Source: openalex · Origin: BR · Tiago Almeida Santos Costa, Isabella Bonilha, Sheila Tatsumi Kimura Medorima, Thiago Quinaglia Araújo Costa Silva, Simon · Journal of Dermatological Treatment · 2026-05-26
URL: https://doi.org/10.1080/09546634.2026.2663649
AI rationale (4/5, tier: preliminary): Prospective interventional trial targeting NLRP3/IL-1β in chronic inflammatory disease; 12-week pilot limits tier despite mechanistic relevance.
INTRODUCTION: Psoriasis is a chronic immune-mediated inflammatory dermatosis associated with systemic comorbidities, including metabolic disorders, atherosclerosis, and increased cardiovascular mortality. OBJECTIVES: To evaluate the impact of methotrexate (MTX) on clinical manifestations of psoriasis, lipid profile, endothelial function, nitric oxide bioavailability, and pro-inflammatory biomarkers. METHODS: This prospective, open-label pilot study assessed patients before and after 12 weeks of MTX therapy (15 mg/week). Endothelial function was evaluated by flow-mediated dilation (FMD1 and FMD2). Nitric oxide bioavailability was estimated by nitrate and nitrite (NOx) levels. Pro-inflammatory biomarkers analyzed included gasdermin D (GSDMD), interleukin-1β (IL-1β), NLRP3 inflammasome, LOX-1 receptor, and VCAM-1. Clinical outcomes (PASI, BSA, DLQI) and laboratory parameters were also assessed. RESULTS: ≤ 0.024). No significant changes were found in endothelial function, NOx levels, or inflammatory biomarkers. CONCLUSION: MTX improved psoriasis severity and lipid profile without affecting endothelial function or inflammatory biomarkers. It appears cardiovascularly safe in patients without baseline endothelial dysfunction, though longer studies are needed.