Relationship between psoriasis treatments and cardiovascular risk explained


Psoriasis is a chronic disease that causes patients to develop patches of dry, scaly, itchy skin. It is an autoimmune disorder, which means that it arises from a person’s immune system inappropriately targeting that person’s own body. It is a deeply unpleasant condition, and patients commonly take medications so that they can live their lives more comfortably.

Professor Min Chen of the Chinese Academy of Medical Sciences and the Peking Union Medical College has conducted extensive research on psoriasis. “There are many patients with psoriasis who also have cardiovascular diseases, such as hypertension, diabetes, hyperlipidemia and coronary heart disease,” she notes. The presence of such cardiovascular diseases is an important consideration when treating patients with psoriasis because, as Prof. Chen explains, “Some of the drugs for psoriasis may increase the risks of these diseases, while some can reduce them.” Now, in a recent review article published in Chinese Medical Journal, Prof. Chen and her colleagues provide a summary of the existing scholarly knowledge concerning the associations between the different treatments for psoriasis and risks of cardiovascular diseases.

The authors explore how various drugs influence the long-term risks of what is known as MACE, an acronym that encompasses myocardial infarction (i.e., heart attack), cerebrovascular accidents (i.e., strokes and similar events), and cardiovascular mortality. They note that some psoriasis treatments such as tumor necrosis factor-α (TNF-α) inhibitors and methotrexate may actually reduce long-term MACE risk. Conversely, they also note that some interleukin (IL) inhibitors may increase MACE risk. For example, the IL-12/23 inhibitor briakinumab increased MACE risks so much across multiple studies that investigators had to suspend all clinical trials. However, other IL inhibitors such as tildrakizumab and guselkumab do not appear to increase MACE risks. The widely used immunosuppressant cyclosporine A can cause damage to heart muscle tissues. Ultimately, these findings indicate that more research is needed before scientists can rank psoriasis treatments in terms of their effects on long-term MACE risks.

There is currently no consensus among medical scientists on whether systemic treatments for psoriasis can mitigate or worsen arterial plaques, vascular function, and vascular inflammation. There is some evidence that treatments for psoriasis counter inflammation of coronary tissues and can lessen the coronary plaque burdens that contribute to coronary artery disease. Conversely, it has also been found that treatment with TNF-α inhibitors may contribute to an undesirable thickening of the carotid arteries, which are found in the neck and provide blood to the head. Scientists do not yet know whether methotrexate, IL-17 inhibitors, and IL-12/23 inhibitors also have any effect on arterial wall thicknesses.

In addition to the heightened risk of cardiovascular diseases, patients with psoriasis are at an increased risk of developing various risk factors for cardiovascular diseases. These risk factors include obesity, diabetes mellitus, and high blood lipid levels, and the existing literature points to several varied relationships between psoriasis treatment options and risk factors for cardiovascular disease. For example, TNF-α inhibitors may contribute to increased body weight, but IL-17 and IL-12/23 inhibitors may help patients lose weight. Cyclosporine A can increase the risk of diabetes, worsen hypertension, and contribute to unhealthy lipid metabolism profiles.

In conclusion, different psoriasis treatments have different effects on cardiovascular diseases and their risk factors, necessitating a more thorough consideration of each patient’s clinical situation before picking a treatment. For example, TNF-α inhibitors and methotrexate are good therapeutic options for patients with psoriasis who are at high risk of experiencing MACE, and inhibitors of IL-17 and IL-12/23 may be beneficial for patients who have arterial plaques.

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What January's Gemini Horoscope Predictions Mean for You

Read what your sign's 2021 horoscope predictions have in store for you or check out the Gemini personality profile. 

Welcome to January and a whole new year, Gemini! At the end of December, you accepted that sometimes you need to slow down and make room for self-care. Last year was rough for you in myriad ways; after all, you are the social butterfly of the zodiac, so being isolated during the pandemic has been hard for you. However, remember that it's important to keep yourself (and each other) safe, and even if it's hard right now, it'll be more than worth it in the long-run. 

