disease (CD), ulcerative colitis (UC) and IBD unclassified (IBDU) events were analysed using exposure-adjusted incidence rates (patient incidence rates per 100 patient-years (PY)). Results A total of 7355 patients with a cumulative exposure of 16 226.9 PY were included in the pooled analysis. Among 5181 patients with PsO, there were 14 cases of UC, 5 cases of CD and 1 case of IBDU, with exposure adjusted incidence rates (EAIRs) of 0.13, 0.05 and 0.01, respectively. Of these 20 cases, 14 were new-onset. In 1380 patients with PsA, there were 3 cases of UC, 3 cases of CD and 2 cases of IBDU (EAIRs 0.08, 0.08 and 0.05); 7 of these represented new-onset cases. Among 794 patients with AS, there were 4 cases of UC, 8 cases of CD and 1 case of IBDU (EAIRs 0.2, 0.4 and 0.1); 9 were new-onset cases. In the per year analysis, the EAIRs for each indication did not increase over time with secukinumab treatment. Conclusions In this pooled secukinumab safety analysis of 7355 patients across 21 clinical trials, cases of IBD events (including CD, UC and IBDU) were uncommon.
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Affiliation(s)
- Stefan Schreiber
- University Hospital Schleswig Holstein, Christian-Alrechts-University, Kiel, Germany
| | | | - Brian G Feagan
- Robarts Clinical Trials, Western University, London, Ontario, Canada
| | - Kristian Reich
- Dermatologikum Berlin and SCIderm Research Institute, Hamburg, Germany
| | - Atul A Deodhar
- Oregon Health & Science University, Portland, Oregon, USA
| | | | | | - Ayan Das Gupta
- Novartis Healthcare Pvt. Ltd, Hyderabad, Telangana, India
| | - Luminita Pricop
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Todd Fox
- Novartis Pharma AG, Basel, Switzerland
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Peluso R, Caso F, Tasso M, Ambrosino P, Dario Di Minno MN, Lupoli R, Criscuolo L, Caso P, Ursini F, Puente AD, Scarpa R, Costa On Behalf Of CaRRDs Study Group L. Cardiovascular Risk Markers and Major Adverse Cardiovascular Events in Psoriatic Arthritis Patients. Rev Recent Clin Trials 2018. [PMID: 29542417 PMCID: PMC6691775 DOI: 10.2174/1574887113666180314105511] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Psoriatic arthritis is a chronic inflammatory arthropathy that affects 14%- 30% of patients with skin and/or nail psoriasis, leading to severe physical limitations and disability. It has been included in the group of spondyloarthropathy with which it shares clinical, radiologic, and serologic features in addition to familial and genetic relationship. Beyond skin and joint involvement, psoriatic arthritis is characterized by a high prevalence of extra-articular manifestation and comorbidities, such as autoimmune, infectious and neoplastic diseases. In particular, an increased risk of cardiovascular comorbidity has been observed in psoriatic arthritis patients. METHODS A systematic search was performed in the electronic databases (PubMed, Web of Science, Scopus, EMBASE) up until January 2017. Studies were included if they contained data on CV disease and/or risk factors in PsA and each article was then reviewed for quality and clinical relevance. After completing the literature search all screened literature was summarized and discussed in our study group (CaRDDs study group). All literature and comments were included in the systematic review. RESULTS The initial search produced 278 abstracts, which were narrowed to 83 potentially relevant articles by preliminary review of the titles and by excluding review articles and case report (n = 195). Thirty articles were deemed ineligible after examining the abstracts. Full texts of the remaining 53 articles were retrieved. The majority of articles excluded were due to only providing data on patients with psoriasis or due to being not relevant to the CV risk in PsA. In the end, 32 articles were deemed eligible for this review. CONCLUSION Psoriatic arthritis appeared significantly associated with subclinical atherosclerosis and endothelial dysfunction and, in turn, with an increased cardiovascular risk. Thus, patients with psoriatic arthritis may benefit from a periodic assessment of surrogate markers of cardiovascular risk. This could help to establish more specific cardiovascular prevention strategies for these patients.
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Affiliation(s)
- Rosario Peluso
- Department of Clinical Medicine and Surgery - Rheumatology Research Unit - Federico II University, Naples, Italy
| | - Francesco Caso
- Department of Clinical Medicine and Surgery - Rheumatology Research Unit - Federico II University, Naples, Italy
| | - Marco Tasso
- Department of Clinical Medicine and Surgery - Rheumatology Research Unit - Federico II University, Naples, Italy
| | - Pasquale Ambrosino
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | | | - Roberta Lupoli
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Livio Criscuolo
- Department of Clinical Medicine and Surgery - Rheumatology Research Unit - Federico II University, Naples, Italy
| | - Paolo Caso
- Geriatric Unit, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Francesco Ursini
- Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Antonio Del Puente
- Department of Clinical Medicine and Surgery - Rheumatology Research Unit - Federico II University, Naples, Italy
| | - Raffaele Scarpa
- Department of Clinical Medicine and Surgery - Rheumatology Research Unit - Federico II University, Naples, Italy
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Tsai TY, Yen H, Huang YC. Serum homocysteine, folate and vitamin B 12 levels in patients with psoriasis: a systematic review and meta-analysis. Br J Dermatol 2018; 180:382-389. [PMID: 30074615 DOI: 10.1111/bjd.17034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Patients with psoriasis are at increased risk for cardiovascular comorbidities. Previous studies examined the possible contribution of serum homocysteine, folate and vitamin B12 to cardiovascular risks in patients with psoriasis but had conflicting conclusions. OBJECTIVES To perform a systematic review and meta-analysis of studies on serum homocysteine, folate and vitamin B12 levels in patients with psoriasis. METHODS Online databases were searched on 15 February 2018 to include studies comparing serum homocysteine, folate and vitamin B12 levels between patients with psoriasis and controls. A random effects model was adopted to estimate odds ratios for dichotomous data and standardized mean differences (SMDs) for continuous data. RESULTS A comprehensive literature search identified 24 studies eligible for inclusion. Compared with controls, patients with psoriasis had a significantly higher serum homocysteine level [SMD 0·41, 95% confidence interval (CI) 0·21-0·61; I2 = 76·7%, 18 studies], a higher prevalence of hyperhomocysteinaemia (odds ratio 3·48, 95% CI 2·08-5·83; I2 = 41·1%, seven studies) and a lower serum folate level (SMD -0·94, 95% CI -1·49 to -0·40; I2 = 95·6%, 14 studies). However, there was no difference in serum vitamin B12 levels between patients with psoriasis and the control group (SMD 0·004, 95% CI -0·49 to 0·50; I2 = 92%, 11 studies). Metaregression analysis revealed a significant inverse correlation between the SMD of homocysteine levels and folate levels. CONCLUSIONS Patients with psoriasis might have higher serum homocysteine and lower folate levels than control patients without psoriasis. However, due to significant heterogeneity and other limitations, the associations require further examinations in more studies.
