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Alsabbagh MM. Cytokines in psoriasis: From pathogenesis to targeted therapy. Hum Immunol 2024; 85:110814. [PMID: 38768527 DOI: 10.1016/j.humimm.2024.110814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/22/2024]
Abstract
Psoriasis is a multifactorial disease that affects 0.84% of the global population and it can be associated with disabling comorbidities. As patients present with thick scaly lesions, psoriasis was long believed to be a disorder of keratinocytes. Psoriasis is now understood to be the outcome of the interaction between immunological and environmental factors in individuals with genetic predisposition. While it was initially thought to be solely mediated by cytokines of type-1 immunity, namely interferon-γ, interleukin-2, and interleukin-12 because it responds very well to cyclosporine, a reversible IL-2 inhibitor; the discovery of Th-17 cells advanced the understanding of the disease and helped the development of biological therapy. This article aims to provide a comprehensive review of the role of cytokines in psoriasis, highlighting areas of controversy and identifying the connection between cytokine imbalance and disease manifestations. It also presents the approved targeted treatments for psoriasis and those currently under investigation.
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Affiliation(s)
- Manahel Mahmood Alsabbagh
- Princess Al-Jawhara Center for Molecular Medicine and Inherited Disorders and Department of Molecular Medicine, Arabian Gulf University, Manama, Bahrain.
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2
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Cai H, Wen H, Li J, Lu L, Zhao W, Jiang X, Bai R. Small-molecule agents for treating skin diseases. Eur J Med Chem 2024; 268:116269. [PMID: 38422702 DOI: 10.1016/j.ejmech.2024.116269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/16/2024] [Accepted: 02/18/2024] [Indexed: 03/02/2024]
Abstract
Skin diseases are a class of common and frequently occurring diseases that significantly impact daily lives. Currently, the limited effective therapeutic drugs are far from meeting the clinical needs; most drugs typically only provide symptomatic relief rather than a cure. Developing small-molecule drugs with improved efficacy holds paramount importance for treating skin diseases. This review aimed to systematically introduce the pathogenesis of common skin diseases in daily life, list related drugs applied in the clinic, and summarize the clinical research status of candidate drugs and the latest research progress of candidate compounds in the drug discovery stage. Also, it statistically analyzed the number of publications and global attention trends for the involved skin diseases. This review might provide practical information for researchers engaged in dermatological drugs and further increase research attention to this disease area.
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Affiliation(s)
- Hong Cai
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, PR China; Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, PR China
| | - Hao Wen
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, PR China; Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, PR China
| | - Junjie Li
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, PR China; Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, PR China
| | - Liuxin Lu
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, PR China; Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, PR China
| | - Wenxuan Zhao
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, PR China; Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, PR China
| | - Xiaoying Jiang
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, PR China; Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, PR China.
| | - Renren Bai
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, PR China; Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, PR China.
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3
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Lei H, Xing Z, Chen X, Dai Y, Cheng B, Wang S, Kang T, Wang Q, Zhang J, Jia J, Zheng Y. Exploration of the causality of frailty index on psoriasis: A Mendelian randomization study. Skin Res Technol 2024; 30:e13641. [PMID: 38426414 PMCID: PMC10905529 DOI: 10.1111/srt.13641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/19/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Frailty is associated with a variety of diseases, but the relationship between frailty and psoriasis remains unclear. METHODS First, we conducted a two-sample Mendelian randomization based on genome-wide association studies (GWAS) to investigate genetic causality between frailty index and common diseases in dermatology. Inverse variance weighted was used to estimate causality. Second, expression quantitative trait locus (eQTLs) analysis was conducted to identify the genes affected by Single nucleotide polymorphisms (SNPs). Third, we performed function and pathway enrichment, transcriptome-wide association studies (TWAS) analysis based on eQTLs. RESULTS It was shown that the rise of frailty index could increase the risk of psoriasis (IVW, beta = 0.916, OR = 2.500, 95%CI:1.418-4.408, p = 0.002) through Mendelian randomization (MR), and there was no heterogeneity and pleiotropy. There was no causality between the frailty index and other common diseases in dermatology. We found 31 eQTLs based on strongly correlated SNPs in the causality. TWAS analysis found that the expressions of four genes were closely related to psoriasis, including HLA-DQA1, HLA-DQA2, HLA-DRB1 and HLA-DQB1. CONCLUSION It suggested that the frailty index had a significant positive causality on the risk of psoriasis, which was well documented by combined genomic, transcriptome, and proteome analyses.
