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Assessment of microvesicles from different cell origins in patients with psoriasis: evidence of thrombogenic, proinflammatory microenvironment in the absence of established cardiovascular disease

Abstract

Psoriasis is associated with increased cardiovascular risk. Endothelial, platelet, and erythrocyte microvesicles (MVs) are novel biomarkers of endothelial dysfunction and thromboinflammation. We explored whether MVs of different cell types are elevated in patients with psoriasis, and investigated potential associations with disease severity and macrovascular function. Endothelial, platelet and erythrocyte MVs were measured using a standardized flow cytometry protocol in psoriasis patients and controls free from established cardiovascular disease. Carotid intima-media thickness (IMT) and pulse wave velocity (PWV) were measured as markers of subclinical atherosclerosis and arterial stiffness. Psoriasis severity was assessed with PASI (Psoriasis Area Severity Index). Both platelet (p < 0.001) and erythrocyte MVs (p = 0.046), yet not endothelial MVs, were significantly increased in patients with psoriasis (n = 41) compared with controls (n = 41). Patients with higher PASI (≥10) presented significantly higher levels of ErMVs compared to those with lower PASI (<10) (p = 0.047). Carotid IMT and PWV were comparable between psoriasis patients and controls and did not significantly correlate with MVs. In the multivariate analysis, psoriasis was identified as an independent predictor of both platelet (p < 0.001) and erythrocyte MVs (p = 0.043), while hypertension was independently associated with endothelial MVs (p < 0.001). Increased formation of platelet and erythrocyte MVs may be evident in psoriasis patients and is indicative of prothrombotic, proinflammatory microenvironment, even in the absence of subclinical macrovascular dysfunction and before the clinical onset of overt cardiovascular complications. Potential mechanistic links and prognostic implications of increased MVs in psoriasis warrant further investigation.

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Data available upon reasonable request from the corresponding author.

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Funding

P.A., E. Gavriilaki and E. Gkaliagkousi are funded by European Social Fund- ESF through the Operational Program “Human Resources Development, Education and Lifelong Learning 2014-2020” in the context of the project “Evaluation of novel markers of endothelial dysfunction and thrombotic microenvironment in patients with rheumatoid arthritis: association with markers of subclinical inflammation and cardiovascular damage (MIS 5047870)”.

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Conceptualization, EG (Eugenia Gkaliagkousi) and SD; methodology, EG (Eugenia Gkaliagkousi) and AP; validation, AL, and BN; formal analysis, PA; investigation, AM, EY, and AL; data curation, EG (Eleni Gavriilaki) and AT; writing—original draft preparation, KG, AM, and EG (Eleni Gavriilaki); writing—review and editing, PA; supervision, EG (Eugenia Gkaliagkousi) and EL; funding acquisition, EG (Eugenia Gkaliagkousi) and SD.

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Correspondence to Panagiota Anyfanti.

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The study was conducted in accordance with the Helsinki declaration and was approved by the institutional ethics committee. Written informed consent was provided before inclusion in the study.

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Margouta, A., Anyfanti, P., Lazaridis, A. et al. Assessment of microvesicles from different cell origins in patients with psoriasis: evidence of thrombogenic, proinflammatory microenvironment in the absence of established cardiovascular disease. J Hum Hypertens 37, 925–930 (2023). https://doi.org/10.1038/s41371-022-00787-6

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