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Affiliation(s)
- T-Y Tsai
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - H Yen
- Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | - Y-C Huang
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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29
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Affiliation(s)
- Joel M Gelfand
- Department of Dermatology and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia
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30
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Hu SCS, Lan CCE. Psoriasis and Cardiovascular Comorbidities: Focusing on Severe Vascular Events, Cardiovascular Risk Factors and Implications for Treatment. Int J Mol Sci 2017; 18:ijms18102211. [PMID: 29065479 PMCID: PMC5666891 DOI: 10.3390/ijms18102211] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 10/16/2017] [Accepted: 10/16/2017] [Indexed: 12/19/2022] Open
Abstract
Psoriasis is a common and chronic inflammatory disease of the skin. It may impair the physical and psychosocial function of patients and lead to decreased quality of life. Traditionally, psoriasis has been regarded as a disease affecting only the skin and joints. More recently, studies have shown that psoriasis is a systemic inflammatory disorder which can be associated with various comorbidities. In particular, psoriasis is associated with an increased risk of developing severe vascular events such as myocardial infarction and stroke. In addition, the prevalence rates of cardiovascular risk factors are increased, including hypertension, diabetes mellitus, dyslipidemia, obesity, and metabolic syndrome. Consequently, mortality rates have been found to be increased and life expectancy decreased in patients with psoriasis, as compared to the general population. Various studies have also shown that systemic treatments for psoriasis, including methotrexate and tumor necrosis factor-α inhibitors, may significantly decrease cardiovascular risk. Mechanistically, the presence of common inflammatory pathways, secretion of adipokines, insulin resistance, angiogenesis, oxidative stress, microparticles, and hypercoagulability may explain the association between psoriasis and cardiometabolic disorders. In this article, we review the evidence regarding the association between psoriasis and cardiovascular comorbidities, focusing on severe vascular events, cardiovascular risk factors and implications for treatment.
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Affiliation(s)
- Stephen Chu-Sung Hu
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
| | - Cheng-Che E Lan
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
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31
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Digestive system in psoriasis: an update. Arch Dermatol Res 2017; 309:679-693. [PMID: 28905102 PMCID: PMC5648743 DOI: 10.1007/s00403-017-1775-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 08/21/2017] [Accepted: 08/25/2017] [Indexed: 02/06/2023]
Abstract
Psoriasis is a chronic inflammatory immune-mediated disorder associated and often coexisting with many other immune-related clinical conditions including those affecting the gastrointestinal tract. Data obtained from the reviewed literature suggest an association between psoriasis and pathologies of the oral cavity, both psoriasis-specific lesions, as well as non-specific, such as geographic tongue or fissured tongue. These findings show the importance of thorough examination of oral mucosa in psoriatic patients. Inflammatory bowel diseases (IBD) are also linked with psoriasis. Crohn’s disease and ulcerative colitis share a common genetic background, inflammatory pathways and have an evident iatrogenic anti-TNF treatment link, necessitating dermatological or gastroenterological care in patients with IBD or psoriasis, respectively, as well as treatment adjusted to manifestations. The presence of celiac disease-specific antibodies in psoriatic patients and their correlation with the severity of the disease show the association between these disorders. The linking pathogenesis comprises vitamin D deficiency, immune pathway, genetic background and increase in the intestinal permeability, which suggests a potential benefit from gluten-free diet among psoriatic patients. The link between psoriasis and non-alcoholic fatty liver disease implies screening patients for components of metabolic syndrome and lifestyle changes necessity. Some studies indicate increased prevalence of cancer in patients with psoriasis, probably due to negative influence of skin lesion impact on lifestyle rather than the role of psoriasis in carcinogenesis. However, there are no sufficient data to exclude such an oncogenic hit, which is yet to be confirmed. Therefore, all psoriasis-associated comorbidities establish the importance of a multidisciplinary approach in the treatment of these patients.
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Abstract
Originally coined as "syndrome X" in 1988 by Gerald Reaven (1928), the metabolic syndrome (MetS) encompasses a constellation of risk factors, the coincidence of which amounts to an increased cardiovascular and diabetic risk. Rising numbers of dermatoses are being recognized as cutaneous markers of MetS. Dermatologists should look beyond treating the cutaneous condition and quantify the associated increase in cardiovascular risk. The original dermatosis associated with obesity was acanthosis nigricans-described in 1889 by Paul Gerson Unna (1850-1929) and Sigmund Pollitzer (1859-1937). Over the last 20 years, clear associations between psoriasis, hidradenitis suppurativa, and MetS have also emerged. Several studies have shown synergistic improvement in the cutaneous pathology after treatment of components of MetS. This suggests common causalities and is a burgeoning area of research. We review the available evidence about the genetics underlying psoriasis, hidradenitis suppurativa, and acanthosis nigricans. Despite the strong clinical associations, the underlying genetic basis for a link to MetS remains unclear.
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Affiliation(s)
- Emma Fanning
- Department of Medicine, St James Hospital, Trinity College Dublin, Dublin, Ireland
| | - Donal O'Shea
- Department of Endocrinology, St Vincent's University Hospital, University College Dublin, Dublin, Ireland.
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Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, Van Voorhees AS, Gelfand JM. Psoriasis and comorbid diseases: Epidemiology. J Am Acad Dermatol 2017; 76:377-390. [PMID: 28212759 DOI: 10.1016/j.jaad.2016.07.064] [Citation(s) in RCA: 584] [Impact Index Per Article: 83.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/17/2016] [Accepted: 07/01/2016] [Indexed: 02/08/2023]
Abstract
Psoriasis is a common chronic inflammatory disease of the skin that is increasingly being recognized as a systemic inflammatory disorder. Psoriatic arthritis is a well-known comorbidity of psoriasis. A rapidly expanding body of literature in various populations and settings supports additional associations between psoriasis and cardiometabolic diseases, gastrointestinal diseases, kidney disease, malignancy, infection, and mood disorders. The pathogenesis of comorbid disease in patients with psoriasis remains unknown; however, shared inflammatory pathways, cellular mediators, genetic susceptibility, and common risk factors are hypothesized to be contributing elements. As additional psoriasis comorbidities continue to emerge, education of health care providers is essential to ensuring comprehensive medical care for patients with psoriasis.
