PSORIASIS Y ENFERMEDAD CARDIOVASCULAR: MECANISMOS INMUNOLÓGICOS Y MOLECULARES.

José Manuel Ríos Yuil; Emma Yuil de Ríos

Submitted October 20, 2024

Published 2026-03-02

Artículos de Investigación

Vol. 24 No. 1 (2011): Revista Médico Científica

PSORIASIS AND CARDIOVASCULAR DISEASE: IMMUNE AND MOLECULAR MECHANISMS.

José Manuel Ríos Yuil ⁺⁻
Emma Yuil de Ríos⁺⁻

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Published: 2026-03-02

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Abstract

Psoriasis is a chronic systemic inflammatory disease related to an increased risk of cardiovascular disease and many other comorbidities. Many cytokines are elevated in psoriasis such as: tumor necrosis factor alpha (TNF-?), interferon gamma, interleukins 6, 8, 12, 17, 18, among others. An elevated concentration of TNF-? favors the development of metabolic syndrome, diabetes mellitus and cardiovascular disease. This occurs because TNF-? generates insulin resistance by interfering with its signal transduction pathway. Insulin resistance contributes to the pathogenesis of metabolic syndrome by generating hyperglycemia and compensatory hyperinsulinemia which favor the development of obesity, hepatic steatosis, dyslipidemia and atherosclerotic disease.

