Can pregnancy-associated plasma protein-A be a marker for the assessment of atherosclerosis risk in patients with chronic plaque psoriasis?

Abstract

IntroductionPsoriasis is an immune-mediated chronic inflammatory dermatosis. Several studies have shown that patients with psoriasis have a much greater risk of cardiovascular diseases than the normal population. The chronic inflammation observed in psoriasis is thought to have a role in the development of atherosclerosis and vascular endothelial injury.AimTo examine serum pregnancy-associated plasma protein-A (PAPP-A) levels, which has been regarded as a marker of early stage atherosclerosis in patients with psoriasis that do not have concurrent conventional cardiovascular risk markers.Material and methodsForty-one patients diagnosed with a chronic plaque type of psoriasis and 42 equally matched healthy volunteers were included in this study. The PAPP-A levels were compared between patient and control groups and the association between PAPP-A levels and disease duration and severity were evaluated in the patient group.ResultsStatistically, serum PAPP-A levels were significantly higher in the psoriasis group than in the control group (p = 0.015). Serum PAPP-A levels were found to be positively correlated with severity (p = 0.036, r = 0.329) and duration (p = 0.014, r = 0.269) of the disease.ConclusionsAs a marker of early stage atherosclerosis, PAPP-A levels were elevated in the psoriasis group and were correlated with disease duration and severity. This elevation reveals the presence of atherosclerosis in patients with psoriasis. Further studies are needed to confirm the use of PAPP-A as an available and inexpensive screening test and cardiovascular risk assessment for all centers.

Large‐scale serum analysis identifies unique systemic biomarkers in psoriasis and hidradenitis suppurativa*

“…In psoriasis, the top markers correlating with severity included corticotropin‐releasing hormone and pregnancy‐associated plasma protein A, markers of early‐stage atherosclerosis, 54,55 previously reported in patients with psoriasis ( r > 0·7; P < 0·05) 54,56,57 . Other markers positively correlated with psoriasis severity included CD69 (a T‐cell marker and a key mediator of psoriasis pathogenesis), 58 granzyme B (a natural killer/T‐cell marker related to atherosclerosis), 59 IL‐17A, IL‐17F, IL‐19 (Th17‐related), CCL23 and CCL13 (Th2‐related), the dendritic cell marker CD300E and IL‐1α (suggested to link immune activation and atherosclerosis) ( r ≥ 0·55; P ≤ 0·1) 38,60,61 …”

“…In psoriasis, the top markers correlating with severity included corticotropin-releasing hormone and pregnancy-associated plasma protein A, markers of early-stage atherosclerosis, 54,55 previously reported in patients with psoriasis (r > 0Á7; P < 0Á05). 54,56,57 Other markers positively correlated with psoriasis severity included CD69 (a T-cell marker and a key mediator of psoriasis pathogenesis), 58 granzyme B (a natural killer/T-cell marker related to atherosclerosis), 59 IL-17A, IL-17F, IL-19 (Th17-related), CCL23 and CCL13 (Th2-related), the dendritic cell marker CD300E and IL-1a (suggested to link immune activation and atherosclerosis) (r ≥ 0Á55; P ≤ 0Á1). 38,60,61 Top proteins positively correlated with HS clinical severity included tissue growth factor-related markers [such as growth hormone 1, chordin like 2 and transforming growth factor (TGF)-a], along with markers related to increased cardiovascular risk [PLA2G2A, CHI3L1 and matrix metalloproteinase (MMP)9], TNF, key Th1-related chemokines (CXCL9/ CXCL10) and Th17-and Th2-related receptors (IL-17RA and IL-4R) (r > 0Á7; P < 0Á01).…”

Evaluation of pregnancy-associated plasma protein-A and some inflammation markers for atherosclerosis in psoriasis patients

“…found that PAPP-A levels were high in psoriasis patients, and they also found that PAPP-A levels correlated with the duration and severity of the disease. They suggested that high PAPP-A levels were related with atherosclerosis, and the use of PAPP-A as a screening test for cardiovascular risk assessment should be supported by further studies [ 24 ]. Unlike that study, we found no significant difference in moderate-severe psoriasis patients compared to the control group in terms of PAPP-A levels as hs-CRP levels, which is an important marker for atherosclerosis.…”