CCL20 in Psoriasis: A Potential Biomarker of Disease Severity, Inflammation, and Impaired Vascular Health.

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Psoriasis is associated with increased cardiovascular risk that is not captured by traditional pro-inflammatory biomarkers.To investigate the relationship between psoriasis area and severity index (PASI), circulating pro-inflammatory biomarkers, and vascular health in psoriasis.In psoriasis and age, sex-matched controls, 273 proteins were analyzed utilizing the OLINK platform, while vascular endothelial inflammation and health was measured via direct transcriptomic analysis of brachial vein endothelial cells.In psoriasis, CCL20, IL-6, and IL-17A were the top three circulating pro-inflammatory cytokines. Vascular endothelial inflammation correlated with CCL20 (r=0.55, p<0.001) and less so with IL-6 (r=0.36, p=0.04) and IL-17A (r=0.29, p=0.12). After adjustment for potential confounders the association between CCL20 and vascular endothelial inflammation remained significant (β =1.71, p=0.02). In nested models, CCL20 added value (χ2 = 79.22, p<0.001) to a model already incorporating PASI, Framingham Risk, hs-CRP, Il-17A and IL-6 (χ2 = 48.18, p<0.001) in predicting vascular endothelial inflammation.Our study was observational and does not allow for causal inference in the relationship between CCL20 and cardiovascular risk.We demonstrate that CCL20 expression has a strong association with vascular endothelial inflammation, reflects systemic inflammation, and may serve as a potential biomarker of impaired vascular health in psoriasis.

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