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Volume 15
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10.3390/ph15020172
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Article

Apremilast Improves Endothelial Glycocalyx Integrity, Vascular and Left Ventricular Myocardial Function in Psoriasis

by
Ignatios Ikonomidis
1,*,
George Pavlidis
1,
Nikolaos Kadoglou
2,
George Makavos
1,
Konstantinos Katogiannis
1,
Aikaterini Kountouri
3,
John Thymis
1,
Gavriella Kostelli
1,
Irini Kapniari
4,
Konstantinos Theodoropoulos
4,
John Parissis
1,
Pelagia Katsimbri
5,
Evangelia Papadavid
4,† and
Vaia Lambadiari
3,†
1
2nd Department of Cardiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
2
Medical School, University of Cyprus, 2029 Nicosia, Cyprus
3
2nd Department of Internal Medicine, Research Unit and Diabetes Center, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
4
2nd Department of Dermatology and Venereology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
5
4th Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
*
Author to whom correspondence should be addressed.
†
Both senior authors equally contributed to this manuscript.
Pharmaceuticals 2022, 15(2), 172; https://doi.org/10.3390/ph15020172
Submission received: 22 December 2021 / Revised: 26 January 2022 / Accepted: 27 January 2022 / Published: 30 January 2022
(This article belongs to the Special Issue Drug Candidates for the Prevention and Treatment of Cardiovascular Diseases)
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Abstract

The phosphodiesterase 4 inhibitor apremilast is used for the treatment of psoriasis. We investigated the effects of apremilast on endothelial glycocalyx, vascular and left ventricular (LV) myocardial function in psoriasis. One hundred and fifty psoriatic patients were randomized to apremilast (n = 50), anti-tumor necrosis factor-α (etanercept; n = 50), or cyclosporine (n = 50). At baseline and 4 months post-treatment, we measured: (1) Perfused boundary region (PBR), a marker of glycocalyx integrity, in sublingual microvessels with diameter 5–25 μm using a Sidestream Dark Field camera (GlycoCheck). Increased PBR indicates damaged glycocalyx. Functional microvascular density, an index of microvascular perfusion, was also measured. (2) Pulse wave velocity (PWV-Complior) and (3) LV global longitudinal strain (GLS) using speckle-tracking echocardiography. Compared with baseline, PBR5–25 μm decreased only after apremilast (−12% at 4 months, p < 0.05) whereas no significant changes in PBR5–25 μm were observed after etanercept or cyclosporine treatment. Compared with etanercept and cyclosporine, apremilast resulted in a greater increase of functional microvascular density (+14% versus +1% versus −1%) and in a higher reduction of PWV. Apremilast showed a greater increase of GLS (+13.5% versus +7% versus +2%) than etanercept and cyclosporine (p < 0.05). In conclusion, apremilast restores glycocalyx integrity and confers a greater improvement of vascular and myocardial function compared with etanercept or cyclosporine after 4 months.
Keywords: psoriasis; phosphodiesterase 4; apremilast; endothelial glycocalyx; perfused boundary region; myocardial deformation psoriasis; phosphodiesterase 4; apremilast; endothelial glycocalyx; perfused boundary region; myocardial deformation
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MDPI and ACS Style

Ikonomidis, I.; Pavlidis, G.; Kadoglou, N.; Makavos, G.; Katogiannis, K.; Kountouri, A.; Thymis, J.; Kostelli, G.; Kapniari, I.; Theodoropoulos, K.; et al. Apremilast Improves Endothelial Glycocalyx Integrity, Vascular and Left Ventricular Myocardial Function in Psoriasis. Pharmaceuticals 2022, 15, 172. https://doi.org/10.3390/ph15020172

AMA Style

Ikonomidis I, Pavlidis G, Kadoglou N, Makavos G, Katogiannis K, Kountouri A, Thymis J, Kostelli G, Kapniari I, Theodoropoulos K, et al. Apremilast Improves Endothelial Glycocalyx Integrity, Vascular and Left Ventricular Myocardial Function in Psoriasis. Pharmaceuticals. 2022; 15(2):172. https://doi.org/10.3390/ph15020172

Chicago/Turabian Style

Ikonomidis, Ignatios, George Pavlidis, Nikolaos Kadoglou, George Makavos, Konstantinos Katogiannis, Aikaterini Kountouri, John Thymis, Gavriella Kostelli, Irini Kapniari, Konstantinos Theodoropoulos, and et al. 2022. "Apremilast Improves Endothelial Glycocalyx Integrity, Vascular and Left Ventricular Myocardial Function in Psoriasis" Pharmaceuticals 15, no. 2: 172. https://doi.org/10.3390/ph15020172

APA Style

Ikonomidis, I., Pavlidis, G., Kadoglou, N., Makavos, G., Katogiannis, K., Kountouri, A., Thymis, J., Kostelli, G., Kapniari, I., Theodoropoulos, K., Parissis, J., Katsimbri, P., Papadavid, E., & Lambadiari, V. (2022). Apremilast Improves Endothelial Glycocalyx Integrity, Vascular and Left Ventricular Myocardial Function in Psoriasis. Pharmaceuticals, 15(2), 172. https://doi.org/10.3390/ph15020172

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