Does methotrexate monotherapy ameliorate systemic inflammation and endothelial dysfunction in psoriasis?

Departments of Biochemistry, * Dermatology and # Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. Introduction: Psoriasis is a chronic immune-mediated skin disease. The concept of "psoriatic march" implicates systemic inflammation, leading...

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Published in:Indian journal of clinical biochemistry Vol. 31; no. S1; p. S19
Main Authors: Revathy, G, Usha, R, Rajappa, Medha, Chandrashekar, Laxmisha, Satheesh, Santhosh, Singh, Nidhi, Natarajan, Nalini, Thappa, D.M
Format: Journal Article
Language:English
Published: Springer 01.12.2016
Subjects:
Atherosclerosis
Cardiology
Development and progression
Endothelium
Inflammation
Medical research
Medicine, Experimental
Methotrexate
Nitric oxide
Psoriasis
Von Willebrand factor
ISSN:0970-1915
Online Access:Get full text
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Summary:Departments of Biochemistry, * Dermatology and # Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. Introduction: Psoriasis is a chronic immune-mediated skin disease. The concept of "psoriatic march" implicates systemic inflammation, leading to endothelial dysfunction as the major causative factor in increased cardiovascular co-morbidity in psoriatic patients. As both psoriasis and atherosclerosis have Th1/Thl7-mediated etiology, this study may aid in understanding the pathogenesis of psoriasis as well as atherosclerosis. Aims and objectives: This study was undertaken to assess the effect of methotrexate-monotherapy on markers of systemic inflammation [pentraxin-3(PTX-3), high sensitivity (hs)-CRP] and endothelial dysfunction [nitric oxide (NO), asymmetric dimethylarginine (ADMA), von Willebrand factor (vWF) and brachial artery flow-mediated dilation (FMD)] in patients with psoriasis and to identify the association of these markers with disease severity. Materials and Methods: 87 patients with psoriasis and 87 age and gender-matched controls were recruited. In all cases of psoriasis, disease severity was assessed by Psoriasis Area Severity Index score (PASI). Subjects underwent FMD at baseline and after 12 weeks of methotrexate-monotherapy. hs-CRP, PTX-3, NO, ADMA and vWF were estimated by ELISA in all study subjects at baseline and after 12 weeks of methotrexate-monotherapy in cases. Results: hs-CRP, PTX-3, ADMA and vWF were significantly elevated while NO and FMD were significantly lowered at baseline in cases, compared to controls. The above markers of inflammation and endothelial dysfunction correlated significantly with PASI and showed a significant decline in their levels, after 12 weeks of methotrexate-monotherapy. Psoriasis remained independently associated with FMD even after adjusting for confounders. Conclusion: Our results suggest significant systemic inflammation and endothelial dysfunction in psoriasis, more so with increasing disease severity. Furthermore, methotrexate-monotherapy ameliorates systemic inflammation and endothelial dysfunction, which might reduce the cardiovascular co-morbidity in psoriasis.
ISSN:0970-1915