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Valencia O, López C, Vanegas-Duarte E, Fillizola C, Bejarano Ramírez DF, Cortés Mejía NA, Vera Torres A. Risk Factors Related to the Development of Nonalcoholic Fatty Liver: A Systematic Review. Can J Gastroenterol Hepatol 2025; 2025:9964486. [PMID: 40264655 PMCID: PMC12014263 DOI: 10.1155/cjgh/9964486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Accepted: 12/05/2024] [Indexed: 04/24/2025] Open
Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) has a major impact on public health owing to its high morbidity and mortality due to its close relationship with several conditions, including metabolic syndrome, cirrhosis, and cancer. Therefore, this review aimed to systematically compile and summarize the scientific literature on early risk factors for NAFLD development. Methods: A systematic review of population-based cohort studies was conducted. Studies reporting the risk factors associated with nonalcoholic steatohepatitis (NASH) and NAFLD were screened. Results: The search yielded 987 unique records, of which 196 articles were selected after title and abstract screening. A total of 39 articles were read in full text after quality analysis using Downs and Black criteria; 10 of the studies were excluded due to heterogeneity or inconclusive results. Finally, 30 publications were included in this systematic review. The review revealed that clinical conditions such as obesity, weight change, psoriasis, polycystic ovary syndrome, diabetes, thyroid disorders, and elevated serum uric acid levels increase the risk of developing nonalcoholic fatty liver. In addition, lifestyle factors such as sedentary behavior, active or passive smoking, poor sleep quality, and consumption of carbonated beverages are associated with this condition. Conclusions: Evidence was found on the association between different clinical and lifestyle risk factors and NAFLD. This supports the need for preventive, diagnostic, and therapeutic strategies to improve the metabolic, hepatic, and oncological outcomes related to this condition.
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Affiliation(s)
- Omaira Valencia
- Population Health, Fundación Santa Fe de Bogota, Bogota, Colombia
| | - Carolina López
- Population Health, Fundación Santa Fe de Bogota, Bogota, Colombia
| | | | | | - Diana Fernanda Bejarano Ramírez
- Transplant and Hepatobiliary Surgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Epidemiology and Biostatistics Group, Graduate School of Epidemiology and Biostatistics, CES University, Medellín, Colombia
| | - Nicolás Andrés Cortés Mejía
- Division of Anesthesiology, Critical Care Medicine and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Alonso Vera Torres
- Transplant and Hepatobiliary Surgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
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Agoglia L, Peixoto H, Cardoso AC, Barbosa L, Victer CSXL, Carneiro S, Salles GF, Villela-Nogueira CA, Chindamo MC. Psoriasis and cardiovascular risk: associated and protective factors. An Bras Dermatol 2025:S0365-0596(25)00021-2. [PMID: 40082144 DOI: 10.1016/j.abd.2024.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 03/16/2025] Open
Abstract
BACKGROUND Psoriasis (Pso) is an inflammatory skin disease associated with Metabolic Syndrome (MetS), Steatotic Liver Disease (SLD) and cardiovascular risk. However, the effect of anti-inflammatory therapy on cardiovascular risk is uncertain. OBJECTIVES To determine the relationship between anti-inflammatory therapy and subclinical atherosclerosis in individuals with Pso, using the gold standard carotid-femoral Pulse Wave Velocity (cf-PWV) measurement. Additionally, to evaluate the association between cf-PWV, steatosis and Advanced Fibrosis (AF) using Transient Elastography (TE) by Fibroscan®. METHODS Cross-sectional study including Pso patients submitted to cf-PWV and TE. Steatosis was defined as a controlled attenuation parameter ≥ 275 dB/m, AF as liver stiffness measurement ≥ 10 kPa, and increased Aortic Stiffness (AoS) as cf-PWV ≥ 10 m/s. Significant cumulative methotrexate dose was ≥ 1500 mg (MTX1500). Logistic regression analysis evaluated the independent variables associated with increased AoS. RESULTS Eighty patients were included (mean age 56.2 ± 11.5-years, 57.5% female, BMI 28.6 ± 5.3 kg/m2). Prevalences of MetS, diabetes mellitus, dyslipidemia, systemic arterial hypertension, steatosis and AF were 57.5%, 40.0%, 67.5%, 70.0%, 50.0% and 16.3%, respectively. MTX1500 was present in 45%, immunobiological treatment in 33.8%, and cf-PWV ≥ 10 m/s in 21.2%. On logistic regression analysis, age was independently related to cf-PWV ≥ 10 m/s (OR = 1.21; 95% CI 1.06‒1.38; p = 0.003) and MTX1500 was a protective cardiovascular factor (OR = 0.18; 95% CI 0.038‒0.87; p = 0.033). No association was observed between steatosis, AF or immunobiological therapy and cf-PWV ≥10 m/s. STUDY LIMITATIONS Sample size. CONCLUSION In patients with Pso, increased AoS was associated with age, but not with steatosis or AF. A protective cardiovascular effect of MTX was found in a Pso population with a high prevalence of MetS and its components.
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Affiliation(s)
- Luciana Agoglia
- Department of Internal Medicine, Faculty of Medicine, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ Brazil; Section of Gastroenterology, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil.
| | - Helena Peixoto
- Department of Internal Medicine, Faculty of Medicine, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ Brazil
| | - Ana Carolina Cardoso
- Department of Internal Medicine, Faculty of Medicine, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ Brazil
| | - Lívia Barbosa
- Dermatology Division, Hospital Federal de Bonsucesso, Rio de Janeiro, RJ, Brazil
| | - Cecília S X L Victer
- Dermatology Unit, Faculty of Medicine, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Sueli Carneiro
- Dermatology Unit, Faculty of Medicine, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Gil F Salles
- Department of Internal Medicine, Faculty of Medicine, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ Brazil
| | - Cristiane A Villela-Nogueira
- Department of Internal Medicine, Faculty of Medicine, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ Brazil
| | - Maria Chiara Chindamo
- Department of Internal Medicine, Faculty of Medicine, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ Brazil
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Szczegielniak M, Lesiak A, Reich A, Opalińska A, Zakrzewski B, Arasiewicz H, Grabowski K, Nolberczak D, Narbutt J. Inflammation-Related Markers in Pediatric Psoriasis: Resistin as a Potential Marker of Psoriasis Severity. J Clin Med 2025; 14:1689. [PMID: 40095687 PMCID: PMC11900389 DOI: 10.3390/jcm14051689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2025] [Revised: 02/20/2025] [Accepted: 02/26/2025] [Indexed: 03/19/2025] Open
Abstract
Background/Objective: Psoriasis is a chronic inflammatory skin disease. Studies on adult population have confirmed that there is an association between psoriasis and metabolic as well as cardiovascular diseases. The aim of this study was to evaluate the inflammatory potential and the association of psoriasis with metabolic and cardiovascular risk by analyzing serum concentrations of homocysteine, adiponectin, resistin, leptin, and pentraxin 3 in pediatric patients with psoriasis. Additionally, the study explored correlations between these biomarkers and psoriasis severity. Methods: The study included 75 pediatric patients (47 girls and 28 boys) aged 2-17 years with clinically confirmed psoriasis. In addition, 28 healthy children (15 girls and 13 boys) without psoriasis, metabolic or inflammatory diseases made up the control group. Psoriasis severity was evaluated using the scales psoriasis area and severity index (PASI) and the body surface area (BSA). Serum concentrations of homocysteine, adiponectin, pentraxin 3, resistin, and leptin were measured in both groups. Results: Children with psoriasis exhibited higher serum levels of homocysteine, resistin, leptin, and pentraxin 3 and lower serum levels of adiponectin compared to the control group. A positive correlation was observed between resistin serum concentration and psoriasis severity. Elevated resistin levels were associated with higher PASI and BSA scores. Conclusions: Psoriasis is an inflammatory disease that is potentially linked to metabolic disorders. Resistin may serve as a biomarker for psoriasis severity; however, this relationship requires further research.
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Affiliation(s)
- Magdalena Szczegielniak
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, 90-419 Lodz, Poland; (A.L.); (K.G.); (D.N.); (J.N.)
| | - Aleksandra Lesiak
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, 90-419 Lodz, Poland; (A.L.); (K.G.); (D.N.); (J.N.)
| | - Adam Reich
- Department of Dermatology, Medical College of Rzeszow University, 35-055 Rzeszow, Poland; (A.R.); (A.O.)
| | - Aleksandra Opalińska
- Department of Dermatology, Medical College of Rzeszow University, 35-055 Rzeszow, Poland; (A.R.); (A.O.)
| | - Bartosz Zakrzewski
- Zakrzewscy Clinic of Aesthetic Medicine and Dermatology, 40-246 Katowice, Poland;
| | - Hubert Arasiewicz
- Department of Dermatology and Vascular Anomalies, John Paul II Centre of Pediatrics, 41-200 Sosnowiec, Poland;
| | - Kamil Grabowski
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, 90-419 Lodz, Poland; (A.L.); (K.G.); (D.N.); (J.N.)
| | - Daniel Nolberczak
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, 90-419 Lodz, Poland; (A.L.); (K.G.); (D.N.); (J.N.)
| | - Joanna Narbutt
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, 90-419 Lodz, Poland; (A.L.); (K.G.); (D.N.); (J.N.)
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Untaaveesup S, Kantagowit P, Ungprasert P, Kitlertbanchong N, Vajiraviroj T, Sutithavinkul T, Techataweewan G, Eiumtrakul W, Threethrong R, Chaemsupaphan T, Pratchyapruit W, Sriphrapradang C. The Risk of Metabolic Dysfunction-Associated Steatotic Liver Disease in Moderate-to-Severe Psoriasis: A Systematic Review and Meta-Analysis. J Clin Med 2025; 14:1374. [PMID: 40004904 PMCID: PMC11855964 DOI: 10.3390/jcm14041374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2025] [Revised: 02/16/2025] [Accepted: 02/17/2025] [Indexed: 02/27/2025] Open
Abstract
Background/Objectives: Psoriasis is a chronic immune-mediated skin disease associated with several metabolic comorbidities. Metabolic dysfunction-associated steatotic liver disease (MASLD) is also linked to psoriasis, but evidence regarding the severity of this association remains inconclusive. This meta-analysis aimed to investigate the relationship between MASLD and varying severities of psoriasis. Methods: We conducted an extensive search of four databases, MEDLINE, EMBASE, OSF, and ClinicalTrials.gov to identify relevant published articles assessing the risk of prevalent MASLD in patients with moderate-to-severe psoriasis up to April 2024. Effect estimates from each included study were combined together to calculate a pooled effect estimate for the meta-analysis using the generic inverse variance method of DerSimonian and Laird. Results: This meta-analysis included eight studies with a total of 109,806 participants. A 4.01-fold increased risk of prevalent MASLD was observed in patients with moderate-to-severe psoriasis compared to those without psoriasis (95% CI: 2.17, 7.77; I2 = 67%, p < 0.0001). The evidence supporting this outcome had low certainty. Conclusions: An incremental trend of MASLD was observed in patients with moderate-to-severe psoriasis. Routine screening for MASLD should be emphasized in this population.
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Affiliation(s)
| | | | - Patompong Ungprasert
- Department of Rheumatic and Immunologic Diseases, Cleveland Clinic Foundation, Cleveland, OH 44195, USA;
| | - Nitchanan Kitlertbanchong
- Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (N.K.); (T.S.)
| | - Tanyatorn Vajiraviroj
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (T.V.); (R.T.)
| | - Tanpichcha Sutithavinkul
- Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (N.K.); (T.S.)
| | - Gynna Techataweewan
- College of Integrative Medicine, Dhurakij Pundit University, Bangkok 10210, Thailand;
| | - Wongsathorn Eiumtrakul
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand;
| | - Rinrada Threethrong
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (T.V.); (R.T.)
| | - Thanaboon Chaemsupaphan
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | | | - Chutintorn Sriphrapradang
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand;
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Morita T, Ichiyama S, Ito M, Ozaki S, Arai T, Atsukawa M, Iwakiri K, Hagino T, Hoashi T, Kanda N, Saeki H. Effects of Biologics on Fibrosis-4 Index in Patients with Psoriasis. J NIPPON MED SCH 2025; 92:88-96. [PMID: 40058840 DOI: 10.1272/jnms.jnms.2025_92-114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2025]
Abstract
BACKGROUND Psoriasis is accompanied by systemic inflammation that includes the liver. The fibrosis-4 (FIB-4) index was developed to predict significant liver fibrosis. The present study evaluated the effects of biologics, including TNF inhibitors, on the FIB-4 index in psoriasis patients. METHODS All adult patients with psoriasis who were prescribed biologics (TNF inhibitors, IL-17 inhibitors, or IL-23 inhibitors) at Nippon Medical School from June 2014 to January 2024 for the first time (biologic-naïve patients) were included in this study. The FIB-4 index was calculated before and after 6 months of treatment with biologics. RESULTS A total of 105 patients were enrolled. The FIB-4 index was higher after 6 months of treatment with TNF inhibitors (P=0.0018) and IL-17 inhibitors (P=0.045) but did not change with IL-23 inhibitors. Aspartate aminotransferase and alanine aminotransferase levels did not change after treatment with TNF inhibitors, IL-17 inhibitors, or IL-23 inhibitors. Platelet count decreased after treatment with TNF inhibitors (P=0.0011) and IL-23 inhibitors (P=0.039) but did not change with IL-17 inhibitors. CONCLUSIONS Downregulation of platelets seems to be a major contributing factor for the increase in FIB-4 index in patients treated with TNF inhibitors. Although the FIB-4 index is a simple marker to screen for liver fibrosis, changes in this index should be interpreted with caution, and imaging findings such as transient elastography should also be used to evaluate the status of liver fibrosis.
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Affiliation(s)
- Takashi Morita
- Department of Dermatology, Nippon Medical School Tama Nagayama Hospital
| | | | - Michiko Ito
- Department of Dermatology, Nippon Medical School
| | - Saeko Ozaki
- Department of Dermatology, Nippon Medical School
| | - Taeang Arai
- Department of Gastroenterology and Hepatology, Nippon Medical School
| | - Masanori Atsukawa
- Department of Gastroenterology and Hepatology, Nippon Medical School
| | - Katsuhiko Iwakiri
- Department of Gastroenterology and Hepatology, Nippon Medical School
| | - Teppei Hagino
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital
| | | | - Naoko Kanda
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital
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Cao L, Lu L, Yu Y, Zhou H, Lin B. Clinical characteristics of patients with a family history of psoriasis: an observational epidemiological study in Chinese Han population. Front Med (Lausanne) 2024; 11:1455953. [PMID: 39219794 PMCID: PMC11362089 DOI: 10.3389/fmed.2024.1455953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction Psoriasis, a chronic inflammatory skin disease, is believed to be influenced by both genetic and environmental factors. Despite this understanding, the clinical epidemiological status of psoriasis patients with a family history of the disease remains uncertain. Methods In this study, we participated in a multicenter observational epidemiological study involved over 1,000 hospitals and enrolled a total of 5,927 psoriasis patients. These patients were categorized into two groups based on the presence or absence of a family history of psoriasis: family history cases (896) and sporadic cases (5,031). The clinical manifestations of these two groups were analyzed through clinical classification, comorbidities, treatment response, and other relevant factors. Results The findings of our study indicate that individuals with a family history of psoriasis predisposition exhibit a notably elevated prevalence of psoriatic arthritis compared to those with sporadic occurrences. Moreover, patients with a family history of psoriasis display a more rapid and efficacious response to secukinumab. Additionally, individuals with moderate to severe psoriasis are at a heightened risk of developing cardiovascular and liver diseases in comparison to those with mild psoriasis, with no discernible impact of familial history on the likelihood of comorbidities. Discussion Our study identified the clinical characteristics of individuals with a familial predisposition to psoriasis, offering novel insights into the management and therapeutic approaches for patients with this condition.
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Affiliation(s)
- Lu Cao
- Department of Dermatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Lingyi Lu
- Department of Dermatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Yingzhe Yu
- Department of Dermatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Huiying Zhou
- National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
- School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Bingjiang Lin
- Department of Dermatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
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7
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Lebwohl M, Merola JF, Strober B, Armstrong A, Yoshizaki A, Gisondi P, Szilagyi B, Peterson L, de Cuyper D, Cross N, Davies O, Gottlieb AB. Bimekizumab safety in moderate to severe plaque psoriasis: Rates of hepatic events and changes in liver parameters over 2 years in randomized phase 3/3b trials. J Am Acad Dermatol 2024; 91:281-289. [PMID: 38588819 DOI: 10.1016/j.jaad.2024.03.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/23/2024] [Accepted: 03/12/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Patients with psoriasis are at increased risk of liver function abnormalities. OBJECTIVE Explore rates of hepatic treatment-emergent adverse events (TEAEs) and changes in liver parameters in bimekizumab-treated patients with psoriasis. METHODS Data are reported from 5 phase 3/3b trials over 2 years. Hepatic TEAEs, laboratory elevations in alanine aminotransferase (ALT) or aspartate aminotransferase (AST), and changes in clinical markers of liver fibrosis (Fibrosis-4 [FIB-4] Index and AST to Platelet Ratio Index [APRI]) are reported. TEAEs are presented using exposure-adjusted incidence rates (EAIRs) per 100 patient-years (PY). RESULTS 2186 patients received ≥1 bimekizumab dose. Over 2 years, the EAIR of hepatic TEAEs was 3.5/100 PY and did not increase from first to second year. 2-year EAIRs of ALT/AST elevations >3x and >5x the upper limit of normal were 2.3 and 0.6/100 PY; rates were similar to placebo, adalimumab, secukinumab, and ustekinumab during controlled study periods. FIB-4 and APRI scores did not increase through 2 years, regardless of fibrosis risk at baseline. LIMITATIONS Obesity, diabetes, dyslipidemia, chronic alcohol consumption, and medication changes are confounding factors for hepatic dysfunction. CONCLUSION Rates of hepatic adverse events (AEs) with bimekizumab were consistent through 2 years; incidences of transaminase elevations were similar to comparators during phase 3/3b controlled study periods.
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Affiliation(s)
- Mark Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Joseph F Merola
- Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts
| | - Bruce Strober
- Department of Dermatology, Yale University, New Haven, Connecticut; Central Connecticut Dermatology Research, Cromwell, Connecticut
| | - April Armstrong
- University of California Los Angeles (UCLA), Los Angeles, California
| | - Ayumi Yoshizaki
- Department of Dermatology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan; Department of Clinical Cannabinoid Research, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | | | | | | | | | | | - Alice B Gottlieb
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
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Bouare N, Delwaide J. Interleukin-mediated therapies in liver diseases and comorbidity effects. World J Hepatol 2024; 16:980-989. [PMID: 39086534 PMCID: PMC11287617 DOI: 10.4254/wjh.v16.i7.980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 07/26/2024] Open
Abstract
Cytokines like interleukins (ILs) play important roles in inflammation and innate immune. Yang and Zhang carried out an interesting study related to ILs and hepatic diseases. They described the role of ILs in the pathogenesis and resolution of hepatic disorders. The authors summarized alcohol-related liver disease and virus-induced hepatitis, as far as clinical studies a fortiori carried out on IL-mediated treatments pertaining to these dysfunctions. This editorial contributes to the review by Yang and Zhang titled, "Interleukins in liver disease treatment", and focuses on therapies mediated by ILs in comorbid liver diseases. The documentary search was conducted on recent pertinent literature, primarily using the Google Scholar and PubMed databases.
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Affiliation(s)
- Nouhoum Bouare
- Department of Quality, Hygien, Biosafety/Biosecurity and Pharmacovigilence, National Institute of Public Health, Bamako 1771, Mali.
| | - Jean Delwaide
- Department of Gastroenterology and Hepatology, CHULiege, Liege 4000, Belgium
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Babakinejad P, Lapsley R, Forster L, McPherson S, Pearce MS, Reynolds NJ, Slack E, Weatherhead SC, Hampton PJ. Cumulative methotrexate dose is not associated with liver fibrosis in patients with a history of moderate-to-severe psoriasis. Br J Dermatol 2024; 191:275-283. [PMID: 38366967 DOI: 10.1093/bjd/ljae069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 02/11/2024] [Accepted: 02/14/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND There are established risk factors for liver fibrosis (LF), but data on the impact of methotrexate on LF in patients with psoriasis are lacking. OBJECTIVES This cross-sectional study aimed to determine the prevalence of LF in patients with psoriasis and to evaluate the relationship between LF, cumulative methotrexate dose and other LF risk factors. METHODS Adults with a history of moderate-to-severe chronic plaque psoriasis were recruited between June 2020 and March 2021. Patients underwent transient elastography to evaluate LF. Three values for liver stiffness measurement (LSM) were assessed, indicating mild or worse LF (≥ 7 kPa), moderate or worse LF (≥ 7.9 kPa) and advanced LF (≥ 9.5kPa). Cumulative methotrexate dose and other potential risk factors for LF were assessed. RESULTS Overall, 240 patients were recruited and 204 participants with valid LSM values were included in the analysis [median age 48 years [interquartile range (IQR) 37-57]; 51% female sex; 56% body mass index (BMI) ≥ 30 (kg m-2) and a median Alcohol Use Disorders Identification Test (AUDIT) score of 4 (IQR 1-7, 23% score ≥ 8)]. In total, 91% had received methotrexate [median duration 36 months (IQR 14-78)]. Prevalence of LF was 36%, 25% and 17% using LSM ≥ 7 kPa, ≥ 7.9 kPa and ≥ 9.5 kPa, respectively. There was no association between cumulative methotrexate dose [median 2.16 (IQR 0.93-5.2)] and continuous LSM values [unstandardized coefficient 0.16, 95% confidence interval (CI) -0.49 to 0.82, P = 0.626] or using the categorical LSM cutoff values: ≥ 7 kPa [unadjusted odds ratio 1.06 (95% CI 0.97-1.15), P = 0.192], ≥ 7.9 kPa [unadjusted odds ratio 1.03 (95% CI 0.94-1.12), P = 0.577] and ≥ 9.5 kPa (unadjusted odds ratio 1.01, 95% CI 0.91-1.12; P = 0.843). The following risk factors were associated with higher LSM values: BMI (P ≤ 0.001), waist circumference (P ≤ 0.001), metabolic syndrome (P ≤ 0.001), AUDIT score (P = 0.020) and FIB-4 score (P = 0.03). BMI ≥ 28, diabetes and metabolic syndrome were shown to be better predictors of LF compared with FIB-4 score. CONCLUSIONS This study confirms a high prevalence of significant LF in patients with psoriasis. Cumulative methotrexate dose was not associated with LF. Patients with BMI ≥ 28, metabolic syndrome and diabetes are at higher risk for LF. These risk factors may help to identify when a more detailed liver health assessment is needed.
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Affiliation(s)
| | | | - Lara Forster
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Stuart McPherson
- Liver unit, Freeman Hospital, Newcastle upon Tyne, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Newcastle Biomedical Research Centre (BRC), Newcastle upon Tyne, UK
| | - Mark S Pearce
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nick J Reynolds
- Royal Victoria Infirmary, Newcastle upon Tyne, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Newcastle Biomedical Research Centre (BRC), Newcastle upon Tyne, UK
| | - Emma Slack
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Philip J Hampton
- Royal Victoria Infirmary, Newcastle upon Tyne, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Newcastle Biomedical Research Centre (BRC), Newcastle upon Tyne, UK
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Agoglia L, Cardoso AC, Barbosa L, Victer CSXL, Carneiro S, de França PHC, Chindamo MC, Villela-Nogueira CA. Psoriasis and steatotic liver disease: Are PNPLA3 and TM6SF2 polymorphisms suitable for the hepato-dermal axis hypothesis? Ann Hepatol 2024; 29:101477. [PMID: 38360269 DOI: 10.1016/j.aohep.2024.101477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/29/2024] [Accepted: 02/04/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION AND OBJECTIVES A high prevalence of steatotic liver disease has been described in psoriasis. However, the influence of genetic polymorphisms has yet to be investigated in this scenario. This study aims to determine the frequency of steatosis, advanced liver fibrosis and PNPLA3/TM6SF2 genotypes in individuals with psoriasis and to evaluate the impact of genetic polymorphisms, metabolic parameters and cumulative methotrexate dose on steatosis and fibrosis. MATERIALS AND METHODS Cross-sectional study that prospectively included psoriasis outpatients, submitted to clinical and laboratory analysis, transient elastography (FibroScan®, Fr) and PNPLA3/TM6SF2 genotyping. Steatosis was defined by CAP ≥275 dB/m and advanced liver fibrosis as transient elastography ≥10 kPa. Logistic regression analysis evaluated the independent variables related to steatosis and fibrosis; p-value< 0.05 was considered significant. RESULTS One hundred and ninety-nine patients were enrolled (age 54.6 ± 12.6 years, 57.3% female). Metabolic syndrome (MetS), steatosis and advanced liver fibrosis prevalence were 55.8%, 54.8% and 9%, respectively. PNPLA3 and TM6SF2 genotypes frequencies were CC 42.3%/CG 49.5%/GG 8.2% and CC 88.7%/ CT 11.3%/ TT 0%. MetS (OR3.01 95%CI 1.51-5.98; p = 0.002) and body mass index (OR1.17 95%CI 1.08-1.26; p < 0.01) were independently associated with steatosis. Diabetes Mellitus (T2DM) (OR10.76 95%CI 2.42-47.87; p = 0.002) and harboring at least one PNPLA3 G allele (OR5.66 95%CI 1.08-29.52; p = 0.039) were associated with advanced fibrosis, but not TM6SF2 polymorphism or cumulative MTX dose. CONCLUSIONS MetS and T2DM confer higher odds for steatosis and advanced fibrosis in individuals with psoriasis. PNPLA3 G allele, but not TM6SF2 polymorphism, impacts a 5-fold odds of advanced liver fibrosis.
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Affiliation(s)
- Luciana Agoglia
- School of Medicine and Hepatology Unit, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Brazil; Section of Gastroenterology, Hospital Universitário Antônio Pedro, Federal University Fluminense, Niterói, Brazil.
| | - Ana Carolina Cardoso
- School of Medicine and Hepatology Unit, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Brazil
| | - Lívia Barbosa
- Dermatology Division, Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil
| | | | - Sueli Carneiro
- School of Medicine and Dermatology Unit, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Brazil
| | | | - Maria Chiara Chindamo
- School of Medicine and Hepatology Unit, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Brazil
| | - Cristiane Alves Villela-Nogueira
- School of Medicine and Hepatology Unit, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Brazil
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Tabak GH, Akdoğan N, Günaydın SD, Parlar YE, Balaban HY, Şimşek H. Evaluation of risk for hepatitis B virus reactivation in patients with psoriasis treated with biologic therapies: a single-center retrospective study. Arch Dermatol Res 2024; 316:163. [PMID: 38734770 DOI: 10.1007/s00403-024-02918-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/19/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024]
Affiliation(s)
- Gülsün Hazan Tabak
- Dermatology and Venereology Clinic, Ankara Sincan Training and Research Hospital, Ankara, Turkey.
| | - Neslihan Akdoğan
- Department of Dermatology and Venereology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Sibel Doğan Günaydın
- Department of Dermatology and Venereology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Yavuz Emre Parlar
- Department of Gastroenterology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Hatice Yasemin Balaban
- Department of Gastroenterology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Halis Şimşek
- Department of Gastroenterology, School of Medicine, Hacettepe University, Ankara, Turkey
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HU J, Shao Y, Gui C, Xiao Y, Li L, Li Z. Prevalence and risk of nonalcoholic fatty liver disease among adult psoriatic patients: A systematic review, meta-analysis, and trial sequential analysis. Medicine (Baltimore) 2024; 103:e38007. [PMID: 38701269 PMCID: PMC11062682 DOI: 10.1097/md.0000000000038007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND This systematic review and meta-analysis aimed to report the evaluation of the prevalence and risk of nonalcoholic fatty liver disease (NAFLD) among adult psoriatic patients in a systematic review and meta-analysis. METHODS A comprehensive search was conducted across 4 databases of PubMed, Scopus, Cochrane Library, and Web of Science to collect relevant studies until November 30, 2023, without any restrictions for finding observational studies. The comprehensive meta-analysis version 3.0 software was used to calculate effect sizes, showing the event rate (ER), odds ratio (OR), and a 95% confidence interval (CI) to evaluate NAFLD risk or prevalence in psoriatic patients and controls or psoriatic patients alone. The quality scoring was performed by 1 author based on the Newcastle-Ottawa Scale tool. Publication bias, meta-regression analysis, and sensitivity analyses were performed. Additionally, Trial Sequential Analysis (TSA) was performed using TSA software. RESULTS A total of 581 records were identified among the databases and electronic sources. At last, 41 studies involving 607,781 individuals were included in the meta-analysis. The pooled ER of NAFLD among psoriatic patients was 29.5% (95%CI: 19.6%-41.7%) and I2 = 99.79%. The pooled OR of NAFLD in psoriatic patients compared to controls was 1.685 (95%CI: 1.382-2.055; P < .001) and I2 = 87.96%. CONCLUSIONS The study found a significant link between psoriasis and NAFLD, with psoriatic patients having a higher chance of developing NAFLD compared to the controls. The study calls for regular NAFLD screening in psoriatic patients to prevent liver complications.
