Erturan Ijlal, Köroğlu Banu Kale, Adiloğlu Ali, Ceyhan Ali M, Akkaya Vahide B, Tamer Numan, Başak Pinar Y, Korkmaz Selma, Ersoy Ismail H, Kilinç Osman
Int J Dermatol. 2014 Apr;53(4):503-9. doi: 10.1111/ijd.12397.
Psoriasis is a chronic inflammatory process associated with an increased risk of cardiovascular risk factors. sCD40L has been suggested to have a possible role in the pathogenesis, of psoriasis and is known to be associated with inflammation, atherogenesis and cardiovascular events. This study investigated cardiovascular risk factors (sCD40L and homocysteine) as well as subclinical atherosclerosis indicators in psoriatic patients and control subjects. The study included 56 consecutive patients with chronic plaque-type psoriasis and 53 age and gender matched healthy controls admitted to a university hospital. Serum sCD40L and homocysteine levels were measured by ELISA. Carotid artery intima-media thickness and brachial artery flow mediated dilatation (FMD) measurements were determined ultrasonographically. Subjects who had a history of cardiovascular diseases and cardiovascular risk factors and receiving any systemic treatment were excluded from the study. Plasma sCD40L levels were significantly higher in psoriasis patients compared with healthy controls (1.33±0.72 vs. 0.98±0.70 ng/ml P=0.012), whereas plasma homocysteine levels did not differ significantly between the two groups. FMD was significantly reduced in the psoriasis group compared to the controls (3.83±5.03 vs. 8.45±7.27% P=0.0001). Multiple linear regression analyses indicated a significant association between psoriasis, sCD40L, and FMD. Psoriatic patients had higher sCD40L levels than healthy controls, which may lead to an increase in cardiovascular diseases. sCD40L may be a more reliable and early predictive marker of cardiovascular events in psoriatic patients. New treatmentoptions that will be developed over sCD40L will benefit in prevention of psoriasis and its cardiovascular comorbidities.
银屑病是一种慢性炎症过程，与心血管危险因素风险增加相关。有研究表明，可溶性CD40配体（sCD40L）可能在银屑病发病机制中发挥作用，且已知其与炎症、动脉粥样硬化形成及心血管事件相关。本研究调查了银屑病患者和对照受试者的心血管危险因素（sCD40L和同型半胱氨酸）以及亚临床动脉粥样硬化指标。该研究纳入了一所大学医院收治的56例连续性慢性斑块型银屑病患者以及53例年龄和性别相匹配的健康对照者。采用酶联免疫吸附测定法（ELISA）检测血清sCD40L和同型半胱氨酸水平。通过超声检查测定颈动脉内膜中层厚度和肱动脉血流介导的血管舒张功能（FMD）。有心血管疾病病史、心血管危险因素且正在接受任何全身治疗的受试者被排除在研究之外。与健康对照者相比，银屑病患者的血浆sCD40L水平显著更高（1.33±0.72对0.98±0.70 ng/ml，P = 0.012），而两组间血浆同型半胱氨酸水平无显著差异。与对照组相比，银屑病组的FMD显著降低（3.83±5.03对8.45±7.27%，P = 0.0001）。多元线性回归分析表明银屑病、sCD40L和FMD之间存在显著关联。银屑病患者的sCD40L水平高于健康对照者，这可能导致心血管疾病增加。sCD40L可能是银屑病患者心血管事件更可靠的早期预测标志物。基于sCD40L开发的新治疗方案将有助于预防银屑病及其心血管合并症。