The first big astrological date of the year for you is Friday, January 8. Your ruling planet, messenger Mercury, enters fellow air sign Aquarius, lighting up your 9th House of Philosophy. While Mercury will start its first retrograde of 2021 at the end of the month, your ruling planet is happy in logical Aquarius. As the 9th House also rules learning, this is a great time to pick up a new hobby, which can help you work out some of that anxious energy from being stuck inside. 

Romance planet Venus enters diligent Capricorn and your 8th House of Sex, Death, and Transformation.

But that's not the only thing the stars are up to on Friday, January 8. Romance planet Venus enters diligent Capricorn and your 8th House of Sex, Death, and Transformation. Don't worry, dear Gemini, this isn't an actual harbinger of death, but it does mean that your love life is in for a serious makeover. Any half-ass relationship or "situationships" past their expiration date will implode (unless you end them first). Geminis tend to have too many crushes and admirers, so don't feel bad about letting something lukewarm go. And while this transit may mean endings, it also means clearing the way for new love to come your way. 

Eccentric planet Uranus goes direct on Thursday, January 14. It's been retrograde since last August, bringing out the activist in all of us. Many of us have taken up the fight against systemic racism, while others have advocated for rent relief or a new administration. Others still emphasized the importance of keeping each other safe during the pandemic. When this revolutionary planet goes direct, life may start to feel just a tad easier, which is a good thing, but we must remember that there's still work to be done to make the world a better place. 

Use the bold energy of the full moon to express your needs to crushes and romantic partners. 

Progressive Aquarius season begins on Tuesday, January 19, and yes, that's the day before Inauguration Day. It's an understatement to say that 2020 was rough on all of us, but don't lose hope that change is possible; after all, it's the only constant. 

A full moon in Leo lights up your 3rd House of Communication and brightens the sky on Thursday, January 28. Use this bold energy to express your needs to crushes and romantic partners, because when Mercury retrograde begins on Saturday, January 30, communication gets a little wonkier. Because Mercury is your ruling planet, these retrogrades can affect you more than other signs. It becomes a bit more likely that you'll text the wrong person, or say something you don't mean to someone you care about, so double-check all your texts and think before you speak on and after this date. However, as noted, the planet is happy in Aquarius, and the sign's detached and logical vibe helps keep us calm when the WiFi cuts out right before an important Zoom meeting. Stay safe and see you in February.  

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We know many of you may be feeling worried, frightened, or isolated right now. Although the stars don't have answers to the multitude of questions running through all of our minds, astrology may at least provide some comfort during times of uncertainty. We urge you to donate to one or all of these organizations if you're able to. If you can't, we created a guide to ways you can support the BLM movement other than financially.

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What January's Aquarius Horoscope Predictions Mean for You

Read what your sign's 2021 horoscope predictions have in store for you or check out the Aquarius personality profile.

Welcome to January and 2021, Aquarius. It's about to be your season. At the end of December, you felt hopeful that the new year would bring positive change, both on personal and societal levels. When communication planet Mercury enters your sign and 1st House of Self on Friday, January 8, you're encouraged to vocalize your personal needs. You can be very community-minded, which is generally a good thing. Whether it's checking in on friends and family, talking about the importance of PPE, or protesting systemic racism, you're someone the world can count on. However, the one person you can forget to advocate for is yourself. 

On this same date, Venus, the planet of love, beauty, and abundance, enters diligent Capricorn and your 12th House of the Unconscious. This transit asks you to confront your deepest fears surrounding intimacy. Do you push lovers away before they see the real you? Are there secrets or insecurities that you're scared to even tell your therapist? It's time to try and confront them. You fight for others, dear Aquarius, so you should also fight for yourself.

Remember to take a deep breath and remember that we're all doing our best under a time of great duress. 