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Affiliation(s)
- Jie HU
- Thoracic Oncology, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - YaQiong Shao
- Department of Integrated Traditional Chinese and Western Medicine, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan City, Hubei Province, China
| | - Cheng Gui
- Department of Integrated Traditional Chinese and Western Medicine, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan City, Hubei Province, China
| | - Yihui Xiao
- Department of Integrated Traditional Chinese and Western Medicine, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan City, Hubei Province, China
| | - Lixia Li
- Department of Integrated Traditional Chinese and Western Medicine, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan City, Hubei Province, China
| | - Zheng Li
- Department of Integrated Traditional Chinese and Western Medicine, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan City, Hubei Province, China
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Dhaher SA, Hilfi NZ, Abdullah MA. Non-alcoholic Fatty Liver Disease Among Iraqi Patients With Psoriasis: A Case-Control Study. Cureus 2024; 16:e57487. [PMID: 38707119 PMCID: PMC11066695 DOI: 10.7759/cureus.57487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide. Several studies have shown that patients with psoriasis have a higher risk of developing NAFLD. Obesity, metabolic syndrome, and cytokine-mediated inflammation might be the link between psoriasis and NAFLD. AIMS This study aims to investigate the prevalence of NAFLD among psoriatic Iraqi patients and examine the relationship with disease severity using the Psoriasis Area and Severity Index (PASI) score and the correlation with different clinical and laboratory parameters. SUBJECTS AND METHODS A case-control study on 130 psoriatic patients and 130 age-, sex-, and BMI-matched healthy controls was conducted at the Department of Dermatology in Basra Teaching Hospital from November 2022 to October 2023. All demographic and clinical data were collected using a pre-designed questionnaire, and NAFLD was diagnosed through a FibroScan examination performed on each participant. The severity of psoriasis was determined using the PASI score. Fasting glucose, liver enzymes, and lipid profile levels were investigated, and metabolic syndrome was identified. RESULTS The prevalence of NAFLD was significantly higher in our psoriatic patients than in the control group (66.2% vs. 42.3%, OR=2.6, P<0.01). Psoriatic patients were found to have more severe NAFLD than the controls, as evidenced by their steatosis and fibrosis staging (P<0.01). In patients with psoriasis, NAFLD was associated with a higher prevalence of diabetes (17.4%) and metabolic syndrome (55.8%). Furthermore, psoriatic patients with NAFLD had significantly higher values of BMI, waist circumference, PASI score, as well as serum alanine transaminase (ALT), triglyceride, cholesterol, low-density lipoprotein (LDL), and fasting glucose levels. The study also found a significant positive correlation between the psoriasis severity based on PASI and the steatosis score. Metabolic syndrome, PASI, BMI, serum triglycerides, LDL, and age are the independent predictors of NAFLD. CONCLUSIONS NAFLD is highly prevalent among psoriatic patients affecting more than half of them and closely associated with metabolic syndrome and severity of psoriasis. Routine screening for NAFLD may be necessary in psoriatic patients particularly when considering the use of hepatotoxic drug therapy.
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Affiliation(s)
- Samer A Dhaher
- Dermatology, College of Medicine, University of Basrah, Basrah, IRQ
| | - Noora Z Hilfi
- Dermatology, College of Medicine, University of Basrah, Basrah, IRQ
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Livzan MA, Gaus OV, Ekimov IN. Non-alcoholic fatty liver disease and psoriasis: mechanisms of comorbidity and approaches to therapy. MEDITSINSKIY SOVET = MEDICAL COUNCIL 2024:113-120. [DOI: 10.21518/ms2024-045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2024]
Abstract
Psoriasis is a chronic immune-mediated skin disease of a multifactorial nature, characterized by accelerated proliferation of keratinocytes and impaired differentiation, an imbalance between pro-inflammatory and anti-inflammatory cytokines, with frequent involvement of the musculoskeletal system in the pathological process. The etiology of psoriasis is unknown, but several risk factors have been identified, including family history, smoking and obesity. The high prevalence of obesity, diseases of the cardiovascular system and digestive organs in patients with psoriasis allows us to consider it as an indicator of the patient’s metabolic disorders. In the structure of comorbidity of patients with psoriasis, special attention is drawn to non-alcoholic fatty liver disease (NAFLD), which occupies a leading position in the structure of the incidence of chronic diffuse liver diseases among the adult population in many countries of the world, including Russia. Patients with psoriasis are more often diagnosed with NAFLD, regardless of the presence of metabolic syndrome and other traditional risk factors. The presence of NAFLD is associated with more severe psoriasis and worse outcomes. On the other hand, a negative effect of psoriasis on the course of liver pathology has been noted. In this regard, it seems particularly relevant to study the etiological factors and pathogenetic links underlying this comorbidity, as potential targets for targeted therapy, which can improve the effectiveness of treatment for this cohort of patients. The purpose of this review publication is to summarize and systematize the available data on the prevalence of comorbidity of psoriasis and NAFLD in the population, the mechanisms of its formation and approaches to patient management.
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Costache DO, Blejan H, Cojocaru DL, Ioniță GA, Poenaru M, Constantin MM, Costache AC, Căruntu C, Balaban DV, Costache RS. Intersecting Pathways: Nonalcoholic Fatty Liver Disease and Psoriasis Duet-A Comprehensive Review. Int J Mol Sci 2024; 25:2660. [PMID: 38473907 PMCID: PMC10932248 DOI: 10.3390/ijms25052660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/17/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
Psoriasis is a chronic, immune-mediated, inflammatory disease that has a major impact on patients' quality of life. Common psoriasis-associated comorbidities include cardiovascular diseases, psoriatic arthritis, inflammatory bowel syndromes, type-2 diabetes, and metabolic syndrome. Nonalcoholic fatty liver disease (NAFLD) is affecting a substantial portion of the population and is closely linked with psoriasis. The interplay involves low-grade chronic inflammation, insulin resistance, and genetic factors. The review presents the pathophysiological connections between psoriasis and nonalcoholic fatty liver disease, emphasizing the role of cytokines, adipokines, and inflammatory cascades. The "hepato-dermal axis" is introduced, highlighting how psoriatic inflammation potentiates hepatic inflammation and vice versa. According to the new guidelines, the preliminary examination for individuals with psoriasis should encompass evaluations of transaminase levels and ultrasound scans as part of the initial assessment for this cohort. Considering the interplay, recent guidelines recommend screening for NAFLD in moderate-to-severe psoriasis cases. Treatment implications arise, particularly with medications impacting liver function. Understanding the intricate relationship between psoriasis and NAFLD provides valuable insights into shared pathogenetic mechanisms. This knowledge has significant clinical implications, guiding screening practices, treatment decisions, and the development of future therapeutic approaches for these chronic conditions.
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Affiliation(s)
- Daniel Octavian Costache
- Discipline of Dermatology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (D.O.C.); (M.M.C.)
- Dermatology Department, Carol Davila Central Emergency Military University Hospital, 010825 Bucharest, Romania; (H.B.); (M.P.)
| | - Horia Blejan
- Dermatology Department, Carol Davila Central Emergency Military University Hospital, 010825 Bucharest, Romania; (H.B.); (M.P.)
| | - Damian Lucian Cojocaru
- Gastroenterology Department, Carol Davila Central Emergency Military University Hospital, 010825 Bucharest, Romania; (D.L.C.); (G.A.I.); (D.V.B.); (R.S.C.)
| | - Georgiana Alexandra Ioniță
- Gastroenterology Department, Carol Davila Central Emergency Military University Hospital, 010825 Bucharest, Romania; (D.L.C.); (G.A.I.); (D.V.B.); (R.S.C.)
| | - Marcela Poenaru
- Dermatology Department, Carol Davila Central Emergency Military University Hospital, 010825 Bucharest, Romania; (H.B.); (M.P.)
| | - Maria Magdalena Constantin
- Discipline of Dermatology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (D.O.C.); (M.M.C.)
- 2nd Dermatology Department, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Andrei Cătălin Costache
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Constantin Căruntu
- Discipline of Internal Medicine and Gastroenterology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Daniel Vasile Balaban
- Gastroenterology Department, Carol Davila Central Emergency Military University Hospital, 010825 Bucharest, Romania; (D.L.C.); (G.A.I.); (D.V.B.); (R.S.C.)
- Discipline of Physiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Raluca Simona Costache
- Gastroenterology Department, Carol Davila Central Emergency Military University Hospital, 010825 Bucharest, Romania; (D.L.C.); (G.A.I.); (D.V.B.); (R.S.C.)
- Discipline of Physiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Academy of Romanian Scientists, 050091 Bucharest, Romania
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Tang ZJ, Yang JR, Yu CL, Dong MH, Wang R, Li CX. A Bibliometric Analysis of Global Research Trends in Psoriasis and Metabolic Syndrome. Clin Cosmet Investig Dermatol 2024; 17:365-382. [PMID: 38352064 PMCID: PMC10863501 DOI: 10.2147/ccid.s446966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/22/2024] [Indexed: 02/16/2024]
Abstract
Background Psoriasis is a frequent form of chronic inflammation in dermatology that is unmistakably linked to the metabolic syndrome (MetS) and its elements. This study was to explore the current status and new developments in the global research, and the holistic landscape of this field more intuitively through bibliometric analysis of scientific output and activity. Methods Publications regarding psoriasis and MetS were searched and chosen from the database of the Web of Science Core Collection. Excel 2019, VOSviewer, and CiteSpace software were utilized to conduct bibliometric analysis. Results There were 1096 publications included. The scientific outputs in this field had increased from 2004 to 2022, and the expansion could continue in the following years. The United States contributed the most publications (241, 21.99%) and had the most citation frequency (13,489 times). The University of California System was the most productive affiliation. Girolomoni G., Armstrong A.W., Gisondi P. and Gelfand J.M. were key and influential researchers. Journal of the European Academy of Dermatology and Venereology published the greatest number of articles (65 articles). By analyzing keyword frequency and clustering, we have identified the following areas of research interest and frontiers: prevalence, risk, association, gene expression, waist circumference, adipose tissue inflammation, vascular inflammation, cardiovascular disease, psoriatic arthritis, and fibrosis. Conclusion This bibliometric analysis elucidates research domain of psoriasis and MetS, portraying present hotspots and future emerging trends. This field has generated significant interest and displays potential for further growth. The United States has made distinguished contributions, and currently dominates this field.
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Affiliation(s)
- Zi-Jie Tang
- Graduate School, Medical School of Chinese People’s Liberation Army (PLA), Beijing, 100853, People’s Republic of China
- Department of Dermatology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China
| | - Jing-Run Yang
- Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China
| | - Chong-Li Yu
- Department of Dermatology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China
| | - Mei-Han Dong
- Graduate School, Medical School of Chinese People’s Liberation Army (PLA), Beijing, 100853, People’s Republic of China
- Department of Dermatology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China
| | - Rui Wang
- Department of Dermatology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China
| | - Cheng-Xin Li
- Graduate School, Medical School of Chinese People’s Liberation Army (PLA), Beijing, 100853, People’s Republic of China
- Department of Dermatology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China
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Ichiyama S, Ito M, Ozaki S, Arai T, Atsukawa M, Iwakiri K, Hagino T, Hoashi T, Kanda N, Saeki H. Real-World Screening Data for Liver Fibrosis in Psoriasis Patients Treated with Biologics. J NIPPON MED SCH 2024; 91:534-540. [PMID: 39756942 DOI: 10.1272/jnms.jnms.2024_91-613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2025]
Abstract
BACKGROUND Metabolic dysfunction-associated steatotic liver disease (MASLD) is positively associated with the prevalence and severity of psoriasis. The fibrosis-4 (FIB-4) index was developed to predict significant liver fibrosis. Using the FIB-4 index, the present study evaluated screening data for liver fibrosis, including MASLD, in patients with refractory psoriasis treated with biologics. METHODS All adult patients with psoriasis who were prescribed biologics at Nippon Medical School from August 2023 to May 2024 were included in this study. The FIB-4 index was classified as high (≥2.67), intermediate (1.30-2.66), and low (<1.30). Patients younger than 65 years were referred to a hepatologist if the FIB-4 index was high. If the score was intermediate, type IV collagen 7S (4COL7S) was checked, and they were referred to a hepatologist if it was ≥4.8 ng/mL. Patients aged ≥65 years were referred to a hepatologist if the FIB-4 index was high. If it was 2.00-2.66, they were referred to a hepatologist if the 4COL7S level was ≥4.8 ng/mL. RESULTS Data from 96 patients were analyzed. The FIB-4 index was high in 10 patients, intermediate in 35 patients, and low in 51 patients. Eleven of 96 registered patients were newly referred to a hepatologist. Of these 11 patients, 5 received lifestyle guidance. CONCLUSIONS For patients with refractory psoriasis, close cooperation between dermatologists and hepatologists is essential to prevent progression of liver fibrosis.
