**8. Protrombotic state**

A proinflammatory and/or prothrombotic state has been associated with MetS and PsO, probably linked to elevated serum levels of PAI-1, fibrinogen and CRP. Elevated CRP levels are induced by IL-6 and they have been shown to be predictive of future CVD in initially

Metabolic Features in Psoriasis 117

a PsO-PsA patient; these increased serum glucose levels resolved after adalimumab

Similar to Infliximab and Etanercept, Adalimumab does not modify lipid profiles and it

Despite further studies on anti-TNF-alpha drug effect on MetS syndrome are required, an examination of literature data suggest that the combined effects of improved insulin resistance and sensitivity and a significant reduction in systemic inflammation may

Taking into consideration the high potentiality of biological therapies to reduce the metabolic effect of TNF-alpha, the future goal might be to demonstrate a real in vivo preventing effect on development of cardiovascular comorbidities in Pso/PsA patients. For

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Antoniou, KM.; Mamoulaki, M.; Malagari, K.; Kritikos, HD.; Bouros, D.; Siafakas, NM. &

Armstrong, AW.; Lin, SW.; Chambers, CJ.; Sockolov, ME. & Chin, DL. (2011) Psoriasis and

Browning, JD.; Szczepaniak, LS.; Dobbins, R. & al. (2004). Prevalence of hepatic steatosis in

Capeau, J. (2008). Insulin resistance and steatosis in humans. *Diabet and Metab*., 34,649-57. Channual, J.; Wu, JJ. & Dann, FJ. (2009) Effects of tumor necrosis factor-alpha blockade on

lessons learned from rheumatoid arthritis. *Dermatol Ther*.,22(1),61-73. Chung, CP.; Oeser, A.; Raggi, P.; Gebretsadik, T.; Shintani, AK.; Sokka, T.; Pincus, T.;

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de Luca, C. & Olefsky, JM. (2008). Inflammation and Insulin Resistance. *FEBS Lett*., 582(1),

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system that identifies liver fibrosis in patients with NAFLD. *Hepatology.,*45(4),846-

Boumpas, D. (2007). Infliximab therapy in pulmonary fibrosis associated with

Hypertension Severity: Results from a Case-Control Study. *PLoSONE.,*6(3),e18227.

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**10. Conclusion** 

**11. References** 

54.

increases BMI and weight gain (Saraceno R et al, 2009).

interrupt inflammatory cascade linking PsO and MetS.

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these reason other longitudinal long term clinical studies are needed.

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healthy individuals, and the risk of CVD in patients with either diabetes or MetS is significantly increased in the presence of elevated CRP levels (Gottlieb A et al, 2008).
