Psoriatic arthritis (PsA) is associated with cardiovascular disease (CVD), but the underlying mechanisms of this link are unclear. Researchers sought to identify contributors to CVD in patients with PsA using positron emission tomography-computed tomography (PET-CT) imaging and other techniques. The study, published in Frontiers in Immunology, showed that PsA-mediated visceral adiposity and adipose inflammation were potential inflammatory and metabolic contributors for subclinical coronary artery disease (CAD).

Furthermore, the investigators theorized a link between the interleukin (IL)-6-related systemic inflammation in patients with PsA and the development of atherosclerotic plaque. They proposed that therapies targeting IL-6 may be valuable for preventing CVD in this population.

The study included 39 patients with PsA and coronary CT angiography-confirmed CAD. The authors assessed the patients’ traditional CVD risk factors, serum markers for inflammation, metabolic dysfunction, inflammatory cytokines, 18fluorine-fluorodeoxyglucose (18F-FDG) uptake, and radiographic measures of metabolic dysfunction to explore links between PsA and CVD.

Results showed that patients with PsA had elevated visceral (P=.005) and subcutaneous (P=.004) adiposity, body mass index (P=.001), hemoglobin A1C (P=.037), high sensitivity C-reactive protein (P=.005), IL-6 (P=.003), IFN-γ (P=.006), and liver FDG uptake (P=.03) when compared with non-psoriatic controls. Additionally, these markers were more pronounced in participants with more severe skin disease.

The authors specified that visceral adiposity (standardized β = 0.681; P=.002), bone marrow FDG uptake (standardized β = 0.488; P=.008), and liver (standardized β = 0.619; P<.001), spleen (standardized β = 0.523; P=.004), and subcutaneous adipose (standardized β = 0.524; P=.003) were all significantly correlated with subclinical CAD.

The collaborators presented their findings to clarify the potential inflammatory and metabolic mechanisms related to PsA that appear to drive the link between PsA and CVD; however, they acknowledged that further studies are needed to validate their inferences and explore novel therapy options.

Reference: Schwartz DM, Parel P, Li H, et al. PET/CT-Based Characterization of 18F-FDG Uptake in Various Tissues Reveals Novel Potential Contributions to Coronary Artery Disease in Psoriatic Arthritis. Front Immunol. 2022;13:909760. doi:10.3389/fimmu.2022.909760