7 Giugno 2022
JJ Wu, A Kavanaugh, MG Lebwohl, R Gniadecki, JF Merola

Psoriasis and metabolic syndrome: implications for the management and treatment of psoriasis

J Eur Acad Dermatol Venereol. 2022 Jun;36(6):797-806
  • La sindrome metabolica è la più frequente comorbidità nella psoriasi e un fattore di rischio di malattia cardiovascolare, una causa maggiore di morte tra i pazienti con psoriasi.
  • La disregolazione della via dell’IL-23/Th-17 ha un ruolo centrale in entrambe le patologie e può avere un ruolo chiave nella suscettibilità alla malattia metabolica/cardiovascolare nei pazienti con e senza psoriasi.


Psoriasis is a chronic systemic inflammatory disorder associated with several comorbidities in addition to the characteristicskin lesions. Metabolic syndrome (MetS) is the most frequent comorbidity in psoriasis and a risk factor for cardiovascular dis-ease, a major cause of death among patients with psoriasis. Although the exact causal relationship between these two disor-ders is not fully established, the underlying pathophysiology linking psoriasis and MetS seems to involve overlapping geneticpredispositions and inflammatory pathways. Dysregulation of the IL-23/Th-17 immune signalling pathway is central to bothpathologies and may be key to promoting susceptibility to metabolic and cardiovascular diseases in individuals with and with-out psoriasis. Thus, biological treatments for psoriasis that interrupt these signals could both reduce the psoriatic inflammatoryburden and also lessen the risk of developing atherosclerosis and cardiometabolic diseases. In support of this hypothesis,improvement of skin lesions was associated with improvement in vascular inflammation in recent imaging studies, demonstrat-ing that the beneficial effect of biological agents goes beyond the skin and could help to prevent cardiovascular disease. Thisreview will summarize current knowledge on underlying inflammatory mechanisms shared between psoriasis and MetS anddiscuss the most recent clinical evidence for the potentialfor psoriasis treatment to reduce cardiovascular risk.Received: 15 October 2021; Accepted: 11 February 2022

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