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Affiliation(s)
| | - Michiko Ito
- Department of Dermatology, Nippon Medical School
| | - Saeko Ozaki
- Department of Dermatology, Nippon Medical School
| | - Taeang Arai
- Department of Gastroenterology and Hepatology, Nippon Medical School
| | - Masanori Atsukawa
- Department of Gastroenterology and Hepatology, Nippon Medical School
| | - Katsuhiko Iwakiri
- Department of Gastroenterology and Hepatology, Nippon Medical School
| | - Teppei Hagino
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital
| | | | - Naoko Kanda
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital
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Zhang Y, Fang XM. The pan-liver network theory: From traditional chinese medicine to western medicine. CHINESE J PHYSIOL 2023; 66:401-436. [PMID: 38149555 DOI: 10.4103/cjop.cjop-d-22-00131] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023] Open
Abstract
In traditional Chinese medicine (TCM), the liver is the "general organ" that is responsible for governing/maintaining the free flow of qi over the entire body and storing blood. According to the classic five elements theory, zang-xiang theory, yin-yang theory, meridians and collaterals theory, and the five-viscera correlation theory, the liver has essential relationships with many extrahepatic organs or tissues, such as the mother-child relationships between the liver and the heart, and the yin-yang and exterior-interior relationships between the liver and the gallbladder. The influences of the liver to the extrahepatic organs or tissues have been well-established when treating the extrahepatic diseases from the perspective of modulating the liver by using the ancient classic prescriptions of TCM and the acupuncture and moxibustion. In modern medicine, as the largest solid organ in the human body, the liver has the typical functions of filtration and storage of blood; metabolism of carbohydrates, fats, proteins, hormones, and foreign chemicals; formation of bile; storage of vitamins and iron; and formation of coagulation factors. The liver also has essential endocrine function, and acts as an immunological organ due to containing the resident immune cells. In the perspective of modern human anatomy, physiology, and pathophysiology, the liver has the organ interactions with the extrahepatic organs or tissues, for example, the gut, pancreas, adipose, skeletal muscle, heart, lung, kidney, brain, spleen, eyes, skin, bone, and sexual organs, through the circulation (including hemodynamics, redox signals, hepatokines, metabolites, and the translocation of microbiota or its products, such as endotoxins), the neural signals, or other forms of pathogenic factors, under normal or diseases status. The organ interactions centered on the liver not only influence the homeostasis of these indicated organs or tissues, but also contribute to the pathogenesis of cardiometabolic diseases (including obesity, type 2 diabetes mellitus, metabolic [dysfunction]-associated fatty liver diseases, and cardio-cerebrovascular diseases), pulmonary diseases, hyperuricemia and gout, chronic kidney disease, and male and female sexual dysfunction. Therefore, based on TCM and modern medicine, the liver has the bidirectional interaction with the extrahepatic organ or tissue, and this established bidirectional interaction system may further interact with another one or more extrahepatic organs/tissues, thus depicting a complex "pan-hepatic network" model. The pan-hepatic network acts as one of the essential mechanisms of homeostasis and the pathogenesis of diseases.
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Affiliation(s)
- Yaxing Zhang
- Department of Physiology; Research Centre of Basic Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong; Issue 12th of Guangxi Apprenticeship Education of Traditional Chinese Medicine (Shi-Cheng Class of Guangxi University of Chinese Medicine), College of Continuing Education, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Xian-Ming Fang
- Department of Cardiology, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine (Guangxi Hospital of Integrated Chinese Medicine and Western Medicine, Ruikang Clinical Faculty of Guangxi University of Chinese Medicine), Guangxi University of Chinese Medicine, Nanning, Guangxi, China
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Mohamed Haris NH, Krishnasamy S, Chin KY, Mariappan V, Arumugam M. Metabolic Syndrome Screening and Nutritional Status of Patients with Psoriasis: A Scoping Review. Nutrients 2023; 15:2707. [PMID: 37375611 PMCID: PMC10302557 DOI: 10.3390/nu15122707] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Background: Patients with plaque psoriasis have an increased risk of metabolic syndrome. However, no studies have assessed the nutritional status or screening methods of this population. Aims: This review aimed to identify and summarise metabolic syndrome screening criteria and the tools/methods used in nutrition assessment in patients with plaque psoriasis. Data synthesis: PubMed, Web of Science, Ovid and Scopus were searched from inception to March 2023, following the Arkensey and O'Malley framework, to identify articles that report nutritional assessment methods/tools and metabolic screening criteria. Twenty-one studies were identified. Overall, these studies used four different screening criteria to define metabolic syndrome. Patients with psoriasis had a high prevalence of metabolic syndrome and had a poor nutritional status compared to controls. However, only anthropometric measures such as weight, height and waist circumference were employed to determine the nutritional status. Only two studies assessed the vitamin D status. Conclusions: Patients with psoriasis have a poor nutritional status, and they are at risk of nutrient deficiencies. However, these health aspects are not routinely assessed and may increase the risk of malnutrition among these patients. Therefore, additional assessments, such as body composition and dietary assessment, are needed to determine the nutritional status to provide a suitable intervention.
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Affiliation(s)
- Nur Hanisah Mohamed Haris
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Shanthi Krishnasamy
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
- Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Vanitha Mariappan
- Centre for Toxicology and Health Risk Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Mohan Arumugam
- Internal Medicine & Dermatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia;
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Carrascosa JM, Vilarrasa E, Belinchón I, Herranz P, Crespo J, Guimerá F, Olveira A. [Translated article] Common Approach to Metabolic-Associated Fatty Liver Disease in Patients With Psoriasis: Consensus-Based Recommendations From a Multidisciplinary Group of Experts. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T392-T401. [PMID: 37068635 DOI: 10.1016/j.ad.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/17/2023] [Indexed: 04/19/2023] Open
Abstract
Recent years have seen concerted efforts to understand the relation between psoriasis and metabolic-associated fatty liver disease (MAFLD). Not only is MALFD diagnosed more often in patients with psoriasis, but its clinical course is also more aggressive. A common approach is therefore needed to enable early detection of liver disease coincident with psoriasis. Especially important is an analysis of risks and benefits of potentially hepatotoxic treatments. This consensus paper presents the recommendations of a group of experts in dermatology and hepatology regarding screening for MALFD as well as criteria for monitoring patients and referring them to hepatologists when liver disease is suspected.
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Affiliation(s)
- J M Carrascosa
- Departamento de Dermatología, Hospital Universitario Germans Trias i Pujol, Universitat Autònoma de Barcelona, IGTP Badalona, Barcelona, Spain.
| | - E Vilarrasa
- Departamento de Dermatología, Hospital Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Belinchón
- Departamento de Dermatología, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica (ISABIAL), Universidad Miguel Hernández de Elche, Alicante, Spain
| | - P Herranz
- Departamento de Dermatología, Hospital Universitario La Paz, Madrid, Spain
| | - J Crespo
- Servicio de Gastroenterología y Hepatología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Escuela de Medicina, Universidad de Cantabria, Santander, Spain
| | - F Guimerá
- Servicio de Dermatología y Patología, Hospital Universitario de Canarias, La Laguna, Spain
| | - A Olveira
- Servicio de Aparato Digestivo, Hospital Universitario La Paz, Madrid, Spain
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Carrascosa JM, Vilarrasa E, Belinchón I, Herranz P, Crespo J, Guimerá F, Olveira A. Common Approach to Metabolic-Associated Fatty Liver Disease in Patients With Psoriasis: Consensus-Based Recommendations From a Multidisciplinary Group of Experts. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:392-401. [PMID: 36720362 DOI: 10.1016/j.ad.2023.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/31/2023] Open
Abstract
Recent years have seen concerted efforts to understand the relation between psoriasis and metabolic-associated fatty liver disease (MAFLD). Not only is MALFD diagnosed more often in patients with psoriasis, but its clinical course is also more aggressive. A common approach is therefore needed to enable early detection of liver disease coincident with psoriasis. Especially important is an analysis of risks and benefits of potentially hepatotoxic treatments. This consensus paper presents the recommendations of a group of experts in dermatology and hepatology regarding screening for MALFD as well as criteria for monitoring patients and referring them to hepatologists when liver disease is suspected.
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Affiliation(s)
- J M Carrascosa
- Departamento de Dermatología, Hospital Universitario Germans Trias i Pujol, Universitat Autònoma de Barcelona. IGTP Badalona, Barcelona, España.
| | - E Vilarrasa
- Departamento de Dermatología, Hospital Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
| | - I Belinchón
- Departamento de Dermatología, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica (ISABIAL), Universidad Miguel Hernández de Elche, Alicante, España
| | - P Herranz
- Departamento de Dermatología, Hospital Universitario La Paz, Madrid, España
| | - J Crespo
- Servicio de Gastroenterología y Hepatología, Hospital Universitario Marqués de Valdecilla. IDIVAL. Escuela de Medicina. Universidad de Cantabria, Santander, España
| | - F Guimerá
- Servicio de Dermatología y Patología, Hospital Universitario de Canarias, La Laguna, España
| | - A Olveira
- Servicio de Aparato Digestivo, Hospital Universitario La Paz, Madrid, España
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Thakur S, Anjum MM, Jaiswal S, Kumar A, Deepak P, Anand S, Singh S, Rajinikanth PS. Novel Synergistic Approach: Tazarotene-Calcipotriol-Loaded-PVA/PVP-Nanofibers Incorporated in Hydrogel Film for Management and Treatment of Psoriasis. Mol Pharm 2023; 20:997-1014. [PMID: 36630478 DOI: 10.1021/acs.molpharmaceut.2c00713] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Psoriasis is an autoimmune skin disease that generally affects 1%-3% of the total population globally. Effective treatment of psoriasis is limited because of numerous factors, such as ineffective drug delivery and efficacy following conventional pharmaceutical treatments. Nanofibers are widely being used as nanocarriers for effective treatment because of their multifunctional and distinctive properties, including a greater surface area, higher volume ratio, increased elasticity and improved stiffness and resistance to traction, favorable biodegradability, high permeability, and sufficient oxygen supply, which help maintain the moisture content of the skin and improve the bioavailability of the drugs. Similar to the extracellular matrix, nanofibers have a regeneration capacity, promoting cell growth, adhesion, and proliferation, and also have a more controlled release pattern compared with that of other conventional therapies at the psoriatic site. To ensure improved drug targeting and better antipsoriatic efficacy, this study formulated and evaluated a tazarotene (TZT)-calcipotriol (CPT)-loaded nanofiber and carbopol-based hydrogel film. The nanofiber was prepared using electrospinning with a polyvinyl alcohol/polyvinylpyrrolidone (PVA/PVP) K-90 polymeric blend that was later incorporated into a carbopol base to form hydrogel films. The prepared nanofibers were biochemically evaluated and in vitro and in vivo characterized. The mean diameters of the optimized formulation, i.e., TZT-loaded polyvinyl alcohol/polyvinylpyrrolidone nanofiber (TZT-PVA/PVP-NF) and TZT-CPT-loaded polyvinyl alcohol/polyvinylpyrrolidone nanofiber (TZT-CPT-PVA/PVP-NF) were 244.67 ± 58.11 and 252.31 ± 35.50 nm, respectively, as determined by scanning electron microscopy, and their tensile strength ranged from 14.02 ± 0.54 to 22.50 ± 0.03 MPa. X-ray diffraction revealed an increase in the amorphous nature of the nanofibers. The biodegradability studies of prepared nanofiber formulations, irrespective of their composition, showed that these completely biodegraded within 2 weeks of their application. The TZT-CPT-PVA/PVP-NF nanofibers exhibited 95.68% ± 0.03% drug release at the end of 72 h, indicating a controlled release pattern and following Higuchi release kinetics as a best-fit model. MTT assay, antioxidant and lipid profile tests, splenomegaly assessment, and weight fluctuation were all performed in the in vitro as well as in vivo studies. We found that the TZT-CPT-PVA/PVP-NF-based hydrogel film has high potential for antipsoriatic activity in imiquimod-induced Wistar rats in comparison with that of TT-PVA/PVP-NF nanofibers.
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Affiliation(s)
- Sunita Thakur
- Department of Pharmaceutical Sciences, Babasaheb Bhimrao Ambedkar University, Lucknow226025, India
| | - Md Meraj Anjum
- Department of Pharmaceutical Sciences, Babasaheb Bhimrao Ambedkar University, Lucknow226025, India
| | - Shweta Jaiswal
- Department of Pharmaceutical Sciences, Babasaheb Bhimrao Ambedkar University, Lucknow226025, India
| | - Anand Kumar
- Department of Pharmaceutical Sciences, Babasaheb Bhimrao Ambedkar University, Lucknow226025, India
| | - Payal Deepak
- Department of Pharmaceutical Sciences, Babasaheb Bhimrao Ambedkar University, Lucknow226025, India
| | - Sneha Anand
- Department of Pharmaceutical Sciences, Babasaheb Bhimrao Ambedkar University, Lucknow226025, India
| | - Sanjay Singh
- Department of Pharmaceutical Sciences, Babasaheb Bhimrao Ambedkar University, Lucknow226025, India
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Olveira A, Augustin S, Benlloch S, Ampuero J, Suárez-Pérez JA, Armesto S, Vilarrasa E, Belinchón-Romero I, Herranz P, Crespo J, Guimerá F, Gómez-Labrador L, Martín V, Carrascosa JM. The Essential Role of IL-17 as the Pathogenetic Link between Psoriasis and Metabolic-Associated Fatty Liver Disease. Life (Basel) 2023; 13:419. [PMID: 36836776 PMCID: PMC9963792 DOI: 10.3390/life13020419] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/19/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
Interleukin 17 (IL-17) is an effector cytokine that plays a key role in the pathogenesis of both psoriasis and metabolic-associated fatty liver disease (MAFLD), a condition that is more prevalent and severe in patients with psoriasis. In liver inflammation, IL-17 is mainly produced by CD4+ T (TH17) and CD8+ T cells (Tc17), although numerous other cells (macrophages, natural killer cells, neutrophils and Tγδ cells) also contribute to the production of IL-17. In hepatocytes, IL-17 mediates systemic inflammation and the recruitment of inflammatory cells to the liver, and it is also implicated in the development of fibrosis and insulin resistance. IL-17 levels have been correlated with progression from MAFLD to steatohepatitis, cirrhosis, and even hepatocellular carcinoma. Clinical trials have shown that inhibiting IL-17A in patients with psoriasis could potentially contribute to the improvement of metabolic and liver parameters. A better understanding of the key factors involved in the pathogenesis of these chronic inflammatory processes could potentially lead to more efficient treatment for both psoriasis and MAFLD, and help to develop holistic strategies to improve the management of these patients.
