Psoriasis patients more vulnerable to cardiovascular disease
In a new discovery link between psoriasis and cardiovascular disease has been established. For the first time, researchers have found the preclinical evidence that shows that psoriasis leads to cardiovascular disease.
The association between the inflammatory skin disease and cardiovascular outcome has been observed for long, however the linkups were not known.
Further, their research also shows that aggressive reversal of psoriasis makes the risk of cardiovascular diseases less severe.
Psoriasis is a chronic disease in which skin becomes inflamed and scaly red patches appear. The disease is also having symptoms like intense itch.
In this study new, innovative mouse model were used to showcase a causal link between the skin disease and cardiovascular disease.
Nicole Ward, PhD, senior author of the study, and her team demonstrated that mice was made to overexpress a protein called Tie-2 in the skin, develop a skin condition that resembles human psoriasis. With the help of this model, they showed that persistent, chronic inflammation confined to the skin could lead to inflammation in large arteries, such as the aorta.
"This discovery is paradigm shifting. There has been a link between the two diseases but to date we had not been able to show cause. Epidemiologic evidence from thousands of patients was convincing that psoriasis patients had a much greater chance of developing cardiovascular disease and dying from it," Ward, PhD, assistant professor of dermatology and neurosciences at Case Western Reserve School of Medicine, and scientist with the Murdough Family Center for Psoriasis at University Hospitals Case Medical Center has been quoted as saying.
It is well known that there is a great risk of heart, cerebrovascular and peripheral artery diseases, as well as risk of death, to those suffering from a variety of chronic inflammatory diseases that includes rheumatoid arthritis (RA), colitis, gum disease, lupus, and psoriasis.
Many researchers demonstrated, statistically, that having psoriasis leads to an increased risk for cardiovascular disease and heart complications. However it was not very clear why this occurs and it was challenging to separate out the importance of other lifestyle factors and their contributions to this risk, she says.
On the basis of published clinical reports showcasing psoriasis patients had increased risk of developing and dying of heart attack and stroke. Dr. Ward and her team all set-out to investigate whether their mouse model of psoriasis is able to showcase cardiac complications, mimicking these seen in human disease.
They collaborated with experts in the role of inflammation in vessel injury - Yunmei Wang, PhD, assistant professor of medicine at the School of Medicine and Daniel I. Simon, MD the Herman K. Hellerstein Professor of Cardiovascular Research at the School of Medicine, and chief, Cardiovascular Medicine at University Hospitals Case Medical Center.
"We believed that chronic inflammation over a large area of the body may be the reason for an increased risk of cardiovascular complications in skin disease patients; however, until now we had no way to model and definitively prove this," Dr. Wang has been quoted as saying.
Dr. Ward and her team analyzed blood clot formation in the psoriasis mouse model and normal mice, revealing that time was very short in diseased mice. This shortened time to vessel blockage is akin to a greater risk for blood vessel blockage in humans that leads to stroke or heart attack.
Further examination says that mice with the skin disease also showed inflammation of the vessel wall similar to that observed with atherosclerotic lesions or plaques.
Importantly, and highly meaningful for patients with psoriasis, Dr. Ward's work was able to showcase that upon reversal of the skin disease, the cardiovascular inflammation and blood clot formation were also decreased.
"Our observations of improved vessel wall inflammation and decreased clot formation following skin-specific repression of disease provide further evidence that skin inflammation promotes vascular inflammation and thrombosis and strongly suggests that aggressive treatment of skin disease may block pathways that produce cardiovascular disease in psoriasis patients," Dr. Ward has been quoted as saying.
The study was published in the Journal of Investigative Dermatology.
--With inputs from ANI
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