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Affiliation(s)
- Junko Takeshita
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
| | - Sungat Grewal
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Sinéad M Langan
- London School of Hygiene and Tropical Medicine and St. John's Institute of Dermatology, London, United Kingdom
| | - Nehal N Mehta
- National Heart, Lung and Blood Institute, Bethesda, Maryland
| | - Alexis Ogdie
- Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Abby S Van Voorhees
- Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia
| | - Joel M Gelfand
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Haddad A, Ashkenazi RI, Bitterman H, Feldhamer I, Greenberg-Dotan S, Lavi I, Batat E, Bergman I, Cohen AD, Zisman D. Endocrine Comorbidities in Patients with Psoriatic Arthritis: A Population-based Case-controlled Study. J Rheumatol 2017; 44:786-790. [PMID: 28412706 DOI: 10.3899/jrheum.161274] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To investigate endocrine comorbidities in patients with psoriatic arthritis (PsA). METHODS A retrospective, cross-sectional study was performed with the database of Clalit Health Services, the largest healthcare provider in Israel, between 2002 and 2014. Patients with PsA were identified and matched by age and sex to healthy controls. The following morbidities were analyzed: hypo/hyperthyroidism, hypo/hyperparathyroidism, hyperprolactinemia, Cushing disease, Addison disease, diabetes insipidus, diabetes mellitus (DM), pituitary adenoma, acromegaly, and osteoporosis. Descriptive statistics were applied. The associations between PsA and endocrine comorbidities were analyzed by univariable and multivariable analysis. RESULTS The study included 3161 patients with PsA, 53.4% women, mean age 58.4 ± 15.4 years, and 31,610 controls. Comparative analyses yielded higher proportion of hypothyroidism (12.7% vs 8.6%, p < 0.0001), Cushing disease (0.3% vs 0.1%, p < 0.0001), osteoporosis (13.2% vs 9.1%, p < 0.0001), and DM (27.9% vs 20.7%, p < 0.0001) in the PsA group compared with the control group. In the multivariable regression analysis, the following diseases were more frequent in the PsA group: hypothyroidism (OR 1.61, 95% CI 1.47-1.81), DM (OR 1.35, 95% CI 1.18-1.42), Cushing disease (OR 3.96, 95% CI 1.67-9.43), and osteoporosis (OR 1.56, 95% CI 1.37-1.78). CONCLUSION PsA is associated with a high frequency of hypothyroidism, osteoporosis, DM, and Cushing disease. Awareness of these comorbidities may help physicians provide the optimal medical care to patients with PsA.
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Affiliation(s)
- Amir Haddad
- From the Department of Rheumatology, and the Department of Internal Medicine, and the Department of Community Medicine and Epidemiology, Carmel Medical Center; Bruce and Ruth Rappaport Faculty of Medicine Technion, Haifa; Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel.,A. Haddad, MD, Department of Rheumatology, Carmel Medical Center; R.I. Ashkenazi, MD, Department of Internal Medicine, Carmel Medical Center; H. Bitterman, MD, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Bruce and Ruth Rappaport Faculty of Medicine Technion; I. Feldhamer, MA, Chief Physician's Office, Central Headquarters, Clalit Health Services; S. Greenberg-Dotan, PhD, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Lavi, MA, MPH, Department of Community Medicine and Epidemiology, Carmel Medical Center; E. Batat, MBA, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Bergman, MD, Professor, Department of Internal Medicine, Carmel Medical Center; A.D. Cohen, PhD, MD, MPH, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev; D. Zisman, MD, Department of Rheumatology, and Department of Community Medicine and Epidemiology, Carmel Medical Center
| | - Ron Ilan Ashkenazi
- From the Department of Rheumatology, and the Department of Internal Medicine, and the Department of Community Medicine and Epidemiology, Carmel Medical Center; Bruce and Ruth Rappaport Faculty of Medicine Technion, Haifa; Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel.,A. Haddad, MD, Department of Rheumatology, Carmel Medical Center; R.I. Ashkenazi, MD, Department of Internal Medicine, Carmel Medical Center; H. Bitterman, MD, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Bruce and Ruth Rappaport Faculty of Medicine Technion; I. Feldhamer, MA, Chief Physician's Office, Central Headquarters, Clalit Health Services; S. Greenberg-Dotan, PhD, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Lavi, MA, MPH, Department of Community Medicine and Epidemiology, Carmel Medical Center; E. Batat, MBA, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Bergman, MD, Professor, Department of Internal Medicine, Carmel Medical Center; A.D. Cohen, PhD, MD, MPH, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev; D. Zisman, MD, Department of Rheumatology, and Department of Community Medicine and Epidemiology, Carmel Medical Center
| | - Haim Bitterman
- From the Department of Rheumatology, and the Department of Internal Medicine, and the Department of Community Medicine and Epidemiology, Carmel Medical Center; Bruce and Ruth Rappaport Faculty of Medicine Technion, Haifa; Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel.,A. Haddad, MD, Department of Rheumatology, Carmel Medical Center; R.I. Ashkenazi, MD, Department of Internal Medicine, Carmel Medical Center; H. Bitterman, MD, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Bruce and Ruth Rappaport Faculty of Medicine Technion; I. Feldhamer, MA, Chief Physician's Office, Central Headquarters, Clalit Health Services; S. Greenberg-Dotan, PhD, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Lavi, MA, MPH, Department of Community Medicine and Epidemiology, Carmel Medical Center; E. Batat, MBA, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Bergman, MD, Professor, Department of Internal Medicine, Carmel Medical Center; A.D. Cohen, PhD, MD, MPH, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev; D. Zisman, MD, Department of Rheumatology, and Department of Community Medicine and Epidemiology, Carmel Medical Center
| | - Ilan Feldhamer
- From the Department of Rheumatology, and the Department of Internal Medicine, and the Department of Community Medicine and Epidemiology, Carmel Medical Center; Bruce and Ruth Rappaport Faculty of Medicine Technion, Haifa; Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel.,A. Haddad, MD, Department of Rheumatology, Carmel Medical Center; R.I. Ashkenazi, MD, Department of Internal Medicine, Carmel Medical Center; H. Bitterman, MD, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Bruce and Ruth Rappaport Faculty of Medicine Technion; I. Feldhamer, MA, Chief Physician's Office, Central Headquarters, Clalit Health Services; S. Greenberg-Dotan, PhD, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Lavi, MA, MPH, Department of Community Medicine and Epidemiology, Carmel Medical Center; E. Batat, MBA, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Bergman, MD, Professor, Department of Internal Medicine, Carmel Medical Center; A.D. Cohen, PhD, MD, MPH, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev; D. Zisman, MD, Department of Rheumatology, and Department of Community Medicine and Epidemiology, Carmel Medical Center
