Psoriasis and Cardiovascular Diseases: An Immune-Mediated Cross Talk?

Abstract

Psoriasis is a chronic immune-mediated inflammatory skin disease, characterized by well-demarcated scaly, erythematous, infiltrated plaques. The cutaneous-to-systemic expansion of the inflammation in psoriasis leads to the concept of “psoriatic march” or “inflammatory skin march”. Accordingly, psoriasis is thought to be a systemic inflammatory disease associated with numerous comorbidities. Indeed, it’s currently considered an independent risk factor for cardiovascular diseases. Here, we discuss the current knowledge on TNF-α and IL-23/IL-17 mediated pathways linking the psoriatic plaque to the cardiovascular compartment. We further argue the possible involvement of the endothelial compartment in the psoriatic plaque- cardiovascular system crosstalk.

Gender, Socioeconomic, and Health Characteristics Associated to Dermatological Visits in Italy: Secondary Analysis of a National Cross-Sectional Survey

“…Some studies have shown statistically significant differences as well among skin care disparities based on gender type [5,6,10] but both in bivariate analyses and in the multilevel regression model we could not assess this difference at a statistically significant level. We decided to analyze if the presence of comorbidities could be correlated since they may be associated with an increased risk of skin diseases that may require dedicated dermatological consultations [11][12][13]. The only variable that was present in the database considering comorbidities was the general presence or absence of at least three chronic diseases.…”

Reactive oxygen species produced by myeloid cells in psoriasis as a potential biofactor contributing to the development of vascular inflammation

“…The skin-vasculature crosstalk in severe psoriasis leads to cardiovascular comorbidity and is of high clinical importance. 10,21,23,46 When confronted with the associated F I G U R E 1 Increased reactive oxygen species (ROS) formation in the psoriatic skin is paralleled by a higher activation. (A) Photometric analysis of superoxide levels in healthy skin of IL-17A ind/+ mice and in plaque-affected skin of K14-IL-17A ind/+ mice after incubation with Lucigenin (bis-N-methylacridinium nitrate), n = 5 mice per group, 4 experiments, unpaired Student's t-test.…”

“…The skin‐vasculature crosstalk in severe psoriasis leads to cardiovascular comorbidity and is of high clinical importance 10,21,23,46 . When confronted with the associated cardiovascular comorbidity in psoriasis, the main question is: How are both diseases interconnected?…”

“…[18][19][20] Oxidative stress formation is understood to have a key role in CVD development in psoriasis patients linking skin and vascular disease. 21 We could show that dermal overexpression of IL-17A which results in a severe chronic psoriasis-like skin inflammation (K14-IL-17A ind/+ psoriatic mice, IL-17A ind/+ control mice) is associated with a significant vascular dysfunction. 22 The vascular phenotype was connected to the infiltration of immune cellsmajorly neutrophilsand increased ROS formation in the aortic vessel wall.…”

“…Besides the endothelial cells, myeloid cells invading into the vessel wall present a relevant ROS source in the vasculature contributing to the progress of vascular inflammation and atherosclerosis 18–20 . Oxidative stress formation is understood to have a key role in CVD development in psoriasis patients linking skin and vascular disease 21 . We could show that dermal overexpression of IL‐17A which results in a severe chronic psoriasis‐like skin inflammation (K14‐IL‐17A ind/+ psoriatic mice, IL‐17A ind/+ control mice) is associated with a significant vascular dysfunction 22 .…”