Asymmetric dimethylarginine but not osteoprotegerin correlates with disease severity in patients with moderate‐to‐severe psoriasis undergoing anti‐tumor necrosis factor‐α therapy

Abstract

Patients with psoriasis, in particular those with severe disease, have an increased risk of cardiovascular (CV) events compared with the general population. The aim of the present study is to determine whether correlation between asymmetric dimethylarginine (ADMA) and osteoprotegerin (OPG), two biomarkers associated with CV disease, and disease severity may exist in patients with moderate-to-severe psoriasis. We also aimed to establish if baseline serum levels of these two biomarkers could correlate with the degree of change in the clinical parameters of disease severity following the use of anti-tumor necrosis factor (TNF)-α therapy in these patients. This was a prospective study on a series of consecutive non-diabetic patients with moderate-to-severe psoriasis who completed 6 months of therapy with anti-TNF-α-adalimumab. Patients with kidney disease, hypertension or body mass index of 35 kg/m(2) or more were excluded. Metabolic and clinical evaluation was performed immediately prior to the onset of treatment and at month 6. Twenty-nine patients were assessed. Unlike OPG, a significant positive correlation between ADMA and resistin serum levels was found at the onset of adalimumab and also after 6 months of biologic therapy. We also observed a positive correlation between the percent of body surface area affected (BSA) and ADMA levels obtained before the onset of adalimumab and a negative correlation between baseline ADMA levels and a 6-month BSA change compared with baseline results. In patients with moderate-to-severe psoriasis, ADMA levels correlate with clinical markers of disease severity.

Impact of adalimumab treatment on cardiovascular risk biomarkers in psoriasis: Results of a pilot study

“…Pina et al . have described asymmetric dimethylarginine (ADMA) and osteoprotegerin (OPG), two biomarkers associated with CVD in 29 patients with moderate to severe psoriasis, and they found that that ADMA correlates with the severity of psoriasis . In another study, the authors investigated the correlation of leptin and resistin with metabolic syndrome features and disease severity in psoriasis patients.…”

“…psoriasis, and they found that that ADMA correlates with the severity of psoriasis. 24 In another study, the authors investigated the correlation of leptin and resistin with metabolic syndrome features and disease severity in psoriasis patients. They showed that leptin correlates with metabolic syndrome and inflammation, whereas resistin correlates with inflammation and disease severity.…”

Cardiovascular and Metabolic Diseases Comorbid with Psoriasis: Beyond the Skin

“…In a six-month prospective study, carotid arterial stiffness in patients with psoriasis was significantly improved by anti-TNF-α therapy (71). In addition, other markers for systemic inflammation such as asymmetric dimethylarginine, red blood cell distribution width, the neutrophil-to-lymphocyte ratio, and the platelet-to-lymphocyte ratio, have proven to be upregulated in psoriatic patients (72-74). …”

Autoimmunity and autoimmune co‐morbidities in psoriasis

“…Additionally, psoriasis has significant co‐morbidity with systemic inflammatory diseases, such as cardiovascular diseases and metabolic syndrome, and these conditions are currently receiving increasing attention . In parallel, a plethora of inflammatory biomarkers are elevated in psoriasis …”

“…[18][19][20][21][22][23][24][25][26][27] In parallel, a plethora of inflammatory biomarkers are elevated in psoriasis. [28][29][30][31][32] In addition to these co-morbid diseases that have a systemic inflammatory nature, 33 psoriasis presents with autoimmune aspects and co-exists with a variety of autoimmune disorders. [34][35][36][37][38][39] In this article, we summarize recent topics on autoimmunity and autoimmune co-morbidities in psoriasis.…”