The effect of cigarette smoking on serum levels of regulatory cytokines and molecules involved in atherogenesis during systemic treatment of psoriasis – results of a preliminary study

Abstract

Introduction: Among the diseases associated with psoriasis linked to smoking are primarily cardiovascular diseases (including atherosclerosis) and metabolic syndrome. In addition, cigarette smoking also affects the effectiveness of systemic treatment of psoriasis. Aim: Assessment of the effect of cigarette smoking on biomarkers of atherosclerosis in patients with psoriasis treated with methotrexate and adalimumab. Material and methods: The serum levels of vascular cell adhesion molecule 1 (VCAM-1), E-selectin, oxidized low density lipoprotein (oxLDL) and anti-oxLDL antibodies, IL-10, IL-35, TGFß1, were assessed in 34 patients with psoriasis (15 smokers and 19 non-smokers), and 8 healthy, non-smoking volunteers. Results and discussion: Smoking patients had significantly higher body mass index, lower high density lipoprotein (HDL), higher risk of 10-year fatal cardiovascular disease, higher IL-10 levels and lower IL-35 levels at baseline compared to healthy, non-smoking volunteers. We observed decreases in IL-10, VCAM-1, E-selectin, and oxLDL levels during 12 weeks of methotrexate treatment and, a decrease in IL-35 during adalimumab treatment, based on enzyme-linked immunosorbent assays. Conclusions: Our results indicate the need for a holistic approach to psoriasis treatment that includes lifestyle modifications like smoking cessation to slow the development of atherosclerosis and increase the possibility of improving skin lesions.