Chronic inflammation, cardiometabolic diseases and effects of treatment: Psoriasis as a human model

Trends Cardiovasc Med. 2020 Nov;30(8):472-478. doi: 10.1016/j.tcm.2019.11.001. Epub 2019 Nov 20.

Abstract

Chronic inflammation in humans is associated with accelerated development of cardiometabolic diseases such as myocardial infarction, stroke, and diabetes. Strong evidence from animal models and human interventional trials including CANTOS (The Canakinumab Anti-inflammatory Thrombosis Outcome Study) suggests that targeting residual systemic inflammation in humans may impart a benefit in reducing cardiometabolic diseases. Diseases associated with heightened immune-activation and systemic inflammation including psoriasis, rheumatoid arthritis, systemic lupus erythematosus, and human immunodeficiency virus infection are associated with upwards of two to seven-fold risk of future adverse cardiac events even when adjusted for traditional risk factors. Over the past decade, psoriasis has been utilized as a human model to study inflammatory-induced cardiometabolic dysfunction and to better understand residual risk due to inflammation. The high prevalence and early onset of cardiovascular disease in psoriasis enhances the likelihood of discovering novel pathways in vascular disease progression when followed over time. Furthermore, the United States Food and Drug Administration approved treatments for psoriasis include cytokine inhibitors (anti-tumor necrosis factor, anti-interleukin 17, anti-interleukin 12/23) which while treating the skin disease provide a unique opportunity to characterize how treating the inflammatory pathways may impact atherosclerosis. Herein, we provide a review of chronic inflammation, cardiometabolic disease associations, and treatment effects with a focus on psoriasis as a human model of study.

Keywords: Adipose dysfunction; Cardiometabolic disease; Immune activation; Inflammation; Lipoprotein dysfunction; Psoriasis.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / therapeutic use*
  • Cardiometabolic Risk Factors
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / immunology
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / prevention & control*
  • Chronic Disease
  • Cytokines / antagonists & inhibitors*
  • Cytokines / metabolism
  • Humans
  • Inflammation / drug therapy*
  • Inflammation / epidemiology
  • Inflammation / immunology
  • Inflammation / metabolism
  • Inflammation Mediators / antagonists & inhibitors*
  • Inflammation Mediators / metabolism
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / immunology
  • Metabolic Syndrome / metabolism
  • Metabolic Syndrome / prevention & control*
  • Prognosis
  • Psoriasis / drug therapy*
  • Psoriasis / epidemiology
  • Psoriasis / immunology
  • Psoriasis / metabolism
  • Risk Assessment
  • Signal Transduction

Substances

  • Anti-Inflammatory Agents
  • Cytokines
  • Inflammation Mediators