Genetic Link Between Heart Disease And Psoriasis

Main Category: Eczema / Psoriasis
Also Included In: Genetics;  Heart Disease
Article Date: 29 Oct 2005 - 19:00 PST

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Genetic links between psoriasis - the systemic skin disease - and heart disease has been suggested by new research from the internationally-renowned Karolinska Institute in Sweden.

The results from the five-year study suggest that cardiovascular disease is associated with abnormal blood cholesterol levels from the outset, suggesting a genetic link between the diseases. This discovery may be the key to genetic profiling for psoriasis. Profiling could be an essential tool for finding innovative, more targeted forms of diagnosis and treatment for the 125 million people around the globe who live with the misery of psoriasis and psoriatic arthritis.

The results are being released to mark the second World Psoriasis Day, a global event organised by the International Federation of Psoriasis Associations (IFPA) to campaign for increased awareness of the condition.

The research adds weight to IFPA's call - captured in an international petition also being launched for World Psoriasis Day - for the World Health Organization to put psoriasis on its list of serious diseases. This would be the first stage in helping more people around the world to access much needed treatment.

Psoriasis is a serious systemic disease affecting around 3% of the world population that can cause debilitating discomfort and distress. Approximately 23% of those with psoriasis - that's 28 million - develop painful psoriatic arthritis. Quality of life research shows that people with psoriasis have almost the same reduction in quality of life as people with diseases such as cancer, diabetes or depression. Psoriasis can even lead some patients to consider suicide.

Main research findings

The results indicate that the skin inflammation associated with psoriasis could be a warning sign for other future health problems.

Cholesterol and heart disease

-- Genetically-determined blood characteristics may be putting people with severe psoriasis at greater risk of cardiovascular disease and death.

-- This is because people with severe psoriasis, especially those under 40, have higher than average blood cholesterol levels, which cannot be accounted for by common cholesterol-raising factors such as smoking, diet or exercise.

Possible implications

-- Although it is known that there are certain triggers for psoriasis, it is not known why these triggers affect some people and not others.

-- This research could open the way for genetic profiling for psoriasis, which would will help scientists better understand the causes and implications of psoriasis, identify those at most risk of developing the condition and develop preventative measures.

-- Psoriasis is often misdiagnosed or dismissed by physicians and, while it is believed to be an inherited disease, many of those who have it do not know about a family member with the same condition so are not aware that they may be at risk.

Other findings - joint disease

-- The study also found that up to 15% of patients with the common form of psoriasis (plaque psoriasis) experience psoriasis-related joint disease in the early stages of psoriasis.

-- Joint disease appears to be an intrinsic part of psoriasis for a significant proportion of people, not simply something that can develop after decades of illness.

Possible implications

-- The study emphasises that psoriasis is a systemic disease that can progressively escalate into a physically debilitating condition.

-- The findings substantiate the need for people with psoriasis to receive appropriate treatment to alleviate the disease as soon as it is diagnosed and for early symptoms of joint disease to be taken seriously by physicians.

Lars Ettarp, President of IFPA, says: "The latest findings from the Karolinska Institute study emphasise the need for perceptions of psoriasis to change urgently. This is a serious systemic disease and not a cosmetic condition, but the importance of psoriasis and psoriatic arthritis has not fully been recognised by the international scientific and medical community. We want the World Health Organisation to take note of this research and help to raise the profile of the disease so that those who have it are given a better standard of care. Anyone who supports this goal should sign our petition."

Call to action - worldwide petition

The World Psoriasis Day international petition is calling for the World Health Organisation (WHO) to take urgent action to recognise psoriasis as a condition deserving of pressing international attention. The petition urges the WHO to take the first step by including psoriasis on its list of serious diseases, so opening the way for better diagnosis and treatment.

The petition - available on worldpsoriasisday.com - gives a voice to all those with psoriasis and psoriatic arthritis who do not feel that their views are currently being given the attention they deserve. Anyone with an interest in psoriasis or psoriatic arthritis should lend their support by signing the petition.

Plaque psoriasis

About 80% of those who have psoriasis have this form. It is characterized by raised, inflamed, red lesions covered by a silvery white scale. It is typically found on the elbows, knees, scalp and lower back, although it can occur on any area of the skin.

Quality of Life research relating to psoriasis

See for example: Choi J, Koo JY, Journal of the American Academy of Dermatology. 2003 Aug;49(2 Suppl):S57-61.

The Karolinksa Institute study

The Stockholm Psoriasis Cohort was established in the year 2000 and recruitment is still ongoing. Today the cohort comprises more than 600 individuals over the age of 15 with recent onset (less than 12 months) of psoriasis.

The overall aim of the project is to generate detailed and robust knowledge about the disease. The perspective is broad; dissecting clinical phenotypes, identifying associated triggers, follow-up of disease development, associated diseases and response to treatment, all of which is set against the underlying genetic background and immunology of the disease.

The Karolinska Institute (www.ki.se), Stockholm, is one of Europe's largest medical universities. It is also Sweden�s largest centre for medical training and research, accounting for 30% of the medical training and 40% of the medical academic research that is conducted nationwide.

The International Federation of Psoriasis Associations (IFPA) IFPA is a nonprofit organization made up of psoriasis associations from around the world. IFPA unites psoriasis associations so that their global campaign for improved medical care, greater public understanding and increased research will improve the lives of people who live with psoriasis and psoriatic arthritis. For more information see http://www.ifpa-pso.org

Events to mark World Psoriasis Day

Events are being held by patient associations around the globe. For more details see www.worldpsoriasisday.com or contact Blue Rubicon.

In all countries people with psoriasis or psoriatic arthritis are being encouraged to wear blue and orange - the World Psoriasis Day colours - to show their support.

Case studies

Case studies of people with psoriasis and psoriatic arthritis are available for interview. Please contact Blue Rubicon for details.

Julia Muir, Sarah Jaconelli or Catherine Bayles at Blue Rubicon
Telephone 020 7340 0430 or Email julia.muir@bluerubicon.com

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