Sex-differential downregulation of methotrexate on plasma viscosity and whole blood viscosity in psoriasis

Article type: Research Article

Authors: Han, Ling^{a; 1} | Guo, Meiliang^{b; 1} | Wang, Bing^a | Meng, Qinqin^b | Zhu, Jie^a | Huang, Qiong^a | Zhang, Zhenghua^a | Fang, Xu^a | Yang, Ke^c | Wu, Siyuan^a | Zheng, Zhizhong^a | Yawalkar, Nikhil^d | Deng, Hui^{b; *} | Yan, Kexiang^{a; *}

Affiliations: [a] Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China | [b] Department of Dermatology, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, China | [c] Department of Information, Huashan Hospital, Fudan University, Shanghai, China | [d] Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

Correspondence: [*] Corresponding authors. Keixiang Yan, MD, PhD and Hui Deng, MD, PhD, Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, Shanghai 200040, China. Tel.: +86 13501748188; Fax: +86 21 52887782; E-mail: ykx2292002@aliyun.com (Keixiang Yan); E-mail: hdeng@sjtu.edu.cn (Hui Deng).

Note: [1] Ling Han and Meiliang Guo contributed equally to this article.

Abstract: BACKGROUND:Psoriasis is associated with an increased risk for cardiovascular disease (CVD). Methotrexate (MTX) is often used as a first-line system therapy and there is a need to determine its effect on whole blood viscosity (WBV) and plasma viscosity (PV) in psoriasis. METHODSA prospective, single-center, interventional study with a total of 111 psoriatic patients who received MTX therapy from October 22, 2018, to December 28, 2019, and 111 age- and sex-matched healthy controls. Changes in WBV, PV, blood counts, liver and renal function were evaluated. RESULTSPsoriatic patients had significantly higher levels of WBV and relative viscosity (RV) at low shear rate (LSR), erythrocyte aggregation index (EAI), and PV than sex and age-matched healthy controls. PV was positively correlated with erythrocyte sedimentation rate (ESR), ESR was positively correlated with high sensitive C-reactive protein (hCRP). But only hCRP was positively associated with psoriasis area severity index (PASI) score. MTX significantly decreased the levels of PV, ESR, hCRP, and blood pressure (BP) in male patients, and the level of WBV in female patients. CONCLUSION:Sex-specific downregulation of MTX on WBV, PV, hCRP, and BP, indicating that the effect of MTX on the risk of cardiovascular disease was related with sex.

Keywords: Methotrexate, psoriasis, whole blood viscosity, plasma viscosity, erythrocyte aggregation index

DOI: 10.3233/CH-211343

Journal: Clinical Hemorheology and Microcirculation, vol. 81, no. 4, pp. 305-314, 2022