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Affiliation(s)
- Hao Lei
- Department of DermatologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Zixuan Xing
- Department of Infectious DiseasesThe Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Xin Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and RegenerationNational Clinical Research Center for Oral DiseasesShaanxi Clinical Research Center for Oral DiseasesDepartment of Orthodontics, School of StomatologyThe Fourth Military Medical UniversityXi′anChina
| | - Yilin Dai
- Department of DermatologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Baochen Cheng
- Department of DermatologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Shengbang Wang
- Department of DermatologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Tong Kang
- Department of DermatologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Qian Wang
- Department of DermatologyTangdu HospitalAir Force Military Medical UniversityXi'anChina
| | - Jing Zhang
- Department of DermatologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Jinjing Jia
- State Key Laboratory of Dampness Syndrome of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
- Department of DermatologyThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
- Department of Dermatology,Guangdong Provincial Key Laboratory of Chinese Medicine for Prevention and Treatment of Refractory Chronic DiseaseGuangzhouChina
| | - Yan Zheng
- Department of DermatologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
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Gkalpakiotis S, Kojanová M, Fialová J, Cetkovská P, Vašků V, Vantuchová Y, Machovcová A, Gkalpakioti P, Hrdá P, Arenberger P. Management of Moderate to Severe Plaque Psoriasis with Brodalumab in Daily Practice: Real-World Evidence from the LIBERO Study in the Czech Republic. Dermatol Ther (Heidelb) 2024; 14:115-130. [PMID: 38032433 PMCID: PMC10828329 DOI: 10.1007/s13555-023-01066-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Psoriasis is a chronic, immune-mediated inflammatory skin disease. Despite the availability of several therapies, many patients affected by this disease remain untreated, do not have adequate response, or suffer from treatment-related toxic effects. It has been shown that the interleukin (IL)-17 pathway plays a key role in the immunopathogenesis of psoriasis. Brodalumab, the first human monoclonal IgG2 antibody that selectively binds to subunit A of the human IL-17 receptor, blocking interactions with a number of cytokines of the IL-17 family, has confirmed fast onset of action, high complete clearance rates, and sustained efficacy. Nevertheless, there is only a limited amount of published real-world evidence (RWE) data. METHODS This was an open-label, multicenter, real-world, prospective, non-interventional, non-controlled (single-arm) observational study (LIBERO-CZ) assessing the management of moderate to severe psoriasis with brodalumab in daily practice for up to 52 weeks of treatment. RESULTS Fifty-four patients (70.4% male, mean age 46.9 ± 13.4 years, weight 95.6 ± 22.7 kg, disease duration 18.6 ± 12.7 years) were enrolled and included in the final analysis. Forty-nine of the patients completed the study and five discontinued prematurely; 51.8% of all the enrolled patients were biologic-naïve. At baseline, 28% patients were classified as severe (psoriasis area severity index (PASI) ≥ 20). Overall, the mean PASI decreased by 15.6 from 16.1 (± 5.0) at baseline to 0.5 (± 1.2) at the last visit. The primary endpoint of an absolute PASI ≤ 3 at week 12 (as observed analysis) was achieved by 95.9% of patients. The static Physician's Global Assessment (sPGA) success (defined as clear = 0 and almost clear = 1) at week 52 was achieved by 92.1% of patients. PASI 75, PASI 90, and PASI 100 were achieved by 98.0%, 87.8%, and 75.5% of patients, respectively, after approximately 52 weeks of treatment. The study also recorded very positive results concerning patient-reported outcomes. CONCLUSIONS LIBERO-CZ confirms the fast onset and high clearance rates of brodalumab in real life in both biologic-naïve and biologic-experienced patients.
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Affiliation(s)
- Spyridon Gkalpakiotis
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic.
| | - Martina Kojanová
- Department of Dermatovenereology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Jorga Fialová
- Department of Dermatovenereology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Petra Cetkovská
- Department of Dermatovenereology, Faculty of Medicine and University Hospital, Charles University, Pilsen, Czech Republic
| | - Vladimír Vašků
- Department of Dermatovenereology, St. Anne's University Hospital, Faculty of Medicine, Masaryk University Brno, Brno, Czech Republic
| | - Yvetta Vantuchová
- Department of Dermatology, Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | - Alena Machovcová
- Department of Dermatovenereology, Motol University Hospital, Prague, Czech Republic
| | - Petra Gkalpakioti
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic
| | | | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic
- Sanatorium of Professor Arenberger, Prague, Czech Republic
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5
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Buja A, Miatton A, Cozzolino C, Brazzale AR, Lo Bue R, Mercuri SR, Proft FN, Kridin K, Cohen AD, Damiani G. The Prevalent Comorbidome at the Onset of Psoriasis Diagnosis. Dermatol Ther (Heidelb) 2023; 13:2093-2105. [PMID: 37542678 PMCID: PMC10442308 DOI: 10.1007/s13555-023-00986-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 07/14/2023] [Indexed: 08/07/2023] Open
Abstract
INTRODUCTION Psoriasis (PsO) is currently regarded as a systemic inflammatory disease with a growing burden of post-diagnosis associated comorbidities. To determine the initial burden of comorbiditis we evaluated the comorbidome at PsO onset. METHODS In a matched case-control study, we extracted data on 57,228 patients and 125 morbidities from the Clalit Health Services Israeli insurance database. PsO cases were matched with control individuals by sex and age at enrolment. As pre-existing comorbidities, we considered all conditions already present in controls at the same age as the matched PsO case at the time of their diagnosis. To test for differences in the odds of comorbidities between the case and control groups, logistic regression analyses were run to calculate the odds ratio (OR) for each comorbidity, after which the comorbidome was graphically represented. RESULTS In this study we enrolled 28,614 PsO patients and 28,614 controls with an average age of 45.3 ± 19.6 years. At the time of diagnosis, PsO patients were more likely to be diagnosed with 2-4 comorbidities (28.8% vs 23.8%) and > 5 (19.6% vs 12.9%,). PsO patients' specific comorbidomes evidenced several pathological cores: autoimmune and inflammatory systemic diseases [i.e., hidradenitis suppurativa (OR 3.55, 95% CI 1.88-7.28) or polymyalgia rheumatica (OR 3.01 95% CI 1.96-4.77)], inflammatory bowel diseases [i.e., Crohn's disease (OR 2.99 95% CI 2.20-4.13)], pulmonary inflammatory diseases [i.e., chronic obstructive pulmonary disease (OR 1.81 95% CI 1.61-2.04)], hepatological diseases [i.e., cirrhosis (OR 2.00 95% CI 1.36-3.00)], endocrine diseases [dysthyroidisms (OR 1.82 95% CI 1.30-2.59)], mental disorders [i.e., depression (OR 1.72 95% CI 1.57-1.87)], and cardiovascular diseases (i.e., hypertension (OR 1.47 95% CI 1.41-1.53)]. CONCLUSION The PsO-onset comorbidome may help health professionals plan more comprehensive patient management. By screening for these common PsO-linked conditions, early diagnosis and treatment may become more frequent, thus greatly benefiting patients on their medical journey.
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Affiliation(s)
- Alessandra Buja
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, Padua, Italy.
| | - Andrea Miatton
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, Padua, Italy
| | - Claudia Cozzolino
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, Padua, Italy
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | | | - Roberta Lo Bue
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, Padua, Italy
| | - Santo Raffaele Mercuri
- Italian Center of Precision Medicine and Chronic Inflammation, University of Milan, Via Commenda 10, 20122, Milan, Italy
- Unit of Dermatology and Cosmetology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Fabian Nikolai Proft
- Department of Gastroenterology, Infectiology and Rheumatology (Including Nutrition Medicine), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Khalaf Kridin
- Unit of Dermatology and Skin Research Laboratory, Barch Padeh Medical Center, Tiberias, Israel
| | - Arnon Dov Cohen
- Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Giovanni Damiani
- Italian Center of Precision Medicine and Chronic Inflammation, University of Milan, Via Commenda 10, 20122, Milan, Italy.
- Unit of Dermatology and Cosmetology, IRCCS San Raffaele Hospital, Milan, Italy.
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy.
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6
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Jeong Y, Song J, Lee Y, Choi E, Won Y, Kim B, Jang W. A Transcriptome-Wide Analysis of Psoriasis: Identifying the Potential Causal Genes and Drug Candidates. Int J Mol Sci 2023; 24:11717. [PMID: 37511476 PMCID: PMC10380797 DOI: 10.3390/ijms241411717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/14/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Psoriasis is a chronic inflammatory skin disease characterized by cutaneous eruptions and pruritus. Because the genetic backgrounds of psoriasis are only partially revealed, an integrative and rigorous study is necessary. We conducted a transcriptome-wide association study (TWAS) with the new Genotype-Tissue Expression version 8 reference panels, including some tissue and multi-tissue panels that were not used previously. We performed tissue-specific heritability analyses on genome-wide association study data to prioritize the tissue panels for TWAS analysis. TWAS and colocalization (COLOC) analyses were performed with eight tissues from the single-tissue panels and the multi-tissue panels of context-specific genetics (CONTENT) to increase tissue specificity and statistical power. From TWAS, we identified the significant associations of 101 genes in the single-tissue panels and 64 genes in the multi-tissue panels, of which 26 genes were replicated in the COLOC. Functional annotation and network analyses identified that the genes were associated with psoriasis and/or immune responses. We also suggested drug candidates that interact with jointly significant genes through a conditional and joint analysis. Together, our findings may contribute to revealing the underlying genetic mechanisms and provide new insights into treatments for psoriasis.
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Affiliation(s)
- Yeonbin Jeong
- Department of Life Sciences, Dongguk University, Seoul 04620, Republic of Korea
| | - Jaeseung Song
- Department of Life Sciences, Dongguk University, Seoul 04620, Republic of Korea
| | - Yubin Lee
- Department of Life Sciences, Dongguk University, Seoul 04620, Republic of Korea
| | - Eunyoung Choi
- Department of Life Sciences, Dongguk University, Seoul 04620, Republic of Korea
| | - Youngtae Won
- Department of Life Sciences, Dongguk University, Seoul 04620, Republic of Korea
| | - Byunghyuk Kim
- Department of Life Sciences, Dongguk University-Seoul, Goyang 10326, Republic of Korea
| | - Wonhee Jang
- Department of Life Sciences, Dongguk University, Seoul 04620, Republic of Korea
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Yang Q, Wang J, Mi N, Zou Y. Literature Overview of the Relation Between Psoriasis and Alzheimer. Neuropsychiatr Dis Treat 2023; 19:461-468. [PMID: 36879948 PMCID: PMC9985423 DOI: 10.2147/ndt.s403854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023] Open
Abstract
The most common type of dementia disease is Alzheimer, which placing a heavy burden on the healthcare system all over the world. At the same time, psoriasis is also one of the most common health problems, as a skin disease. Alzheimer's disease (AD) is more often in patients with psoriasis than in the general people. Several evidence has proved the relation between AD and psoriasis through immune-mediated pathophysiologic processes. This review aims to summary the potential relation between AD and psoriasis, and provide suggestions based on the relationship at the same time. Neurologists, dermatologists should pay attention to the relationship between Alzheimer's disease and psoriasis. Dermatology and neurology need referral each other when it is necessary.
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Affiliation(s)
- Qian Yang
- Department of Obstetrics, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Jing Wang
- Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Ningyu Mi
- Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Yulin Zou
- Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
- Department of Dermatology, Jinzhou Medical University Graduate Training Base, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
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8
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Considerations of the Genetic Background of Obesity among Patients with Psoriasis. Genes (Basel) 2023; 14:genes14030594. [PMID: 36980866 PMCID: PMC10048146 DOI: 10.3390/genes14030594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/31/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
Psoriasis comorbidities may emerge from pleiotropic mechanisms, including common proinflammatory pathways, cellular mediators or genetic predisposition. Obesity is considered to be an independent risk factor of psoriasis, which may influence the severity of the disease and its early onset, decrease patients’ quality of life, alter response to psoriasis therapies and affect morbidity by reduced life expectancy due to cardiovascular events. Although novel approaches, including genetic techniques, have provided a wide range of new research, there are still scarce studies elaborating on the common genetic background of psoriasis and obesity. The aim of this study was to present and evaluate a possible common genetic background of psoriasis and concomitant increased body mass based on the review of the available literature.
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Autoreactive T-Cells in Psoriasis: Are They Spoiled Tregs and Can Therapies Restore Their Functions? Int J Mol Sci 2023; 24:ijms24054348. [PMID: 36901778 PMCID: PMC10002349 DOI: 10.3390/ijms24054348] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/25/2023] Open
Abstract
Psoriasis is a chronic inflammatory skin disease, which affects 2-4% of the population worldwide. T-cell derived factors such as Th17 and Th1 cytokines or cytokines such as IL-23, which favors Th17-expansion/differentiation, dominate in the disease. Therapies targeting these factors have been developed over the years. An autoimmune component is present, as autoreactive T-cells specific for keratins, the antimicrobial peptide LL37 and ADAMTSL5 have been described. Both autoreactive CD4 and CD8 T-cells exist, produce pathogenic cytokines, and correlate with disease activity. Along with the assumption that psoriasis is a T-cell-driven disease, Tregs have been studied extensively over the years, both in the skin and in circulation. This narrative review resumes the main findings about Tregs in psoriasis. We discuss how Tregs increase in psoriasis but are impaired in their regulatory/suppressive function. We debate the possibility that Tregs convert into T-effector cells under inflammatory conditions; for instance, they may turn into Th17-cells. We put particular emphasis on therapies that seem to counteract this conversion. We have enriched this review with an experimental section analyzing T-cells specific for the autoantigen LL37 in a healthy subject, suggesting that a shared specificity may exist between Tregs and autoreactive responder T-cells. This suggests that successful psoriasis treatments may, among other effects, restore Tregs numbers and functions.
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10
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Balato A, Scala E, Eyerich K, Brembilla NC, Chiricozzi A, Sabat R, Ghoreschi K. Management of Infections in Psoriatic Patients Treated with Systemic Therapies: A Lesson from the Immunopathogenesis of Psoriasis. Dermatol Pract Concept 2023; 13:dpc.1301a16. [PMID: 36892377 PMCID: PMC9946081 DOI: 10.5826/dpc.1301a16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 02/04/2023] Open
Abstract
Modern treatments continue to be developed based on identifying targets within the innate and adaptive immune pathways associated with psoriasis. Whilst there is a sound biologic rationale for increased risk of infection following treatment with immunomodulators, the clinical evidence is confounded by these agents being used in patients affected with several comorbidities. In an era characterized by an ever greater and growing risk of infections, it is necessary to always be updated on this risk. In this mini-review, we will discuss recent updates in psoriasis immunopathogenesis as a rationale for systemic therapy, outline the risk of infections linked to the disease itself and systemic therapy as well, and provide an overview of the prevention and management of infections.
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Affiliation(s)
- Anna Balato
- Dermatology Unit, University of Campania, Naples, Italy
| | - Emanuele Scala
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kilian Eyerich
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Dermatology and Venereology, Unit of Dermatology, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Robert Sabat
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin, Berlin, Germany.,Psoriasis Research and Treatment Center, Department of Dermatology and Allergy and Institute of Medical Immunology, Charité-Universitätsmedizin, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin, Berlin, Germany
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Chronic Inflammation as the Underlying Mechanism of the Development of Lung Diseases in Psoriasis: A Systematic Review. Int J Mol Sci 2022; 23:ijms23031767. [PMID: 35163689 PMCID: PMC8836589 DOI: 10.3390/ijms23031767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/30/2022] [Accepted: 02/02/2022] [Indexed: 01/04/2023] Open
Abstract
Psoriasis is a systemic inflammatory disease caused by dysfunctional interactions between the innate and adaptive immune responses. The systemic inflammation in psoriasis may be associated with the development of comorbidities, including lung diseases. In this review, we aimed to provide a summary of the evidence regarding the prevalence of lung diseases in patients with psoriasis and the potential underlying mechanisms. Twenty-three articles published between March 2010 and June 2021 were selected from 195 initially identified records. The findings are discussed in terms of the prevalence of asthma, chronic obstructive pulmonary disease, interstitial lung disease, obstructive sleep apnea, pulmonary hypertension, and sarcoidosis in psoriasis. A higher prevalence of lung diseases in psoriasis has been confirmed in asthma, chronic obstructive pulmonary disease, obstructive sleep apnea, and pulmonary hypertension. These conditions are important as they are previously unrecognized causes of morbidity and mortality in psoriasis. The development of lung diseases in patients with psoriasis can be explained by several mechanisms, including common risk factors, shared immune and molecular characteristics associated with chronic inflammation, as well as other mechanisms. Understanding the prevalence of lung diseases in psoriasis and their underlying mechanisms can help implement appropriate preventative and therapeutic strategies to address respiratory diseases in patients with psoriasis.
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12
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Yan BX, Chen XY, Ye LR, Chen JQ, Zheng M, Man XY. Cutaneous and Systemic Psoriasis: Classifications and Classification for the Distinction. Front Med (Lausanne) 2021; 8:649408. [PMID: 34722555 PMCID: PMC8548430 DOI: 10.3389/fmed.2021.649408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 09/16/2021] [Indexed: 12/23/2022] Open
Abstract
Psoriasis is a chronic multisystem inflammatory disease that affects ~0.1–1.5% of the world population. The classic cutaneous manifestation of psoriasis is scaly erythematous plaques, limited or widely distributed. Moreover, psoriasis could be associated with comorbidities like psoriatic arthritis, metabolic syndrome, diabetes, cardiovascular disease, nephropathy, bowel disease, and brain diseases. In this review, we suggest that psoriasis should be classified as cutaneous psoriasis or systemic psoriasis and propose the classification for distinction. This would help to better understand and manage psoriasis.
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Affiliation(s)
- Bing-Xi Yan
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xue-Yan Chen
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li-Ran Ye
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jia-Qi Chen
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Min Zheng
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao-Yong Man
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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13
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Identification and prediction of common molecular culprits between psoriasis and melanoma via bioinformatical analysis. GENE REPORTS 2021. [DOI: 10.1016/j.genrep.2021.101143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Yazdanpanah MJ, Vahabi-Amlashi S, Nematy M, Shaelaei N, Mohajeri SAR, Tafazzoli Z. Association of serum lipid profiles and dietary intakes of vitamin E and fiber with psoriasis severity. CASPIAN JOURNAL OF INTERNAL MEDICINE 2021; 12:606-612. [PMID: 34820070 PMCID: PMC8590413 DOI: 10.22088/cjim.12.4.606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/22/2020] [Accepted: 06/30/2020] [Indexed: 11/07/2022]
Abstract
Background: Dyslipidemia has been reportedly associated with an increased risk of atherosclerosis among psoriatic patients. Dietary intake can be a key factor in the pathophysiology of psoriasis. Herein, we assessed serum lipid profile and dietary intake in psoriatic patients, in comparison with healthy subjects. Methods: In this case-control study, 45 psoriatic patients and 43 healthy controls were evaluated. We estimated the macro/micronutrient intakes and energy, using a food frequency questionnaire (FFQ). Anthropometric parameters and serum levels of triglyceride (TG), high-density lipoproteins (HDL), low-density lipoproteins (LDL), and very low-density lipoproteins were assessed. The case group was categorized by severity measured by PASI score (mild<10, moderate 10-20, severe >20). Diet plan 6.0 was used to analyze FFQs and data were analyzed in SPSS 16.0, with p<0.05 considered significant. Results: The case group had markedly higher body mass index (BMI), LDL, and cholesterol and significantly lower HDL compared with controls (p<0.05). Carbohydrate, energy, fat intakes were significantly higher in cases, while folate, fiber, and vitamin E intakes were significantly lower in the case group, compared with the control group (p<0.05). BMI, cholesterol, and triglyceride values and dietary intakes of fiber and vitamin E were significantly associated with severity of psoriasis (p<0.05). Conclusion: Serum lipid profile and dietary intake are substantially important in psoriasis severity. Therefore, close monitoring of lipid profile and BMI during admission and follow-up and dietary modification can improve the severity of psoriasis.
