Characterization of PCSK9 in the Blood and Skin of Psoriasis.

Characterization of PCSK9 in the Blood and Skin of Psoriasis.
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银屑病血液和皮肤中PCSK 9的表征。

DOI:
10.1016/j.jid.2020.05.115
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发表时间:
2021-03
期刊:
The Journal of investigative dermatology
影响因子:
--
通讯作者:
Mehta NN
Mehta NN
中科院分区:
其他
文献类型:
--
作者:
Garshick MS;Baumer Y;Dey AK;Grattan R;Ng Q;Teague HL;Yu ZX;Chen MY;Tawil M;Barrett TJ;Underberg J;Fisher EA;Krueger J;Powell-Wiley TM;Playford MP;Berger JS;Mehta NN

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解释银屑病(一种促炎性疾病)和心血管疾病(CVD)之间联系的机制尚不完全清楚。前蛋白转化酶枯草杆菌蛋白酶/kexin 9型(PCSK 9)主要在肝细胞中表达,是脂质代谢的关键调节剂,靶向PCSK 9的临床试验可降低CVD。PCSK 9水平与内皮功能障碍相关,并可预测CV事件,这与其在脂质代谢中的作用无关。我们使用两个单独的人类银屑病队列和K14-Rac 1V 12 −/+银屑病小鼠模型来研究银屑病中的PCSK 9和CV风险。在两个银屑病队列中(n=88和n=20),PCSK 9水平分别比年龄、性别和胆固醇匹配的对照组高20%和13%(每次比较p<0.05),并与银屑病面积严重程度指数相关(r=0.43,p<0.05)。尽管肝细胞表达无差异,但K14-Rac 1V 12 −/+小鼠显示皮肤特异性PCSK 9染色,这在人类银屑病皮损皮肤中得到证实。在银屑病患者中,PCSK 9水平与受损的内皮血管健康(例如早期动脉粥样硬化,β=4.5,p<0.01)和冠状动脉钙评分(β=0.30,p=0.01)相关,在校正了果糖风险、体重指数和活性生物制剂使用后,这两项指标仍具有显著性。总之,这些研究结果表明,独立于胆固醇,循环PCSK 9之间的关联,早期和晚期阶段的动脉粥样硬化银屑病。
Mechanisms explaining the link between psoriasis, a pro-inflammatory condition, and cardiovascular disease (CVD) are not fully known. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is predominantly expressed in hepatocytes as a critical regulator of lipid metabolism and clinical trials targeting PCSK9 reduce CVD. Independent of its role in lipid metabolism, PCSK9 levels associate with endothelial dysfunction and predict CV events. We used two separate human psoriasis cohorts and the K14-Rac1V12−/+ murine model of psoriasis to investigate PCSK9 and CV risk in psoriasis. In both psoriasis cohorts, (n=88 and n=20), PCSK9 levels were 20% and 13% higher than age, sex, and cholesterol matched controls respectively (p<0.05 for each comparison), and correlated with psoriasis area severity index (r=0.43, p<0.05). Despite no difference in hepatocyte expression, K14-Rac1V12−/+ mice demonstrated skin-specific PCSK9 staining which was confirmed in human psoriatic lesional skin. In psoriasis patients, PCSK9 levels correlated with impaired endothelial vascular health (e.g. early atherosclerosis, β=4.5, p<0.01) and coronary artery calcium score (β=0.30, p=0.01) which remained significant after adjustment for Framingham risk, body mass index and active biologic use. Taken together, these findings suggest independent of cholesterol, an association between circulating PCSK9, and early and advanced stages of atherosclerosis in psoriasis.
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