TNF-α blockade may lead to improvement of vascular function in psoriasis patients.
Joanna WegnerSusanne KarbachIoannis DrososBoris SchnorbusSelina MuxelFrank SchmidtPhilip WenzelAri WaismanThomas MünzelTommaso GoriEsther von StebutPublished in: Experimental dermatology (2021)
Psoriasis is one of the most common chronic inflammatory skin diseases and at the same time a risk factor for cardiovascular disease. Interleukin-17A (IL-17A)-mediated inflammation in psoriasis may lead to vascular dysfunction. This study aimed at investigating whether anti-inflammatory treatment by tumor necrosis factor (TNF)-α blockade alters vascular function in psoriasis patients. A total of 11 patients with psoriasis who underwent treatment with either adalimumab (n = 8) or etanercept (n = 3), 10 healthy control individuals and 14 patients with coronary artery disease (CAD) were included in this study. Treatment response was assessed using the Psoriasis Area and Severity Index (PASI) score. Endothelial reactivity and resting endothelium-dependent vascular tone were assessed by ultrasound measurement of flow-mediated dilation (FMD) and low-flow-mediated constriction (l-FMC), respectively. FMD was slightly impaired in psoriasis patients compared to healthy controls. Anti-TNF-α treatment did not significantly change FMD levels. Psoriasis patients showed a trend towards increased baseline vascular activity compared to healthy controls. Anti-TNF-α treatment significantly improved l-FMC in psoriasis patients. Noteworthy, both FMD and l-FMC in psoriasis patients were comparable to those in patients with CAD; however, an important influence of age differences between the groups or co-existent classical cardiovascular risk factors on FMD and l-FMC cannot be ruled out by our small study. The results suggest that anti-inflammatory treatment with TNF-α blockade improves vascular function in patients with psoriasis, mainly by altering baseline vascular tone. Further studies will be necessary to establish the potentially protective impact of anti-inflammatory therapy on vascular function in patients with chronic inflammatory diseases.
Keyphrases
- end stage renal disease
- rheumatoid arthritis
- ejection fraction
- newly diagnosed
- cardiovascular disease
- chronic kidney disease
- peritoneal dialysis
- magnetic resonance imaging
- oxidative stress
- anti inflammatory
- prognostic factors
- patient reported outcomes
- metabolic syndrome
- blood pressure
- spinal cord injury
- bone marrow
- heart rate
- endothelial cells
- nitric oxide
- combination therapy
- spinal cord
- drug induced
- juvenile idiopathic arthritis