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Affiliation(s)
- Antonio Olveira
- Department of Digestive Diseases, La Paz University Hospital, 28046 Madrid, Spain
| | - Salvador Augustin
- Liver Unit, Vall d’Hebron Hospital Universitari, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Salvador Benlloch
- Department of Digestive Diseases, Arnau de Vilanova Hospital, Centro Biomédico en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 46015 Valencia, Spain
| | - Javier Ampuero
- Department of Digestive Diseases, Virgen del Rocío University Hospital, Lab 213, Institute of Biomedicine of Sevilla (IBIS), Department of Medicine, University of Sevilla, Centro Biomédico en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 41004 Sevilla, Spain
| | | | - Susana Armesto
- Department of Dermatology, Marqués de Valdecilla University Hospital, 39008 Santander, Spain
| | - Eva Vilarrasa
- Department of Dermatology, Santa Creu i Sant Pau Hospital, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Isabel Belinchón-Romero
- Dermatology Department, Alicante University General Hospital, Institute for Health and Biomedical Research (ISABIAL), Miguel Hernández University of Elche, 03202 Alicante, Spain
| | - Pedro Herranz
- Department of Dermatology, La Paz University Hospital, 28046 Madrid, Spain
| | - Javier Crespo
- Gastroenterology and Hepatology Department, Marqués de Valdecilla University Hospital, IDIVAL, School Medicine, University of Cantabria, 39005 Santander, Spain
| | - Francisco Guimerá
- Dermatology and Pathology Department, Canarias University Hospital, 38320 La Laguna, Spain
| | | | - Víctor Martín
- Immunology Franchise, Novartis Farmacéutica S.A., 28033 Madrid, Spain
| | - José Manuel Carrascosa
- Department of Dermatology, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, IGTP, 08193 Badalona, Spain
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Sun X, Zhao H, Wang R, Li H, Wu Y, Ze K, Su Y, Li B, Li X. Psoriasis complicated with metabolic disorder is associated with traditional Chinese medicine syndrome types: a hospital-based retrospective case-control study. Curr Med Res Opin 2023; 39:19-25. [PMID: 36189747 DOI: 10.1080/03007995.2022.2129803] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To explore the distribution law of traditional Chinese medicine (TCM) syndrome types in patients with psoriasis vulgaris complicated by metabolic disorders based on the same pathogenic factors as blood-heat and blood-stasis in the pathogenesis of psoriasis and metabolic disorders and to further analyze the correlation between adiponectin and the distribution law. METHODS From 1 January 2018 to 31 December 2019, patients diagnosed with psoriasis in the inpatient or outpatient department of Dermatology Ward of Shanghai Yueyang Hospital and normal participants who underwent physical examination in the physical examination center over the same period were retrospectively reviewed. Demographic data, medical history, metabolic disorder indices, and TCM syndrome indices of psoriasis patients and healthy volunteers were evaluated. RESULTS We included 307 patients with psoriasis and 613 healthy controls. On analyzing past medical history, the proportion of overweight and obesity and the comorbidity of diabetes in the psoriasis group (53.42 and 14.66%) were significantly higher than in the control group (43.88 and 7.67%, respectively; p < .05). The abnormal rates of triglyceride (34.20%), high-density lipoprotein cholesterol (50.49%), and HbA1c (18.57%) levels in the psoriasis group were higher than those in the normal control group (26.75, 17.13, and 12.56%, respectively). Overall, the incidence of metabolic disorders in psoriasis patients (267/307, 86.97%) was higher than that in the normal controls (484/613, 78.96%). Among the different syndrome types, the blood-stasis group had significantly higher rates of hypertension, diabetes, and abnormal glycosylated hemoglobin (46.07, 19.10, and 24.72%, respectively) than those of the control group (27.57, 7.67, and 12.56%; p < .05). Patients with blood stasis syndrome had the highest metabolic disorder comorbidity rate (93.26%) and lowest adiponectin level (p < .05). CONCLUSIONS TCM syndrome differentiation of psoriasis, especially the diagnosis of blood-stasis syndrome, prompts the early screening of patients with metabolic comorbidities. For patients with psoriasis with metabolic disorder, TCM for promoting blood circulation and removing blood stasis can be compatibly applied without contraindications. TRIAL REGISTRATION The trial was registered at ClinicalTrials.gov (Trial ID: NCT03942185).
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Affiliation(s)
- Xiaoying Sun
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Huaibo Zhao
- Dermatology of TCM, Shanghai Skin Diseases Hospital, Shanghai, China
| | - Ruiping Wang
- Office of Clinical Research Center, Shanghai Skin Diseases Hospital, Shanghai, China
| | - Hongjin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Yong Wu
- Second Department of Preventive Treatment, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Kan Ze
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Yonghua Su
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Bin Li
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
- Dermatology of TCM, Shanghai Skin Diseases Hospital, Shanghai, China
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
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Huiban L, Trifan A, Stanciu C. Nonalcoholic Fatty Liver Disease and Psoriasis. ESSENTIALS OF NON-ALCOHOLIC FATTY LIVER DISEASE 2023:229-241. [DOI: 10.1007/978-3-031-33548-8_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Gau SY, Hsiao YP, Liao WC, Ma KSK, Wu MC. Risk of liver dysfunction and non-alcoholic fatty liver diseases in people with hidradenitis suppurativa: A systematic review and meta-analysis of real-world evidences. Front Immunol 2022; 13:959691. [PMID: 36591267 PMCID: PMC9794989 DOI: 10.3389/fimmu.2022.959691] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND To date, evidences with high evidence-level evaluating the association between liver diseases and hidradenitis suppurativa was lacking. Given that inconsistency exists in some of the previous observational studies, evaluating the prevalence of liver diseases in HS patients could potentially serve as a reference of future guidelines for HS comorbidity screening. The aim of the current study was to evaluate potential association between hidradenitis suppurativa and liver diseases and provide integrated evidences. METHODS A search in PubMed, Web of Science and Embase based on the syntaxes ''hidradenitis suppurativa'' or ''acne inversa'' with "comorbidities", "liver diseases", "fatty liver" or "hepatitis" was performed. Observational studies evaluating epidemiological association between hidradenitis suppurativa and the risk of all liver diseases, including specific diseases as non-alcoholic fatty liver disease, hepatitis B, hepatitis C were targeted to be extracted in this systematic review and meta-analysis. RESULTS Within the initial 702 records, there were finally 8 real-world observational studies extracted. Results suggest that patients with HS are associated with all liver diseases (OR= 1.50; 95% CI, 1.27, 1.76), non-alcoholic fatty liver disease (OR= 1.78; 95% CI, 1.28, 2.48) and hepatitis B (OR=1.48; 95% CI, 1.12, 1.94), but not hepatitis C (OR= 1.27; 95% CI, 0.78, 2.07). HS patients were associated with significantly increased risk of liver diseases, especially the risk of non-alcoholic fatty liver disease and hepatitis B. CONCLUSIONS Clinicians should be alert to the clinical relationship while caring people with hidradenitis suppurativa and the screening of liver function should be recommended to HS patients. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/, identifier CRD42022296034.
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Affiliation(s)
- Shuo-Yan Gau
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Education, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Ping Hsiao
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Dermatology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Wen-Chieh Liao
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Kevin Sheng-Kai Ma
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, United States
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Meng-Che Wu
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Division of Gastroenterology, Children’s Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan
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Näslund-Koch C, Bojesen SE, Gluud LL, Skov L, Vedel-Krogh S. Non-alcoholic fatty liver disease is not a causal risk factor for psoriasis: A Mendelian randomization study of 108,835 individuals. Front Immunol 2022; 13:1022460. [PMID: 36353626 PMCID: PMC9638101 DOI: 10.3389/fimmu.2022.1022460] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/03/2022] [Indexed: 12/03/2022] Open
Abstract
Background Psoriasis is observationally associated with a higher risk of non-alcoholic fatty liver disease (NAFLD); however, the causal relationship between the two diseases remains unclear. Objective We hypothesized that individuals with NAFLD or elevated liver fat content have higher risk of psoriasis and that NAFLD is a causal risk factor for psoriasis. We tested this using a Mendelian randomization approach. Methods We included 108,835 individuals from the Danish general population, including 1,277 individuals with psoriasis and 802 individuals with NAFLD according to ICD codes. To estimate liver fat content, a subset of the participants (N = 7,416) also had a CT scan performed. First, we tested whether a diagnosis of NAFLD or elevated liver fat content was observationally associated with risk of psoriasis. Subsequently, we used the genetic variants PNPLA3 and TM6SF2, both strongly associated with NAFLD and high liver fat content, to test whether NAFLD was causally associated with increased risk of psoriasis. Results Observationally, individuals with vs. without a diagnosis of NAFLD had higher risk of psoriasis with an odds ratio of 2.03 (95% confidence interval 1.28-3.21). The risk of psoriasis increased in a stepwise manner with increasing liver fat content with an odds ratio of 5.00 (2.63-9.46) in individuals in the highest quartile of liver fat content compared to individuals in the lowest quartile. In genetic analyses, PNPLA3 and TM6SF2 were both associated with increased risk of NAFLD but not with increased risk of psoriasis. Conclusion Observationally, a diagnosis of NAFLD or elevated liver fat content was associated with higher risk of psoriasis. However, using genetic variants as a proxy for NAFLD, we did not find evidence of a causal relationship between NAFLD and psoriasis. Thus, the observational association between NAFLD and psoriasis is presumably a result of shared confounding factors or reverse causation.
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Affiliation(s)
- Charlotte Näslund-Koch
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- *Correspondence: Charlotte Näslund-Koch,
| | - Stig Egil Bojesen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Lise Lotte Gluud
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Gastro Unit, Copenhagen University Hospital–Hvidovre, Copenhagen, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Signe Vedel-Krogh
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
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28
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Li B, Su R, Yan H, Liu J, Gao C, Li X, Wang C. Immunological risk factors for nonalcoholic fatty liver disease in patients with psoriatic arthritis: New predictive nomograms and natural killer cells. Front Immunol 2022; 13:907729. [PMID: 35935983 PMCID: PMC9355654 DOI: 10.3389/fimmu.2022.907729] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/27/2022] [Indexed: 01/22/2023] Open
Abstract
Objective To search for the immunological risk factors of Psoriatic arthritis (PsA) combined with nonalcoholic fatty liver disease (NAFLD), development and assessment of predictive nomograms for NAFLD risk in patients with PsA, and to further explore the correlation between risk factors and dyslipidemia. Methds A total of 127 patients with PsA (46 with NAFLD and 81 without NAFLD) were included in this retrospective study. The clinical and serological parameters of the patients were collected. The percentage and the absolute number of lymphocytes and CD4+T cells were determined by Flow cytometry. Univariate and multivariate binary logistic regression analysis was used to screen independent risk factors of PsA complicated with NAFLD in the model population, and a nomogram prediction model was developed and assessed. Results (1) Univariate and multivariate logistic regression analysis of the modeling population showed that the percentage of peripheral blood T helper 1 cells (Th1%) (OR=1.12, P=0.001), body mass index (BMI) (OR=1.22, P=0.005) and triglycerides (TG) (OR=4.78, P=0.003) were independent risk factors for NAFLD in patients with PsA, which were incorporated and established a nomogram prediction model. The model has good discrimination and calibration, and also has certain clinical application value. (2) The number of peripheral blood NK cells in PsA patients was significantly positively correlated with serum triglyceride (TG) (r=0.489, P<0.001), cholesterol (CHOL) (r=0.314, P=0.003) and low-density lipoprotein (LDL) (r=0.362, P=0.001) levels. Conclusions Our study shows that the novel NAFLD nomogram could assess the risk of NAFLD in PsA patients with good efficiency. In addition, peripheral blood NK cell levels may be associated with dyslipidemia in patients with PsA.
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Affiliation(s)
- Baochen Li
- Department of Rheumatology, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Rui Su
- Department of Rheumatology, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Huanhuan Yan
- Department of Rheumatology, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Juanjuan Liu
- Department of General Medicine, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Chong Gao
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Xiaofeng Li
- Department of Rheumatology, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Caihong Wang
- Department of Rheumatology, the Second Hospital of Shanxi Medical University, Taiyuan, China
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29
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Xu M, Tan J, Dong W, Zou B, Teng X, Zhu L, Ge C, Dai X, Kuang Q, Zhong S, Lai L, Yi C, Tang T, Zhao J, Wang L, Liu J, Wei H, Sun Y, Yang Q, Li Q, Lou D, Hu L, Liu X, Kuang G, Luo J, Xiong M, Feng J, Zhang C, Wang B. The E3 ubiquitin-protein ligase Trim31 alleviates non-alcoholic fatty liver disease by targeting Rhbdf2 in mouse hepatocytes. Nat Commun 2022; 13:1052. [PMID: 35217669 PMCID: PMC8881609 DOI: 10.1038/s41467-022-28641-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 02/02/2022] [Indexed: 12/30/2022] Open
Abstract
Systemic metabolic syndrome significantly increases the risk of morbidity and mortality in patients with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). However, no effective therapeutic strategies are available, practically because our understanding of its complicated pathogenesis is poor. Here we identify the tripartite motif-containing protein 31 (Trim31) as an endogenous inhibitor of rhomboid 5 homolog 2 (Rhbdf2), and we further determine that Trim31 directly binds to Rhbdf2 and facilitates its proteasomal degradation. Hepatocyte-specific Trim31 ablation facilitates NAFLD-associated phenotypes in mice. Inversely, transgenic or ex vivo gene therapy-mediated Trim31 gain-of-function in mice with NAFLD phenotypes virtually alleviates severe deterioration and progression of steatohepatitis. The current findings suggest that Trim31 is an endogenous inhibitor of Rhbdf2 and downstream cascades in the pathogenic process of steatohepatitis and that it may serve as a feasible therapeutical target for the treatment of NAFLD/NASH and associated metabolic disorders.
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Affiliation(s)
- Minxuan Xu
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, College of Bioengineering, Chongqing University, 400030, Chongqing, PR China
| | - Jun Tan
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China.