| | - Sari Greenberg-Dotan
- From the Department of Rheumatology, and the Department of Internal Medicine, and the Department of Community Medicine and Epidemiology, Carmel Medical Center; Bruce and Ruth Rappaport Faculty of Medicine Technion, Haifa; Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel.,A. Haddad, MD, Department of Rheumatology, Carmel Medical Center; R.I. Ashkenazi, MD, Department of Internal Medicine, Carmel Medical Center; H. Bitterman, MD, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Bruce and Ruth Rappaport Faculty of Medicine Technion; I. Feldhamer, MA, Chief Physician's Office, Central Headquarters, Clalit Health Services; S. Greenberg-Dotan, PhD, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Lavi, MA, MPH, Department of Community Medicine and Epidemiology, Carmel Medical Center; E. Batat, MBA, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Bergman, MD, Professor, Department of Internal Medicine, Carmel Medical Center; A.D. Cohen, PhD, MD, MPH, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev; D. Zisman, MD, Department of Rheumatology, and Department of Community Medicine and Epidemiology, Carmel Medical Center
| | - Idit Lavi
- From the Department of Rheumatology, and the Department of Internal Medicine, and the Department of Community Medicine and Epidemiology, Carmel Medical Center; Bruce and Ruth Rappaport Faculty of Medicine Technion, Haifa; Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel.,A. Haddad, MD, Department of Rheumatology, Carmel Medical Center; R.I. Ashkenazi, MD, Department of Internal Medicine, Carmel Medical Center; H. Bitterman, MD, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Bruce and Ruth Rappaport Faculty of Medicine Technion; I. Feldhamer, MA, Chief Physician's Office, Central Headquarters, Clalit Health Services; S. Greenberg-Dotan, PhD, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Lavi, MA, MPH, Department of Community Medicine and Epidemiology, Carmel Medical Center; E. Batat, MBA, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Bergman, MD, Professor, Department of Internal Medicine, Carmel Medical Center; A.D. Cohen, PhD, MD, MPH, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev; D. Zisman, MD, Department of Rheumatology, and Department of Community Medicine and Epidemiology, Carmel Medical Center
| | - Erez Batat
- From the Department of Rheumatology, and the Department of Internal Medicine, and the Department of Community Medicine and Epidemiology, Carmel Medical Center; Bruce and Ruth Rappaport Faculty of Medicine Technion, Haifa; Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel.,A. Haddad, MD, Department of Rheumatology, Carmel Medical Center; R.I. Ashkenazi, MD, Department of Internal Medicine, Carmel Medical Center; H. Bitterman, MD, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Bruce and Ruth Rappaport Faculty of Medicine Technion; I. Feldhamer, MA, Chief Physician's Office, Central Headquarters, Clalit Health Services; S. Greenberg-Dotan, PhD, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Lavi, MA, MPH, Department of Community Medicine and Epidemiology, Carmel Medical Center; E. Batat, MBA, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Bergman, MD, Professor, Department of Internal Medicine, Carmel Medical Center; A.D. Cohen, PhD, MD, MPH, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev; D. Zisman, MD, Department of Rheumatology, and Department of Community Medicine and Epidemiology, Carmel Medical Center
| | - Irina Bergman
- From the Department of Rheumatology, and the Department of Internal Medicine, and the Department of Community Medicine and Epidemiology, Carmel Medical Center; Bruce and Ruth Rappaport Faculty of Medicine Technion, Haifa; Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel.,A. Haddad, MD, Department of Rheumatology, Carmel Medical Center; R.I. Ashkenazi, MD, Department of Internal Medicine, Carmel Medical Center; H. Bitterman, MD, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Bruce and Ruth Rappaport Faculty of Medicine Technion; I. Feldhamer, MA, Chief Physician's Office, Central Headquarters, Clalit Health Services; S. Greenberg-Dotan, PhD, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Lavi, MA, MPH, Department of Community Medicine and Epidemiology, Carmel Medical Center; E. Batat, MBA, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Bergman, MD, Professor, Department of Internal Medicine, Carmel Medical Center; A.D. Cohen, PhD, MD, MPH, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev; D. Zisman, MD, Department of Rheumatology, and Department of Community Medicine and Epidemiology, Carmel Medical Center
| | - Arnon Dov Cohen
- From the Department of Rheumatology, and the Department of Internal Medicine, and the Department of Community Medicine and Epidemiology, Carmel Medical Center; Bruce and Ruth Rappaport Faculty of Medicine Technion, Haifa; Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel.,A. Haddad, MD, Department of Rheumatology, Carmel Medical Center; R.I. Ashkenazi, MD, Department of Internal Medicine, Carmel Medical Center; H. Bitterman, MD, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Bruce and Ruth Rappaport Faculty of Medicine Technion; I. Feldhamer, MA, Chief Physician's Office, Central Headquarters, Clalit Health Services; S. Greenberg-Dotan, PhD, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Lavi, MA, MPH, Department of Community Medicine and Epidemiology, Carmel Medical Center; E. Batat, MBA, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Bergman, MD, Professor, Department of Internal Medicine, Carmel Medical Center; A.D. Cohen, PhD, MD, MPH, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev; D. Zisman, MD, Department of Rheumatology, and Department of Community Medicine and Epidemiology, Carmel Medical Center
| | - Devy Zisman
- From the Department of Rheumatology, and the Department of Internal Medicine, and the Department of Community Medicine and Epidemiology, Carmel Medical Center; Bruce and Ruth Rappaport Faculty of Medicine Technion, Haifa; Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel. .,A. Haddad, MD, Department of Rheumatology, Carmel Medical Center; R.I. Ashkenazi, MD, Department of Internal Medicine, Carmel Medical Center; H. Bitterman, MD, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Bruce and Ruth Rappaport Faculty of Medicine Technion; I. Feldhamer, MA, Chief Physician's Office, Central Headquarters, Clalit Health Services; S. Greenberg-Dotan, PhD, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Lavi, MA, MPH, Department of Community Medicine and Epidemiology, Carmel Medical Center; E. Batat, MBA, Chief Physician's Office, Central Headquarters, Clalit Health Services; I. Bergman, MD, Professor, Department of Internal Medicine, Carmel Medical Center; A.D. Cohen, PhD, MD, MPH, Chief Physician's Office, Central Headquarters, Clalit Health Services, and Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev; D. Zisman, MD, Department of Rheumatology, and Department of Community Medicine and Epidemiology, Carmel Medical Center.