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References

Puig-Sanz L. La sistémica?. Actas Dermosifiliogr 2007; 98: 396-402.
Ejaz A, Raza N, Iftikhar N, Iftikhar A, Farooq M. Presentation of early onset psoriasis in comparison with late onset psoriasis: a clinical study from Pakistan. Ind J Dermatol Venereol Leprol 2009; 75: 36-40.
García Pérez A. Dermatología clínica. Quinta edición. Salamanca, España. Editorial Cervantes. 1997. p. 229, 238, 275-8, 280-1, 406, 541, 579.
Mazzini M. Dermatología clínica. Segunda edición. Buenos Aires, Argentina. López Libreros Editores. 1985. p. 120, 152, 395, 497, 504, 506-7.
Traub M, Marshall K. Psoriasis – Pathophysiology, conventional, and alternative approaches to treatment. Altern Med Rev. 2007; 12: 319-30.
Kourosh AS, Miner A, Menter A. Psoriasis as the marker of underlying systemic disease. Skin Therapy Lett. 2008; 13: 1-5.
Augustin M, Reich K, Glaeske G, Schaefer I, Radtke M. Co-morbidity and age-related prevalence of psoriasis: Analysis of health insurance data in Germany. Acta Derm Venereol. 2010; 90: 147-51.
Choi WJ, Park EJ, Kwon IH, Kim KH, Kim KJ. Association between psoriasis and cardiovascular risk factors in Korean patients. Ann Derm. 2010; 22: 300-6.
Kaplan M. Cardiometabolic risk in psoriasis: differential effects of biologic agents. Vasc Health Risk Manag. 2008; 4: 1229-35.
Contessa C, Ramonda R, Lo Nigro A, Modesti V, Lorenzin M, Puato M, Zanon M, Balbi G, Doria A, Punzi L. Subclinical atherosclerosis in patients with psoriatic arthritis: a case-control study. Preliminary data. Reumatismo. 2009; 61: 298-305.
Soy M, Yildiz M, Sevki Uyanik M, Karaca N, Güfer G, Piskin S. Susceptibility to atherosclerosis in patients with psoriasis and psoriatic arthritis as determined by carotid-femoral (aortic) pulse-wave velocity measurement. Rev Esp Cardiol. 2009; 62: 96-9.
Cohen AD, Weitzman D, Dreiher J. Psoriasis and hypertension: a case-control study. Acta Derm Venereol. 2010; 90: 23-6.
Setty AR, Curhan G, Choi HK. Obesity, waist circumference, weight change and the risk of psoriasis in women: Nurses' Health Study II. Arch Intern Med. 2007; 167: 1670-5.
Sidiropoulos P, Karvounaris S, Boumpas D. Metabolic syndrome in rheumatic diseases: epidemiology, pathophysiology and clinical implications. Arthritis Res Ther 2008; 10: 207.
Mukherjee S, Maitra A. Molecular & genetic factors contributing to insulin resistance in polycystic ovary syndrome. Ind J Med Res. 2010; 131: 743-60.
Choi K, Kim YB. Molecular Mechanism of Insulin Resistance in Obesity and Type 2 Diabetes. Korean J Intern Med. 2010 Jun; 25(2): 119-29.
Lee YH, White MF. Insulin receptor substrate proteins and diabetes. Arch Pharm Res. 2004; 27: 361-70.
Schleyer V, Landthaler M, Szeimies RM. Novel pharmacological approaches in the treatment of psoriasis. J Eur Acad Dermatol Venereol. 2005; 19: 1-20.
Nestle FO, Conrad C. The IL-12 family member p40 chain as a master switch and novel therapeutic target in psoriasis. J Invest Dermatol. 2004; 123: xiv-xv.
Rios JM. Nuevos conceptos en la fisiopatología de la psoriasis. Revista Medica-CSS 2009; 35(1): 50-56.
Arican O, Aral M, Sasmaz S, Ciragil P. Serum levels of TNF-?, IFN-?, IL-6, IL-8, IL-12, IL-17, and IL-18 in Patients with Active Psoriasis and Correlation with Disease Severity. Mediators Inflamm. 2005; 5: 273-9.
Duarte GV, Follador I, Cavalheiro CMA, Silva TS, Oliveira MFSP. Psoriasis and obesity: literature review and recommendations for management. An Bras Dermatol. 2010; 85: 355-60.
Ghazizadeh R, Shimizu H, Tosa M, Ghazizadeh M. Pathogenic mechanisms shared between psoriasis and cardiovascular disease. Int J Med Sci. 2010; 7: 284-9.
Rizvi AA. Inflammation markers as mediators of vasculo-endothelial dysfunction and atherosclerosis in the metabolic syndrome and type 2 diabetes. Chin Med J. 2007; 120: 1918-24.
Kiortsis DN, Mavridis AK, Vasakos S, Nikas SN, Drosos AA. Effects of infliximab treatment on insulin resistance in patients with rheumatoid arthritis and ankylosing spondylitis. Ann Rheum Dis. 2005; 64: 765-6.
Picchi A, Gao X, Belmadani S, Potter BJ, Focardi M, Chilian WM. Tumor necrosis factor-? induces endothelial dysfunction in the prediabetic metabolic syndrome. Circ Res. 2006; 99: 69-77.
Plomgaard P, Keller P, Keller C, Pedersen BK. TNF-?, but not IL-6, stimulates plasminogen activator inhibitor expression in human subcutaneous adipose tissue. J Appl Physiol. 2005; 98: 2019-23.
Gwozdziewiczová S, Lichnovská R, Ben Yahia R, Chlup R, Hrebicek J. TNF-? in the development of insulin resistance and other disorders in metabolic syndrome. Biomed Papers. 2005; 149: 109-17.
Wullaert A, van Loo G, Heyninck K, Beyaert R. Hepatic tumor necrosis factor signaling and nuclear factor-?B: effects on liver homeostasis and beyond. Endocr Rev. 2007; 28: 365-86.
Tilg H, Moschen AR. Inflammatory mechanisms in the regulation of insulin resistance. Mol Med. 2008; 14: 222-31.
Rabe K, Lehrke M, Parhofer KG, Broedl UC. Adipokines and insulin resistance. Mol Med. 2008; 14: 741-51.
Aguirre V, Werner ED, Giraud J, Lee YH, Shoelson SE, White MF. Phosphorylation of Ser307 in insulin receptor substrate-1 blocks interactions with the insulin receptor and inhibits insulin action. J Biol Chem. 2002 Jan 11; 277(2): 1531-7.
Plomgaard P, Bouzakri K, Krogh-Madsen R, Mittendorfer B, Zierath JR, Pedersen BK. Tumor necrosis factor-? induces skeletal muscle insulin resistance in healthy human subjects via inhibition of Akt substrate 160 phosphorylation. Diabetes. 2005 Oct; 54(10): 2939-45.
Friedman JE, Kirwan JP, Jing M, Presley L, Catalano PM. Increased skeletal muscle tumor necrosis factor-? and impaired insulin signaling persist in obese women with gestational diabetes mellitus 1 year postpartum. Diabetes. 2008; 57: 606-13.
Savage DB, Petersen KF, Shulman GI. Disordered lipid metabolism and the pathogenesis of insulin resistance. Physiol Rev. 2007; 87: 507-20.

