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Treat Psoriasis and Help Avoid Cardiovascular Disease

Posted Mar 22 2012 12:00am

It has been known for a long time that acute inflammation, as measured by the plasma level of C-reactive protein, can be a predictor for future strokes and myocardial infarctions (see: INFLAMMATION,  ASPIRIN,  AND THE RISK OF CARDIOVASCULAR DISEASE IN APPARENTLY HEALTHY MEN ). Now comes news that treating psoriatic patients with adalimumab to reduce inflammation can also reduce their incidence of subsequent heart attacks and strokes (see: Treating psoriasis to prevent heart attacks and strokes ). Below is an excerpt from the article:

A clinical study...shows that a new treatment for psoriasis could be associated with a significant decrease in vascular inflammation, a major risk factor of cardiovascular disease. Psoriasis is a chronic inflammatory disease of the skin and joints that affects up to 3% of the population. This disease is associated with a greater risk of heart attack (infarction) and stroke. The goal of this clinical study was to show that a treatment to reduce skin inflammation in psoriasis patients could be associated with a decrease in vascular inflammation. The study had positive results, as vascular inflammation decreased significantly in patients suffering from psoriasis who were treated with adalimumab, a biological anti-inflammatory compound. The study also showed a 51% decrease in C-reactive protein among patients treated with adalimumab compared to a 2% decrease among patients in the control group. These results are significant, as a high level of C-reactive protein is known to be associated with an increased risk of heart attack and stroke. In relation to the treatment of psoriasis, 70% of patients who received the compound presented with a major decrease in skin lesion severity, compared to 20% of patients in the control group....“[One of the study authors] added that this clinical research study suggests that it is possible to assess the impact of psoriasis treatments on the heart without having to resort to long-term studies that require thousands of patients and have higher costs.

The significance of the last sentence above is that the degree of cardiovascular disease for each of these study patients was measured at both the start and end of the study with positron emission tomography (PET), a type of medical imaging, to scan the carotid arteries and the ascending aorta. These PET studies enabled the assessment of small changes in the arteries, thus avoiding the necessity of longer-term, and thus more expensive, assessment of disease progression.

Here's a brief summary of the autoimmune basis for psoriasis from the Wikipedia :

[One hypothesis for psoriasis] sees the disease as being an immune-mediated disorder in which the excessive reproduction of skin cells is secondary to factors produced by the immune system. T cells (which normally help protect the body against infection) become active, migrate to the dermis and trigger the release of cytokines (tumor necrosis factor-alpha TNFα, in particular) which cause inflammation and the rapid production of skin cells. It is not known what initiates the activation of the T cells. The immune-mediated model of psoriasis has been supported by the observation that immunosuppressant medications can clear psoriasis plaques. However, the role of the immune system is not fully understood....

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