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Abstract
Psoriasis is a systemic chronic inflammatory disease associated with comorbidity. Many epidemiological studies have shown that psoriasis is associated with psoriatic arthritis as well as cardiovascular and metabolic diseases. Furthermore, obesity and psychological diseases such as depression and anxiety disorders are linked with psoriasis and play a central role in its management. The association of psoriasis and its comorbidity can be partly explained by genetic and pathophysiological mechanisms. Approximately 40 psoriasis susceptibility loci have been described with the majority linked to the innate and adaptive immune system. In some associated diseases, such as psoriatic arthritis, an overlap of their genetic susceptibility exists. Pathophysiologically the "psoriatic march" is a model that describes the development of metabolic and cardiovascular diseases due to the presence of underlying systemic inflammation. Dermatologists are the gatekeepers to treatment for patients with psoriasis. The early detection and the management of comorbidity is part of their responsibility. Concepts for the management of psoriasis and tools to screen for psoriatic comorbidity have been developed in order to support dermatologists in daily practice.
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Affiliation(s)
- S Gerdes
- Psoriasis-Zentrum, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 7, 24105, Kiel, Deutschland.
| | - U Mrowietz
- Psoriasis-Zentrum, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 7, 24105, Kiel, Deutschland
| | - W-H Boehncke
- Service de Dermatologie et Vénéréologie, Hôpitaux Universitaires de Genève und Département de Pathologie et Immunologie, Université de Genève, Genf, Schweiz
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Griffiths CEM, van de Kerkhof P, Czarnecka-Operacz M. Psoriasis and Atopic Dermatitis. Dermatol Ther (Heidelb) 2017; 7:31-41. [PMID: 28150106 PMCID: PMC5289118 DOI: 10.1007/s13555-016-0167-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Indexed: 12/19/2022] Open
Abstract
Psoriasis and atopic dermatitis are common, chronic inflammatory skin diseases. We discuss several aspects of these disorders, including: risk factors; incidence and prevalence; the complex disease burden; and the comorbidities that increase the clinical significance of each disorder. We also focus on treatment management strategies and outline why individualized, patient-centered treatment regimens should be part of the care plans for patients with either psoriasis or atopic dermatitis. Finally, we conclude that, while our theoretical knowledge of the optimum care plans for these patients is increasingly sophisticated, this understanding is, unfortunately, not always reflected in daily clinical practice.
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Affiliation(s)
- Christopher E M Griffiths
- Dermatology Centre, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
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37
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Abstract
Epidemiological studies have shown that patients with psoriatic arthritis (PsA) are often affected by numerous comorbidities that carry significant morbidity and mortality. Reported comorbidities include diabetes mellitus, obesity, metabolic syndrome, cardiovascular diseases, osteoporosis, inflammatory bowel disease, autoimmune eye disease, non-alcoholic fatty liver disease, depression, and fibromyalgia. All health care providers for patients with PsA should recognize and monitor those comorbidities, as well as understand their effect on patient management to ensure an optimal clinical outcome.
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Affiliation(s)
- Amir Haddad
- Rheumatology Unit, Carmel Medical Centre, Haifa, Israel
| | - Devy Zisman
- Rheumatology Unit, Carmel Medical Centre, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
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38
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Li N, Ma J, Li K, Guo C, Ming L. Different Contributions of CDKAL1, KIF21B, and LRRK2/MUC19 Polymorphisms to SAPHO Syndrome, Rheumatoid Arthritis, Ankylosing Spondylitis, and Seronegative Spondyloarthropathy. Genet Test Mol Biomarkers 2016; 21:122-126. [PMID: 27936930 DOI: 10.1089/gtmb.2016.0112] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome, rheumatoid arthritis (RA), ankylosing spondylitis (AS), and seronegative spondyloarthropathy (SPA) are autoimmune diseases of unknown etiology, which share some clinical manifestations in common. Previous family-based investigations support genetic contributions to the susceptibility of these diseases. The current study evaluated whether three previously reported AS-associated single-nucleotide polymorphisms (SNPs), rs6908425 T>C in CDKAL1, rs11584383 T>C near KIF21B, and rs11175593 C>T near LRRK2/MUC19, have any genetic overlap across multiple autoimmune diseases including SAPHO syndrome, RA, AS, and SPA. MATERIALS AND METHODS Genomic DNA was obtained from 71 SAPHO, 125 RA, 67 AS, and 35 SPA Han Chinese patients, as well as 104 healthy controls. SNPs were genotyped by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Genotype and allele frequencies were analyzed using chi-square test. RESULTS rs6908425 T>C in CDKAL1 was significantly different between SAPHO cases and healthy controls (odds ratios = 2.056, 95% confidence intervals: 1.211-3.490; p = 0.007), but no SNPs were associated with the risk of developing RA, AS, or SPA (p > 0.05). Analysis of genotype distributions showed similar results. A significant difference was only found in the genotype frequency of rs6908425 in SAPHO cases (p = 0.004); no significant differences were detected among patients with RA, AS, and SPA (p > 0.05). CONCLUSIONS Our results suggest that rs6908425 in CDKAL1 is associated with the risk of developing SAPHO in Han Chinese populations. People who carry the risk allele T of rs6908425 might be more prone to developing SAPHO syndrome.
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Affiliation(s)
- Nan Li
- 1 Clinic Laboratory, First Affiliated Hospital of Zhengzhou University , Zhengzhou, China .,2 Key Clinical Laboratory of Henan Province , Zhengzhou, China
| | - Junfen Ma
- 1 Clinic Laboratory, First Affiliated Hospital of Zhengzhou University , Zhengzhou, China .,2 Key Clinical Laboratory of Henan Province , Zhengzhou, China
| | - Kai Li
- 3 Clinic Laboratory, First Affiliated Hospital of Henan Polytechnic University (Second People's Hospital of Jiaozuo) , Jiaozuo, China
| | - Changlong Guo
- 4 National Research Institute for Family Planning , Beijing, China
| | - Liang Ming
- 1 Clinic Laboratory, First Affiliated Hospital of Zhengzhou University , Zhengzhou, China .,2 Key Clinical Laboratory of Henan Province , Zhengzhou, China
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AlFadhli S, Al-Zufairi AAM, Nizam R, AlSaffar HA, Al-Mutairi N. De-regulation of diabetic regulatory genes in psoriasis: Deciphering the unsolved riddle. Gene 2016; 593:110-116. [PMID: 27530212 DOI: 10.1016/j.gene.2016.08.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/08/2016] [Accepted: 08/12/2016] [Indexed: 10/21/2022]
Abstract
The purpose of our study was to identify the currently lacking molecular mechanism that accounts for the co-occurrence of two seemingly disparate diseases: psoriasis and type II diabetes. We aimed to investigate a panel of 84 genes related to the diabetic regulatory network in psoriasis (Ps), psoriasis type II diabetes (Ps-T2D), type II diabetes (T2D) and healthy control (HC). We hypothesize that such attempts would provide novel diagnostic markers and/or insights into pathogenesis of the disease. A quantitative Real Time-PCR Human Diabetes RT(2) Profiler PCR Array was chosen to explore the expression profile 84 diabetic genes in study subjects. Statistical analysis was carried out using appropriate software. The analysis revealed three candidate genes GSK3B, PTPN1, STX4 that are differentially expressed in study subjects. GSK3B was highly significant in Ps-T2D (P=0.00018, FR=-26.6), followed by Ps (P=0.0028, FR=-14.5) and T2D groups (P=0.032, FR=-5.9). PTPN1 showed significant association only with PS-T2D (P=0.00027, FR=-8.5). STX4 showed significant association with both Ps (P=0.0002, FR=-20) and Ps-T2D (P=0.0016, FR=-11.2). ACE represents an additional marker that showed suggestive association with Ps (P=0.0079, FR=-9.37). Our study highlights the complex genetics of Ps-T2D and present biomarkers for the development of T2D in Ps cases.