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[1] Puig-Sanz L. La sistémica?. Actas Dermosifiliogr 2007; 98: 396-402.

[2] Ejaz A, Raza N, Iftikhar N, Iftikhar A, Farooq M. Presentation of early onset psoriasis in comparison with late onset psoriasis: a clinical study from Pakistan. Ind J Dermatol Venereol Leprol 2009; 75: 36-40.

[3] García Pérez A. Dermatología clínica. Quinta edición. Salamanca, España. Editorial Cervantes. 1997. p. 229, 238, 275-8, 280-1, 406, 541, 579.

[4] Mazzini M. Dermatología clínica. Segunda edición. Buenos Aires, Argentina. López Libreros Editores. 1985. p. 120, 152, 395, 497, 504, 506-7.

[5] Traub M, Marshall K. Psoriasis – Pathophysiology, conventional, and alternative approaches to treatment. Altern Med Rev. 2007; 12: 319-30.

[6] Kourosh AS, Miner A, Menter A. Psoriasis as the marker of underlying systemic disease. Skin Therapy Lett. 2008; 13: 1-5.

[7] Augustin M, Reich K, Glaeske G, Schaefer I, Radtke M. Co-morbidity and age-related prevalence of psoriasis: Analysis of health insurance data in Germany. Acta Derm Venereol. 2010; 90: 147-51.

[8] Choi WJ, Park EJ, Kwon IH, Kim KH, Kim KJ. Association between psoriasis and cardiovascular risk factors in Korean patients. Ann Derm. 2010; 22: 300-6.

[9] Kaplan M. Cardiometabolic risk in psoriasis: differential effects of biologic agents. Vasc Health Risk Manag. 2008; 4: 1229-35.

[10] Contessa C, Ramonda R, Lo Nigro A, Modesti V, Lorenzin M, Puato M, Zanon M, Balbi G, Doria A, Punzi L. Subclinical atherosclerosis in patients with psoriatic arthritis: a case-control study. Preliminary data. Reumatismo. 2009; 61: 298-305.

[11] Soy M, Yildiz M, Sevki Uyanik M, Karaca N, Güfer G, Piskin S. Susceptibility to atherosclerosis in patients with psoriasis and psoriatic arthritis as determined by carotid-femoral (aortic) pulse-wave velocity measurement. Rev Esp Cardiol. 2009; 62: 96-9.

[12] Cohen AD, Weitzman D, Dreiher J. Psoriasis and hypertension: a case-control study. Acta Derm Venereol. 2010; 90: 23-6.

[13] Setty AR, Curhan G, Choi HK. Obesity, waist circumference, weight change and the risk of psoriasis in women: Nurses' Health Study II. Arch Intern Med. 2007; 167: 1670-5.

[14] Sidiropoulos P, Karvounaris S, Boumpas D. Metabolic syndrome in rheumatic diseases: epidemiology, pathophysiology and clinical implications. Arthritis Res Ther 2008; 10: 207.

[15] Mukherjee S, Maitra A. Molecular & genetic factors contributing to insulin resistance in polycystic ovary syndrome. Ind J Med Res. 2010; 131: 743-60.

[16] Choi K, Kim YB. Molecular Mechanism of Insulin Resistance in Obesity and Type 2 Diabetes. Korean J Intern Med. 2010 Jun; 25(2): 119-29.

[17] Lee YH, White MF. Insulin receptor substrate proteins and diabetes. Arch Pharm Res. 2004; 27: 361-70.

