Gyldenløve M, Jensen P, Løvendorf M B, Zachariae C, Hansen P R, Skov L
Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
J Eur Acad Dermatol Venereol. 2015 Mar;29(3):591-4. doi: 10.1111/jdv.12385. Epub 2014 Feb 21.
Psoriasis is associated with increased risk of cardiovascular disease (CVD), possibly due to chronic low-grade systemic inflammation. Systemic anti-inflammatory treatment might reduce the risk of CVD.
Our aim was to investigate if short-term treatment with methotrexate influences microvascular endothelial function (MEF), an early surrogate marker of atherosclerosis, in patients with psoriasis.
We prospectively studied a hospital cohort of patients with psoriasis. Measurements of MEF were performed with the Endo-PAT2000© device at baseline and after 8-10 weeks of treatment with methotrexate. At the same time points, we recorded anamnestic information, measured body mass index (BMI), waist and hip circumferences and blood pressure, and drew blood samples (lipid profile, HbA1 and hs-CRP). Psoriasis severity was evaluated by psoriasis area and severity index (PASI) and the dermatology life quality index (DLQI).
A total of 32 patients with psoriasis were included. Median age was 46 (range 18-82) years, and 50% were men. Twenty-seven patients completed the study. After 8-10 weeks, median PASI had decreased significantly by 6.2 (from 9.8 to 3.6), and DLQI had decreased by 7 (from 9 to 2). No significant changes were observed in MEF, expressed by reactive hyperaemia index and augmentation index. Also, we saw no significant changes in BMI, waist-hip ratio, blood pressure and blood samples.
Short-term treatment with methotrexate did not affect MEF in patients with psoriasis. Further studies are warranted.
银屑病与心血管疾病（CVD）风险增加相关，可能是由于慢性低度全身炎症。全身抗炎治疗可能会降低CVD风险。
我们的目的是研究甲氨蝶呤短期治疗是否会影响银屑病患者的微血管内皮功能（MEF），这是动脉粥样硬化的早期替代标志物。
我们对一组银屑病患者进行了前瞻性研究。在基线时以及使用甲氨蝶呤治疗8 - 10周后，使用Endo - PAT2000©设备测量MEF。在相同时间点，我们记录既往病史信息，测量体重指数（BMI）、腰围和臀围以及血压，并采集血样（血脂谱、糖化血红蛋白和高敏C反应蛋白）。通过银屑病面积和严重程度指数（PASI）以及皮肤病生活质量指数（DLQI）评估银屑病严重程度。
共纳入32例银屑病患者。中位年龄为46岁（范围18 - 82岁），50%为男性。27例患者完成了研究。8 - 10周后，中位PASI显著下降了6.2（从9.8降至3.6），DLQI下降了7（从9降至2）。以反应性充血指数和增强指数表示的MEF未观察到显著变化。此外，我们在BMI、腰臀比、血压和血样方面也未观察到显著变化。
甲氨蝶呤短期治疗对银屑病患者的MEF没有影响。有必要进行进一步研究。