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Affiliation(s)
- Suad AlFadhli
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Kuwait University, Kuwait.
| | - Alaa A M Al-Zufairi
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Kuwait University, Kuwait
| | - Rasheeba Nizam
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Kuwait University, Kuwait
| | | | - Nawaf Al-Mutairi
- Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait
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40
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Lee JH, Youn JI, Kim TY, Choi JH, Park CJ, Choe YB, Song HJ, Kim NI, Kim KJ, Lee JH, Yoo HJ. A multicenter, randomized, open-label pilot trial assessing the efficacy and safety of etanercept 50 mg twice weekly followed by etanercept 25 mg twice weekly, the combination of etanercept 25 mg twice weekly and acitretin, and acitretin alone in patients with moderate to severe psoriasis. BMC DERMATOLOGY 2016; 16:11. [PMID: 27455955 PMCID: PMC4960797 DOI: 10.1186/s12895-016-0048-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 07/08/2016] [Indexed: 11/17/2022]
Abstract
Background Etanercept, a soluble tumor necrosis factor receptor, and acitretin have been shown to be effective in treating psoriasis. Acitretin is widely used in Korea. However, the combination of etanercept plus acitretin has not been evaluated among Korean patients with psoriasis. The objective of this study was to investigate the efficacy and safety of combination therapy with etanercept and acitretin in patients with moderate to severe plaque psoriasis. Methods Sixty patients with psoriasis were randomized to receive etanercept 50 mg twice weekly (BIW) for 12 weeks followed by etanercept 25 mg BIW for 12 weeks (ETN-ETN); etanercept 25 mg BIW plus acitretin 10 mg twice daily (BID) for 24 weeks (ETN-ACT); or acitretin 10 mg BID for 24 weeks (ACT). The primary efficacy measurement was the proportion of patients achieving 75 % improvement in Psoriasis Area and Severity Index (PASI 75) at week 24. Secondary end points included 50 % improvement in PASI (PASI 50) at week 24 and clear/almost-clear by Physician Global Assessment (PGA) at each visit through week 24. Results The proportions of patients achieving PASI 75, PASI 50, and PGA clear/almost-clear at week 24 in the ETN-ETN (52.4, 71.4, and 52.4 %, respectively) and ETN-ACT groups (57.9, 84.2, and 52.6 %, respectively) were higher than in the ACT group (22.2, 44.4, and 16.7 %, respectively). The incidence of adverse events was similar across all arms. This was an open-label study with a small number of patients. Conclusion In Korean patients with moderate to severe plaque psoriasis, etanercept alone or in combination with acitretin was more effective than acitretin. All treatments were well tolerated throughout the study. Trial registration This study was registered on July 7, 2009 at ClinicalTrials.gov, NCT00936065.
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Affiliation(s)
- Joo-Heung Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, Korea.
| | - Jai-Il Youn
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - Tae-Yoon Kim
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jee-Ho Choi
- Department of Dermatology, Asian Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chul-Jong Park
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong-Beom Choe
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Korea
| | - Hae-Jun Song
- Department of Dermatology, College of Medicine, Korea University, Seoul, Korea
| | - Nack-In Kim
- Department of Dermatology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Kwang-Joong Kim
- Department of Dermatology, Hallym University Sacred Heart Hospital, Seoul, Korea
| | - Jeung-Hoon Lee
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
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Vlachos C, Gaitanis G, Katsanos KH, Christodoulou DK, Tsianos E, Bassukas ID. Psoriasis and inflammatory bowel disease: links and risks. PSORIASIS-TARGETS AND THERAPY 2016; 6:73-92. [PMID: 29387596 PMCID: PMC5683131 DOI: 10.2147/ptt.s85194] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Psoriasis and the spectrum of inflammatory bowel diseases (IBD) are chronic, inflammatory, organotropic conditions. The epidemiologic coexistence of these diseases is corroborated by findings at the level of disease, biogeography, and intrafamilial and intrapatient coincidence. The identification of shared susceptibility loci and DNA polymorphisms has confirmed this correlation at a genetic level. The pathogenesis of both diseases implicates the innate and adaptive segments of the immune system. Increased permeability of the epidermal barrier in skin and intestine underlies the augmented interaction of allergens and pathogens with inflammatory receptors of immune cells. The immune response between psoriasis and IBD is similar and comprises phagocytic, dendritic, and natural killer cell, along with a milieu of cytokines and antimicrobial peptides that stimulate T-cells. The interplay between dendritic cells and Th17 cells appears to be the core dysregulated immune pathway in all these conditions. The distinct similarities in the pathogenesis are also reflected in the wide overlapping of their therapeutic approaches. Small-molecule pharmacologic immunomodulators have been applied, and more recently, biologic treatments that target proinflammatory interleukins have been introduced or are currently being evaluated. However, the fact that some treatments are quite selective for either skin or gut conditions also highlights their crucial pathophysiologic differences. In the present review, a comprehensive comparison of risk factors, pathogenesis links, and therapeutic strategies for psoriasis and IBD is presented. Specific emphasis is placed on the role of the immune cell species and inflammatory mediators participating in the pathogenesis of these diseases.
