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The following is a summary of “Relationship of Soluble Lectin‐Like Low‐Density Lipoprotein Receptor‐1 (sLOX‐1) With Inflammation and Coronary Plaque Progression in Psoriasis,” published in the November 2023 issue of Cardiology by Florida et al.

Psoriasis, a chronic inflammatory condition, has been linked to an augmented risk of coronary artery disease. Our investigation focused on elucidating the correlation between the soluble extracellular domain of the lectin-like low-density lipoprotein receptor-1 (sLOX-1), inflammation, and the advancement of coronary plaque in individuals with psoriasis. We conducted a study involving 327 psoriasis patients, analyzing their serum sLOX-1 levels at baseline through an ELISA-based assay. Subsequent stratification based on high-sensitivity C-reactive protein (hs-CRP) levels ≥4.0 mg/L (quartile 4) identified 81 participants who underwent coronary plaque phenotyping at baseline and were longitudinally monitored via coronary computed tomography angiography. 

Within the quartile 4 hs-CRP subgroup, the participants were typically middle-aged (mean age: 51.47±12.62 years), predominantly male (54.3%), and exhibited moderate severity of psoriasis (6.60 [interquartile range, 3.30–13.40]). Notably, individuals displaying sLOX-1 levels above the median exhibited an escalation in vulnerable coronary plaque characteristics. At baseline, elevated sLOX-1 levels were associated with increased total burden (rho=0.296; P=0.01), noncalcified burden (rho=0.286; P=0.02), fibro-fatty burden (rho=0.346; P=0.004), and necrotic burden (rho=0.394; P=0.002) within the study cohort. Strong associations between sLOX-1, noncalcified burden (β=0.19; P=0.03), and fibro-fatty burden (β=0.29; P=0.003) persisted in fully adjusted models at baseline, as well as at 1- and 4-year follow-ups. Notably, coronary plaque features continued to progress over one year regardless of whether subjects were undergoing biologic or systemic treatments, particularly in those with elevated sLOX-1 levels.

In conclusion, individuals with psoriasis exhibiting high levels of both sLOX-1 and hs-CRP demonstrate amplified coronary plaque burden, which contributes to atherosclerotic plaque advancement independently of biologic or systemic treatments. Hence, sLOX-1 emerges as a potential marker for estimating coronary artery disease risk, offering additional insights beyond conventional risk factors.

Source: ahajournals.org/doi/10.1161/JAHA.123.031227