Differential Effects of Biologics on Psoriasis-Related Vascular Inflammation and Risk of Thrombosis

Psoriasis is associated with an increased risk of cardiovascular disease beyond that due to traditional risk factors. The underlying mechanisms of this enhanced risk are not clear, although the high prevalence of atherosclerosis in these patients is consistent with a low-grade systemic inflammation affecting the CV system. This study evaluates the impact of psoriasis on vascular inflammation (leukocyte/endothelium interactions) and on the formation of thrombi, and assesses the influence of drugs from the major pharmacological families used to treat psoriasis on both vascular features by means of a comprehensive experimental approach using blood samples from psoriatic patients and a well-established translational animal model of the disease. Our results suggest that psoriasis coexists with a state of vascular inflammation, as demonstrated by the presence of activated circulating leukocytes in the blood of patients. Treatment with anti-TNFα and anti-IL-17 drugs, but not anti-IL-12/23, prevented leukocyte recruitment by the endothelium, and protected against the onset of thrombosis in an animal model of psoriasis. Overall, our findings endorse the idea that treatment of psoriasis with some of the currently prescribed biological drugs can have a positive impact on concomitant manifestations of vascular inflammation and on the increased risk of cardiovascular events associated with the disease.