JMIR Publications

ABSTRACT

Background:

Patients with psoriasis have increased risk of cardiovascular disease (CVD) independent of traditional risk factors. The molecular mechanisms underlying the psoriasis-CVD connection are not fully understood. Advances in high-throughput molecular profiling technologies and computational analysis techniques offer new opportunities to improve understanding of disease connections.

Objective:

In this study we aim to characterize the complexity of cardiovascular risk in patients with psoriasis by integrating deep phenotypic data with systems biology techniques to perform comprehensive multi-omic analyses and construct network models of the two interacting diseases.

Methods:

The study includes 120 adult patients with psoriasis, namely 60 with prior atherosclerotic CVD and 60 without CVD. Half of the patients are already receiving systemic anti-psoriatic treatment. All patients complete a questionnaire and a medical interview is conducted to collect medical history and information on, for example, socioeconomics, mental health, diet and physical exercise. Participants are examined clinically with assessment of Psoriasis Area and Severity Index and undergo imaging by transthoracic echocardiography, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) and carotid artery ultrasonography. Skin swabs are collected for analysis of microbiome metagenomics, skin biopsies and blood samples for transcriptomic profiling by RNA-sequencing, skin biopsies for immunohistochemistry, plasma samples for analyses of proteomics, lipidomics and metabolomics, blood samples for high dimensional mass cytometry, and feces samples for gut microbiome metagenomics, respectively. Bioinformatics and systems biology techniques are utilised to analyze the multi-omic data and to integrate data into a network model of CVD in patients with psoriasis.

Results:

Recruitment was completed in September 2020. A preliminary result of 18F-FDG-PET/CT data has recently been published. All analyses are underway, and results are expected to be published in 2021/22.

Conclusions:

This system biology approach with integration of multi-omics and clinical data in patients with psoriasis with or without CVD is likely to provide novel insights into the biological mechanisms underlying these diseases and their interplay that can impact future treatment.