Genetic Markers for Cardiovascular Disease in Psoriasis: The Missing Piece
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SHORT COMMUNICATION
Genetic Markers for Cardiovascular Disease in Psoriasis: The Missing Piece Tiago Torres • Andrea Chiricozzi • Sergio Chimenti • Rosita Saraceno
Published online: 28 September 2013 Ó Springer International Publishing Switzerland 2013
Abstract Psoriasis is a common, chronic inflammatory disease associated with serious comorbidities. Severe psoriasis has been associated with increase cardiovascular mortality, due to a higher prevalence of traditional cardiovascular risk factors such as diabetes, hypertension, dyslipidemia and obesity, and premature atherosclerosis, as a consequence of its systemic inflammation. It is likely that there are genetic links between psoriasis, its comorbidities and cardiovascular disease. Although there are some studies performed in rheumatoid arthritis reporting some gene polymorphisms that may be associated with cardiovascular diseases and comorbidities these studies are lacking in psoriasis. Recognizing genetic markers that could predict which patients are at risk of developing psoriasis-linked cardiovascular comorbidities would facilitate screening strategies and permit an earlier management of cardiovascular risk factors, with important clinical implications.
Psoriasis is a chronic, immune-mediated inflammatory disease affecting 2 % of the global population [1]. In the majority of cases skin manifestations negatively impact on T. Torres (&) Servic¸o de Dermatologia, Centro Hospitalar do Porto, Edifı´cio das Consultas Externas, Ex-CICAP, Rua D. Manuel II, s/n, 4100 Porto, Portugal e-mail: [email protected] T. Torres Instituto Cieˆncias Abel Salazar, University of Porto, Porto, Portugal A. Chiricozzi S. Chimenti R. Saraceno Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
patient’s quality of life, however there is mounting evidence that psoriasis is more than a skin disease and it is now widely believed that psoriasis is a systemic inflammatory process, associated with several cardiovascular comorbidities [2]. Diseases that occur concurrently (namely comorbidities) are often thought to be related to common pathogenic mechanisms, shared genetic risk variants, shared environmental triggers or a combination of these factors. Thus, it is likely that there are genetic links between psoriasis and its comorbidities. Psoriasis has been associated with an increased risk of cardiovascular disease, such as myocardial infarction and stroke [3, 4]. Due to this higher incidence of cardiovascular disease, life expectancy in severe psoriasis is reduced up to 5 years [5]. Moreover, it appears that the age of mortality is linked to age of psoriasis onset, with a longevity decrease as much as 20 years in patients whose psoriasis begins before 25 years [6]. This higher cardiovascular risk may be explained in part by an increased prevalence of classical coronary risk factors, including hypertension, hypercholesterolemia, diabetes mellitus and obesity [7]. On the other hand, some studies have suggested that psoriasis could be an independent risk for
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