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China.
| | - Wei Dong
- Shandong Cancer Hospital and Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, 250117, Jinan, PR China
| | - Benkui Zou
- Shandong Cancer Hospital and Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, 250117, Jinan, PR China
| | - Xuepeng Teng
- Shandong Cancer Hospital and Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, 250117, Jinan, PR China
| | - Liancai Zhu
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, College of Bioengineering, Chongqing University, 400030, Chongqing, PR China
| | - Chenxu Ge
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, College of Bioengineering, Chongqing University, 400030, Chongqing, PR China
| | - Xianling Dai
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, College of Bioengineering, Chongqing University, 400030, Chongqing, PR China
| | - Qin Kuang
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, College of Bioengineering, Chongqing University, 400030, Chongqing, PR China
| | - Shaoyu Zhong
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
| | - Lili Lai
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
| | - Chao Yi
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
| | - Tingting Tang
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, College of Bioengineering, Chongqing University, 400030, Chongqing, PR China
| | - Junjie Zhao
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
| | - Longyan Wang
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
| | - Jin Liu
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
| | - Hao Wei
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
| | - Yan Sun
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, College of Bioengineering, Chongqing University, 400030, Chongqing, PR China
| | - Qiufeng Yang
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
| | - Qiang Li
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
| | - Deshuai Lou
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
| | - Linfeng Hu
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, College of Bioengineering, Chongqing University, 400030, Chongqing, PR China
| | - Xi Liu
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
| | - Gang Kuang
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
| | - Jing Luo
- Department of Experimental Center, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
| | - Mingxin Xiong
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- Research Center of Brain Intellectual Promotion and Development for Children Aged 0-6 Years, Chongqing University of Education, 400067, Chongqing, PR China
| | - Jing Feng
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, 400067, Chongqing, PR China
- The Laboratory of Cell Biochemistry and Topogenetic Regulation, College of Bioengineering and Faculty of Sciences, Chongqing University, 400067, Chongqing, PR China
| | - Chufeng Zhang
- Shandong Cancer Hospital and Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, 250117, Jinan, PR China.
| | - Bochu Wang
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, College of Bioengineering, Chongqing University, 400030, Chongqing, PR China.
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Gau SY, Huang KH, Lee CH, Kuan YH, Tsai TH, Lee CY. Bidirectional Association Between Psoriasis and Nonalcoholic Fatty Liver Disease: Real-World Evidence From Two Longitudinal Cohort Studies. Front Immunol 2022; 13:840106. [PMID: 35251036 PMCID: PMC8889012 DOI: 10.3389/fimmu.2022.840106] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Association between nonalcoholic fatty liver disease (NAFLD) and future psoriasis has not yet been confirmed, although the two diseases partially share a common pathogenesis pathway. Studies have revealed an association between psoriasis and subsequent NAFLD; however, these studies were limited to small sample sizes and a cross-sectional study design. Hence, the main objective of this population-based longitudinal cohort study was to evaluate the bidirectional association between psoriasis and NAFLD. METHODS Data were retrieved from Taiwan's National Health Insurance Research Database. Patients with new-onset NAFLD and psoriasis were respectively enrolled in two cohorts. For each comparison cohort, propensity-score-matched controls with no record of NAFLD or psoriasis were selected. An adjusted hazard ratio (aHR) was applied to evaluate subsequent risks. RESULTS The risk of patients with new-onset NAFLD developing psoriasis was statistically significant, with an HR of 1.07 (95% CI, 1.01-1.14). For younger patients with NAFLD, the risk of developing psoriasis was 1.3-fold higher. The risk of patients with new-onset psoriasis developing NAFLD in the future was 1.28-fold higher than that of patients without psoriasis (95% CI, 1.21-1.35), and patients in younger psoriasis subgroups below the age of 40 years were at a higher risk than those in older subgroups, with an aHR of 1.55 (95% CI, 1.40-1.71). CONCLUSION Evidence supports a bidirectional association between NAFLD and psoriasis, especially in patients below the age of 40 years. The correlation between the two diseases and the subsequent risk of disease development should be considered when caring for patients.
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Affiliation(s)
- Shuo-Yan Gau
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Kuang-Hua Huang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Chiu Hsiang Lee
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Hsiang Kuan
- Department of Pharmacology, Chung Shan Medical University, Taichung, Taiwan
- Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Tung-Han Tsai
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Chien-Ying Lee
- Department of Pharmacology, Chung Shan Medical University, Taichung, Taiwan
- Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan
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Patel S, Kumthekar A. Psoriatic Arthritis: The Influence of Co-morbidities on Drug Choice. Rheumatol Ther 2022; 9:49-71. [PMID: 34797530 PMCID: PMC8814223 DOI: 10.1007/s40744-021-00397-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/28/2021] [Indexed: 12/20/2022] Open
Abstract
Psoriatic arthritis (PsA) is associated with a higher burden of co-morbidities such as obesity, cardiovascular disease, non-alcoholic fatty liver disease, inflammatory eye disease, inflammatory bowel disease, skin cancer and depression compared to the general population. In the last 20 years, the therapeutic options for PsA have increased exponentially with the availability of tumor necrosis factor-alpha (TNF) inhibitors, interleukin (IL)-17 inhibitors, IL-12/23 inhibitors and Janus kinases/signal transducer and activator of transcription proteins (JAK/STAT) inhibitors. The articular and extra-articular manifestations of PsA usually dictate the treatment choice but important consideration must be given to the corresponding co-morbidities while deciding the drug therapy due to associated safety profile, effect on disease activity, etc. This review provides a comprehensive review of common co-morbidities in PsA and how they can influence treatment choices.
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Affiliation(s)
- Sneha Patel
- Rheumatology, Acclaim Physicians/JPS Hospital, Fort Worth, TX, USA
| | - Anand Kumthekar
- Division of Rheumatology, Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA.
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Gonzalez-Cantero A, Teklu M, Sorokin AV, Prussick R, González-Cantero J, Martin-Rodriguez JL, Patel N, Parel PM, Manyak GA, Teague HL, Rodante JA, Keel A, Pérez-Hortet C, Sanchéz-Moya AI, Jiménez N, Ballester A, Solis J, Fernandez-Friera L, Barderas MG, Gonzalez-Calvin JL, Jaen P, Playford MP, Dey AK, Gelfand JM, Mehta NN. Subclinical Liver Disease Is Associated with Subclinical Atherosclerosis in Psoriasis: Results from Two Observational Studies. J Invest Dermatol 2022; 142:88-96. [PMID: 34293354 DOI: 10.1016/j.jid.2021.05.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/10/2021] [Accepted: 05/17/2021] [Indexed: 12/13/2022]
Abstract
Psoriasis is associated with a higher risk of liver diseases. We investigated the impact of hepatic steatosis (European cohort) and hepatic inflammation (United States cohort) on subclinical atherosclerosis. In the European cohort (n = 76 psoriasis participants and 76 controls), nonalcoholic fatty liver disease, assessed by the sonographic hepatorenal index, was more prevalent in psoriasis than in controls (61% vs. 45%; P = 0.04). Participants with psoriasis with nonalcoholic fatty liver disease had a higher prevalence of subclinical atherosclerosis (ultrasonographic presence of plaque in femoral or carotid arteries) than participants with psoriasis without nonalcoholic fatty liver disease (61% vs. 23%; P = 0.006) and controls with nonalcoholic fatty liver disease (61% vs. 32%; P < 0.05). Sonographic hepatorenal index was a determinant of subclinical atherosclerosis in psoriasis (OR = 3.5; P = 0.01). In the United States cohort (n = 162 participants with psoriasis who underwent positron emission tomography and coronary computed tomography angiography), those with high hepatic 2-[fluorine-18]fluoro-2-deoxy-D-glucose uptake had higher noncalcified (1.3 [0.49 mm2] vs. 1.0 [0.40 mm2]), fibrofatty (0.23 [0.15 mm2] vs. 0.11 [0.087 mm2]), and lipid-rich necrotic core (4.3 [2.3 mm2] vs. 3.0 [1.7 mm2]) coronary burden (all P < 0.001). Hepatic 2-[fluorine-18]fluoro-2-deoxy-D-glucose uptake associated with noncalcified (β = 0.28; P < 0.001), fibrofatty (β = 0.49; P < 0.001), and lipid-rich necrotic core (β = 0.28; P = 0.003) burden. These results show the downstream cardiovascular effects of subclinical liver disease in psoriasis.
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Affiliation(s)
- Alvaro Gonzalez-Cantero
- Department of Dermatology, Hospital Universitario Ramon y Cajal, Madrid, Spain; Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, Spain
| | - Meron Teklu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Alexander V Sorokin
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Ronald Prussick
- The Department of Dermatology, The George Washington School of Medicine & Health Sciences, Washington, District of Columbia, USA
| | | | | | - Nidhi Patel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Philip M Parel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Grigory A Manyak
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Heather L Teague
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Justin A Rodante
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrew Keel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Ana I Sanchéz-Moya
- Department of Dermatology, Complejo Hospitalario de Toledo, Toledo, Spain
| | - Natalia Jiménez
- Department of Dermatology, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - Asunción Ballester
- Department of Dermatology, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - Jorge Solis
- Department of Cardiology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - María G Barderas
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| | | | - Pedro Jaen
- Department of Dermatology, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - Martin P Playford
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Amit K Dey
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Joel M Gelfand
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nehal N Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
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Balak DMW, Piaserico S, Kasujee I. Non-Alcoholic Fatty Liver Disease (NAFLD) in Patients with Psoriasis: A Review of the Hepatic Effects of Systemic Therapies. PSORIASIS (AUCKLAND, N.Z.) 2021; 11:151-168. [PMID: 34909410 PMCID: PMC8665778 DOI: 10.2147/ptt.s342911] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/09/2021] [Indexed: 12/12/2022]
Abstract
There is increasing interest in the association between psoriasis and non-alcoholic fatty liver disease (NAFLD), which is a prevalent liver disease characterized by excessive fat storage and inflammation that can progress to fibrosis and cancer. Patients with psoriasis have a two-fold higher risk to develop NAFLD and a higher risk to progress to more severe liver disease. Psoriasis and NAFLD share common risk factors such as smoking, alcohol consumption, and the presence of metabolic syndrome and its component disorders. In addition, both psoriasis and NAFLD hinge upon a systemic low-grade inflammation that can lead to a vicious cycle of progressive liver damage in NAFLD as well as worsening of the underlying psoriasis. Other important shared pathophysiological pathways include peripheral insulin resistance and oxidative stress. NAFLD should receive clinical awareness as important comorbidity in psoriasis. In this review, we assess the recent literature on the epidemiological and pathophysiological relationship of psoriasis and NAFLD, discuss the clinical implications of NAFLD in psoriasis patients, and summarize the hepatotoxic and hepatoprotective potential of systemic psoriasis therapies.
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Affiliation(s)
- Deepak M W Balak
- Department of Dermatology, LangeLand Ziekenhuis, Zoetermeer, the Netherlands.,Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - Stefano Piaserico
- Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
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Tomaszewski M, Dahiya M, Mohajerani SA, Punja H, Ko HH, Sun M, Ramji A. Hepatic steatosis as measured by the computed attenuation parameter predicts fibrosis in long-term methotrexate use. CANADIAN LIVER JOURNAL 2021; 4:370-380. [PMID: 35989896 PMCID: PMC9235122 DOI: 10.3138/canlivj-2020-0040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 05/15/2021] [Indexed: 08/10/2023]
Abstract
INTRODUCTION To determine predictors of hepatic steatosis by the computed attenuation parameter (CAP) and fibrosis via transient elastography (TE) in persons on methotrexate (MTX) therapy with rheumatologic and dermatologic diseases. METHODS A single-centred retrospective cohort study was performed. Patients on >6 months of MTX for a rheumatologic or dermatologic disease who had undergone TE from January 2015 to September 2019 were included. Multivariate analysis was performed to determine predictors of steatosis and fibrosis. RESULTS A total of 172 patients on methotrexate were included. Psoriasis was the most frequent diagnosis (n = 55), followed by rheumatoid arthritis (n = 45) and psoriatic arthritis (n = 34). Steatosis (CAP ≥245 dB/m) was present in 69.8% of patients. Multivariate regression analysis revealed that diabetes mellitus (OR 10.47, 95% CI 1.42-75.35), hypertension (OR 5.15, 95% CI 1.75-15.38), and BMI ≥30 kg/m2 (OR 16.47, 95% CI 5.56-45.56) were predictors of steatosis (CAP ≥245 dB/m). Predictors of moderate to severe fibrosis (Metavir ≥F2 = TE ≥8.0 kPa) by multivariate regression analysis included moderate to severe steatosis (CAP ≥270 dB/m) (OR 8.36, 95% CI 1.88-37.14), diabetes mellitus (OR 2.85, 95% CI 1.09-7.48), hypertension (OR 5.4, 95% CI 2.23-13.00), dyslipidemia (OR 3.71, 95% CI 1.50-9.18), and moderate alcohol use (OR 3.06, 95% CI 1.2-7.49). CONCLUSIONS In patients on MTX for rheumatologic and dermatologic diseases, hepatic steatosis as measured by CAP was common and moderate to severe steatosis predicted moderate to severe fibrosis.
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Affiliation(s)
- Marcel Tomaszewski
- Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Monica Dahiya
- Faculty of Medicine, University of Alberta., Edmonton, Alberta, Canada
| | - Seyed Amir Mohajerani
- Saint Paul’s Hospital, Gastrointestinal Research Institute, Vancouver, British Columbia, Canada
| | - Hanaa Punja
- Department of Biology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hin Hin Ko
- Clinical Associate Professor of Medicine, Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Muxin Sun
- Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alnoor Ramji
- Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Perez-Carreras M, Casis-Herce B, Rivera R, Fernandez I, Martinez-Montiel P, Villena V. Non-alcoholic fatty liver disease in patients with intestinal, pulmonary or skin diseases: Inflammatory cross-talk that needs a multidisciplinary approach. World J Gastroenterol 2021; 27:7113-7124. [PMID: 34887631 PMCID: PMC8613653 DOI: 10.3748/wjg.v27.i41.7113] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/04/2021] [Accepted: 09/16/2021] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is currently considered the most common cause of liver disease. Its prevalence is increasing in parallel with the obesity and type 2 diabetes mellitus (DM2) epidemics in developed countries. Several recent studies have suggested that NAFLD may be the hepatic manifestation of a systemic inflammatory metabolic disease that also affects other organs, such as intestine, lungs, skin and vascular endothelium. It appears that local and systemic proinflammatory/anti-inflammatory cytokine imbalance, together with insulin resistance and changes in the intestinal microbiota, are pathogenic mechanisms shared by NAFLD and other comorbidities. NAFLD is more common in patients with extrahepatic diseases such as inflammatory bowel disease (IBD), obstructive syndrome apnea (OSA) and psoriasis than in the general population. Furthermore, there is evidence that this association has a negative impact on the severity of liver lesions. Specific risk characteristics for NAFLD have been identified in populations with IBD (i.e. age, obesity, DM2, previous bowel surgery, IBD evolution time, methotrexate treatment), OSA (i.e. obesity, DM2, OSA severity, increased transaminases) and psoriasis (i.e. age, metabolic factors, severe psoriasis, arthropathy, elevated transaminases, methotrexate treatment). These specific phenotypes might be used by gastroenterologists, pneumologists and dermatologists to create screening algorithms for NAFLD. Such algorithms should include non-invasive markers of fibrosis used in NAFLD to select subjects for referral to the hepatologist. Prospective, controlled studies in NAFLD patients with extrahepatic comorbidities are required to demonstrate a causal relationship and also that appropriate multidisciplinary management improves these patients’ prognosis and survival.
