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New Frontiers in Psoriasis: From Immunogenetics to the Concept of Endotypes

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 11371

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Dr. Giovanni Damiani

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Guest Editor

Dermatology Unit, Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
Interests: special populations; stigmatization and psychodermatology; hidradenitis suppurativa; systemic inflammation; dermatoepidemiology; multi-omics integration; machine learning; artificial intelligence; big data; biologics; systemic treatments
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Special Issue Information

Dear Colleagues,

Psoriasis is now a well-known systemic inflammatory disease that heavily impacts patients' quality of life; however, several efficacious treatments are currently available. Despite the latest therapeutic and biological advances, determining the most suitable drug for a patient (precision medicine) continues to be challenging.

Recently omics, big data, immunogenetics, and artificial intelligence have contributed to making precision medicine possible; in fact, all these technologies have allowed clinicians to better cluster psoriatic patients susceptible to responding to certain drugs or developing complications.

These clusters of clinical, biological, genetic, and therapeutic characteristics depict the endotypes.

This new approach is also of paramount importance in order to decrease healthcare costs related to anti-psoriatic drugs unresponsiveness, lack of response, and complications.

Within this Special Issue of the Journal of Clinical Medicine, we invite you to describe the state-of-the-art for psoriasis care, new therapeutical strategies omics-based, big data, and artificial intelligence contributions in psoriasis precision medicine.

We welcome both lab-based and dermatoepidemiological studies that may shed light on new therapeutic approaches in psoriasis care.

Dr. Giovanni Damiani
Guest Editor

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Keywords

Psoriasis
Hidradenitis suppurativa
Systemic inflammation
Dermatoepidemiology
Multi-omics integration
Machine learning
Artificial intelligence
Big-data
Biologics
Systemic treatments

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Research

11 pages, 485 KiB

Open AccessArticle

Psoriasis and Its Impact on In-Hospital Outcome in Patients Hospitalized with Acute Kidney Injury

by Johannes Wild, Lukas Hobohm, Thomas Münzel, Philip Wenzel, Kerstin Steinbrink, Susanne Karbach and Karsten Keller

J. Clin. Med. 2020, 9(9), 3004; https://doi.org/10.3390/jcm9093004 - 17 Sep 2020

Cited by 7 | Viewed by 2116

Abstract

Background: Psoriasis is a chronic inflammatory disease which affects the body far beyond the skin. Whereas there is solid evidence that chronic skin inflammation in psoriasis drives cardiovascular disease, the impact on renal impairment and acute kidney injury (AKI) is still unclear. We aimed to analyze the impact of psoriasis on the in-hospital outcome of patients hospitalized with AKI. Methods: In this retrospective database study, we investigated data on characteristics, comorbidities, and in-hospital outcomes for all hospitalized patients with AKI stratified for concomitant psoriasis, which were collected by the Federal Office of Statistics in Germany between 2005 and 2016. Results: Among the 3,162,449 patients treated for AKI in German hospitals between 2005 and 2016, 11,985 patients (0.4%) additionally suffered from psoriasis. While the annual number of AKI patients with psoriasis increased significantly from 485 cases (4.0%) in 2005 to 1902 (15.9%) in 2016 (p < 0.001), the in-hospital mortality decreased substantially (from 24.9% in 2005 to 17.4% in 2016; p < 0.001). AKI patients with concomitant psoriasis were younger (70 (IQR; 60–78) vs. 76 (67–83) years; p < 0.001) and were more often treated with dialysis (16.3% vs. 13.6%, p < 0.001). Presence of psoriasis in AKI patients was associated with reduced prevalence of myocardial infarction (OR 0.62; p < 0.001), stroke (OR 0.85; p = 0.013), and in-hospital mortality (OR 0.75; p < 0.001). Conclusions: AKI patients with psoriasis were hospitalized in median 6 years earlier than those without. Despite younger age, we detected higher use of kidney replacement therapy in patients with psoriasis, indicating a more severe course of AKI. Our findings might improve management of these patients and contribute evidence for extracutaneous, systemic manifestations of psoriasis. Full article

(This article belongs to the Special Issue New Frontiers in Psoriasis: From Immunogenetics to the Concept of Endotypes)

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14 pages, 1257 KiB

Open AccessArticle

Methotrexate Decreases the Level of PCSK9—A Novel Indicator of the Risk of Proatherogenic Lipid Profile in Psoriasis. The Preliminary Data

by Julita Anna Krahel, Anna Baran, Tomasz W. Kamiński, Magdalena Maciaszek and Iwona Flisiak

J. Clin. Med. 2020, 9(4), 910; https://doi.org/10.3390/jcm9040910 - 26 Mar 2020

Cited by 25 | Viewed by 3250

Abstract

Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) exerts an important role in inflammatory processes, lipids homeostasis, and cardiometabolic disorders that are closely associated with psoriasis. The aim of the study was to analyze the clinical and diagnostic value of serum PCSK9 concentrations and their connections with disease severity, inflammation, metabolic syndrome, and impact of systemic therapies in psoriatic patients. The study enrolled thirty-five patients with active plaque-type psoriasis and eighteen healthy volunteers served as controls. Blood samples were obtained before and after 12 weeks of treatment with methotrexate or acitretin. Serum PCSK9 concentrations were measured by the ELISA (Enzyme-Linked Immunosorbent Assay) commercial kits. Morphological and biochemical parameters were assayed using routine laboratory techniques. Psoriatic patients showed significantly elevated levels of PCSK9 compared to controls (p < 0.01), mostly in patients with a mild and moderate course of psoriasis. PCSK9 concentrations correlated positively with BMI and triglyceride levels (p < 0.05). Interestingly, PCSK9 had a strong negative correlation with low-density lipoprotein levels and total cholesterol (p < 0.05). Three months of monotherapy with methotrexate significantly reduced PCSK9 level (p < 0.05), on the contrary, the acitretin group showed a further increase of PCSK9 levels (p < 0.05). PCSK9 seems to be a novel marker of psoriasis and a putative explanation of lipid disturbances, which are common in patients with psoriasis and are vital for the further developing of metabolic syndrome. Methotrexate should be considered as a treatment of choice in patients with an elevated PCSK9 concentration. Full article

(This article belongs to the Special Issue New Frontiers in Psoriasis: From Immunogenetics to the Concept of Endotypes)

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17 pages, 4061 KiB

Open AccessArticle

Psoriasis and Psoriatic Arthritis Cardiovascular Disease Endotypes Identified by Red Blood Cell Distribution Width and Mean Platelet Volume

by Rosalynn RZ Conic, Giovanni Damiani, Kory P. Schrom, Amy E. Ramser, Chunlei Zheng, Rong Xu, Thomas S. McCormick and Kevin D. Cooper

J. Clin. Med. 2020, 9(1), 186; https://doi.org/10.3390/jcm9010186 - 9 Jan 2020

Cited by 61 | Viewed by 4987

Abstract

In a subset of psoriasis (PsO) and psoriatic arthritis (PsA) patients, the skin and/or joint lesions appear to generate biologically significant systemic inflammation. Red cell distribution width (RDW) and mean platelet volume (MPV) are readily available clinical tests that reflect responses of the bone marrow and/or plasma thrombogenicity (e.g., inflammation), and can be markers for major adverse cardiac events (MACE). We aimed to evaluate if RDW and MPV may be employed as inexpensive, routinely obtained biomarkers in predicting myocardial infarction (MI), atrial fibrillation (AF), and chronic heart failure (CHF) in psoriatic and psoriatic arthritis patients. The study was divided into two parts: (a) case control study employing big data (Explorys) to assess MPV and RDW in psoriasis, psoriatic arthritis and control cohorts; (b) a clinical observational study to validate the predictive value of RDW and to evaluate RDW response to anti-psoriatic therapies. We used Explorys, an aggregate electronic database, to identify psoriatic patients with available MPV and RDW data and compared them to gender and age matched controls. The incidence of myocardial infarction (MI), atrial fibrillation (AF), and chronic heart failure (CHF) was highest among patients with both elevated RDW and MPV, followed by patients with high RDW and normal MPV. RDW elevation among PsA patients was associated with an increased risk of MI, AF, and CHF. In a local clinical cohort, high RDWs were concentrated in a subset of patients who also had elevated circulating resistin levels. Among a small subset of participants who were treated with various systemic and biologic therapies, and observed over a year, and in whom RDW was elevated at baseline, a sustained response to therapy was associated with a decrease in RDW. RDW and MPV, tests commonly contained within routine complete blood count (CBC), may be a cost-effective manner to identify PsO and PsA patients at increased risk of MACE. Full article

(This article belongs to the Special Issue New Frontiers in Psoriasis: From Immunogenetics to the Concept of Endotypes)

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