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