PSORIASIS AND COMORBIDITIES – CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

Over recent years psoriasis has been classified as a systemic chronic inflammatory disorder and has been linked with several diseases and conditions that are also immune-mediated inflammatory conditions.

Chronic obstructive pulmonary disease (COPD) is characterized by the gradual progression of irreversible airflow obstruction and increased inflammation in the airways and lungs that is generally distinguishable from the inflammation caused by asthma. The symptoms of COPD are shortage of breath, increased risk of bronchitis and emphysema. There are a variety of factors associated with an enhanced chronic inflammatory response have been implicated in the development of COPD, including immune regulation defects, genetic susceptibility, infection, and environmental factors. Smoking being the most important environmental risk factor and key cause. 1, 2

Research has found that increased smoking intensity also corresponds to a higher risk of developing severe psoriasis whilst longer cumulative duration smoking (pack-years) increases the overall likelihood of developing psoriasis. (For more information read on our blog Psoriasis and Smoking). 3

Whilst the exact relationship between psoriasis and COPD remains unclear and controversial among some clinicians, the current research has found consistent association between psoriasis and COPD suggesting a likely pathophysiologic link between the two diseases. The hypothesis of a common cytokine-based pathology, wherein one inflammatory autoimmune disease significantly increased the risk of another, is gradually being accepted.1

COPD in the general population can affect up to 10% across all race types. There appears to be a general consensus that patients with psoriasis are at a greater risk of developing COPD. Preliminary research data has found that the risk to developing COPD by psoriasis patients is increased by between 2.35% and 5.7%. The association between psoriasis and COPD was even stronger in patients with severe psoriasis.  Another study also pointed out that patients >50 years and men were more susceptible to developing COPD.  In another study concentrating only on patients with psoriatic arthritis, COPD was the fifth most frequently found comorbidity, behind only to hypertension, obesity, diabetes, and kidney disease.2, 3

Researchers noted that psoriasis and COPD present shared risk factors such as obesity and physical inactivity, and that both diseases are associated with metabolic syndrome. (Metabolic syndrome includes high blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol levels.) These factors could be confounding factors in the association between these two diseases.

Psoriasis patients should of course monitor their blood pressure and sugar serum levels. Controlling one’s weight is also important. If you are concerned about the status of your health please contact your Health Care Practitioner.

And lastly it is recommended that those with psoriasis quit smoking. Not only can smoking trigger and exacerbate psoriasis but it also increases the risk for psoriasis smokers to develop COPD.

You may find these links helpful in your QUIT program:

quitline

http://www.quitnow.gov.au/

 

 

American Lung Association   

http://www.lung.org/stop-smoking/

 

 

SSMOKEFREE    NHS

https://www.nhs.uk/smokefree

 

Check out the Quit Smoking campaigns or websites in your country.

 

 

REFERENCES

  1. Li, Xin et al. “Association between Psoriasis and Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.” Ed. Alexander V. Alekseyenko. PLoS ONE12 (2015): e0145221.
  2. Dewar M. and Whit Curry JR. J.; Chronic Obstructive Pulmonary Disease: Diagnostic Considerations; American Family Physician; Volume 73, Number 4 U February 15, 2006
  3. Machado-Pinto Jackson, Diniz Michelle dos Santos, Bavoso Nádia Couto. Psoriasis: new comorbidities. An. Bras. Dermatol.  [Internet]. 2016 Feb [cited 2017 Aug 31]; 91 (1): 8-14.