Sometimes you feel like you're an alien; there's no other explanation for why others are making the choices they're making. Uranus, your ruling planet, has been retrograde since last August, which has started to help others get on your level. We've seen this in action when it came to voter turnout in the election, and when many people chose not to travel over the holidays to avoid putting others at risk. However, when Uranus goes direct on Thursday, January 14, you may feel like a lot of people are starting to think life has just gone back to normal. Before you accuse anyone of being careless, remember to take a deep breath and remember that we're all doing our best under a time of great duress. 

The sun enters your sign on Tuesday, January 19, kicking off Aquarius season. Happy birthday, beautiful water-bearer! You have a tendency to downplay your birthday because you think there are more important things to deal with. Even if you want lots of attention, it's hard to get you to admit it. Your assignment this year is to celebrate as boldly as possible (while following social distancing protocol, of course). You deserve it. January comes to an end with the first Mercury retrograde of the year in your sign on Saturday, January 30. Remember to text your friends back, Aquarius, but don't let the retrograde stop you from celebrating you. See you next month! 

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Read more stories about astrology:

  • Your Guide to Lunar & Solar Eclipses in 2021 and How They’ll Affect Your Life

  • Each Zodiac Sign's Unique Personality, Explained by an Astrologer

  • Your Sign's 2021 Horoscope Predictions Are Here

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My husband masturbates in bed while I’m asleep, and won’t have sex with me. What’s going on?

Samantha Lee/Insider

  • A person's self-pleasure frequency isn't always linked to a lack of partnered sex. Still, your feelings are valid since your husband's personal time is affecting your bond.
  • Consider how this experience has made you feel, and then relay that information to your husband.
  • Be vocal about what you could do together to improve the situation for both of you, and ask your husband what he needs in the bedroom.
  • Have a question for Julia? Fill out this anonymous form. All questions will be published anonymously. You can read more Doing It Right here.
  • Visit Insider's homepage for more stories.

I think my husband has a problem with porn and masturbation. Maybe I'm exaggerating and his daily habit is normal, but I'm unsure.

The problem started on our honeymoon. He said he couldn't be intimate with me because he had been masturbating so much. It broke my heart. I found myself in a very romantic suite crying myself to sleep because the one thing the honeymoon is about (at least in my head) is to be intimate with your spouse, and that didn't happen.

Now that I know about how often he masturbates, I can't forget it. I also recently learned that he does it next to me when I am asleep. I have talked about it with him, but he often gets upset and defensive when I do.

He said it's my fault for feeling this way about the situation, and I don't have to. We even went to therapy for this and only after six months of that did he apologize, saying he wished our honeymoon had been different.

But this issue keeps happening and I feel our intimacy is severely affected. He doesn't make the effort to be with me anymore. We have sex probably once every two weeks at most. Every time we are intimate, I feel I am used as a hand, quick and fast. It is so not enjoyable for me.

I don't want to feel this way. It is not nice that every time he goes to the toilet or goes to bed earlier than me, I have the immense fear I'll catch him masturbating. What do I do now?

– Holland

Dear Holland,

I'm sorry you feel like you're being used rather than loved.

Though you've already tried talking to your husband about the situation, which I applaud you for, approaching the conversation in a new way may help.

First, it's important to reframe the issues you've been experiencing, because a person's masturbation frequency isn't directly linked to their appetite for partnered sex, New York City-based therapist and sex educator Rachel Wright told me.

These two patterns, your husband's daily masturbation and your lack of coupled intimacy, are occurring at the same time, but "they're two separate things that need to be tended to," Wright said.

At the same time, remember your feelings are valid because your husband's self-pleasure routine is affecting your relationship.

Wright suggested pinpointing the emotions you've been experiencing due to a lack of intimacy with your husband. That could be anything from feeling lonely to disconnected to unloved. But it's important that they come directly from you.

Then, set aside a time to talk with your husband.

