Abstract
The association between psoriasis and cardiovascular disease risk has been supported by recent epidemiological data. Patients with psoriasis have an increased adjusted relative risk for myocardial infarction. As such, the cardiovascular risk conferred by severe psoriasis may be comparable to what is seen with other well-established risk factors, such as diabetes mellitus. Previous studies demonstrated that low-density lipoprotein (LDL) plays critical roles during atherogenesis. It may be caused by the accumulation of macrophages and lipoprotein in the vessel wall. Oxidized LDL (ox-LDL) stimulates the expression of adhesion molecules, such as ICAM-1 and VCAM-1, on endothelial cells and increases the attachment of mononuclear cells and the endothelium. Even though previous evidence demonstrated that psoriasis patients have tortuous and dilated blood vessels in the dermis, which results in the leakage of ox-LDL, the leaked ox-LDL may increase the expression of adhesion molecules and cytokines, and disturb the static balance of osmosis. Therefore, exploration of the relationship between hyperlipidemia and psoriasis may be another novel treatment option for psoriasis and may represent the most promising strategy.
Highlights
Psoriasis is a chronic inflammatory disease related to many diseases, especially cardiovascular disease
TNFα lowers the quality of lipoprotein by inducing the production of low-density lipoprotein (LDL) and Oxidized LDL (oxLDL) and reducing the level of high-density lipoprotein (HDL)-C at the same time [6]
Oxidized LDL exacerbates inflammation and promotes cholesterol accumulation in lysosomes, which eventually leads to cell death [7]
Summary
Psoriasis is a chronic inflammatory disease related to many diseases, especially cardiovascular disease. Psoriasis and atherosclerosis share the same cytokines involved in the immunological mechanism, such as interleukin (IL)-17, and have common angiogenic factors and oxidative pathways [2] Both of them have similar lipid profiles, including decreased high-density lipoprotein (HDL) levels and/or increased low-density lipoprotein (LDL) levels [3]. HDL has a reverse cholesterol transport (RCT) function, anti-oxidative capacity, and anti-inflammatory properties by regulating dendritic cells’ (DCs) differentiation [8], and reducing T cell activation and IL-12 production [9]. These properties are reduced during chronic inflammation, such as psoriasis [10]. Identification of the relationship between hyperlipidemia and psoriasis is of paramount importance to develop a new therapeutic prospect for psoriasis
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