Psoriasis and cardiovascular study

[Fred]

Understand the connection between psoriasis and cardiovascular disease.

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Background:
Psoriasis is an inflammatory skin disease associated with increased cardiovascular (CV) risk, whose pathogenesis is not fully known.

Objective:
We identified a transcriptomic signature in psoriasis and investigated its association with prevalent and future risk of a CV event to understand the connection between psoriasis and CV disease (CVD).

Methods:
Psoriasis patients (n=37) with a history of moderate-severe skin disease without CVD and 11 matched controls underwent whole blood RNA sequencing. This transcriptomic signature in psoriasis vs controls was evaluated in two CVD cohorts: Women referred for cardiac catheterization with (n=76) vs without (n=97) myocardial infarction (MI), and patients with peripheral artery disease (n=106) followed over 2.5 years for major adverse CV or limb events (MACLE). The association between genes differentially expressed in psoriasis and prevalent and incident CV events was assed.

Results:
In psoriasis, median age was 44 (IQR; 34 – 51) years, 49% male, and ACC/AHA ASCVD Risk Score of 1.0% (0.6 – 3.4) with no significant difference vs controls. The median psoriasis area and severity index score (PASI) was 4.0 (IQR 2.9 – 8.2) with 36% on biologic therapy. Overall, 247 whole blood genes were upregulated and 228 downregulated in psoriasis vs controls (p<0.05), and 1,302 genes positively and 1,244 genes negatively correlated with PASI (p<0.05). Seventy-three genes overlapped between psoriasis prevalence and PASI with key regulators identified as IL-6, IL-1β, and interferon gamma. In the CVD cohorts, 50 of 73 genes (68%) identified in psoriasis associated with prevalent MI, and 29 (40%) with incident MACLE. Key regulator transcripts identified in psoriasis and CVD cohorts included SOCS3, BCL3, OSM, PIM2, PIM3, and STAT5A.

Conclusions:
A whole blood transcriptomic signature of psoriasis diagnosis and severity associated with prevalent MI and incident MACLE. These data have implications for better understanding the link between psoriasis, systemic inflammation, and CVD.

Source: onlinelibrary.wiley.com

*Early view funding unknown.