Impact of adalimumab treatment on cardiovascular risk biomarkers in psoriasis: Results of a pilot study

J Dermatol. 2017 Apr;44(4):363-369. doi: 10.1111/1346-8138.13661. Epub 2016 Oct 24.

Abstract

Psoriasis is a chronic systemic immune-mediated inflammatory dermatosis associated with several comorbidities. Psoriasis patients are at increased risk of developing cardiovascular diseases (CVD), namely, coronary heart disease, stroke or peripheral vascular disease, and psoriasis seems to be an independent cardiovascular risk factor. Antipsoriatic systemic therapy, especially anti-tumor necrosis factor (TNF)-α, seems to exert a beneficial effect on these comorbidities. The purpose of this study was: (i) to measure the level of cardiovascular serum markers in psoriasis patients in comparison with healthy volunteers; and (ii) to compare the serum level of the same markers in patients before and 3 months after adalimumab therapy. We investigated six biomarkers connected to CVD: C-reactive protein (measured high sensitively, hsCRP), oxidized low-density lipoproteins (oxLDL), oxLDL/β-glycoprotein I complex (oxLDL/β2GPI), vascular endothelial adhesion molecule 1 (VCAM-1), E-selectin and interleukin (IL)-22. These biomarkers were measured in 21 patients with moderate/severe psoriasis before and after treatment with adalimumab and in healthy volunteers. hsCRP (P < 0.05), oxLDL-β2GPI complex (P < 0.05), E-selectin (P < 0.001) and IL-22 (P < 0.001) were significantly increased in comparison with healthy controls, whereas oxLDL and VCAM-1 were also higher in psoriasis patients but the difference did not reach statistical significance. A decrease of E-selectin (P < 0.001) and IL-22 (P < 0.001) was observed after 3 months of adalimumab therapy. Inhibition of TNF-α seems to not only improve psoriasis but also decreases serum cardiovascular biomarkers. E-selectin and IL-22 could serve for monitoring of the efficacy of antipsoriatic systemic therapy on cardiovascular risk.

Keywords: adalimumab; atherosclerosis; biomarkers; cardiovascular; psoriasis.

Publication types

  • Comparative Study

MeSH terms

  • Adalimumab / administration & dosage
  • Adalimumab / adverse effects
  • Adalimumab / therapeutic use*
  • Adult
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / complications
  • Dermatologic Agents / administration & dosage
  • Dermatologic Agents / adverse effects
  • Dermatologic Agents / therapeutic use*
  • E-Selectin / blood
  • Female
  • Healthy Volunteers
  • Humans
  • Interleukin-22
  • Interleukins / blood
  • Lipoproteins, LDL / blood
  • Male
  • Middle Aged
  • Pilot Projects
  • Psoriasis / blood
  • Psoriasis / complications
  • Psoriasis / drug therapy*
  • Risk Factors
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*
  • Vascular Cell Adhesion Molecule-1 / blood
  • beta 2-Glycoprotein I / blood

Substances

  • Biomarkers
  • Dermatologic Agents
  • E-Selectin
  • Interleukins
  • Lipoproteins, LDL
  • SELE protein, human
  • Tumor Necrosis Factor-alpha
  • Vascular Cell Adhesion Molecule-1
  • beta 2-Glycoprotein I
  • oxidized low density lipoprotein
  • C-Reactive Protein
  • Adalimumab