Psoriasis Therapy and Cardiovascular Risk Factors

Abstract

Our data show that psoriatic patients present with several lipid profile changes that seem to be related to the severity of the disease and/or the treatment used. Mild psoriasis patients receiving topical treatment presented before starting therapy with a lipid profile similar to controls, whereas those undergoing NB-UVB and PUVA, who had higher PASI scores, presented with several risk factors. Moreover, PUVA therapy seems to interact in a different way with lipids that might result from an interaction of psoralen with plasma lipids, namely Lp(a). Inflammation, a hallmark of psoriasis, also seems to be related to psoriasis severity. Both NB-UVB and PUVA were effective, as shown by the reduction in PASI score, as well as in the oxidative and inflammatory stress markers. However, after NB-UVB and PUVA, a low-grade inflammatory process still persisted, which might be related to the duration of remission of the disease.

Systemic treatment and narrowband ultraviolet B differentially affect cardiovascular risk markers in psoriasis

“…10 Our results are also supported by the data from Romaní et al, who observed increased systemic levels of LDL cholesterol, non-HDL (high-density lipoprotein) cholesterol and Apo-B in psoriasis patients, levels which were unaffected by phototherapy. 41 Signs of a persistent inflammatory process after UV therapy were also established by Coimbra et al 42 In contrast, UV therapy led to a decrease in IL-22, IL-17, IL-23, IL-8 TNF-α, and VEGF serum levels, 43 suggesting that the skin is the major source of these cytokines in psoriasis. However, the literature is controversial and both we and others have shown a lack of effect by UV therapy on the studied cytokines.…”

The role of lipids in psoriasis

“…Cignoline stimulates oxidative stress by enhancing the peroxidation of lipids in keratinocytes and nucleated cells in peripheral blood [75]. Coimbra et al demonstrated no effect of NB-UVB on the inflammatory process or decrease in the risk of atherogenicity: the levels of ox-LDL/LDL, Chol/HDL, CRP and Lp(a) still remained higher than in the control group.…”

“…Cygnolina stymuluje stres oksydacyjny poprzez nasilanie peroksydacji lipidów w keratynocytach i komórkach jednojądrzastych krwi obwodowej [75]. Coimbra i wsp.…”

Biochemical markers of psoriasis as a metabolic disease

“…Coimbra et al [219] determined a prevalence of cardiovascular risk factors in patients with psoriasis. They demonstrated significantly higher levels of CRP compared to a control group.…”