Psoriasis is associated with atherosclerosis, in which circulating microparticles play a key role. A new research study demonstrated that the increased levels of circulating CD41a and CD31 microparticles were unchanged after anti-IL-12/23 treatment, suggesting that this therapy may not alter the development of cardiovascular disease in patients with psoriasis.
The research study, entitled “No Significant Reduction of Circulating Endothelial-Derived and Platelet-Derived Microparticles in Patients with Psoriasis Successfully Treated with Anti-IL12/23” was published in BioMed Research International.
Psoriasis is a common and chronic inflammatory disease, which is associated with a high risk of atherosclerosis development, leading to cardiovascular events and stroke. The detailed pathophysiological mechanisms of the atherosclerosis development is still unclear; however, the endothelial and inflammation dysfunction, and persistent thrombosis can contribute.
The authors of the research study investigated the levels of microparticles in patients suffering from severe psoriasis. Eleven patients (between ages of 38 – 68 years, male : female = 9 : 2) with severe psoriasis who received anti-IL12/23 (ustekinumab) treatments and healthy controls between August 2014 and July 2015 were involved. The results showed that the levels of CD41a and CD31 microparticles were consistently above the normal levels, however were not significantly different among psoriatic patients with or without comorbidities.
Microparticles, such as membrane vesicles in the circulation derived from activated and apoptotic cells, are associated with many risk factors for vascular diseases, they can induce noxious responses and endothelial dysfunction by activation of procoagulant and proinflammatory pathways.
This study showed that CD31 and CD41a microparticle levels in patients with severe psoriasis did not decrease despite showing better PASI (psoriasis area severity index) after ustekinumab treatment. A previous research report showed that levels of platelet and endothelial microparticles decreased after 3-month anti-TNF-α therapy. According to current clinical studies, anti-TNF-α agents offer better evidence of benefit to lower the risk of cardiovascular diseases in patients with psoriasis.
Other previous studies also suggest that anti-TNF-α drugs have the capacity to influence cardiovascular risk by ameliorating vascular inflammation. The increased endothelial microparticle levels could result from TNF-α in favor of endothelial microparticles generation. The anti-TNF-α therapy may be effective to reduce cardiovascular risk through the reduction of circulating microparticles. However, further long-term study is needed to quantify the benefits of cardiovascular diseases associated with ustekinumab treatment.