Having the conversation

Start by reminding your husband how much you love him, and that you want to find solutions that make you both happy in your relationship. Then, say what you'd like to improve and steps you want to take to get there. 

Acknowledge what's been going on in a fact-focused way. Say something like: "I've noticed we haven't been as sexually intimate with each other as I'd like. I also noticed you masturbate often, and though the two may not be related, I've been feeling disconnected from your lately."

Reduce the risk of your partner becoming defensive by explaining how the facts of the situation play into your emotions, since it's impossible for him to decide or control how it makes you feel.

You can offer ways to work on the problem together, and then you should also give your partner space to offer his own solutions. Perhaps you'd like to have sex a certain number of times a week, or want to set boundaries so he doesn't masturbate next you in bed.

If it's more regular sex you'd like, ask your husband if he'd be open to scheduling a weekly session or two (and before you poo-poo scheduling sex, there's nothing wrong or unsexy about carving out quality time with your partner!). You could say you want to explore specific sex positions or experiment with toys in the bedroom so your needs are met, if that interests you.

Don't forget to ask your husband what he needs to feel a more intimate connection and enjoy bedroom time with you. During this conversation he might give you more insight into why he enjoys daily self-pleasure (which, by the way, can be completely normal and healthy, Wright said) and what's been going on in his head.

On the other hand, he might admit he needs help with an addiction.

Either way, lead with kindness, compassion, and curiosity so he's more likely to match your tone and be willing to solve the issues at hand alongside you.

As Insider's resident sex and relationships reporter, Julia Naftulin is here to answer all of your questions about dating, love, and doing it — no question is too weird or taboo. Julia regularly consults a panel of health experts including relationship therapists, gynecologists, and urologists to get science-backed answers to your burning questions, with a personal twist.

Have a question? Fill out this anonymous form. All questions will be published anonymously.

Related coverage from Doing It Right:

My partner won't have sex until marriage, but I'm very sexual. Should I have an affair to get it out of my system?

I'm having an affair with my best friend's partner, and he's become manipulative. Should I come clean?

My father-in-law recently moved in, and he insults me and my kids daily. How do I cope with his unappreciative attitude?

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What November's Cancer Horoscope Predictions Mean for You

Read what your sign's 2020 horoscope predictions have in store for you or check out the Cancer personality profile. 

Welcome to November, Cancer! At the end of October, you tapped into your inner caregiver, finding ways to make Halloween fun for others while keeping it safe. It's often thought that there's no problem you can't solve with your warmth, as you're one of the most hospitable signs of the zodiac. Keep up that positive and loving attitude, because Tuesday, November 3 promises to be a stressful day. It's the last day of Mercury retrograde in Scorpio, and of course, Election Day. Try and keep yourself and others calm by talking about the things that bring you joy, and catching up with anyone you've been meaning to chat with for a while. You're a caring, emotional sign that gains strength by looking after loved ones. 

You're such a good caretaker, Cancer, that people often overlook the warrior in you.

You're such a good caretaker, Cancer, that people often overlook the warrior in you. Sometimes you even hide in your crab shell so that your fierce side is hidden on purpose. The truth is that you're so loyal and protective that you would instantly go to bat to protect anyone you love. However, warrior planet Mars has been retrograde since September, dampening the fighter within. You may have been feeling as though your activist efforts have been for naught, or worried that you haven't been doing enough to keep up with your long-distance relatives. On Friday, November 13, Mars goes direct and ends its retrograde, so your inner fire will be renewed. Dive full force into fighting for what you believe in, including causes that matter to you and your most important relationships. The end of Mars retrograde also means that your sex life should flow more easily, giving you another reason to celebrate. 

One downside of worrying so much about those around you, Cancer, is that you sometimes forget to take care of yourself. Saturday, November 14 brings a new moon in fellow emotional water sign Scorpio. Draw a bath, light some candles, try aromatherapy, and focus only on your own inner thoughts. You may be surprised at how many emotions you've been repressing for the sake of keeping up appearances. It's time to feel them, so that you may eventually let them go. 

