Impaired aortic elastic properties in normotensive patients with psoriasis.

OBJECTIVE: Psoriasis is a chronic inflammatory disease affecting approximately 1.5-3% of the general population. Several studies have demonstrated an association between psoriasis and atherosclerosis. The aim of this study is the investigate relation between aortic wall stiffness and duration and severity of the disease in patients with psoriasis. METHOD: The study population included 58 patients with psoriasis (27 men, mean age = 36.3 ± 10.6 years, and mean disease duration = 9.8 ± 6.7 years) and 36 healthy control subjects (17 men, and mean age = 40.0 ± 11.1 years). Aortic stiffness index, aortic strain and distensibility, were calculated from the aortic systolic and diastolic diameters measured by echocardiography and blood pressure obtained by sphygmomanometer. Cardiac functions were determined by using echocardiography, consisting of standard two-dimensional and conventional Doppler. RESULTS: The conventional echocardiographic parameters were similar between patients and controls. There were significant differences between the control and the patient groups in aortic stiffness index (2.7 ± 1.0 vs 2.0 ± 0.8, p = 0.001), aortic strain (10.3 ± 3.3% vs 14.2 ± 4.5%, p <0.001) and distensibility (4.2 ± 1.7 × 10(-6) cm(2)/dyn vs 5.8 ± 2.0 × 10(-6) cm(2)/dyn, p=0.001). There were significant negative correlations between the disease duration and distensibility (r = -0.54, p < 0.001), aortic strain (r=-0.41, p=0.001), aortic diameter change (r = -0.35, p = 0.007) and positive correlations between the disease duration and aortic stiffness index (r = 0.58, p < 0.001). Also heart rate and high-sensitive C reactive protein were significantly higher in psoriasis patients than in healthy controls (80.0 ± 11.8 beats/min vs 72.4 ± 8.8 beats/min, p = 0.001 and 9.7 ± 21.4 mg/l vs 3.7 ± 2.1 mg/l, p = 0.04, respectively). CONCLUSION: Aortic stiffness measurements were found abnormal in patients with psoriasis. We have also demonstrated that there were significant correlations between aortic stiffness parameters and disease duration. This study suggests that aortic stiffness measurement could be used for assessment of cardiovascular risk in psoriasis patients, and that only continuous long-term disease control may be helpful in reducing the cardiovascular risk associated with psoriasis.

Micronucleus evaluation in mitogen-stimulated lymphocytes of narrow-band (311 nm TL01) UVB-treated patients.

BACKGROUND: Narrow-band UVB (311 nm) lamps (TL01) are being increasingly used for phototherapy of psoriasis and other dermatoses, for their excellent effect compared with broad-band UVB sources and photochemotherapy. It is acknowledged that the TL01 lamp is probably two to three times more carcinogenic per minimum erythema dose than broad-band UVB, but the cumulative dose is considerably less than broadband UVB sources. Micronucleus (MN) test is used to detect both clastogenic (breaking) and aneugenic (abnormal segregation) effect of physical/chemical agents on chromosomes. The aim of this study is to evaluate MN frequencies in mitogen-stimulated lymphocytes of narrow-band UVB-treated patients. METHODS: Frequency of micronuclei in 72 h cultivated/mitogen-stimulated lymphocytes of 36 patients (age 7-73 years, mean+/-SD: 25.33+/-18.54) have been evaluated at pretreatment and after 20, 40, 60 sessions of narrowband UVB treatment. RESULTS: While the beginning MN frequency +/-SD (%) was 1.07+/-0.63, it increased to 1.47+/-0.92, 1.47+/- 0.77, 1.41+/-0.31 corresponding, respectively, to 20, 40, 60 sessions. These sessions reciprocally correspond to 0.85+/-0.23, 2.97+/-0.72, 5.68+/-1.46 J/cm(2) doses of narrow-band UVB. Difference of MN frequency was statistically significant (P=0.002). Significant differences have been observed between the initial MN frequency and after that of 20, 40, 60 sessions (P=0.001, 0.004, 0.002, respectively). CONCLUSIONS: The results of this study show that narrow-band UVB treatment causes a detectable chromosome damaging effect.

Micronucleus evaluation in mitogen-stimulated lymphocytes of PUVA treated patients.

PUVA describes the treatment of patients with psoralens plus an exposure to a source of UV light of 320-400 nm (UVA). Contradictory results have been reported on the chromosomal damage of PUVA when assayed by sister chromatid exchange (SCE) method. Micronucleus (MN) test is used to detect both clastogenic (breaking) and aneugenic (abnormal segregation) effect of physical/chemical agents on the chromosomes. No data have been found on the MN formation in the cells of PUVA treated patients. Frequency of micronuclei in 72 hours cultivated/mitogen-stimulated lymphocytes of patients have been evaluated at zero time and after 20, 40, 60 sessions of PUVA treatment. While the beginning MN frequency was approximately 0.22% (n=23), it raised to approximately 0.32 (n=23), approximately 0.42 (n=14) and approximately 0.53% (n=10) corresponding respectively to 20, 40 and 60 sessions. These sessions correspond reciprocally to 54+/-23, 172+/-48, 300+/-61 joules/cm2 of UVA and 13, 26, 39 mg/kg of 8-metoxypsoralen (8-MOP). While large interindividual variances were apparent, highly significant differences have been observed between initial MN frequency and after that of the 20, 40 and 60 sessions, (p = 0.000, p = 0.004, p = 0.005, reciprocally, Wilcoxon two-related samples test). The coefficient of correlation between MN frequency and UVA doses starting from zero to 60 sessions of treatment has been found as r = 0.61. This indicates a significant relationship between UVA doses and MN frequencies. However, MN inducibility and synergistic property of 8-MOP with UVA should be taken into account. Gradual MN increase during different sessions of PUVA treatment shows that--once appeared--a part of MN at least persist in the cells of patients from a few days to a few weeks. Smoking as a confounding factor seems to increase MN frequency (p = 0.053, Mann-Whitney U-test) in the beginning population, taken as the control population. This is the first report on the kinetics of MN formation during different sessions of PUVA treatment. Based on our results, we concluded that PUVA treatment causes a detectable chromosome damaging effect on the relatively profound cells/tissues of its human users. Therapists should be careful with its use, especially on the patients who may be more susceptible to carcinogenesis (e.g. immunosuppressed and/or elderly subjects).