Severity of psoriasis associates with aortic vascular inflammation detected by FDG PET/CT and neutrophil activation in a prospective observational study

HB Naik, B Natarajan, E Stansky… - … , and vascular biology, 2015 - Am Heart Assoc
HB Naik, B Natarajan, E Stansky, MA Ahlman, H Teague, T Salahuddin, Q Ng, AA Joshi
Arteriosclerosis, thrombosis, and vascular biology, 2015Am Heart Assoc
Objective—To understand whether directly measured psoriasis severity is associated with
vascular inflammation assessed by 18F-fluorodeoxyglucose positron emission tomography
computed tomography. Approach—In-depth cardiovascular and metabolic phenotyping was
performed in adult psoriasis patients (n= 60) and controls (n= 20). Psoriasis severity was
measured using psoriasis area severity index. Vascular inflammation was measured using
average aortic target-to-background ratio using 18F-fluorodeoxyglucose positron emission …
Objective
To understand whether directly measured psoriasis severity is associated with vascular inflammation assessed by 18F-fluorodeoxyglucose positron emission tomography computed tomography.
Approach
In-depth cardiovascular and metabolic phenotyping was performed in adult psoriasis patients (n=60) and controls (n=20). Psoriasis severity was measured using psoriasis area severity index. Vascular inflammation was measured using average aortic target-to-background ratio using 18F-fluorodeoxyglucose positron emission tomography computed tomography.
Results
Both the psoriasis patients (28 men and 32 women, mean age 47 years) and controls (13 men and 7 women, mean age 41 years) were young with low cardiovascular risk. Psoriasis area severity index scores (median 5.4; interquartile range 2.8–8.3) were consistent with mild-to-moderate skin disease severity. Increasing psoriasis area severity index score was associated with an increase in aortic target-to-background ratio (β=0.41, P=0.001), an association that changed little after adjustment for age, sex, and Framingham risk score. We observed evidence of increased neutrophil frequency (mean psoriasis, 3.7±1.2 versus 2.9±1.2; P=0.02) and activation by lower neutrophil surface CD16 and CD62L in blood. Serum levels of S100A8/A9 (745.1±53.3 versus 195.4±157.8 ng/mL; P<0.01) and neutrophil elastase-1 (43.0±2.4 versus 30.8±6.7 ng/mL; P<0.001) were elevated in psoriasis. Finally, S100A8/A9 protein was related to both psoriasis skin disease severity (β=0.53; P=0.02) and vascular inflammation (β=0.48; P=0.02).
Conclusions
Psoriasis severity is associated with vascular inflammation beyond cardiovascular risk factors. Psoriasis increased neutrophil activation and neutrophil markers, and S100A8/A9 was related to both skin disease severity and vascular inflammation.
Am Heart Assoc