Is enhanced platelet activation the missing link leading to increased cardiovascular risk in psoriasis?

Chandrashekar, Laxmisha; Rajappa, Medha; Revathy, G.; Indhumathi, S; Munisamy, Malathi; Ananthanarayanan, Palghat Hariharan; Thappa, Devinder Mohan; Basu, Debdatta

doi:10.1016/j.cca.2015.04.023

Cited by 46 publications

(63 citation statements)

References 41 publications

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“…This intriguing hypothesis has particularly been proposed for psoriasis as one of the possible explanations for the increased frequency of cardiovascular comorbidities [45,46]. Significant signs of platelet activation and systemic inflammation have been reported in patients with psoriasis, especially in those with severe disease [46]. …”

Section: Platelets In Inflammationmentioning

confidence: 99%

The Role of Platelets in Chronic Urticaria

Veña¹,

Cassano

Marzano

et al. 2016

Int Arch Allergy Immunol

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Background: Platelets are implicated in many pathophysiological processes, including inflammation and immunity. Ever-growing evidence suggests the active involvement of platelets in the pathogenesis of various inflammatory disorders, including cutaneous inflammatory diseases. A limited number of studies have investigated the role of platelets in chronic urticaria (CU). In this review, we summarize the current knowledge regarding the role of platelets in chronic spontaneous and inducible urticarias. Methods: A literature search was performed using PubMed and Google Scholar, and the references of relevant literature were reviewed. Results: Overall, in CU patients, conflicting results have been obtained from the assessment of platelet indices, such as mean platelet volume, platelet count and distribution width, as well as markers of platelet aggregation and activation. Nevertheless, a few studies showed significant changes of such parameters in CU patients compared to controls, in apparent correlation with clinical severity, autoreactivity and/or inflammatory status. Conclusions: In the absence of definitive conclusions, the pathogenic role of platelets in CU needs to be further explored. Platelets might represent a link between inflammation, coagulation and histamine release in the pathophysiological network of CU.

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Section: Platelets In Inflammationmentioning

confidence: 99%

The Role of Platelets in Chronic Urticaria

Veña¹,

Cassano

Marzano

et al. 2016

Int Arch Allergy Immunol

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“…Psoriatic patients have been found to have increased concentrations of inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6, and tumor necrosis factor α (TNF-α) which reflect an inflammatory status that is the trigger for the development of cardiovascular disease. Thus, while psoriasis is considered primarily as a cutaneous disease, many reports suggest that psoriasis patients have increased risk for occlusive vascular diseases such as atherosclerosis, coronary artery disease and cerebrovascular diseases [1–3]. …”

Section: Introductionmentioning

confidence: 99%

“…Platelets also play a crucial role in psoriasis pathogenesis as activated platelets increase migration of leukocytes to skin and release many pro-inflammatory cytokines [2, 3, 5]. Mean platelet volume (MPV) has been previously reported as a platelet activation marker and has been found significantly higher in psoriasis patients [2, 8].…”

Section: Introductionmentioning

confidence: 99%

Platelet mass index is increased in psoriasis. A possible link between psoriasis and atherosclerosis

Ünal¹

2016

Arch Med Sci Atheroscler Dis

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Introduction: Psoriasis, whose relation with atherosclerosis etc. has long been known, is a chronic inflammatory disease. Besides providing hemostasis, platelets play important roles in inflammatory reactions and immune responses and contribute to endothelial damage, thus leading to atherosclerotic plaque formation. Mean platelet volume (MPV) has been previously reported as a platelet activation marker. Platelet mass index (PMI) is also related to platelet functionality and is thought to be a useful parameter for plaque formation capacity of platelets. Material and methods: Sex, age, age of onset, disease duration, family history, psoriasis area severity index, nail and joint involvement, platelet count, mean platelet volume, platelet mass index, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) of 320 patients with psoriasis and 200 healthy persons were evaluated. Results: Mean platelet counts were 277.7 ±73.374 and 265.06 ±59.682 (p = 0.032); MPV values were 8.248 ±1.150 and 7.442 ±1.626 (p < 0.001); and PMI values were 2259 ±545.617 and 1964 ±622.762 (p < 0.001) respectively in the psoriasis and control group. The MPV showed a significant but inverse correlation with hs-CRP (p = 0.047, r = –0.149), and no correlation with ESR (p > 0.05). Platelet count and PMI had a significant and positive correlation with ESR (p < 0.001, r = 0.404 and p < 0.001, r = 0.371), but had no correlation with hs-CRP (p > 0.05). Conclusions: Higher PMI and MPV values, which mean higher plaque formation capacity and more active platelets, in psoriasis may make psoriasis patients more sensitive to atherosclerotic plaque formation and complications. On the other hand, because of the positive PMI correlation with ESR (MPV had no correlation with ESR and had a negative correlation with CRP), PMI may be a better predictor of inflammation than MPV in psoriasis.

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“…Five studies so far have shown elevated PMPs in psoriasis patients[7,8,23-25], two of them methodologically limited in PMP detection by using ELISA-based assays[7,24]. PMPs were also shown, albeit not always[8,23,25], to correlate with the activity of psoriasis, as assessed by the Psoriasis Area Severity Index (PASI) score[7,24].…”

Section: Introductionmentioning

confidence: 99%

“…PMPs were also shown, albeit not always[8,23,25], to correlate with the activity of psoriasis, as assessed by the Psoriasis Area Severity Index (PASI) score[7,24]. However, a possible association of platelet activation with cytokines identified as key players in psoriasis has not yet been examined, to the best of our knowledge.…”

Section: Introductionmentioning

confidence: 99%

Increased levels of circulating platelet-derived microparticles in psoriasis: Possible implications for the associated cardiovascular risk

Papadavid

Diamanti

Spathis

et al. 2016

WJC

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AIMTo evaluate platelet activation markers in psoriasis patients, compared to controls, and investigate their association with the inflammatory burden of psoriasis.METHODSForty psoriatic patients without cardiovascular disease, and 12 healthy controls were subjected to measurement of baseline platelet CD62P, CD63 and CD42b expression, platelet-leukocyte complexes, i.e., platelet-monocyte complexes (PMC), platelet-neutrophil complexes (PNC) and platelet-lymphocyte complexes, and concentrations of platelet-derived microparticles (PMPs) using flow cytometry. Both larger-size (0.5-0.9 μm) and smaller-size (< 0.5 μm) PMPs were determined. Serum interleukin (IL)-12 and IL-17 levels were also measured by enzyme-linked immunosorbent assay. The severity of psoriasis was evaluated by the Psoriasis Area Severity Index (PASI).RESULTSPMP concentrations were significantly higher in psoriasis patients than controls [mean ± standard error of mean (SEM): 22 ± 5/μL vs 11 ± 6/μL; P = 0.018), for both smaller-size (10 ± 2/μL vs 4 ± 2/μL; P = 0.033) and larger-size (12 ± 3/μL vs 6 ± 4/μL; P = 0.014) PMPs. Platelet CD62P, CD63 and CD42b expression and circulating PMC and PNC were similar between the two groups. Lower circulating PLC were observed in psoriasis patients compared to controls (mean ± SEM: 16% ± 3% vs 23% ± 6%; P = 0.047). Larger-size PMPs were related with IL-12 levels (P < 0.001) and smaller-size PMPs with both IL-12 and IL-17 levels (P < 0.001). Total PMPs also correlated with IL-12 (P < 0.001). CD63 expression was positively correlated with both IL-12 and IL-17 (P < 0.05). Increased PASI score was associated with increased levels of larger-size PMPs (r = 0.45; P = 0.011) and increased CD63 expression (r = 0.47; P < 0.01).CONCLUSIONPMPs, known to be predictive of cardiovascular outcomes, are increased in psoriasis patients, and associated with high inflammatory disease burden. Enhanced platelet activation may be the missing link leading to cardiovascular events in psoriatic patients.

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Is enhanced platelet activation the missing link leading to increased cardiovascular risk in psoriasis?

Cited by 46 publications

References 41 publications

The Role of Platelets in Chronic Urticaria

The Role of Platelets in Chronic Urticaria

Platelet mass index is increased in psoriasis. A possible link between psoriasis and atherosclerosis

Increased levels of circulating platelet-derived microparticles in psoriasis: Possible implications for the associated cardiovascular risk

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