Naslov
Psoriasis as a systemic disease: metabolic comorbidities, epidemiology, etiopathogenesis, therapeutic options and public health goals

Autori
Stanimirović, Andrija ; Kovačević, Maja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
2/19. Kongres Udruženja dermatovenerologa Srbije / Zečević, Radoš - Beograd, 2013, 9-9

Skup
2/19. Kongres Udruženja dermatovenerologa Srbije

Mjesto i datum
Beograd, Srbija, 13.06.2013. - 15.06.2013

Vrsta sudjelovanja
Pozvano predavanje

Vrsta recenzije
Nije recenziran

Ključne riječi
psoriasis; comorbidities

Sažetak
Psoriasis is a systemic chronic immune-inflammatory-mediated disease that can have a significant impact on a patient's quality of life and it predisposes patients to other inflammatory conditions. Although the systemic nature of psoriasis very often remains unrecognized, the presented inflammatory processes may be associated with the development of various comorbidities which have a significant impact on the patient's health and quality of life. Psoriasis is associated with serious comorbidities. Traditional conditions include psoriatic arthritis, inflammatory bowel disease and psychiatric disorders. Recently recognized emerging comorbidities include cardiovascular disease and metabolic syndrome. Psoriasis patients have an increased prevalence of the main components of metabolic syndrome, including obesity, dyslipidemia, and insulin resistance. The relationship between psoriasis and comorbidities such as metabolic syndrome and cardiovascular diseases is most likely linked to the underlying chronic inflammatory origin of psoriasis. The molecular mechanisms involved in metabolic dysregulation associated with psoriasis are connected mainly to the action of increased levels of proinflammatory factors. Proinflammatory cytokines, such as tumor necrosis factor-alpha (TNF-alpha), as well other overproduced proinflammatory factors in patients with psoriasis likely contribute to the increased risk for development of metabolic syndrome. The metabolic syndrome is an important leader of adverse cardiovascular outcomes, so an integrated therapeutic approach targeting both cutaneous and systemic inflammation is of benefit, and strategies to improve overall management of the patient should be encouraged, in order to reduce the disease burden. For example, successful psoriasis treatment with methotrexate decreases the rates of cardiovascular incidents ; further, tumour necrosis factor-α (TNF-α) inhibitors are known to possess high protective effect against the development of diabetes or cardiovascular comorbidities in psoriatic patients. The recent data indicate a role for earlier and more appropriate treatment of psoriasis with systemic drugs such as TNF-α antagonists.As psoriasis and its comorbidities therefore represent obvious increased cardiovascular risk factors, they must be taken into account by GP and family physicians when estimating treatment goals for the comorbidities ; tertiary care specialists need to introduce a more complex treatment approach, including aspects of lifestyle advise and intervention. Finally, effective long-term anti-inflammatory, disease-modifying therapy may contribute to reducing patients' cardiovascular risk and improve the life quality and expectancy.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA