Cardiovascular Comorbidities in Patients with Psoriasis: Risk Profile Including Carotide Ultrasonography Assessed in Hospital-based Case Control Study

Psoriasis is a chronic inflammatory disease and its comorbidities have attracted serious interest in recent years. The evidence that psoriasis is associated with systemic inflammation and significantly higher incidence of cardiovascular risk factors was already described. The results of published studies are highly variable, the conclusions are ambiguous and further epidemiological studies are needed for validation of published data. Therefore, we initiated a project aimed at identifying the carriership of cardiovascular risk factors including early stages of atherosclerosis that represent important comorbidities in patients with psoriasis. We carried out a hospital-based case-control study. 189 patients with chronic plaque psoriasis were enrolled as cases. The group consisted of 378 patients with other skin diseases complying with the same restriction criteria were recruited to the study as the controls. All participants underwent physical examination, blood tests, measuring of blood pressure, waist circumference. Furthermore, in the subset of 117 cases and controls (matched 1:2) with no history of cardiovascular disease we evaluated the intima-media thickness (cIMT). The results show higher prevalence of hypertension, hyperlipidaemia, waist circumference, weight, BMI and CRP level in patients with psoriasis than in controls. These parameters have been clearly demonstrated as risk factors for the development of cardiovascular diseases. The associations among psoriasis and diastolic blood pressure, BMI value and LDL cholesterol are statistically significant in the binary data logistic model as well. cIMT in patients  compared to controls was not significant.</p

Cardiovascular Comorbidities in Patients with Psoriasis: Risk Profile Including Carotide Ultrasonography Assessed in Hospital-based Case Control Study

Psoriasis is a chronic inflammatory disease and its comorbidities have attracted serious interest in recent years. The evidence that psoriasis is associated with systemic inflammation and significantly higher incidence of cardiovascular risk factors was already described. The results of published studies are highly variable, the conclusions are ambiguous and further epidemiological studies are needed for validation of published data. Therefore, we initiated a project aimed at identifying the carriership of cardiovascular risk factors including early stages of atherosclerosis that represent important comorbidities in patients with psoriasis. We carried out a hospital-based case-control study. 189 patients with chronic plaque psoriasis were enrolled as cases. The group consisted of 378 patients with other skin diseases complying with the same restriction criteria were recruited to the study as the controls. All participants underwent physical examination, blood tests, measuring of blood pressure, waist circumference. Furthermore, in the subset of 117 cases and controls (matched 1:2) with no history of cardiovascular disease we evaluated the intima-media thickness (cIMT). The results show higher prevalence of hypertension, hyperlipidaemia, waist circumference, weight, BMI and CRP level in patients with psoriasis than in controls. These parameters have been clearly demonstrated as risk factors for the development of cardiovascular diseases. The associations among psoriasis and diastolic blood pressure, BMI value and LDL cholesterol are statistically significant in the binary data logistic model as well. cIMT in patients  compared to controls was not significant.</p

Dysbiosis of Skin Microbiota in Psoriatic Patients: Co-occurrence of Fungal and Bacterial Communities

Psoriasis is a chronic inflammatory skin disease, whose pathogenesis involves dysregulated interplay among immune cells, keratinocytes and environmental triggers, including microbiota. Bacterial and fungal dysbiosis has been recently associated with several chronic immune-mediated diseases including psoriasis. In this comprehensive study, we investigated how different sampling sites and methods reflect the uncovered skin microbiota composition. After establishing the most suitable approach, we further examined correlations between bacteria and fungi on the psoriatic skin. We compared microbiota composition determined in the same sample by sequencing two distinct hypervariable regions of the 16S rRNA gene. We showed that using the V3V4 region led to higher species richness and evenness than using the V1V2 region. In particular, genera, such as Staphylococcus and Micrococcus were more abundant when using the V3V4 region, while Planococcaceae, on the other hand, were detected only by the V1V2 region. We performed a detailed analysis of skin microbiota composition of psoriatic lesions, unaffected psoriatic skin, and healthy control skin from the back and elbow. Only a few discriminative features were uncovered, mostly specific for the sampling site or method (swab, scraping, or biopsy). Swabs from psoriatic lesions on the back and the elbow were associated with increased abundance of Brevibacterium and Kocuria palustris and Gordonia, respectively. In the same samples from psoriatic lesions, we found a significantly higher abundance of the fungus Malassezia restricta on the back, while Malassezia sympodialis dominated the elbow mycobiota. In psoriatic elbow skin, we found significant correlation between occurrence of Kocuria, Lactobacillus, and Streptococcus with Saccharomyces, which was not observed in healthy skin. For the first time, we showed here a psoriasis-specific correlation between fungal and bacterial species, suggesting a link between competition for niche occupancy and psoriasis. However, it still remains to be elucidated whether observed microbial shift and specific inter-kingdom relationship pattern are of primary etiological significance or secondary to the disease