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Von der Haut zum Gefäßsystem – Psoriasis und das kardiovaskuläre Risiko

From skin to the vasculature – psoriasis and cardiovascular risk

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Zusammenfassung

Psoriasis ist eine Interleukin-17A (IL-17A) mediierte Hauterkrankung, die mit einem erhöhten kardiovaskulären Risiko einhergeht. Sie stellt eine der häufigsten chronischen Hauterkrankungen in den europäischen Industrienationen dar. Lange Zeit wurde die kardiovaskuläre Komorbidität der Psoriasis auf ein vermehrt vorliegendes klassisches kardiovaskuläres Risikoprofil von Psoriasispatienten zurückgeführt wie Rauchen oder Adipositas. Mittlerweile weiß man jedoch, dass die schwere Psoriasis an sich ein neuer eigenständiger kardiovaskulärer Risikofaktor ist. Da das Zytokin IL-17A sowohl zu Hautinflammation als auch zu vaskulärer Inflammation führen kann, stellt es ein naheliegendes Bindeglied zwischen der Psoriasis und der kardiovaskulären Erkrankung dar. Eine kardiologische Mitbetreuung von Patienten mit schwerer Psoriasis scheint neben der dermatologischen Versorgung essenziell.

Abstract

Psoriasis is a skin disease mediated by interleukin 17A (IL-17A), which is associated with an increased cardiovascular risk. It is one of the most common chronic skin diseases in European industrial nations. For a long time the cardiovascular comorbidity of psoriasis was attributed to the increased presence of a classical cardiovascular risk profile in psoriasis patients, such as obesity and smoking; however, it is now known that severe psoriasis alone is a new independent cardiovascular risk factor. As the cytokine IL-17A can lead to skin inflammation and also evoke vascular inflammation, it thus forms an obvious connecting factor between psoriasis and the cardiovascular disease. In addition to dermatological treatment, cardiological treatment seems to be necessary in patients suffering from severe psoriasis.

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Danksagung

Wir danken Prof. Ari Waisman, Prof. Esther von Stebut, Prof. Jens Titze und besonders der Arbeitsgruppe um Prof. Philip Wenzel für anregende Diskussionen. Vielen Dank auch an Prof. Münzel für die wissenschaftliche Unterstützung. Vielen Dank ebenfalls an Prof. Grabbe und die Klinik für Dermatologie Mainz für die andauernde und gute Zusammenarbeit.

Funding

Die wissenschaftliche Arbeit der Autoren wird unterstützt durch die Deutsche Forschungsgemeinschaft (DFG KA 4035/1-1) für SK. JW erhält Unterstützung durch das Bundesministerium für Bildung und Forschung (Virchow-Fellowship). SK erhält Unterstützung durch das Bundesministerium für Bildung und Forschung (BMBF 01EO1503) und durch den SFB TR156. SK und JW werden unterstützt durch die Boehringer Ingelheim Foundation „Novel and neglected cardiovascular risk factors: molecular mechanisms and therapeutic implications“. JW und SK sind Mitglieder im Deutschen Zentrum für Herz-Kreislauf-Forschung, DZHK.

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Authors and Affiliations

  1. Zentrum für Kardiologie – Kardiologie 1, Universitätsmedizin Mainz, Langenbeckstr. 1, 55116, Mainz, Deutschland

    Johannes Wild &  Susanne Karbach

  2. Zentrum für Thrombose und Hämostase, Universitätsmedizin Mainz, Mainz, Deutschland

    Johannes Wild &  Susanne Karbach

  3. Hautklinik und Poliklinik, Universitätsmedizin Mainz, Mainz, Deutschland

    Joanna Wegner

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J. Wild, J. Wegner und S. Karbach geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Wild, J., Wegner, J. & Karbach, S. Von der Haut zum Gefäßsystem – Psoriasis und das kardiovaskuläre Risiko. Kardiologe 14, 205–211 (2020). https://doi.org/10.1007/s12181-019-00373-0

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