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Affiliation(s)
| | | | - Konstantinos H Katsanos
- Division of Gastroenterology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Dimitrios K Christodoulou
- Division of Gastroenterology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Epameinondas Tsianos
- Division of Gastroenterology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Chiricozzi A, Raimondo A, Lembo S, Fausti F, Dini V, Costanzo A, Monfrecola G, Balato N, Ayala F, Romanelli M, Balato A. Crosstalk between skin inflammation and adipose tissue-derived products: pathogenic evidence linking psoriasis to increased adiposity. Expert Rev Clin Immunol 2016; 12:1299-1308. [PMID: 27322922 DOI: 10.1080/1744666x.2016.1201423] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Psoriasis is a chronic skin disorder associated with several comorbid conditions. In psoriasis pathogenesis, the role of some cytokines, including TNF-α and IL-17, has been elucidated. Beside their pro-inflammatory activity, they may also affect glucose and lipid metabolism, possibly promoting insulin resistance and obesity. On the other hand, adipose tissue, secreting adipokines such as chemerin, visfatin, leptin, and adiponectin, not only regulates glucose and lipid metabolism, and endothelial cell function regulation, but it may contribute to inflammation. Areas covered: This review provides an updated 'state-of-the-art' about the reciprocal contribution of a small subset of conventional cytokines and adipokines involved in chronic inflammatory pathways, upregulated in both psoriasis and increased adiposity. A systematic search was conducted using the PubMed Medline database for primary articles. Expert commentary: Because psoriasis is associated with increased adiposity, it would be important to define the contribution of chronic skin inflammation to the onset of obesity and vice versa. Clarifying the pathogenic mechanism underlying this association, a therapeutic strategy having favorable effects on both psoriasis and increased adiposity could be identified.
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Affiliation(s)
| | - Annunziata Raimondo
- b Department of Clinical Medicine and Surgery, Section of Dermatology , University of Naples Federico II , Naples , Italy
| | - Serena Lembo
- c Department of Medicine and Surgery , University of Salerno , Salerno , Italy
| | - Francesca Fausti
- d Skin Biology Laboratory , University of Rome Tor Vergata , Rome , Italy
| | - Valentina Dini
- a Department of Dermatology , University of Pisa , Pisa , Italy
| | - Antonio Costanzo
- e Dermatology Unit, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS) , Sapienza University of Rome , Rome , Italy
| | - Giuseppe Monfrecola
- b Department of Clinical Medicine and Surgery, Section of Dermatology , University of Naples Federico II , Naples , Italy
| | - Nicola Balato
- b Department of Clinical Medicine and Surgery, Section of Dermatology , University of Naples Federico II , Naples , Italy
| | - Fabio Ayala
- b Department of Clinical Medicine and Surgery, Section of Dermatology , University of Naples Federico II , Naples , Italy
| | - Marco Romanelli
- a Department of Dermatology , University of Pisa , Pisa , Italy
| | - Anna Balato
- f Department of Advanced Biomedical Sciences , University of Naples Federico II , Naples , Italy
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Exome-wide study of ankylosing spondylitis demonstrates additional shared genetic background with inflammatory bowel disease. NPJ Genom Med 2016; 1:16008. [PMID: 29263810 PMCID: PMC5685324 DOI: 10.1038/npjgenmed.2016.8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 03/28/2016] [Indexed: 12/15/2022] Open
Abstract
Ankylosing spondylitis (AS) is a common chronic immune-mediated arthropathy affecting primarily the spine and pelvis. The condition is strongly associated with HLA-B*27 as well as other human leukocyte antigen variants and at least 47 individual non-MHC-associated variants. However, substantial additional heritability remains as yet unexplained. To identify further genetic variants associated with the disease, we undertook an association study of AS in 5,040 patients and 21,133 healthy controls using the Illumina Exomechip microarray. A novel association achieving genome-wide significance was noted at CDKAL1. Suggestive associations were demonstrated with common variants in FAM118A, C7orf72 and FAM114A1 and with a low-frequency variant in PNPLA1. Two of the variants have been previously associated with inflammatory bowel disease (IBD; CDKAL1 and C7orf72). These findings further increase the evidence for the marked similarity of genetic risk factors for IBD and AS, consistent with the two diseases having similar aetiopathogenesis.
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Li X, Miao X, Wang H, Wang Y, Li F, Yang Q, Cui R, Li B. Association of Serum Uric Acid Levels in Psoriasis: A Systematic Review and Meta-Analysis. Medicine (Baltimore) 2016; 95:e3676. [PMID: 27175702 PMCID: PMC4902544 DOI: 10.1097/md.0000000000003676] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
High levels of serum uric acid (SUAC) are frequently detected in patients with psoriasis. However, the relationship between psoriasis and hyperuricemia remains unknown. Here we conducted a meta-analysis to identify the SUAC levels in subjects with psoriasis and to determine whether there is an associated risk between psoriasis and hyperuricemia.A comprehensive search of the literature from January 1980 to November 2014 across 7 databases (MEDLINE, Embase, Cochrane Central Register, and 4 Chinese databases) was conducted to determine whether there is an associated risk between psoriasis and hyperuricemia.Among the 170 identified reports, 14 observational studies were included in this meta-analysis. We found a significant higher SUAC level (MD 0.68, 95% CI 0.26-1.09; P = 0.002) in patients with psoriasis in Western Europe, but no significant differences were found between the East Asia and India subgroup (MD 1.22, 95% CI -0.13-2.56; P = 0.08) or the Middle East subgroup (MD 0.48, 95% CI -0.49-1.44; P = 0.33). Similar results were obtained from the meta-analysis of SUAC levels in subjects with severe psoriasis.Our meta-analysis showed that the correlation between psoriasis and hyperuricemia was either ethnicity- or region-dependent and that patients with psoriasis in Western Europe were more likely to have hyperuricemia.
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Affiliation(s)
- Xin Li
- From the Department of Dermatology (XL, XM, YW, FL, BL), Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Department of Pharmacology and Experimental Therapeutics (XL, HW, RC), Boston University School of Medicine; and Department of Statistics (QY), Boston University School of Public Health, Boston, MA
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Sundarrajan S, Arumugam M. Comorbidities of Psoriasis - Exploring the Links by Network Approach. PLoS One 2016; 11:e0149175. [PMID: 26966903 PMCID: PMC4788348 DOI: 10.1371/journal.pone.0149175] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 01/08/2016] [Indexed: 12/21/2022] Open
Abstract
Increasing epidemiological studies in patients with psoriasis report the frequent occurrence of one or more associated disorders. Psoriasis is associated with multiple comorbidities including autoimmune disease, neurological disorders, cardiometabolic diseases and inflammatory-bowel disease. An integrated system biology approach is utilized to decipher the molecular alliance of psoriasis with its comorbidities. An unbiased integrative network medicine methodology is adopted for the investigation of diseasome, biological process and pathways of five most common psoriasis associated comorbidities. A significant overlap was observed between genes acting in similar direction in psoriasis and its comorbidities proving the mandatory occurrence of either one of its comorbidities. The biological processes involved in inflammatory response and cell signaling formed a common basis between psoriasis and its associated comorbidities. The pathway analysis revealed the presence of few common pathways such as angiogenesis and few uncommon pathways which includes CCKR signaling map and gonadotrophin-realising hormone receptor pathway overlapping in all the comorbidities. The work shed light on few common genes and pathways that were previously overlooked. These fruitful targets may serve as a starting point for diagnosis and/or treatment of psoriasis comorbidities. The current research provides an evidence for the existence of shared component hypothesis between psoriasis and its comorbidities.