Self-care works, and when adventurous Sagittarius season begins on Saturday, November 21, you may be inspired to take on a new project that's just for you. Like Sagittarius, you love to explore new places, and the way the pandemic has affected travel has been hard for you. However, this time of the year inspires you to be creative with your version of exploration, and you may decide to enroll in an online class, learn a new language, or pick up a satisfying hobby, such as sewing or painting. 

We've all been cooped up for months, and it's understandable if you're having a hard time emotionally. 

Saturday, November 21, is not all fun and games, though. Romance planet Venus enters obsessive Scorpio, and it may bring out your jealous side. We've all been cooped up for months, and it's understandable if you're having a hard time emotionally. This transit could make you feel a bit insecure and possessive, so try to implement self-care rather than lash out at partners or crushes based on paranoid hunches. 

Finally, on Monday, November 30, there is a full moon and lunar eclipse in chatty Gemini. You are ruled by the moon, Cancer, so eclipses tend to stress you out even more than other signs. This makes it even more important to avoid making any sudden moves. If you can, put your phone on airplane mode and indulge in your water sign nature with a hot bath. This too will pass, and you should never forget how strong you are. You have claws and armor, after all. See you next month. 

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All products featured on Allure are independently selected by our editors. However, when you buy something through our retail links, we may earn an affiliate commission.

We know many of you may be feeling worried, frightened, or isolated right now. Although the stars don't have answers to the multitude of questions running through all of our minds, astrology may at least provide some comfort during times of uncertainty. We urge you to donate to one or all of these organizations if you're able to. If you can't, we created a guide to ways you can support the BLM movement other than financially.

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Relationship Explored Between Physical Activity and Lymphoma

TUESDAY, Oct. 13, 2020 — High levels of physical activity may lower the risk for developing lymphoma, according to a review/meta-analysis published online Oct. 6 in BMC Cancer.

Gwynivere A. Davies, M.D., M.P.H., from the Juravinski Cancer Centre-Hamilton Health Sciences in Canada, and colleagues conducted a systematic literature review/meta-analysis to examine the association between physical activity and incident lymphoma. Eighteen studies (nine cohort, nine case-control) were included in the final analysis.

The researchers found that for all lymphoma, comparing the highest with the lowest activity categories showed physical activity was protective (relative risk, 0.89; 95 percent confidence interval, 0.81 to 0.98). In a sensitivity analysis, the effect persisted in case-control studies (relative risk, 0.82; 95 percent confidence interval, 0.71 to 0.96) but not in cohort studies (relative risk, 0.95; 95 percent confidence interval, 0.84 to 1.07). A subgroup analysis showed some protective effect of physical activity for non-Hodgkin lymphoma (relative risk, 0.92; 95 percent confidence interval, 0.84 to 1.00) but not for Hodgkin lymphoma (relative risk, 0.72; 95 percent confidence interval, 0.50 to 1.04). A protective effect was demonstrated in a dose-response analysis, with a 1 percent reduction in risk per three metabolic equivalent of task (MET) hours/week (relative risk, 0.99; 95 percent confidence interval, 0.98 to 1.00; P = 0.034).

“Dose response analysis supports these conclusions, with a linear decrease in incidence seen with increasing recreational physical activity,” the authors write.

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The brain’s functional organization slows down following a relationship breakup

During a person’s life, the experience of a stressful life event can lead to the development of depressive symptoms, even in a non-clinical population. For example, a relationship breakup is a fairly common event and is a powerful risk factor for quality of life, in addition to increasing the risk of a major depressive disorder.

Resting-state neuroimaging studies have increasingly identified abnormal whole-brain communication in patients with depression, but it is currently unclear whether depressive symptoms in individuals without a clinical diagnosis have reliable neural underpinnings. Therefore, there is not enough reliable neurological data concerning the symptoms of depression that some individuals may present after a stressful event without a clinical diagnosis.

