Severity of Psoriasis Associates with Aortic Vascular Inflammation Detected by FDG PET/CT and Neutrophil Activation in a Prospective Observational Study

Haley B. Naik, Balaji Natarajan, Elena Stansky, Mark A. Ahlman, Heather Teague, Taufiq Salahuddin, Qimin Ng, Aditya A. Joshi, Parasuram Krishnamoorthy, Jenny Dave, Shawn M. Rose, Julia Doveikis, Martin P. Playford, Ronald B. Prussick, Alison Ehrlich, Mariana J. Kaplan, Benjamin N. Lockshin, Joel M. Gelfand, Nehal N. Mehta

Research output: Contribution to journalArticlepeer-review

149 Scopus citations

Abstract

To understand whether directly measured psoriasis severity is associated with vascular inflammation assessed by 18F-fluorodeoxyglucose positron emission tomography computed tomography. Approach-In-depth cardiovascular and metabolic phenotyping was performed in adult psoriasis patients (n=60) and controls (n=20). Psoriasis severity was measured using psoriasis area severity index. Vascular inflammation was measured using average aortic target-to-background ratio using 18F-fluorodeoxyglucose positron emission tomography computed tomography. Results-Both the psoriasis patients (28 men and 32 women, mean age 47 years) and controls (13 men and 7 women, mean age 41 years) were young with low cardiovascular risk. Psoriasis area severity index scores (median 5.4; interquartile range 2.8-8.3) were consistent with mild-to-moderate skin disease severity. Increasing psoriasis area severity index score was associated with an increase in aortic target-to-background ratio (β=0.41, P=0.001), an association that changed little after adjustment for age, sex, and Framingham risk score. We observed evidence of increased neutrophil frequency (mean psoriasis, 3.7±1.2 versus 2.9±1.2; P=0.02) and activation by lower neutrophil surface CD16 and CD62L in blood. Serum levels of S100A8/A9 (745.1±53.3 versus 195.4±157.8 ng/mL; P<0.01) and neutrophil elastase-1 (43.0±2.4 versus 30.8±6.7 ng/mL; P<0.001) were elevated in psoriasis. Finally, S100A8/A9 protein was related to both psoriasis skin disease severity (β=0.53; P=0.02) and vascular inflammation (β=0.48; P=0.02). Conclusions-Psoriasis severity is associated with vascular inflammation beyond cardiovascular risk factors. Psoriasis increased neutrophil activation and neutrophil markers, and S100A8/A9 was related to both skin disease severity and vascular inflammation.

Original languageEnglish
Pages (from-to)2667-2676
Number of pages10
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Volume35
Issue number12
DOIs
StatePublished - 1 Dec 2015
Externally publishedYes

Keywords

  • CT
  • Inflammation
  • PET
  • neutrophils
  • psoriasis
  • vascular inflammation

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