Association Between Soluble Lectinlike Oxidized Low-Density Lipoprotein Receptor-1 and Coronary Artery Disease in Psoriasis – DocWire News

IMPORTANCE:

Psoriasis, a chronic inflammatory skindiseaseassociated with accelerated noncalcifiedcoronaryburden (NCB) bycoronarycomputed tomography angiography (CCTA), accelerates lipoprotein oxidation in the form of oxidized modified lipoproteins. A transmembrane scavenger receptor for these oxidized modified lipoproteins is lectinlike oxidized low-density lipoprotein receptor-1 (LOX-1), which has been reported to be associated withcoronary artery disease. It is unknown whether this receptor is associated withcoronary artery diseasein psoriasis.

To assess the association between soluble LOX-1 (sLOX-1) and NCB in psoriasis over time.

In a cohort study at the National Institutes of Health, 175 consecutive patients with psoriasis were referred from outpatient dermatology practices between January 1, 2013, and October 1, 2017. A total of 138 consecutively recruited patients with psoriasis were followed up at 1 year.

Circulating soluble lectinlike oxidized low-density lipoprotein receptor-1 levels were measured blindly by field scientists running undiluted serum using an enzyme-linked immunosorbent assay.

Coronarycomputed tomography angiography scans were performed to quantify NCB in all 3 major epicardialcoronaryarteries by a reader blinded to patient demographics, visit, and treatment status.

Among the 175 patients with psoriasis, the mean (SD) age was 49.7 (12.6) years and 91 were men (55%). The cohort had relatively low median cardiovascular risk by Framingham risk score (median, 2.0 [interquartile range (IQR), 1.0-6.0]) and had a mean (SD) body mass index (calculated as weight in kilograms divided by height in meters squared) suggestive of overweight profiles (29.6 [6.0]). Elevated sLOX-1 levels were found in patients with psoriasis compared with age- and sex-matched controls (median, 210.3 [IQR, 110.9-336.2] vs 83.7 [IQR, 40.1-151.0]; P<.001), and were associated with Psoriasis Area Severity Index (PASI) score (=0.23; 95% CI, 0.082-0.374; P=.003). Moreover, sLOX-1 was associated with NCB independent of hyperlipidemia status (=0.11; 95% CI, 0.016-0.200; P=.023), an association which persisted after adjusting for traditional cardiovascular risk factors, statin use, and biologic psoriasis treatment (=0.10; 95% CI, 0.014-0.193; P=.03). At 1 year, in those who had clinical improvement in PASI (eg, >50% improvement), a reduction in sLOX-1 (median, 311.1 [IQR, 160.0-648.8] vs median, 224.2 [IQR, 149.1 427.4]; P=.01) was associated with a reduction in NCB (=0.14; 95% CI, 0.028-0.246; P=.02).

Soluble lectinlike oxidized low-density lipoprotein receptor-1 levels were elevated in patients with psoriasis and were associated with severity of skindisease. Moreover, sLOX-1 associated with NCB independent of hyperlipidemia status, suggesting that inflammatory sLOX-1 induction may modulate lipid-rich NCB in psoriasis. Improvement of skindiseasewas associated with a reduction of sLOX-1 at 1 year, demonstrating the potential role of sLOX-1 in inflammatory atherogenesis in psoriasis.

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Association Between Soluble Lectinlike Oxidized Low-Density Lipoprotein Receptor-1 and Coronary Artery Disease in Psoriasis - DocWire News