Benjamin Ungar1, Ana B Pavel1, Philip M Robson2, Audrey Kaufman2, Alison Pruzan2, Patrick Brunner3, Shivani Kaushik1, James G Krueger3, Mark G Lebwohl1, Venkatesh Mani2, Zahi A Fayad2, Emma Guttman-Yassky4. 1. Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY. 2. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY; The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY. 3. The Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY. 4. Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY; The Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY; Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: Emma.Guttman@mountsinai.org.
Abstract
BACKGROUND: Recent data suggest that patients with atopic dermatitis (AD) have increased systemic immune activation and cardiovascular risk. However, unlike psoriasis, evaluation of active vascular inflammation using state-of-the-art imaging is lacking in AD. OBJECTIVE: To assess aortic and carotid vascular inflammation using 18F-fluorodeoxyglucose-positron emission tomography/magnetic resonance imaging (18F-FDG-PET/MRI) imaging in moderate-to-severe AD versus healthy individuals. METHODS: A total of 27 patients with moderate-to-severe AD and 12 healthy controls were imaged using 18F-FDG-PET/MRI. Target-to-background ratio (TBR) values were calculated in multiple segments of the aorta and carotid vessels. RESULTS: Patients with AD had elevated aortic max TBR (fold change [FCH] = 1.45, P = .057) versus healthy controls and significantly elevated mean TBR (FCH = 1.20; P < .05) in the right carotid (RC) arteries versus controls. When examining greatest focal inflammation (most diseased segment [MDS] TBR), patients with AD had higher aortic inflammation (FCH = 1.28; P = .052). AD clinical severity significantly correlated with C-reactive protein (ρ = 0.60, P < .01) and with RC mean TBR levels (ρ = 0.60, P = .04). Stratifying patients into moderate-to-severe and very severe AD showed greater RC mean TBR in patients with very severe AD versus controls (FCH = 1.31; P = .02) and versus patients with moderate/severe AD (FCH = 1.23, P = .05). Aortic inflammation was also significantly greater in patients with very severe AD versus controls (max TBR: FCH = 1.6, P = .04; MDS TBR: FCH = 1.73, P = .03). CONCLUSIONS: This preliminary study is the first that establishes greater vascular (aorta and carotid) inflammation in moderate-to-severe AD versus healthy controls. Furthermore, very severe AD showed higher inflammation than both moderate/severe patients and healthy controls. Future studies with larger patient cohorts and evaluation before and after treatment are needed to determine the extent to which vascular inflammation in AD is modifiable.
BACKGROUND: Recent data suggest that patients with atopic dermatitis (AD) have increased systemic immune activation and cardiovascular risk. However, unlike psoriasis, evaluation of active vascular inflammation using state-of-the-art imaging is lacking in AD. OBJECTIVE: To assess aortic and carotid vascular inflammation using 18F-fluorodeoxyglucose-positron emission tomography/magnetic resonance imaging (18F-FDG-PET/MRI) imaging in moderate-to-severe AD versus healthy individuals. METHODS: A total of 27 patients with moderate-to-severe AD and 12 healthy controls were imaged using 18F-FDG-PET/MRI. Target-to-background ratio (TBR) values were calculated in multiple segments of the aorta and carotid vessels. RESULTS:Patients with AD had elevated aortic max TBR (fold change [FCH] = 1.45, P = .057) versus healthy controls and significantly elevated mean TBR (FCH = 1.20; P < .05) in the right carotid (RC) arteries versus controls. When examining greatest focal inflammation (most diseased segment [MDS] TBR), patients with AD had higher aortic inflammation (FCH = 1.28; P = .052). AD clinical severity significantly correlated with C-reactive protein (ρ = 0.60, P < .01) and with RC mean TBR levels (ρ = 0.60, P = .04). Stratifying patients into moderate-to-severe and very severe AD showed greater RC mean TBR in patients with very severe AD versus controls (FCH = 1.31; P = .02) and versus patients with moderate/severe AD (FCH = 1.23, P = .05). Aortic inflammation was also significantly greater in patients with very severe AD versus controls (max TBR: FCH = 1.6, P = .04; MDS TBR: FCH = 1.73, P = .03). CONCLUSIONS: This preliminary study is the first that establishes greater vascular (aorta and carotid) inflammation in moderate-to-severe AD versus healthy controls. Furthermore, very severe AD showed higher inflammation than both moderate/severe patients and healthy controls. Future studies with larger patient cohorts and evaluation before and after treatment are needed to determine the extent to which vascular inflammation in AD is modifiable.
Authors: Yuki M F Andersen; Alexander Egeberg; Gunnar H Gislason; Peter R Hansen; Lone Skov; Jacob P Thyssen Journal: J Allergy Clin Immunol Date: 2016-03-11 Impact factor: 10.793
Authors: Philip M Robson; Marc R Dweck; Maria Giovanna Trivieri; Ronan Abgral; Nicolas A Karakatsanis; Johanna Contreras; Umesh Gidwani; Jagat P Narula; Valentin Fuster; Jason C Kovacic; Zahi A Fayad Journal: JACC Cardiovasc Imaging Date: 2017-01-18
Authors: Cynthia S Crowson; Katherine P Liao; John M Davis; Daniel H Solomon; Eric L Matteson; Keith L Knutson; Mark A Hlatky; Sherine E Gabriel Journal: Am Heart J Date: 2013-08-29 Impact factor: 4.749
Authors: Sergio A Rodríguez Hernández; Abraham A Kroon; Martin P J van Boxtel; Werner H Mess; Jan Lodder; Jelle Jolles; Peter W de Leeuw Journal: Hypertension Date: 2003-06-16 Impact factor: 10.190
Authors: Julia K Gittler; Avner Shemer; Mayte Suárez-Fariñas; Judilyn Fuentes-Duculan; Kara J Gulewicz; Claire Q F Wang; Hiroshi Mitsui; Irma Cardinale; Cristina de Guzman Strong; James G Krueger; Emma Guttman-Yassky Journal: J Allergy Clin Immunol Date: 2012-08-27 Impact factor: 10.793
Authors: Shawn Rose; Nikhil H Sheth; Joshua F Baker; Alexis Ogdie; Anna Raper; Babak Saboury; Thomas J Werner; Preethi Thomas; Abby Vanvoorhees; Abass Alavi; Drew A Torigian; Joel M Gelfand; Nehal N Mehta Journal: Am J Cardiovasc Dis Date: 2013-11-01
Authors: Jakub Kaczynski; Stephanie Sellers; Michael A Seidman; Maaz Syed; Martin Dennis; Gillian Mcnaught; Maurits Jansen; Scott I Semple; Carlos Alcaide-Corral; Adriana A S Tavares; Thomas MacGillivray; Samuel Debono; Rachael Forsythe; Andrew Tambyraja; Piotr J Slomka; Jonathon Leipsic; Marc R Dweck; William Whiteley; Joanna Wardlaw; Edwin J R van Beek; David E Newby; Michelle C Williams Journal: Radiology Date: 2022-06-07 Impact factor: 29.146
Authors: A L Bosma; A Ascott; R Iskandar; K Farquhar; J Matthewman; M W Langendam; A Mulick; K Abuabara; H C Williams; P I Spuls; S M Langan; M A Middelkamp-Hup Journal: J Eur Acad Dermatol Venereol Date: 2022-02-25 Impact factor: 9.228
Authors: Johannes Schwenck; Manfred Kneilling; Niels P Riksen; Christian la Fougère; Douwe J Mulder; Riemer J H A Slart; Erik H J G Aarntzen Journal: Eur J Hybrid Imaging Date: 2022-09-01