[18] Schleyer V, Landthaler M, Szeimies RM. Novel pharmacological approaches in the treatment of psoriasis. J Eur Acad Dermatol Venereol. 2005; 19: 1-20.

[19] Nestle FO, Conrad C. The IL-12 family member p40 chain as a master switch and novel therapeutic target in psoriasis. J Invest Dermatol. 2004; 123: xiv-xv.

[20] Rios JM. Nuevos conceptos en la fisiopatología de la psoriasis. Revista Medica-CSS 2009; 35(1): 50-56.

[21] Arican O, Aral M, Sasmaz S, Ciragil P. Serum levels of TNF-?, IFN-?, IL-6, IL-8, IL-12, IL-17, and IL-18 in Patients with Active Psoriasis and Correlation with Disease Severity. Mediators Inflamm. 2005; 5: 273-9.

[22] Duarte GV, Follador I, Cavalheiro CMA, Silva TS, Oliveira MFSP. Psoriasis and obesity: literature review and recommendations for management. An Bras Dermatol. 2010; 85: 355-60.

[23] Ghazizadeh R, Shimizu H, Tosa M, Ghazizadeh M. Pathogenic mechanisms shared between psoriasis and cardiovascular disease. Int J Med Sci. 2010; 7: 284-9.

[24] Rizvi AA. Inflammation markers as mediators of vasculo-endothelial dysfunction and atherosclerosis in the metabolic syndrome and type 2 diabetes. Chin Med J. 2007; 120: 1918-24.

[25] Kiortsis DN, Mavridis AK, Vasakos S, Nikas SN, Drosos AA. Effects of infliximab treatment on insulin resistance in patients with rheumatoid arthritis and ankylosing spondylitis. Ann Rheum Dis. 2005; 64: 765-6.

[26] Picchi A, Gao X, Belmadani S, Potter BJ, Focardi M, Chilian WM. Tumor necrosis factor-? induces endothelial dysfunction in the prediabetic metabolic syndrome. Circ Res. 2006; 99: 69-77.

[27] Plomgaard P, Keller P, Keller C, Pedersen BK. TNF-?, but not IL-6, stimulates plasminogen activator inhibitor expression in human subcutaneous adipose tissue. J Appl Physiol. 2005; 98: 2019-23.

[28] Gwozdziewiczová S, Lichnovská R, Ben Yahia R, Chlup R, Hrebicek J. TNF-? in the development of insulin resistance and other disorders in metabolic syndrome. Biomed Papers. 2005; 149: 109-17.

[29] Wullaert A, van Loo G, Heyninck K, Beyaert R. Hepatic tumor necrosis factor signaling and nuclear factor-?B: effects on liver homeostasis and beyond. Endocr Rev. 2007; 28: 365-86.

[30] Tilg H, Moschen AR. Inflammatory mechanisms in the regulation of insulin resistance. Mol Med. 2008; 14: 222-31.

[31] Rabe K, Lehrke M, Parhofer KG, Broedl UC. Adipokines and insulin resistance. Mol Med. 2008; 14: 741-51.

[32] Aguirre V, Werner ED, Giraud J, Lee YH, Shoelson SE, White MF. Phosphorylation of Ser307 in insulin receptor substrate-1 blocks interactions with the insulin receptor and inhibits insulin action. J Biol Chem. 2002 Jan 11; 277(2): 1531-7.

[33] Plomgaard P, Bouzakri K, Krogh-Madsen R, Mittendorfer B, Zierath JR, Pedersen BK. Tumor necrosis factor-? induces skeletal muscle insulin resistance in healthy human subjects via inhibition of Akt substrate 160 phosphorylation. Diabetes. 2005 Oct; 54(10): 2939-45.

[34] Friedman JE, Kirwan JP, Jing M, Presley L, Catalano PM. Increased skeletal muscle tumor necrosis factor-? and impaired insulin signaling persist in obese women with gestational diabetes mellitus 1 year postpartum. Diabetes. 2008; 57: 606-13.

[35] Savage DB, Petersen KF, Shulman GI. Disordered lipid metabolism and the pathogenesis of insulin resistance. Physiol Rev. 2007; 87: 507-20.

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