FUNCTIONAL STATE OF ENDOTHELIUM IN PATIENTS WITH PSORIASIS
Authors:   Hippocrates Medical Center, Sterlitamak, ARSLANOVA RENATA M. , MUTALOVA ELVIRA G ,   Bashkir State Medical University, KHISMATULLINA ZAREMA R. ,   Bashkir State Medical University, NIGMATULLINA ALBINA E. ,   Bashkir State Medical University, GALYAUTDINOVA VELENA R. ,   Bashkir State Medical University, KAMALTDINOVA GULNARA J. ,   Bashkir State Medical University, ASADULLINA GULNARA V. ,   Bashkir State Medical University, SAMIGULLINA LIANA I. ,   Bashkir State Medical University, RUSTYAMOVA ZULFIYA Y. ,   Bashkir State Medical University, SADIKOVA REGINA I. ,   Bashkir State Medical University, FRID SVETLANA A. ,   Bashkir State Medical University, KAMALTDINOV ELDAR R. ,   Bashkir State Medical University, MUSINA FLARISA S. ,   Bashkir State Medical University
Published: March 2024

Abstract. Introduction. Psoriasis is an independent risk factor for cardiovascular diseases, accompanied by an increased risk of mortality from cardiovascular diseases, as compared with the population, which is mainly associated with chronic systemic inﬂammation (increased levels of C-reactive protein, ﬁbrinogen, and homocysteine) and with the accumulation of conventional cardiovascular risk factors, such as dyslipidemia, obesity, decreased physical activity, and arterial hypertension. There are only few studies evaluating the link between psoriasis, inﬂammation, and cardiovascular disease. Our aim was to study the relationship between pro-inﬂammatory mediators and the endothelium functional state indicators of the in patients with psoriasis. Materials and Methods. We examined 116 patients with veriﬁed psoriasis, aged 19-62 years. The control group consisted of 25 comparably aged and practically healthy individuals. The diagnosis was made considering the psoriasis clinical form, stage, seasonality, type, and severity. All patients underwent a standard laboratory and instrumental examination. The levels of pro-inﬂammatory markers (IL-6, VEGF,CRPvh) were determined by enzyme-linked immunosorbent assay using commercial ELISA-BEST kits manufactured by OOO Vector-Best, Novosibirsk, Russia. The endothelial function was assessed by using the Biomedical ENDOTELIN test system by BioKhimMak JSC to measure the quantitative content of endothelin-1, a characteristic of the vasomotor function of endothelium, determined by ultrasound according to the method proposed by Celermajer D. et al. Results and Discussion. The study revealed a high incidence of the disease in people of working age and a slight predominance among male patients. In 55.2% of patients, classic atherosclerosis risk factors were identiﬁed: Arterial hypertension, smoking, low physical activity, alcohol abuse, and improper nutrition. 33.6% of patients were overweight; 24.1% had obesity I-II degree, and 39.7% with abdominal obesity. According to the ﬁndings of the study of pro-inﬂammatory markers in the blood serum, there is a signiﬁcant increase in their levels as compared with the control group indicators, which correlates with the severity of psoriasis and a decrease in the ratio of IL-6/CRPvh. Endothelial dysfunction was characterized by a statistically signiﬁcant increase in endothelin-1 and a signiﬁcant increase in the content of vascular endothelial growth factor (VEGF) in the blood serum of psoriasis patients. Percentage increase in the brachial artery diameter on the endothelium-dependent stimulus was reduced and averaged 9.14% in the group of patients with psoriasis. Conclusion. A high comorbidity of psoriasis and cardiovascular diseases has been established. A signiﬁcant increase in the levels of systemic immune inﬂammation mediators IL-6 and C-RBhv and a decrease in the ratio of IL-6/C-RPhvh were identiﬁed, which correlates with the severity of the disease and the presence of cardiovascular diseases. Vascular endothelium dysfunction is characterized by an increase in the content of ET-1 and VEGF in the blood serum and a decrease in the ﬂow-mediated dilatation of the brachial artery.