Upload
byron-young
View
226
Download
3
Tags:
Embed Size (px)
Citation preview
Prof. Dr. W.-H. Boehncke
Zentrum der Dermatologie
und Venerologie
JWG-Universität
Frankfurt am Main
Prof. Dr. W.-H. Boehncke
Zentrum der Dermatologie
und Venerologie
JWG-Universität
Frankfurt am Main
PSORIASIS
AND
CORONARY ARTERY CALCIFICATION (CAC)
PSORIASIS and co-morbidity
• no. 1 co-morbidity: PSA!• evidence for increased risk for
cardiovascular mortality– NEJM 1973, 288: 912– BJD 1978, 99: 469– JID 2001, 117: 1531– Eur J Epidemiol 2004, 19: 225
• but:– more smokers
• BJD 1996, 135: 859– more diabetes
• ADR 1975, 254: 43 – more hypertension
• Dermatologica 1986, 172: 298
• so: What is the role of PSO?– background:
• chronic inflammation causes atherosclerosis
A ROLE FOR P-SELECTIN IN „ENDOTHELITIS“?
CD3
CD
41
11.9
28.1
6.7
Ludwig R, Schultz JE, Boehncke W-H et al. JID 2004, 122: 830
0
10
20
30
40
50
60
rolli
ng
frac
tion
(PB
MC
)
no resting activatedplatelets
PBMC alone
Platelet-PBMC-aggregates
p<0.05
p<0.05
Thrombocytes augment „rolling“ through formation of aggegates via P-selectin
p<0.05
0
10
20
30
40
NaCl PS3 NaCl PS3
rolli
ng P
MB
C (
%)
p<0.05
C57Bl/6 P-sel-/-
0
5
10
15
20
25
NaCl PS3
p<0.05
ear
swelli
ng
(cm
x 1
0-3)
Contact Dermatitis
Intravitalmicroscopy
Blockade of P-selectin dependent aggregate formation results in anti-inflammatory effects in-vivo
PSORIASIS AND CAC
• Is there a correlation between disease severity and P-selectin expression?– monitoring of in-
patients• PASI• FACS
0
10
20
30
PA
SI s
core
a
P-s
elec
tin (
%)
0
1
2
3
4
b
before
0
10
20
30
PA
SI s
core
P-selectin (%)
after
c
0 1 2 3 4
PSORIASIS AND CAC
• Are PSO patients at risk to develop cardiac disease?– 32 PSO patients– matched controls– spiral CT
• CAC score (Agatston)
0
10
20
30
PA
SI s
core
a
P-s
elec
tin (
%)
0
1
2
3
4
b
before
0
10
20
30
PA
SI s
core
P-selectin (%)
after
c
0 1 2 3 4
Ludwig R, … Boehncke W-H. BJD, in press
28.1%
71.9%
59.4%40.6%
prevalence
controls
patients
CAC
no CAC
0 50 100 150 200 250
controls
Psoriasis *
CAC score
severity
„Psoriasis“ is a risk factor for coronary artery calicification