银屑病、心血管疾病与脂肪因子

Psoriasis,Cardiovascular Disease,and Adipokines

银屑病常合并代谢性疾病,且银屑病患者心血管疾病患病率明显升高。研究显示在代谢性疾病中发挥重要作用的脂肪因子在心血管疾病及银屑病患者中也存在表达水平的异常,脂肪因子可能在诱发加重银屑病及心血管疾病中扮演重要角色,是银屑病与心血管疾病相互影响的原因之一。研究表明与银屑病及心血管疾病相关的脂肪因子包括脂联素、瘦素、抵抗素、网膜素、内脂素、趋化素及视黄醇结合蛋白4等。其中脂联素、网膜素在银屑病患者中的水平较正常对照者下降,可能在银屑病中充当保护角色。同样,脂联素在心血管疾病中充当保护角色,而网膜素在心血管疾病中的作用尚有争议。瘦素、抵抗素、内脂素、趋化素及视黄醇结合蛋白4在银屑病及心血管疾病患者中较正常对照者升高,可能是银屑病及心血管疾病的致病因素,其中脂联素缺乏、瘦素、内脂素、趋化素已在体外实验或动物模型中证实可通过激活浆细胞样树突状细胞、T细胞等而诱发加重银屑病。但内脂素在体外实验中对心肌细胞发挥抗凋亡的保护作用。

Psoriasis usually combines with metabolic diseases,and the prevalence of cardiovascular disease remarkably increases in psoriatic patients.Adipokines,which play an important role in the cardiovascular diseases,also express abnormally in psoriasis and may induce or exacerbate the skin lesion.The adipokines associated with psoriasis and cardiovascular disease include adiponectin,leptin,resistin,omentin,visfatin,chemerin,and retinoid binding protein 4(RBP-4).The levels of adiponectin and omentin apparently decrease in psoriatic patients compared to healthy controls,and thus they may play protective roles for psoriasis.Similarly,adiponectin plays a protective role in cardiovascular disease,but the role of retina in cardiovascular disease is still controversial.However,the concentrations of leptin,resistin,visfatin,chemerin,and RBP-4 in patients with psoriasis or cardiovascular disease are significantly higher than those of the controls;therefore,they may serve as the pathogenic factors for both diseases.Low adiponectin,leptin,visfatin,and chemerin levels may induce or aggravate psoriasis by activating plasmacytoid dendritic cells or T cells,as demonstrated in in vitro experiments.However,in vitro experiments also have shown that visfatin may inhibit cardiomyocyte apoptosis.