Linking psoriasis inflammation and treatment with risk for cardiovascular disease

2017

Challenge

Epidemiologic evidence suggested that psoriasis, an inflammatory skin disease, shortens life-span by increasing risk for premature coronary artery disease. However, the mechanisms underpinning this relationship and whether it is amenable to therapy were unknown.

Advance

IRP researchers led by Nehal N. Mehta, M.D., explored whether the extent of psoriatic skin disease was linked to accompanying vascular inflammation and whether the treatment of psoriasis-induced skin inflammation, or dermatitis, could reduce vascular inflammation. Dr. Mehta’s group found a very strong link between the extent of dermatitis and the degree of vascular inflammation. The team also showed that psoriatic dermatitis gives rise to premature plaque in coronary arteries. Finally, in a series of preliminary studies, treating psoriatic dermatitis reduced vascular inflammation.

Impact

These findings have begun to delineate the mechanisms by which vascular inflammation and atherosclerosis develop in patients with psoriasis. Furthermore, this work suggests that controlling psoriatic dermatitis may be an important cardiac risk reduction strategy.

Publications

Dey AK, Joshi AA, Chaturvedi A, Lerman JB, Aberra TM, Rodante JA, Teague HL, Harrington CL, Rivers JP, Chung JH, Kabbany MT, Natarajan B, Silverman JI, Ng Q, Sanda GE, Sorokin AV, Baumer Y, Gerson E, Prussick RB, Ehrlich A, Green LJ, Lockshin BN, Ahlman MA, Playford MP, Gelfand JM, Mehta NN. Association Between Skin and Aortic Vascular Inflammation in Patients With Psoriasis: A Case- Cohort Study Using Positron Emission Tomography/Computed Tomography. (2017). JAMA Cardiol. 1013-1018.

Baumer Y, Ng Q, Sanda GE, Dey AK, Teague HL, Sorokin AV, Dagur PK, Silverman JI, Harrington CL, Rodante JA, Rose SM, Varghese NJ, Belur AD, Goyal A, Gelfand JM, Springer DA, Bleck CK, Thomas CL, Yu ZX, Winge MC, Kruth HS, Marinkovich MP, Joshi AA, Playford MP, Mehta NN. Chronic skin inflammation accelerates macrophage cholesterol crystal formation and atherosclerosis. (2018). JCI Insight. 3(1). pii: 97179.

Wu JJ, Joshi AA, Reddy SP, Batech M, Egeberg A, Ahlehoff O, Mehta NN. Anti-inflammatory therapy with tumor necrosis factor inhibitors is associated with reduced risk of major adverse cardiovascular events in psoriasis. (2018). J Eur Acad Dermatol Venereol