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Affiliation(s)
- Sudharsana Sundarrajan
- Division of Bioinformatics, School of Biosciences and Technology, Vellore Institute of Technology University, Vellore, Tamil Nadu, India
| | - Mohanapriya Arumugam
- Division of Bioinformatics, School of Biosciences and Technology, Vellore Institute of Technology University, Vellore, Tamil Nadu, India
- * E-mail:
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Furue M, Kadono T. Psoriasis: Behind the scenes. J Dermatol 2016; 43:4-8. [DOI: 10.1111/1346-8138.13186] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 09/16/2015] [Indexed: 12/21/2022]
Affiliation(s)
- Masutaka Furue
- Department of Dermatology; Kyushu University; Fukuoka Japan
| | - Takafumi Kadono
- Department of Dermatology; St Marianna University School of Medicine; Kawasaki Japan
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Haque N, Lories RJ, de Vlam K. Comorbidities Associated with Psoriatic Arthritis Compared with Non-psoriatic Spondyloarthritis: A Cross-sectional Study. J Rheumatol 2015; 43:376-82. [PMID: 26669922 DOI: 10.3899/jrheum.141359] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2015] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Psoriatic arthritis (PsA) is a chronic inflammatory skeletal disease associated with health concerns such as obesity, Type II diabetes, dyslipidemia, hypertension (HTN), and cardiovascular (CV) disease. The involvement of these metabolic factors in the pathogenesis, severity, and progression of PsA remains unclear. In our study, we compared comorbidities associated with PsA to those patients with related but non-PsA forms of spondyloarthritis (SpA). METHODS The SpA database at the Rheumatology Department of University Hospitals Leuven was analyzed in a cross-sectional manner using the demographic, medical, and laboratory information of 518 patients with PsA and non-PsA SpA. The patients were grouped by their diagnosis and evaluated on the basis of sex, age, education, work status, disease duration, treatment, and type and number of comorbidities. The data were assessed using the chi-square test, Student t test, Fisher's exact test, and logistic regression, including correction for multiple testing. RESULTS Out of the 518 patients (62.74% men, 37.25% women), 53.66% had comorbidities. The PsA group had 262 patients (mean age 58.8 yrs) and the non-PsA SpA group had 256 patients (mean age 44.9 yrs, p < 0.001). The PsA group was found to have more and multiple comorbidities compared with non-PsA SpA (p < 0.001). The CV and metabolic comorbidities were also significantly higher in the PsA group (p < 0.001). Coronary artery disease, HTN, hyperlipidemia, and metabolic syndrome showed a marked difference between the 2 groups (p < 0.05). An increased incidence of malignancy was found in PsA group (p < 0.05). CONCLUSION Comorbidities and malignancies are increased in patients with PsA compared with non-PsA SpA, irrespective of demographic factors and type of treatment.
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Affiliation(s)
- Naba Haque
- From the Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven; Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium.N. Haque, MD, MS, PhD Student, Division of Rheumatology, University Hospitals Leuven; R.J. Lories, MD, PhD, Professor, Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven, and Division of Rheumatology, University Hospitals Leuven; K. de Vlam, MD, PhD, Consultant, Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven, and Division of Rheumatology, University Hospitals Leuven
| | - Rik J Lories
- From the Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven; Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium.N. Haque, MD, MS, PhD Student, Division of Rheumatology, University Hospitals Leuven; R.J. Lories, MD, PhD, Professor, Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven, and Division of Rheumatology, University Hospitals Leuven; K. de Vlam, MD, PhD, Consultant, Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven, and Division of Rheumatology, University Hospitals Leuven
| | - Kurt de Vlam
- From the Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven; Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium.N. Haque, MD, MS, PhD Student, Division of Rheumatology, University Hospitals Leuven; R.J. Lories, MD, PhD, Professor, Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven, and Division of Rheumatology, University Hospitals Leuven; K. de Vlam, MD, PhD, Consultant, Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven, and Division of Rheumatology, University Hospitals Leuven.
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Coto-Segura P, Batalla A, González-Fernández D, Gómez J, Santos-Juanes J, Queiro R, Alonso B, Iglesias S, Coto E. CDKAL1 gene variants affect the anti-TNF response among Psoriasis patients. Int Immunopharmacol 2015; 29:947-949. [DOI: 10.1016/j.intimp.2015.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/05/2015] [Indexed: 01/03/2023]
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Gyldenløve M, Vilsbøll T, Zachariae C, Holst JJ, Knop FK, Skov L. Impaired incretin effect is an early sign of glucose dysmetabolism in nondiabetic patients with psoriasis. J Intern Med 2015; 278:660-70. [PMID: 26174490 DOI: 10.1111/joim.12388] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Patients with psoriasis have an increased risk of type 2 diabetes. The gastrointestinal system plays a major role in normal glucose metabolism, and in healthy individuals, postprandial insulin secretion is largely mediated by the gut incretin hormones. This potentiation is termed the incretin effect and is reduced in type 2 diabetes. The impact of psoriasis on gastrointestinal factors involved in glucose metabolism has not previously been examined. OBJECTIVE To investigate whether the incretin effect, gastrointestinal-mediated glucose disposal (GIGD) and/or secretion of glucagon and gut incretin hormones are impaired in normal glucose-tolerant patients with psoriasis. METHODS Oral glucose tolerance tests and intravenous isoglycaemic glucose infusions were performed in 12 patients with moderate-to-severe psoriasis and 12 healthy matched control subjects. RESULTS In patients with psoriasis, the incretin effect (39% vs. 57%, P = 0.02) and GIGD (53% vs. 61%, P = 0.04) were significantly reduced compared to control subjects. In addition, patients were glucose intolerant and showed exaggerated glucose-dependent insulinotropic polypeptide responses. CONCLUSION These novel findings support the notion that psoriasis is a prediabetic condition and suggest that gastrointestinal-related mechanisms are involved in the increased susceptibility to type 2 diabetes in patients with psoriasis.
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Affiliation(s)
- M Gyldenløve
- Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - T Vilsbøll
- Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - C Zachariae
- Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - J J Holst
- NNF Centre for Basic Metabolic Research, Department of Biomedicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - F K Knop
- Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,NNF Centre for Basic Metabolic Research, Department of Biomedicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - L Skov
- Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
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