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Celiac.com 10/23/2024 - Cardiovascular diseases, such as coronary artery disease and stroke, have long been connected with various immune-mediated disorders due to the role inflammation plays in both conditions. This study explores whether there is a genetic connection between cardiovascular diseases and specific immune-mediated diseases, with a particular focus on psoriasis. Psoriasis is a chronic inflammatory condition that has previously been associated with an increased risk of cardiovascular disease. However, it is unclear whether the genetic risk factors for cardiovascular disease are also linked to an increased risk of psoriasis and other immune-related conditions. Study Objectives The main goal of the study was to investigate whether genetic predispositions to coronary artery disease and stroke also increase the risk of developing psoriasis or other immune-mediated diseases. The researchers utilized a method called Mendelian randomization, which uses genetic data to determine whether there is a causal relationship between two traits, as opposed to just an observed association. By using large datasets from genome-wide association studies, the study aimed to uncover whether genetic predictors of cardiovascular disease are directly linked to immune-mediated diseases, such as psoriasis, rheumatoid arthritis, and inflammatory bowel disease. Methods and Data To conduct the analysis, the study used Mendelian randomization to evaluate the genetic links between cardiovascular disease and immune-mediated diseases. This approach is particularly effective in differentiating causality from correlation because it uses genetic markers as proxies for risk factors. The researchers analyzed summary data from genome-wide association studies for coronary artery disease, stroke, psoriasis, and nine other immune-mediated diseases. The data included a large sample of participants, with over 1.1 million individuals for cardiovascular disease traits and nearly 500,000 for psoriasis. The study specifically examined whether genetic markers associated with coronary artery disease and stroke were linked to an increased risk of developing psoriasis or any of the other immune-mediated diseases. Key Findings The results of the study revealed that genetic predictors for both coronary artery disease and stroke were significantly associated with an increased risk of psoriasis. In particular, genetic risk factors for coronary artery disease were found to increase the risk of developing psoriasis by about 7%, while genetic risk factors for stroke increased the risk by 22%. Interestingly, when adjustments were made for stroke risk, the association between coronary artery disease and psoriasis became statistically insignificant. This suggests that there may be a shared genetic component that links both cardiovascular diseases and psoriasis, rather than two separate pathways. On the other hand, the study found no significant genetic link between cardiovascular disease risk factors and other immune-mediated diseases, such as rheumatoid arthritis and inflammatory bowel disease. This finding was somewhat unexpected, as these diseases also involve inflammation, which is thought to be a common factor in both cardiovascular disease and immune-mediated disorders. Genetic Risk and Celiac Disease The study also explored the relationship between genetic predictors of cardiovascular disease and various immune-mediated diseases, including celiac disease. Data from 4,533 cases of celiac disease and 10,750 controls were included in the analysis. The results indicated no significant association between genetic risk factors for cardiovascular disease—such as coronary artery disease or stroke—and the risk of developing celiac disease. This finding suggests that while cardiovascular genetic factors may influence the risk of developing psoriasis, they do not appear to have the same effect on celiac disease or other immune-mediated conditions. Understanding the Relationship Between Psoriasis and Cardiovascular Disease The discovery that genetic risk factors for cardiovascular disease are linked specifically to psoriasis, but not to other immune-mediated diseases, points to the possibility of a unique shared biological mechanism. Psoriasis is a disease driven by inflammation, and inflammation is also a key factor in the development of cardiovascular diseases like coronary artery disease and stroke. However, the study’s findings suggest that this connection may not extend to all immune-mediated diseases, challenging previous assumptions about the broad relationship between cardiovascular disease and inflammation-driven conditions. One possible explanation for this connection could lie in the specific inflammatory pathways involved in both cardiovascular disease and psoriasis. Psoriasis is known to involve certain inflammatory cellular and cytokine pathways, and these same pathways may play a role in the development of cardiovascular disease. However, these pathways may not be as significant in other immune-mediated diseases, which could