Figure 1.

Systemic effects of chronic low-grade inflammation in psoriasis. (A) Psoriasis, both cutaneous and arthritic, is a low-grade chronic, systemic inflammatory disease associated with increased circulating pro-inflammatory cytokines. (B) Chronic inflammation in psoriasis is associated with adipose tissue dysfunction characterized by pro-inflammatory cytokines and adipokines associated with endothelial dysfunction. (C) Furthermore, psoriasis exhibits a deranged lipid profile and impaired HDL function, which in combination with chronic inflammation accelerate atherosclerotic vascular disease. (D) The vessel wall is infiltrated through a complex interplay of pro-inflammatory cellular components, cholesterol crystals, and various lipoproteins. Over the time, with build-up of the plaque, this atherosclerotic lesion poses a significant threat to blood flow and is prone to rupture, often accelerated by inflammation leading to myocardial infarction. (E) Thus, psoriasis and psoriatic arthritis upregulate T-cell, neutrophil chemotaxis, and keratinocyte activation and endothelial dysfunction leading to increased atherosclerosis in blood vessels. Abbreviations: TNF-α, tumor necrosis factor-alpha; IL, interleukin; IFN-γ, interferon-gamma.