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Psoriasis severity linked to vascular inflammation beyond CV risk factors
Severity of psoriasis appears to be associated with vascular inflammation independent of risk factors for vascular disease, according to recent findings.
In a prospective observational study, researchers evaluated 60 patients with psoriasis (median age, 47.5 years; 28 men and 32 women) and 20 matched controls (median age, 41 years; 13 men and seven women).
The researchers measured psoriasis severity using the psoriasis area severity index (PASI), and measured vascular inflammation using average aortic target-to-background ratio employing 18F-fluorodeoxyglucose PET/CT. Both patients and controls were at low overall risk for CVD according to Framingham risk scores (median for psoriasis group, 3; median for controls, 1).
The researchers observed mild-to-moderate skin disease severity in the patients with psoriasis (median PASI score, 5.4). Unadjusted linear regression models revealed an association between increasing PASI score vascular inflammation (beta = 0.41; P = .001). This correlation largely persisted after adjustment for age and sex (beta = 0.39; P = .002) and Framingham risk score (beta = 0.39; P = .001).
Patients with psoriasis had higher absolute neutrophil counts (psoriasis, mean 3.7 ± 1.2 vs. controls, mean 2.9 ± 1.2; P = .02), the researchers wrote. Immunophenotyping confirmed an increase in neutrophil frequencies in circulating whole blood among patients compared with controls (patients, mean 65.2 ± 11.9 vs. controls, mean 56.3 ± 13.8; P < .01). Patients with psoriasis also had elevated serum levels of S100A8/A9 protein (745.1 ± 53.3 vs. 195.4 ± 157.8 ng/mL; P < .01) and neutrophil elastase-1 (43 ± 2.4 vs. 30.8 ± 6.7 ng/mL; P < .001). Researchers also observed an association between S100A8/A9 protein and psoriasis skin disease severity (beta = 0.53; P = .02), as well as between S100A8/A9 and vascular inflammation after adjustment for Framingham risk score (beta = 0.48; P = .02).
“This study provides strong evidence that psoriasis severity is linked with increased vascular inflammation beyond risk factors for vascular disease,” the researchers wrote. “Furthermore, psoriasis severity predicted vascular inflammation beyond the [Framingham risk scores], suggesting that psoriasis plaques are biologically active in promoting inflammation at remote sites.”– by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures.