CHEST Guidelines-Bariatric-Surgery-in-Obese-Patients-With-Psoriasis

Bariatric-Surgery-in-Obese-Patients-With-Psoriasis

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The document discusses a potential treatment strategy involving bariatric surgery for patients dealing with obesity, psoriasis, and chronic obstructive pulmonary disease (COPD). It references a study by Goto et al. that reported a reduced risk of acute COPD exacerbation following bariatric surgery in obese patients. De Vita and Hansen from the Young Dermatologists Italian Network (YDIN) and Copenhagen University Hospital suggest that bariatric surgery could also help in alleviating psoriasis, a chronic inflammatory disease that shares a higher incidence of COPD with its comorbid conditions.<br /><br />The letter highlights that patients with psoriasis tend to have risk factors like smoking, asthma, and respiratory infections, contributing to the potential development of COPD. Psoriasis, obesity, and COPD could be connected through mechanisms driven by T helper 17 cells, which are implicated in inflammatory responses. Bariatric surgery has been linked to a reduction in the T helper 17/regulatory T-cell ratio, potentially contributing to improved outcomes for these conditions.<br /><br />In response, Goto and colleagues conducted an exploratory analysis incorporating individuals with psoriasis into their study to understand better the interplay between these conditions. They found that bariatric surgery reduced COPD exacerbation risks in patients with and without psoriasis, albeit with limited statistical power due to a small sample size of psoriasis patients. Nevertheless, the initial data suggest a potentially greater risk reduction in psoriasis patients than non-psoriasis counterparts in the months following bariatric surgery.<br /><br />This correspondence underscores the potential of bariatric surgery as a multifunctional treatment in carefully selected patients, offering a holistic approach to managing obesity, psoriasis, and COPD collectively.

Keywords

bariatric surgery

obesity

psoriasis

chronic obstructive pulmonary disease

COPD exacerbation

T helper 17 cells

inflammatory response

Young Dermatologists Italian Network

Copenhagen University Hospital

multifunctional treatment