Soluble lectin-like oxidized LDL receptor-1, or sLOX-1, was elevated in psoriasis and associated with lipid-rich noncalcified coronary burden independent of hyperlipidemia status, according to results published in JAMA Dermatology.
“The pro-inflammatory state in psoriasis is associated with elevated sLOX-1 levels,” Amit K. Dey, MD, postdoctoral fellow of the National Heart, Lung and Blood Institute at NIH, and colleagues wrote. “Additionally, sLOX-1 levels are associated with lipid-rich noncalcified coronary plaque burden independent of hyperlipidemia status in patients with psoriasis, supporting a role for sLOX-1 in modulation of lipid-rich plaque in psoriasis.”
One hundred seventy-five patients with psoriasis and 94 age- and sex-matched controls underwent blood draw and CCTA imaging at baseline and 1-year follow-up. Change in psoriasis severity was calculated with Psoriasis Area and Severity Index (PASI) score from baseline to follow-up.
Levels of circulating sLOX-1 were measured at the NIH laboratory by field scientists under blinded review using an ELISA-based assay (MedImmune) developed with the Meso Scale Discovery platform (Meso Scale Discovery). Patients completed a questionnaire on smoking, previous CVD, family history of CVD, hypertension and diabetes. Responses were confirmed during examination by a health care professional.
The patients had a low median cardiovascular risk by Framingham risk score (2.0; IQR, 1.0-6.0) and a mean BMI of 29.6, suggestive of overweight profiles.
Those with psoriasis had moderate to severe disease with a median PASI score of 5.6 (3.0-9.2), and 37 of those patients (21%) were receiving biologic psoriasis therapy at baseline. Additionally, those with psoriasis had significantly elevated median levels of sLOX-1 at 210.3 (110.9-336.2) compared with age- and sex-matched controls at 83.7 (40.1-151.0) (P < .001).
There was a linear dependent association between sLOX-1 and psoriasis severity ( = 0.23; 95% CI, 0.082-0.374), which remained after adjusting for risk factors such as Framingham risk score, BMI, statin use and biologic psoriasis treatment ( = 0.20; 95% CI, 0.05-0.35).
Moreover, sLOX-1 was also associated with noncalcified coronary burden independent of hyperlipidemia status in psoriasis ( = 0.11; 95% CI, 0.02-0.20), which also held in the fully adjusted model ( = 0.10; 95% CI, 0.01-0.19).
There was an improvement in psoriasis severity of at least 50% in 45 of 138 patients (33%) at 1 year compared with either less than 50% improvement or a worsening of severity in 93 of 138 patients (67%).
At 1 year, a decrease was seen in high-sensitivity C-reactive protein levels and sLOX-1 levels in the PASI50 responders.
The researchers suggested further studies evaluating sLOX-1 within chronic inflammation and cardiometabolic disease. – by Abigail Sutton
Disclosures: Dey reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.