Influence of interleukin-6 gene polymorphisms in epicardial adipose tissue and coronary artery calcification in patients with psoriasis

Funding sources: This study was supported in part by an unrestricted grant from the Portuguese Society of Dermatology and Venereology. Conflicts of interest: none declared. Dear Editor, Psoriasis is currently considered a systemic inflammatory disorder associated with several comorbidities and an increased risk of cardiovascular disease (CVD).1 Several proinflammatory cytokines have been shown to have cutaneous and systemic overexpression and may be responsible not only for skin lesions but also for conditions associated with psoriasis.1 Epicardial adipose tissue (EAT), a type of visceral fat surrounding the heart, is now regarded as an important factor in the pathogenesis of coronary atherosclerosis and CVD through inflammatory burden proximal to the coronary arteries. EAT has been shown to be increased in patients with psoriasis independently of abdominal visceral fat (AVF) and has also been associated with subclinical atherosclerosis.2 Interleukin (IL)‐6 has been implicated in the pathogenesis of psoriasis1 and also in the pathogenesis of abdominal obesity,3 atherosclerosis and CVD.4 IL‐6 is produced by several cells, with adipose tissue accounting for up to 30% of total circulating concentrations in healthy subjects.3 The expression of many cytokines is thought to be influenced by polymorphisms in their gene loci and this may contribute to the development of psoriasis and also excess adiposity.3 The association between IL‐6 polymorphisms and psoriasis has been investigated,5 as well as their association with excess adiposity.3 Recognizing genetic markers that could predict which patients are at risk of developing psoriasis‐linked cardiovascular comorbidities may permit earlier management with important clinical implications.6 This study aimed to evaluate the potential contribution of four IL‐6 genetic variants (rs1800795, ‐174G>C; rs1800796, ‐572G>C; rs2069827, ‐1426G>T; rs2069840, ‐1753C>G) in psoriasis susceptibility and how they influence EAT and coronary artery calcification (CAC) in patients with severe psoriasis.