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Multiscale biology of cardiovascular risk in psoriasis: Protocol for a case-control study

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BACKGROUND: Patients with psoriasis have increased risk of cardiovascular disease (CVD) independent of traditional risk factors. The molecular mechanisms underlying the psoriasis-CVD connection are not fully understood. Advances in high-throughput molecular profiling technologies and computational analysis techniques offer new opportunities to improve the understanding of disease connections.

OBJECTIVE: We aim to characterize the complexity of cardiovascular risk in patients with psoriasis by integrating deep phenotypic data with systems biology techniques to perform comprehensive multiomic analyses and construct network models of the two interacting diseases.

METHODS: The study aims to include 120 adult patients with psoriasis (60 with prior atherosclerotic CVD and 60 without CVD). Half of the patients are already receiving systemic antipsoriatic treatment. All patients complete a questionnaire, and a medical interview is conducted to collect medical history and information on, for example, socioeconomics, mental health, diet, and physical exercise. Participants are examined clinically with assessment of the Psoriasis Area and Severity Index and undergo imaging by transthoracic echocardiography, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT), and carotid artery ultrasonography. Skin swabs are collected for analysis of microbiome metagenomics; skin biopsies and blood samples are collected for transcriptomic profiling by RNA sequencing; skin biopsies are collected for immunohistochemistry; plasma samples are collected for analyses of proteomics, lipidomics, and metabolomics; blood samples are collected for high-dimensional mass cytometry; and feces samples are collected for gut microbiome metagenomics. Bioinformatics and systems biology techniques are utilized to analyze the multiomic data and to integrate data into a network model of CVD in patients with psoriasis.

RESULTS: Recruitment was completed in September 2020. Preliminary results of 18F-FDG-PET/CT data have recently been published, where vascular inflammation was reduced in the ascending aorta (P=.046) and aortic arch (P=.04) in patients treated with statins and was positively associated with inflammation in the visceral adipose tissue (P<.001), subcutaneous adipose tissue (P=.007), pericardial adipose tissue (P<.001), spleen (P=.001), and bone marrow (P<.001).

CONCLUSIONS: This systems biology approach with integration of multiomics and clinical data in patients with psoriasis with or without CVD is likely to provide novel insights into the biological mechanisms underlying these diseases and their interplay that can impact future treatment.


TidsskriftJMIR research protocols
Udgave nummer9
StatusUdgivet - sep. 2021

Bibliografisk note

Funding Information:
The study is supported by the LEO Foundation (grant LF16115). The LEO Foundation has no role in the design of the study; in the collection, analysis, and interpretation of data; and in writing this manuscript. Joel Dudley, PhD, and Brian Kidd, PhD, are acknowledged for their initial roles in the study design and the development of the molecular profiling strategy. We also acknowledge the Human Immune Monitoring Core and the Genomics Core Facility at Icahn School of Medicine at Mount Sinai for their contributions toward the study design and sample processing.

Funding Information:
PRH is the recipient of a Borregaard clinical scientist fellowship from the Novo Nordisk Foundation and chairs a clinical academic group supported by the Greater Region of Copenhagen. CB is a consultant for Onegevity Health. LS has been a paid speaker for AbbVie, Eli Lilly, and LEO Pharma, and has been a consultant or has served on advisory boards for AbbVie, Janssen Cilag, Novartis, Eli Lilly, LEO Pharma, UCB, Admirall, and Sanofi. Moreover, she has served as an investigator for AbbVie, Janssen Cilag, Boehringer Ingelheim, AstraZeneca, Eli Lilly, Novartis, Regeneron, and LEO Pharma and has received research and educational grants from Pfizer, AbbVie, Novartis, Sanofi, Janssen Cilag, and LEO Pharma. CZ has been a scientific consultant, advisor, investigator, and speaker for Eli Lilly, Jansen Cilag, Novartis, Abb Vie, Takeda, Amgen, Almirall, CSL Behring, UCB, Regeneron, MSD, and LEO Pharma. HK, AKH, XW, BDM, MK, PMG, and KMAH declare that they have no competing interests.

Publisher Copyright:
©Hannah Kaiser, Amanda Kvist-Hansen, Christine Becker, Xing Wang, Benjamin D McCauley, Martin Krakauer, Peter Michael Gørtz, Kristoffer Mads Aaris Henningsen, Claus Zachariae, Lone Skov, Peter Riis Hansen.

ID: 70537000