explain the lack of genetic association with conditions like rheumatoid arthritis and inflammatory bowel disease. Implications for Treatment and Future Research The findings of this study have several important implications. First, they highlight the need for further research into the shared genetic mechanisms underlying cardiovascular disease and psoriasis. Understanding these mechanisms could lead to the development of new treatments that target both conditions. For example, therapies that reduce inflammation in psoriasis patients could potentially help lower their risk of cardiovascular disease, and vice versa. Second, the study underscores the importance of personalized medicine. As more is learned about the genetic links between different diseases, it becomes increasingly possible to develop tailored treatments that address an individual's unique genetic risk factors. For patients with psoriasis who are also at risk for cardiovascular disease, this could mean more targeted interventions that address both conditions simultaneously. Implications for Those with Celiac Disease The study’s findings highlight the importance of understanding the genetic overlap between cardiovascular disease and psoriasis, but they also underline the distinction when it comes to celiac disease. For those with celiac disease, the results are reassuring as they show no genetic link between cardiovascular risks and the condition. This separation emphasizes that while shared inflammatory pathways may exist between certain immune-mediated diseases and cardiovascular disease, celiac disease does not appear to be influenced by these cardiovascular genetic factors. As such, this research may provide a better understanding of how different immune-mediated diseases interact with cardiovascular health, guiding future research and treatment strategies. Read more at: jamanetwork.com

Celiac.com 02/13/2023 - Because earlier studies have been small, or relied on sources with limited socio-demographic and lifestyle data, there's conflicting information associating celiac disease with a higher risk of cardiovascular disease. Prior studies examining the ties between celiac disease and cardiovascular disease have often omitted traditional cardiovascular risk factors, such as blood pressure or serum total cholesterol, despite research showing healthier cardiovascular profiles in people with celiac disease. A team of researchers recently set out to investigate whether people with celiac disease are at increased risk of cardiovascular disease, including ischaemic heart disease, myocardial infarction, and stroke. The research team included Megan Conroy, Naomi Allen, Ben Lacey, Elizabeth Soilleux and Thomas Littlejohns. They are variously affiliated with theNuffield Department of Population Health, University of Oxford, Oxford, UK; the UK Biobank, Stockport, UK; and the Department of Pathology, University of Cambridge, Cambridge, UK. For their prospective analysis of a large group study, they turned to the UK Biobank database. From between 2006 and 2010, they pulled data on nearly 470,000 adults, just under 2,100 of whom had celiac disease. Participants were aged 40-69 years from England, Scotland, and Wales, and without cardiovascular disease at baseline. The team focused on the relative risk of cardiovascular disease, ischaemic heart disease, myocardial infarction, and stroke in people with celiac disease compared with people who do not have celiac disease, and used Cox proportional hazard models to determine risk levels. Over an average follow-up of about 12.5 years, the team found nearly 41,000 cardiovascular disease events, with about 220 events in celiac patients. Celiacs were less likely to smoke or have traditional cardiovascular risk factors, such as systolic blood pressure, total cholesterol, high body mass index. Even so, they had a higher rate of cardiovascular disease, than their non-celiac peers. Participants with celiac disease had an incidence rate of 9.0 cardiovascular disease cases per 1,000 person years compared with 7.4 per 1,000 person years in non-celiacs. The team connected celiac disease to an increased risk of cardiovascular disease, even adjusted for lifestyle factors. The connection was stronger after further adjusting for other cardiovascular risk factors. The team found similar connections between ischaemic heart disease and myocardial infarction, but noted fewer stroke events, and saw no evidence of a connection between celiac disease and risk of stroke. People with celiac disease had a fewer traditional cardiovascular risk factors, but still had a higher risk of developing cardiovascular disease than non-celiacs. Based on these findings, cardiovascular risk scores used in clinical practice may not adequately account for a the higher risk among celiacs. Ideally, this study will help people with celiac disease and their clinicians to improve their awareness regarding the higher cardiovascular risks, and to take relevant precautionary action. Still, more research is needed to improve our understanding of these connections. Read more at BMJ Medicine