Accumulating Evidence for the Association and Shared Pathogenic Mechanisms Between Psoriasis and Cardiovascular-related Comorbidities

Abstract

The International Psoriasis Council (IPC), a global non-profit organization dedicated to advancing psoriasis research and treatment, led an initiative to better define the association of various cardiometabolic comorbidities with psoriasis. In November 2013, a workshop was held in Boston, MA. By assembling a panel of global dermatology, immunology and cardiovascular experts, the objective was to better define the current status of the science that explains the association of psoriasis with various cardiometabolic-related comorbidities. IPC has played a historical role in associating psoriasis with various comorbidities by integrating multidisciplinary expertise to advance the scientific and clinical knowledge through publications and clinical trials. This report synthesizes the current understanding of psoriasis with various cardiometabolic risk factors by exploring the potential shared pathogenic mechanisms and genetic connectivity.

Metabolic Syndrome Sinkholes: What to Do When Occam's Razor Gets Blunted

“…Common chronic diseases of our modern societydincluding hypertension, heart disease, heart failure, kidney disease, stroke, arthritis, rheumatoid disease, and even cancerdare associated with multiple comorbidities, such as obesity, dyslipidemia, diabetes, inflammatory diseases (eg, psoriasis and rheumatoid arthritis), and aging. 17,18 Whether these comorbidities act synergistically to promote cardiovascular disease and worsen outcomes, whether they are simply bystanders representing epiphenomena of chronicity, and whether they actually constitute part of the metabolic syndrome awaits further clarification.…”

The translational revolution and use of biologics in patients with inflammatory skin diseases

“…Patients with psoriasis have a shorter lifespan and are at higher risk of cardiovascular diseases, obesity, and diabetes. [18][19][20][21] Ten percent to 20% of patients are estimated to have severe psoriasis, [22][23][24] necessitating systemic therapies. Conventional treatments include phototherapy, methotrexate, cyclosporine, and acitretin, which are associated with a risk of loss of efficacy, many side effects, and organ-specific toxicity.…”

Macrophage activation in human diseases

“…This fosters the production of pro-inflammatory cytokines which activate macrophages that significantly augment this inflammatory state especially by secreting TNF-␣ and IL-23. Psoriasis has been linked to an increased prevalence of depression and cardiometabolic-related comorbidities among them diabetes and obesity [78,79]. A recent large prospective nurses' health study in which 78.626 women were monitored over a time period of 14 years points to adiposity and weight gain as significant risk factors for incident psoriasis and for a more severe course of the disease [80].…”