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银屑病:他汀类药物能发挥双重作用吗?

Psoriasis: can statins play a dual role?

作者信息

Rajpara Anand N, Goldner Ronald, Gaspari Anthony

机构信息

School of Medicine, University of Maryland, Baltimore, Maryland, USA.

出版信息

Dermatol Online J. 2010 Feb 15;16(2):2.

PMID:20178698
Abstract

Recently, a strong association between "psoriasis" and "atherosclerosis" has emerged. Psoriasis patients have an increased prevalence of atherosclerotic disease including coronary artery, cerebrovascular, and peripheral vascular diseases. The exact connection between psoriasis and atherosclerosis remains unclear, but it is thought that inflammation, which plays an important role in both diseases, may be the causative link. Nevertheless, psoriasis patients suffer from an increased burden of atherosclerotic disease and most commonly die from "coronary artery disease" (CAD). Psoriatic patients have an increased prevalence of CAD risk factors and an increased risk of myocardial infarction (MI). One CAD risk factor in psoriasis patients that can easily be managed is "hyperlipidemia." "Statins" are safe, cost-effective, and have been proven to be highly effective in preventing CAD, including MI, in patients with hyperlipidemia. Furthermore, in addition to their lipid lowering properties, statins have anti-inflammatory immunomodulator activities that may be beneficial in several autoimmune diseases including psoriasis. Considering the safety and cost-effectiveness of statins, we feel that it is worth investigating if statins can play a dual role in psoriasis by treating the increased atherosclerotic disease burden in these patients through their lipid lowering effects and by decreasing psoriatic disease activity through their anti-inflammatory immunomodulatory properties.

摘要

最近,“银屑病”与“动脉粥样硬化”之间出现了紧密的关联。银屑病患者患动脉粥样硬化疾病的患病率增加,包括冠状动脉疾病、脑血管疾病和外周血管疾病。银屑病与动脉粥样硬化的确切联系尚不清楚,但人们认为炎症在这两种疾病中都起着重要作用,可能是致病环节。然而,银屑病患者承受着动脉粥样硬化疾病增加的负担,最常见的死因是“冠状动脉疾病”(CAD)。银屑病患者患CAD危险因素的患病率增加,心肌梗死(MI)风险也增加。银屑病患者中一种易于控制的CAD危险因素是“高脂血症”。“他汀类药物”安全、性价比高,已被证明在预防高脂血症患者的CAD(包括MI)方面非常有效。此外,除了其降脂特性外,他汀类药物还具有抗炎免疫调节活性,这可能对包括银屑病在内的几种自身免疫性疾病有益。考虑到他汀类药物的安全性和性价比,我们认为值得研究他汀类药物是否可以通过降低血脂作用治疗这些患者增加的动脉粥样硬化疾病负担,并通过其抗炎免疫调节特性降低银屑病疾病活动度,从而在银屑病中发挥双重作用。

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Psoriasis and comorbidities: links and risks.银屑病及其合并症:关联与风险。
Clin Cosmet Investig Dermatol. 2014 Apr 17;7:119-32. doi: 10.2147/CCID.S44843. eCollection 2014.
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Lipid disturbances in psoriasis: an update.银屑病中的脂质紊乱:最新进展。
Mediators Inflamm. 2010;2010. doi: 10.1155/2010/535612. Epub 2010 Jul 20.