Psoriasis and systemic inflammatory diseases: potential mechanistic links between skin disease and co-morbid conditions.
Psoriasis is now classified as an immune-mediated inflammatory disease (IMID) of the skin. It is being recognized that patients with various IMIDs, including psoriasis, are at higher risk of developing "systemic" co-morbidities, e.g., cardiovascular disease (CVD), metabolic syndrome, and overt diabetes. In non-psoriatic individuals, the pathophysiology of obesity, aberrant adipocyte metabolism, diabetes, and CVDs involves immune-mediated or inflammatory pathways. IMIDs may impact these co-morbid conditions through shared genetic risks, common environmental factors, or common inflammatory pathways that are co-expressed in IMIDs and target organs. Given that pathogenic immune pathways in psoriasis are now well worked out and a large number of inflammatory mediators have been identified in skin lesions, in this review we will consider possible mechanistic links between skin inflammation and increased risks of (1) obesity or metabolic alterations and (2) CVD. In particular, we will discuss how well-established risk factors for CVD can originate from inflammation in other tissues.
Davidovici
Batya B
BB
Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York, USA.
Sattar
Naveed
N
Prinz
Jörg  C
J
Jörg
Prinz C
PC
Puig
Luis
L
Emery
Paul
P
Barker
Jonathan N
JN
van de Kerkhof
Peter
P
Ståhle
Mona
M
Nestle
Frank O
FO
Girolomoni
Giampiero
G
Krueger
James G
JG
D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000276:immunology*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D007154:Immune System Diseases / Q000453:epidemiology / Q000276:immunology; D011565:Psoriasis / Q000453:epidemiology* / Q000276:immunology*; D012307:Risk Factors