Research published in the advanced online edition of the journal NeuroImage: Clinical on 26 May investigates whether individual differences in the severity of depressive symptoms following the breakdown of a relationship are associated to changes in resting-state whole-brain dynamics.

The study was led by Sonsoles Alonso Martínez under the supervision of Gustavo Deco, an ICREA research professor with the Department of Information and Communication Technologies (DTIC) and director of the Center for Brain and Cognition (CBC) at UPF, and co-author of the work, along with members of research centers at the European universities of Groningen (Netherlands), Oxford (UK), Aarhus (Denmark) and Minho (Braga, Portugal).

“In this study, we set out to investigate the dynamical complexity of the brain at rest by applying the intrinsic ignition framework to a dataset of 69 participants with varying degrees of depressive symptoms following a relationship breakup. We hypothesized that greater levels of self-reported depressive symptoms are associated with reduced global integration and reduced spatiotemporal variability in the functional organization of the brain,” says Deco.

Intrinsic ignition analysis, proposed by Deco and Kringelbach (2017), characterizes the degree of integration in the brain that results from spontaneous events arising over time. These events reveal the ability of a given region to start the propagation of neural activity (i.e., ignition) to other regions, eliciting varying degrees of integration in the brain. In turn, integration reflects the capacity of the brain to become interconnected and exchange information.

“We investigated whether the severity of depressive symptoms in non-clinical individuals was associated with changes in the dynamical complexity of the brain at rest,” the authors state. At the global level, ignition and ignition variability can be averaged across all brain regions to produce a global measure of integration and temporal variability, respectively. Temporal variability indicates the degree of dynamic flexibility, also referred to as metastability.

The results of the study revealed that the severity of depressive symptoms was associated with deficits in the brain’s ability to integrate and process information globally over time. In addition, the researchers found that the majority of depressive symptoms were associated with reduced spatial diversity (i.e., hierarchy) and reduced temporal variability (i.e., metastability) in the functional organization of the brain.

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Scientists reveal relationship between Dek and Intron retention during muscle stem cells quiescence

Muscle stem cells, the reserve stem cell in the skeletal muscles, are responsible for muscle repair after damage. They are the ‘regenerative medicine’ to cure muscle diseases and muscle damage. In a healthy uninjured condition, muscle stem cells are in quiescence, a dormant state, to preserve them. Whenever there is muscle damage, they will wake up instantly and contribute themselves to building new muscles.

If this dormant state is loosely controlled, muscle stem cells will be wasted when there is no need for repair. If this dormant state is kept too tight, the muscle stem cells will not wake up when they are needed to contribute to muscle repair.

How muscle stem cells control this balance of quiescence remains a topic of heightened interest. Recently, a team of scientists at the Hong Kong University of Science and Technology revealed that intron detention (IR) is a key to the mechanism—when stem cells enter quiescence exit, Dek releases conserved introns, which allow the cell to be activated.

“Using skeletal muscle stem cells, also called satellite cells (SCs), we demonstrated prevalent intron retention (IR) in the transcriptome of quiescent SCs (QSCs),” said Prof. Tom Cheung, lead researcher of the team and SH Ho Associate Professor of Life Science at HKUST. “Intron-retained transcripts found in QSCs are essential for fundamental functions including RNA splicing, protein translation, cell-cycle entry, and lineage specification. Our analysis reveals that phosphorylated Dek protein modulates IR during SC quiescence exit.”

While Dek protein is not present in QSCs, Dek overexpression in vivo results in a global decrease of IR, quiescence dysregulation, premature differentiation of QSCs, and undermined muscle regeneration. The researchers also found in their IR analysis on hundreds of public RNA-seq data that IR is conserved among quiescent adult stem cells, which suggests that IR functions as a conserved post-transcriptional regulation mechanism that plays an important role during stem cell quiescence exit.

Their findings were published online in the journal Developmental Cell on June 4, 2020.

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