Relationship between chronic stress-related neural activity, physiological dysregulation and coronary artery disease in psoriasis: Findings from a longitudinal observational cohort study. (October 2020)

• Record Type: Journal Article
• Authors: Lateef, Sundus S.; Al Najafi, Mina; Dey, Amit K.; Batool, Mariyam; Abdelrahman, Khaled M.; Uceda, Domingo E.; Reddy, Aarthi S.; Svirydava, Maryia D.; Nanda, Navya; Ortiz, Jenis E.; Prakash, Nina; Rodante, Justin A.; Keel, Andrew; Zhou, Wunan; Chen, Marcus Y.; Playford, Martin P.; Teague, Heather L.; Tawakol, Ahmed A.; Gelfand, Joel M.; Powell-Wiley, Tiffany M.; Mehta, Nehal N.
• Is Part Of: Atherosclerosis. Volume 310(2020)
• Page Start: 37
• Page End: 44
• Publication Date: 2020-10
• Subjects: Stress -- Amygdalar activity -- Allostatic load score -- Coronary artery disease -- Physiological dysregulation; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2020.07.012
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: Amygdalar 18F-fluorodeoxyglucose (FDG) uptake represents chronic stress-related neural activity and associates with coronary artery disease by coronary computed tomography angiography (CCTA). Allostatic load score is a multidimensional measure related to chronic physiological stress which incorporates cardiovascular, metabolic and inflammatory indices. To better understand the relationship between chronic stress-related neural activity, physiological dysregulation and coronary artery disease, we studied the association between amygdalar FDG uptake, allostatic load score and subclinical non-calcified coronary artery burden (NCB) in psoriasis. Methods: Consecutive psoriasis patients (n = 275 at baseline and n = 205 at one-year follow-up) underwent CCTA for assessment of NCB (QAngio, Medis). Amygdalar FDG uptake and allostatic load score were determined using established methods. Results: Psoriasis patients were middle-aged, predominantly male and white, with low cardiovascular risk by Framingham risk score and moderate-severe psoriasis severity. Allostatic load score associated with psoriasis severity (β = 0.17, p = 0.01), GlycA (a systemic marker of inflammation, β = 0.49, p < 0.001), amygdalar activity (β = 0.30, p < 0.001), and NCB (β = 0.39; p < 0.001). Moreover, NCB associated with amygdalar activity in participants with high allostatic load score (β = 0.27; p < 0.001) but not in those with low allostatic load score (β = 0.07; p = 0.34). Finally, in patients with an improvement in allostatic load score at one year, there was an 8% reduction in amygdalar FDG uptake ( p < 0.001) and a 6% reduction in NCB ( p = 0.02). Conclusions: In psoriasis, allostatic load score represents physiological dysregulation and may capture pathways by which chronic stress-related neural activity associates with coronary artery disease, emphasizing the need to further study stress-induced physiological dysregulation in inflammatory disease states. Graphical abstract: Image 1 Highlights: Allostatic load score represents physiological stress mechanisms. Allostatic load associates with increases in psoriasis severity and systemic inflammation. Neural stress activity relates to allostatic load score. Allostatic load score relates to subclinical atherosclerosis at baseline and over time.