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皮肤斑块之外:银屑病及其心血管合并症

Beyond the Skin Plaques: Psoriasis and Its Cardiovascular Comorbidities.

作者信息

Kakarala Chandra L, Hassan Mohammad, Belavadi Rishab, Gudigopuram Sri Vallabh Reddy, Raguthu Ciri C, Gajjela Harini, Kela Iljena, Sange Ibrahim

机构信息

Internal Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, IND.

Internal Medicine, Mohi-ud-Din Islamic Medical College, Mirpur, PAK.

出版信息

Cureus. 2021 Nov 17;13(11):e19679. doi: 10.7759/cureus.19679. eCollection 2021 Nov.

Abstract

Psoriasis, a widely prevalent chronic disease of the skin and joints, has long been associated with far-reaching systemic ramifications and decreased quality of life. However, psoriasis is largely underdiagnosed and insufficiently treated. Classical risk factors predisposing to cardiovascular diseases, such as hypertension, diabetes, metabolic syndrome, and dyslipidemia, have been noted in patients with mild and severe psoriasis. Furthermore, the magnitude of the cardiovascular comorbidity and the need to screen for risk factors has often been ignored while considering the management options for psoriasis. This article has reviewed the cardiovascular implications of psoriasis from the shared pathogenesis behind these two diseases to the increased incidence of cardiovascular events, such as myocardial infarction, stroke, and other causes of vascular mortality. Additionally, the therapeutic targets of common inflammatory pathways, such as those involving tumor necrosis factor α (TNF-α), interleukin-12/interleukin-23 (IL-12/IL-23), and helper T cells 17 (Th17), have been discussed with an emphasis on their efficacy in controlling psoriasis and its cardiovascular consequences.

摘要

银屑病是一种广泛流行的皮肤和关节慢性疾病,长期以来一直与深远的全身影响和生活质量下降相关。然而,银屑病在很大程度上存在诊断不足和治疗不充分的情况。轻度和重度银屑病患者中已发现易患心血管疾病的经典风险因素,如高血压、糖尿病、代谢综合征和血脂异常。此外,在考虑银屑病的管理方案时,心血管合并症的严重程度以及筛查风险因素的必要性常常被忽视。本文从这两种疾病背后的共同发病机制到心血管事件(如心肌梗死、中风和其他血管性死亡原因)发病率的增加,综述了银屑病对心血管的影响。此外,还讨论了常见炎症途径的治疗靶点,如涉及肿瘤坏死因子α(TNF-α)、白细胞介素-12/白细胞介素-23(IL-12/IL-23)和辅助性T细胞17(Th17)的途径,重点阐述了它们在控制银屑病及其心血管后果方面的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bef/8683276/ed06c0f5795d/cureus-0013-00000019679-i01.jpg

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