Abramczyk Rachel, Queller Jenna N, Rachfal Amy W, Schwartz Stanley S
Main Line Health System, Wynnewood, PA, USA.
Private Practice, Boca Raton, FL, USA.
Diabetes Metab Syndr Obes. 2020 Oct 7;13:3571-3577. doi: 10.2147/DMSO.S273147. eCollection 2020.
Diabetes and psoriasis are prevalent conditions with a spectrum of serious adverse outcomes. Both diseases are common comorbidities for each other, and diabetes is considered as a risk factor for psoriasis and vice versa. However, it is our contention that these diseases are not merely comorbidities of each other but rather share common underlying pathophysiologies (ie, genes and epigenetic changes, inflammation, abnormal environment, and insulin resistance) that drive disease. As such, they can be viewed as facets of the same prism. Genes can cause or permit susceptibility to damage from abnormal external and internal environmental factors, inflammation, and insulin resistance which can also drive epigenetic changes. These co-existing mechanisms act in a vicious cycle over time to potentiate cell and tissue damage to ultimately drive disease. Viewing diabetes and psoriasis through the same prism suggests potential for therapies that could be used to treat both conditions. Although additional controlled trials and research are warranted, we believe that our understanding of the overlapping pathophysiologies continues to grow, so too will our therapeutic options.
糖尿病和银屑病是常见疾病,会产生一系列严重不良后果。这两种疾病互为常见的合并症,糖尿病被视为银屑病的一个风险因素,反之亦然。然而,我们认为这些疾病并非仅仅是彼此的合并症,而是具有共同的潜在病理生理学特征(即基因和表观遗传变化、炎症、异常环境以及胰岛素抵抗),这些因素驱动疾病发生。因此,它们可被视为同一棱镜的不同面。基因可导致或使人易受异常的外部和内部环境因素、炎症以及胰岛素抵抗的损害,而这些因素也可驱动表观遗传变化。随着时间的推移,这些共存机制会形成恶性循环,加剧细胞和组织损伤,最终导致疾病。从同一角度看待糖尿病和银屑病表明,有可能找到可用于治疗这两种疾病的疗法。尽管还需要更多对照试验和研究,但我们相信,随着我们对重叠病理生理学的理解不断深入,治疗选择也会不断增加。