Biological anti-psoriatic therapy profoundly affects high-density lipoprotein function.

Area of Science:

• Cardiovascular Research
• Dermatology
• Immunology

Background:

• Psoriasis is a chronic inflammatory skin condition associated with increased cardiovascular disease risk.
• Impaired high-density lipoprotein (HDL) function may contribute to cardiovascular mortality in psoriasis.
• Limited data exists on how biologic anti-psoriatic therapies affect HDL composition and function.

Purpose of the Study:

• To investigate the impact of biologic anti-psoriatic therapies on HDL functionality and composition.
• To compare HDL function in psoriasis patients before and after short-term and intermediate-term biologic treatment.

Main Methods:

• Blood samples were collected from healthy volunteers and psoriasis patients at baseline and after 3-6 months and 1-2 years of biologic therapy.
• Biologics used included anti-interleukin (IL)-12/23p40, anti-IL17A, and anti-tumor necrosis factor-α antibodies.
• HDL function was assessed by measuring cholesterol efflux capacity, paraoxonase, and lecithin-cholesterol acyltransferase activities.

Main Results:

• Psoriasis patients at baseline exhibited impaired HDL function compared to controls.
• Biologic therapy, particularly intermediate-term, significantly reduced HDL cholesterol efflux capacity and made HDL more pro-inflammatory.
• All tested biologics induced similar alterations in HDL composition, subclass distribution, and cholesterol efflux capacity.

Conclusions:

• Anti-psoriatic biologic therapy is associated with significant changes in HDL functionality, particle composition, and subclass distribution.
• These HDL alterations may have implications for the cardiovascular risk in psoriasis patients undergoing biologic treatment.
• Further research is needed to understand the long-term cardiovascular consequences of these HDL changes.