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Affiliation(s)
- Mercedes Perez-Carreras
- Gastroenterology and Hepatology Unit, 12 de Octubre Universitary Hospital, Madrid 28041, Spain
- Faculty of Medicine, Complutense University, Madrid 28040, Spain
| | - Begoña Casis-Herce
- Gastroenterology and Hepatology Unit, 12 de Octubre Universitary Hospital, Madrid 28041, Spain
- Faculty of Medicine, Complutense University, Madrid 28040, Spain
| | - Raquel Rivera
- Faculty of Medicine, Complutense University, Madrid 28040, Spain
- Dermatology Department, 12 de Octubre Universitary Hospital, Madrid 28041, Spain
| | - Inmaculada Fernandez
- Gastroenterology and Hepatology Unit, 12 de Octubre Universitary Hospital, Madrid 28041, Spain
- Faculty of Medicine, Complutense University, Madrid 28040, Spain
| | - Pilar Martinez-Montiel
- Gastroenterology and Hepatology Unit, 12 de Octubre Universitary Hospital, Madrid 28041, Spain
- Faculty of Medicine, Complutense University, Madrid 28040, Spain
| | - Victoria Villena
- Faculty of Medicine, Complutense University, Madrid 28040, Spain
- Pneumology Service, 12 de Octubre Universitary Hospital, Madrid 28041, Spain
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Abstract
The acronym nonalcoholic fatty-liver disease (NAFLD) groups a heterogeneous patient population. Although in many patients the primary driver is metabolic dysfunction, a complex and dynamic interaction of different factors (i.e., sex, presence of one or more genetic variants, coexistence of different comorbidities, diverse microbiota composition, and various degrees of alcohol consumption among others) takes place to determine disease subphenotypes with distinct natural history and prognosis and, eventually, different response to therapy. This review aims to address this topic through the analysis of existing data on the differential contribution of known factors to the pathogenesis and clinical expression of NAFLD, thus determining the different clinical subphenotypes observed in practice. To improve our understanding of NAFLD heterogeneity and the dominant drivers of disease in patient subgroups would predictably impact on the development of more precision-targeted therapies for NAFLD.
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Affiliation(s)
- Marco Arrese
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Envejecimiento y Regeneración (CARE), Departamento de Biología Celular y Molecular, Facultad de Ciencias Biologicas, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Juan P. Arab
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Envejecimiento y Regeneración (CARE), Departamento de Biología Celular y Molecular, Facultad de Ciencias Biologicas, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Francisco Barrera
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Envejecimiento y Regeneración (CARE), Departamento de Biología Celular y Molecular, Facultad de Ciencias Biologicas, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Benedikt Kaufmann
- Department of Pediatric Gastroenterology, Rady Children's Hospital, University of California San Diego, California
| | - Luca Valenti
- Department of Pathophysiology and Transplantation, Universita degli Studi di Milano, Translational Medicine, Department of Transfusion, Medicine and Hematology, Fondazione IRCCS Ca' Granda, Pad Marangoni, Milan, Italy
| | - Ariel E. Feldstein
- Department of Pediatric Gastroenterology, Rady Children's Hospital, University of California San Diego, California
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Neagoe CD, Farmazon AS, Amzolini AM, Singer CE, Ianoşi SL, Tutunaru CV, Genunche-Dumitrescu AV, Ianoşi NG, Păun I, Leru PM, Tica OS, Popescu M. The role of non-invasive scores in determining the liver fibrosis in NAFLD and psoriatic patients. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2021; 61:503-511. [PMID: 33544802 PMCID: PMC7864297 DOI: 10.47162/rjme.61.2.20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
According to recent data, psoriatic patients have an increased prevalence of non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome, compared with the general population. In some published studies, the severity and presence of psoriasis disease were correlated with the severity of NAFLD. In the current study, we aimed to compare the sensibility and specificity of the non-invasive scores and liver biopsy in determining fibrosis in patients with NAFLD and moderate to severe psoriasis. We performed the scientific research from June 2014–December 2017 and we included 71 patients: 40 patients with NAFLD and 31 patients with moderate to severe psoriasis according to Psoriasis Area and Severity Index (PASI) score and NAFLD, who received Etanercept treatment for at least one year. Based on the clinical and laboratory data, we calculated the following scores for fibrosis: body mass index (BMI), aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, diabetes (BARD) score, Fibrosis-4 (FIB-4) score, and NAFLD fibrosis score (NFS). For liver biopsy, we used the Menghini technique. By calculating Kendall’s test, we also observed a strong direct correlation between the degree of fibrosis and FIB-4 (tau=0.558) and NFS (tau=0.490) scores, with a critical statistical impact, and the lack of a correlation with the BARD score (tau=0.095; p=0.332). The hepatic biopsy allowed the more accurate establishment of the role of the non-invasive tests in the diagnosis of the lesions of steatosis, steatohepatitis, and hepatic fibrosis. The non-invasive tests are most useful for the exclusion of the evolution lesions and for the confirmation of the advanced stages of the disease. Among these, the NFS score proved a high statistically significant correlation (p<0.0001) with the fibrosis histological lesions.
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Affiliation(s)
- Carmen Daniela Neagoe
- Department of Dermatology, Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; ,
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Ruiyang B, Panayi A, Ruifang W, Peng Z, Siqi F. Adiponectin in psoriasis and its comorbidities: a review. Lipids Health Dis 2021; 20:87. [PMID: 34372872 PMCID: PMC8353790 DOI: 10.1186/s12944-021-01510-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/20/2021] [Indexed: 02/08/2023] Open
Abstract
Psoriasis is a chronic, immune-mediated inflammatory skin disease characterized by abnormal T cell activation and excessive proliferation of keratinocytes. In addition to skin manifestations, psoriasis has been associated with multiple metabolic comorbidities, such as obesity, insulin resistance, and diabetes. An increasing amount of evidence has highlighted the core role of adipokines in adipose tissue and the immune system. This review focus on the role of adiponectin in the pathophysiology of psoriasis and its comorbidities, highlighting the future research avenues.
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Affiliation(s)
- Bai Ruiyang
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Adriana Panayi
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St., Boston, MA, 02115, USA
| | - Wu Ruifang
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Zhang Peng
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
| | - Fu Siqi
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
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Rattanakaemakorn P, Pinyowiwat P, Iamsumang W, Chanprapaph K, Suchonwanit P. Incidence and Risk Factors of Hepatic Fibrosis in Psoriatic Patients Receiving Methotrexate with Concomitant Acitretin Therapy and Methotrexate Monotherapy. DRUG DESIGN DEVELOPMENT AND THERAPY 2021; 15:2299-2307. [PMID: 34093007 PMCID: PMC8170124 DOI: 10.2147/dddt.s304168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/12/2021] [Indexed: 12/24/2022]
Abstract
Background The use of methotrexate-acitretin (MTX-ACI) combination therapy in treating psoriasis has been limited due to concerns related to hepatic fibrosis. However, in vitro evidence revealed a protective effect of acitretin in methotrexate (MTX)-induced liver fibrosis. Objective This study aimed to compare the real-life incidence of hepatic fibrosis in patients with psoriasis receiving MTX-ACI and MTX monotherapy and to investigate factors associated with hepatic fibrosis in MTX-exposed patients. Methods A retrospective cohort study was conducted based on a real-life registry containing data on patients with psoriasis who were administered MTX-ACI or MTX between 2008 and 2019 and underwent transient elastography according to cumulative MTX dose of 1.0–1.5 g and/or 3.5–4.0 g. Time-to-event analysis was performed to determine the cumulative incidence, incidence rate, and factors potentially affecting the occurrence of hepatic fibrosis. Results Of the 160 patients, 32 (20%) were treated with MTX-ACI, and 128 (80%) with MTX alone. Four patients (12.5%) in MTX-ACI group and 21 (16.4%) in MTX group developed hepatic fibrosis (p = 0.59). There was no statistically significant difference in cumulative incidence (16% in MTX-ACI vs 17% in MTX, p = 0.89) and incidence rate (37 cases per 1000 person-year in MTX-ACI vs 23 cases per 1000 person-year in MTX; hazard ratio [HR] = 1.07; p = 0.90) of hepatic fibrosis between the two groups. Diabetes and obesity were identified as significant factors associated with hepatic fibrosis (adjusted HR = 2.40, 95% confidence interval [CI]: 1.05–5.51; p = 0.04 and adjusted HR = 3.28, 95% CI: 1.18–9.16; p = 0.02, respectively) regardless of the cumulative MTX dose. Conclusion The incidence of hepatic fibrosis in a real-life clinical situation, determined by transient elastography in patients with psoriasis receiving MTX-ACI, was not increased compared to those receiving MTX monotherapy. Type 2 diabetes mellitus and obesity were identified as risk factors of hepatic fibrosis; hence, patients with these factors receiving long-term MTX therapy should be regularly monitored for this particular event.
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Affiliation(s)
- Ploysyne Rattanakaemakorn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Prinpat Pinyowiwat
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wimolsiri Iamsumang
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kumutnart Chanprapaph
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Korsakova YL, Korotaeva TV, Loginova EI, Gubar EE, Vasilenko EA, Vasilenko AA, Kuznetsova NA, Patrikeeva IM, Nasonov EL. The relationship between obesity, cardiometabolic disorders and disease activity in psoriatic arthritis patients: data from the Russian register. TERAPEVT ARKH 2021; 93:71511. [DOI: 10.26442/00403660.2021.05.200789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 06/12/2021] [Indexed: 02/08/2023]
Abstract
Aim. To study the relationship between obesity, cardiometabolic disorders and disease activity in patients with psoriatic arthritis (PsA) in real practice.
Materials and methods. The Russian register included 614 PsA patients [female 331 (54%)/283 (46%)]. Average age 45.20.52 years, PsA duration 5.70.27 years, psoriasis 15.710.56 years. Patients underwent examination, body mass index (BMI), PsA activity according to DAPSA, cDAPSA, analysis of concomitant diseases were assessed. The patients were divided into 3 groups depending on BMI (kg/m2): normal 25 (group 1), increased 2530 (group 2), obesity 30 (group 3).
Results. The average BMI was 27.70.23 kg/m2, normal BMI in 213 (34.7%), increased in 214 (34.8%) and obesity in 187 (30.5%). Concomitant diseases in 297 (48%). In group 3, arterial hypertension was observed significantly more often than in groups 1 and 2 (p0.0001); more often than in group 2 diabetes mellitus (p0.0001), metabolic syndrome (p0.0001); more often than in group 1 ischemic heart disease (p=0.026). PsA activity at Baseline, after 6/12 months was significantly higher in group 3 (p0.031). In obese patients, the chance of a decrease in disease activity to a moderate/low level and remission during therapy for 6/12 months is 2.484 times lower than in group 1, and 2.346 times lower than in group 2: odds ratio 2.346 (95% сonfidence interval 1.075.143) and 2.484 (95% сonfidence interval 1.1355.439), respectively.
Conclusion. In the majority (65.3%) of PsA patients, BMI exceeded the norm. Obesity is associated with a high incidence of cardiometabolic disorders, with higher PsA activity and lower treatment efficacy.
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Heitmann J, Frings VG, Geier A, Goebeler M, Kerstan A. Nicht‐alkoholische Fettlebererkrankung und Psoriasis – besteht ein gemeinsames proinflammatorisches Netzwerk? J Dtsch Dermatol Ges 2021; 19:517-529. [PMID: 33861000 DOI: 10.1111/ddg.14425_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/10/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Johanna Heitmann
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - Verena G Frings
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - Andreas Geier
- Schwerpunkt Hepatologie, Medizinische Klinik II, Universitätsklinikum Würzburg
| | - Matthias Goebeler
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - Andreas Kerstan
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
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Schön MP. Psoriasis und nichtalkoholische Fettleber. J Dtsch Dermatol Ges 2021; 19:503-504. [PMID: 33860996 DOI: 10.1111/ddg.14469_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Adenote A, Dumic I, Madrid C, Barusya C, Nordstrom CW, Rueda Prada L. NAFLD and Infection, a Nuanced Relationship. Can J Gastroenterol Hepatol 2021; 2021:5556354. [PMID: 33977096 PMCID: PMC8087474 DOI: 10.1155/2021/5556354] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/30/2021] [Accepted: 04/05/2021] [Indexed: 02/06/2023] Open
Abstract
The prevalence of nonalcoholic fatty liver disease (NAFLD) has increased significantly over the last few decades mirroring the increase in obesity and type II diabetes mellitus. NAFLD has become one of the most common indications for liver transplantation. The deleterious effects of NAFLD are not isolated to the liver only, for it has been recognized as a systemic disease affecting multiple organs through protracted low-grade inflammation mediated by the metabolic activity of excessive fat tissue. Extrahepatic manifestations of NAFLD such as cardiovascular disease, polycystic ovarian syndrome, chronic kidney disease, and hypothyroidism have been well described in the literature. In recent years, it has become evident that patients suffering from NAFLD might be at higher risk of developing various infections. The proposed mechanism for this association includes links through hyperglycemia, insulin resistance, alterations in innate immunity, obesity, and vitamin D deficiency. Additionally, a risk independent of these factors mediated by alterations in gut microbiota might contribute to a higher burden of infections in these individuals. In this narrative review, we synthetize current knowledge on several infections including urinary tract infection, pneumonia, Helicobacter pylori, coronavirus disease 2019, and Clostridioides difficile as they relate to NAFLD. Additionally, we explore NAFLD's association with hidradenitis suppurativa.
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Affiliation(s)
- Abimbola Adenote
- Division of Hospital Internal Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
- Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Igor Dumic
- Division of Hospital Internal Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
- Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Cristian Madrid
- Division of Hospital Internal Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
- Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Christopher Barusya
- Division of Hospital Internal Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
- Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Charles W. Nordstrom
- Division of Hospital Internal Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
- Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Libardo Rueda Prada
- Division of Hospital Internal Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
- Mayo Clinic College of Medicine and Science, Rochester, MN, USA
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Heitmann J, Frings VG, Geier A, Goebeler M, Kerstan A. Non-alcoholic fatty liver disease and psoriasis - is there a shared proinflammatory network? J Dtsch Dermatol Ges 2021; 19:517-528. [PMID: 33768700 DOI: 10.1111/ddg.14425] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/10/2020] [Indexed: 02/06/2023]
Abstract
Psoriasis is an immune-mediated systemic inflammatory disease that is not limited to the skin but may be associated with arthritis, cardiovascular diseases, metabolic syndrome including diabetes and obesity and, as identified more recently, non-alcoholic fatty liver disease (NAFLD) that occurs in approximately 50 % of all patients with psoriasis. NAFLD is characterized by accumulation of fat in hepatocytes in the absence of excessive alcohol consumption. Over the last two decades, NAFLD has developed to the most common chronic liver disease with an estimated prevalence of 25 % in the Western population. NAFLD ranges from non-inflammatory or bland hepatic steatosis to inflammation of hepatic tissue (non-alcoholic steatohepatitis, NASH) and consecutive liver fibrosis. It is controversial whether the underlying systemic inflammation of psoriasis is contributing to development of NAFLD or if comorbid diseases such as obesity enhance NAFLD development. Recent findings indicate that cytokine-mediated inflammation through TNFα, interleukin (IL)-6 and IL-17 might be the common link between psoriasis and NAFLD. Considering the shared inflammatory pathways, IL-17 pharmacological blockade, which is already well-established for psoriasis, may be a promising strategy to treat both psoriasis and NAFLD. Therefore, early detection of NAFLD and a better understanding of its pathophysiology in the context of the systemic inflammation in psoriasis is important with regard to individualized treatment approaches.
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Affiliation(s)
- Johanna Heitmann
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Verena G Frings
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Andreas Geier
- Division of Hepatology, Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Matthias Goebeler
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Andreas Kerstan
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
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Sikora M, Stec A, Chrabaszcz M, Giebultowicz J, Samborowska E, Jazwiec R, Dadlez M, Olszewska M, Rudnicka L. Clinical Implications of Intestinal Barrier Damage in Psoriasis. J Inflamm Res 2021; 14:237-243. [PMID: 33542642 PMCID: PMC7851376 DOI: 10.2147/jir.s292544] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/24/2020] [Indexed: 12/12/2022] Open
Abstract
Background An increasing amount of evidence suggests an association between increased intestinal permeability and the pathogenesis of chronic inflammatory diseases. However, the clinical significance of gut barrier dysfunction in psoriasis remains to be established. Objective To evaluate whether there are differences in disease activity, the severity of gastrointestinal symptoms and the blood concentration of bacterial metabolites in psoriatic patients with a normal and altered intestinal barrier. Patients and Methods Gut barrier integrity was assessed with the serum concentrations of claudin-3, a modulator of intestinal tight junctions and an intestinal fatty acid-binding protein, a marker of enterocyte damage. Gastrointestinal symptoms were evaluated with a validated questionnaire. The concentration of trimethylamine N-oxide (TMAO), a gut microbiota-associated metabolite, was measured with high-performance liquid chromatography. Results One hundred and fourteen patients with psoriasis were finally enrolled in the study – 68 with an altered gut barrier and 46 with a properly functioning intestinal barrier. Patients with an altered gut barrier showed a significantly higher score in the Gastrointestinal Symptom Rating Scale (3.20 vs 1.46, p<0.001). Moreover, patients with psoriasis and a disrupted intestinal barrier demonstrated a higher disease activity (PASI: 19.7 vs 10.3, p<0.001) and systemic inflammatory parameters (neutrophil-to-lymphocyte ratio: 2.86 vs 1.71, p<0.001; C-reactive protein 3.76 vs 1.92; p<0.05). The marker of bacterial translocation was significantly higher in psoriatic patients with damaged gut integrity (TMAO: 375.7±51.9 vs 119.4±27.5 ng/mL; p<0.05). Conclusion The altered gut barrier in psoriasis is associated with gastrointestinal symptoms, systemic inflammatory profile and the increased blood concentration of gut microbiota-derived metabolite – TMAO. Intestinal barrier modulation represents a new promising therapeutic approach.
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Affiliation(s)
- Mariusz Sikora
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Albert Stec
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | | | - Joanna Giebultowicz
- Department of Bioanalysis and Drug Analysis, Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, Warsaw, Poland
| | - Emilia Samborowska
- Mass Spectrometry Laboratory, Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Warsaw, Poland
| | - Radoslaw Jazwiec
- Mass Spectrometry Laboratory, Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Warsaw, Poland
| | - Michal Dadlez
- Mass Spectrometry Laboratory, Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Warsaw, Poland.,Institute of Genetics and Biotechnology, Biology Department, Warsaw University, Warsaw, Poland
| | | | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
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Li AA, Ahmed, A, Kim D. Extrahepatic Manifestations of Nonalcoholic Fatty Liver Disease. Gut Liver 2020; 14:168-178. [PMID: 31195434 PMCID: PMC7096231 DOI: 10.5009/gnl19069] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/26/2019] [Accepted: 04/05/2019] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and encompasses a spectrum of pathology from simple steatosis to inflammation and significant fibrosis that leads to cirrhosis. NAFLD and its comorbid conditions extend well beyond the liver. It is a multisystemic clinical disease entity with extrahepatic manifestations such as cardiovascular disease, type 2 diabetes, chronic kidney disease, hypothyroidism, polycystic ovarian syndrome, and psoriasis. Indeed, the most common causes of mortality in subjects with NAFLD are cardiovascular disease, followed by malignancies and then liver-related complications as a distant third. This review focuses on several of the key extrahepatic manifestations of NAFLD and areas for future investigation. Clinicians should learn to screen and initiate treatment for these extrahepatic manifestations in a prompt and timely fashion before they progress to end-organ damage.
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Affiliation(s)
- Andrew A. Li
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Aijaz Ahmed,
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA
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Gerdes S, Pinter A, Papavassilis C, Reinhardt M. Effects of secukinumab on metabolic and liver parameters in plaque psoriasis patients. J Eur Acad Dermatol Venereol 2019; 34:533-541. [PMID: 31599476 PMCID: PMC7065121 DOI: 10.1111/jdv.16004] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 09/13/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Psoriasis is associated with metabolic, liver and cardiovascular comorbidity. Secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin-17A, has shown significant and sustained efficacy in the treatment of moderate to severe psoriasis. OBJECTIVES This was an exploratory post hoc analysis of pooled data from three phase 3 studies in plaque psoriasis patient populations. The objective was to show the course of metabolic and liver parameters under secukinumab, etanercept or placebo treatment over time. A further objective was to assess the impact of selected comorbidities and metabolic characteristics on high-sensitivity C-reactive protein (hs-CRP), as a surrogate marker of systemic inflammation. METHODS Data from the phase 3 randomized controlled trials [FIXTURE (NCT01358578), ERASURE (NCT01365455) and SCULPTURE (NCT01406938); n = 3010] were included in this analysis. Patients were treated with secukinumab 150 mg or 300 mg, placebo or etanercept 50 mg (FIXTURE only) as active comparator. A set of metabolic and liver parameters was longitudinally assessed over 52 weeks. Multivariate regression analyses assessed the impact of selected comorbidities and metabolic characteristics on hs-CRP levels at baseline and under treatment. RESULTS Secukinumab treatment reduced hs-CRP levels. Body weight and uric acid levels tended to decrease over 52 weeks with secukinumab. Secukinumab showed a neutral effect on fasting plasma glucose, lipid parameters and liver enzymes. Psoriatic arthritis, metabolic syndrome, obesity, impaired glucose metabolism, and hyperuricemia were each associated with increased hs-CRP levels at baseline. Concomitant obesity attenuated the decline in hs-CRP under treatment. CONCLUSIONS These analyses suggest neutral to favourable long-term trends in metabolic and liver parameters under secukinumab treatment. Metabolic comorbidities were associated with increased hs-CRP levels, reflecting the role of systemic inflammatory processes in their pathophysiology.
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Affiliation(s)
- S Gerdes
- Psoriasis-Center, Department of Dermatology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - A Pinter
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | | | - M Reinhardt
- Novartis Pharma AG, Basel, Switzerland.,Novartis Pharma GmbH, Nürnberg, Germany
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Ortolan A, Lorenzin M, Tadiotto G, Russo FP, Oliviero F, Felicetti M, D'Incà R, Favero M, Piaserico S, Doria A, Ramonda R. Metabolic syndrome, non-alcoholic fatty liver disease and liver stiffness in psoriatic arthritis and psoriasis patients. Clin Rheumatol 2019; 38:2843-2850. [PMID: 31254236 DOI: 10.1007/s10067-019-04646-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/07/2019] [Accepted: 06/14/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Non-alcoholic fatty liver disease (NAFLD), potentially evolving into liver fibrosis (LF), is frequent in psoriasis (PsO), but data in psoriatic arthritis (PsA) are lacking. Our study aimed to investigate the prevalence of NALFD and LF in PsA/PsO and the contribution of arthritis in their onset. METHOD PsA and PsO patients were consecutively enrolled. Exclusion criteria were liver diseases causing fibrosis (except NAFLD), alcohol ≥ 20 g/day, daily use of non-steroidal anti-inflammatory drugs and current/previous methotrexate use. Clinical history, biochemical and clinimetrical data and insulin-resistance index HOMA (homeostatic model assessment) were assessed. Patients underwent a liver ultrasound to identify steatosis (therefore NAFLD) and transient elastography, to evaluate LF (stiffness≥ 7 kPa = fibrosis). Statistical analysis included basic statistics, logistic and linear regression analyses (to assess the contribution of arthritis to NAFLD and LF grading, respectively) and Spearman's correlations; p ≤ 0.05 was considered significant. RESULTS Seventy-six patients were enrolled (PsA/PsO 43/33). MetS and LF prevalence were similar between PsA and PsO (35% vs 33%, p = 0.88; 31% vs 28%, p = 0.77, respectively). NAFLD was more frequent in PsO (65% vs 35%, p = 0.044). In multivariable models with NAFLD and LF grading as outcomes, arthritis was not a significant predictor, while HOMA was independently associated with both (OR 1.34; 95%CI 1.06, 1.69; beta 0.88; 95%CI 0.54, 1.21, respectively). Female sex was independently associated with LF grading (beta 1.81; 95%CI 0.05, 3.57). CONCLUSIONS NAFLD was more frequent in PsO, but MetS and LF prevalence were similar in PsA and PsO. Insulin resistance is the main determinant of NAFLD and LF, while additional contribution of arthritis seems small. Key Points • The prevalence of metabolic comorbidities, including liver fibrosis, is overall quite similar between psoriatic arthritis and psoriasis. • NAFLD is more frequently found in psoriasis than psoriatic arthritis. • The contribution of arthritis in the onset of metabolic comorbidities seems small.
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Affiliation(s)
- Augusta Ortolan
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Mariagrazia Lorenzin
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Giulia Tadiotto
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | | | - Francesca Oliviero
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Mara Felicetti
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Renata D'Incà
- Gastroenterology Unit, University of Padova, Padova, Italy
| | - Marta Favero
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | | | - Andrea Doria
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, 35128, Padova, Italy.
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Schwarz PEH, Pinter A, Melzer N, Barteczek P, Reinhardt M. ERAPSO: Revealing the High Burden of Obesity in German Psoriasis Patients. Dermatol Ther (Heidelb) 2019; 9:579-587. [PMID: 31297711 PMCID: PMC6704194 DOI: 10.1007/s13555-019-0314-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Plaque psoriasis is a chronic, systemic-inflammatory disease characterized by skin erythema, plaques and scaling, and is associated with different comorbidities like psoriatic arthritis, obesity, and cardiometabolic diseases. Obesity aggravates cardiovascular risk in psoriasis patients and can negatively affect psoriasis disease severity with proinflammatory adipocytokine production by adipocytes and infiltrated immune cells. METHODS An online survey on nutrition and physical activity in psoriasis participants (ERAPSO) collected cross-sectional data about eating behavior, physical activity, and prevalence of obesity and metabolic syndrome components from 9940 psoriasis participants in Germany. RESULTS ERAPSO revealed a high burden of obesity in German psoriasis participants with 66.9% overweight or obese (body mass index [BMI] ≥ 25 kg/m2), compared to approximately 50% of the German general population. Affected body surface area (BSA), cardiovascular risk factors, and cardiovascular event frequency increased with increasing BMI. Severe psoriasis was more frequent in overweight participants and impaired engagement in weight loss diets and physical activity. Most German psoriasis participants (90.2%) with BMI ≥ 25 kg/m2 perceived themselves as overweight. A minority (21.2%) were currently exercising with the aim of losing weight, and 12.6% were currently on a weight loss diet. In overweight participants, just 13.3% stated that their physicians and/or health insurance offered specific weight loss programs. CONCLUSION ERAPSO revealed inadequate medical care of obese psoriasis participants with insufficient support for weight loss through diet or increased physical activity. Although psoriasis participants showed an intact self-perception of obesity, they seemed to lack intrinsic motivation to lose weight, highlighting the need for external support in losing weight via tailored programs. Since psoriasis severity correlates with impairment in diets and sports, treating psoriasis adequately may allow participants to follow weight loss programs more successfully. FUNDING Novartis Pharma GmbH, Nuremberg, DE.
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Affiliation(s)
| | - Andreas Pinter
- University Hospital Frankfurt, Frankfurt am Main, Germany
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