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Affiliation(s)
| | - Sadegh Vahabi-Amlashi
- Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Nematy
- Department of Nutrition and Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Neda Shaelaei
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Zahra Tafazzoli
- Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,Correspondence: Zahra Tafazzoli, Department of Dermatology, Imam Reza Hospital, Ibn e Sina street, Mashhad, Iran. E-mail: , Tel: +98 5138583845, Fax: +98 5138583845
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Verbenko DA, Karamova AE, Artamonova OG, Deryabin DG, Rakitko A, Chernitsov A, Krasnenko A, Elmuratov A, Solomka VS, Kubanov AA. Apremilast Pharmacogenomics in Russian Patients with Moderate-to-Severe and Severe Psoriasis. J Pers Med 2020; 11:jpm11010020. [PMID: 33383665 PMCID: PMC7823747 DOI: 10.3390/jpm11010020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/18/2020] [Accepted: 12/25/2020] [Indexed: 12/14/2022] Open
Abstract
One of the target drugs for plaque psoriasis treatment is apremilast, which is a selective phosphodiesterase 4 (PDE4) inhibitor. In this study, 34 moderate-to-severe and severe plaque psoriasis patients from Russia were treated with apremilast for 26 weeks. This allowed us to observe the effectiveness of splitting patient cohorts based on clinical outcomes, which were assessed using the Psoriasis Area Severity Index (PASI). In total, 14 patients (41%) indicated having an advanced outcome with delta PASI 75 after treatment; 20 patients indicated having moderate or no effects. Genome variability was investigated using the Illumina Infinium Global Screening Array. Genome-wide analysis revealed apremilast therapy clinical outcome associations at three compact genome regions with undefined functions situated on chromosomes 2, 4, and 5, as well as on a single single-nucleotide polymorphism (SNP) on chromosome 23. Pre-selected SNP sets were associated with psoriasis vulgaris analysis, which was used to identify four SNP-associated targeted therapy efficiencies: IL1β (rs1143633), IL4 (IL13) (rs20541), IL23R (rs2201841), and TNFα (rs1800629) genes. Moreover, we showed that the use of the global polygenic risk score allowed for the prediction of onset psoriasis in Russians. Therefore, these results can serve as a starting point for creating a predictive model of apremilast therapy response in the targeted therapy of patients with psoriasis vulgaris.
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Affiliation(s)
- Dmitry A. Verbenko
- State Research Center of Dermatovenereology and Cosmetology, Korolenko St., 3, bldg 6, 107076 Moscow, Russia; (A.E.K.); (O.G.A.); (D.G.D.); (V.S.S.); (A.A.K.)
- Correspondence:
| | - Arfenya E. Karamova
- State Research Center of Dermatovenereology and Cosmetology, Korolenko St., 3, bldg 6, 107076 Moscow, Russia; (A.E.K.); (O.G.A.); (D.G.D.); (V.S.S.); (A.A.K.)
| | - Olga G. Artamonova
- State Research Center of Dermatovenereology and Cosmetology, Korolenko St., 3, bldg 6, 107076 Moscow, Russia; (A.E.K.); (O.G.A.); (D.G.D.); (V.S.S.); (A.A.K.)
| | - Dmitry G. Deryabin
- State Research Center of Dermatovenereology and Cosmetology, Korolenko St., 3, bldg 6, 107076 Moscow, Russia; (A.E.K.); (O.G.A.); (D.G.D.); (V.S.S.); (A.A.K.)
| | - Alexander Rakitko
- Genotek Ltd., Nastavnicheskiipereulok 17/1, 105120 Moscow, Russia; (A.R.); (A.C.); (A.K.); (A.E.)
| | - Alexandr Chernitsov
- Genotek Ltd., Nastavnicheskiipereulok 17/1, 105120 Moscow, Russia; (A.R.); (A.C.); (A.K.); (A.E.)
| | - Anna Krasnenko
- Genotek Ltd., Nastavnicheskiipereulok 17/1, 105120 Moscow, Russia; (A.R.); (A.C.); (A.K.); (A.E.)
| | - Artem Elmuratov
- Genotek Ltd., Nastavnicheskiipereulok 17/1, 105120 Moscow, Russia; (A.R.); (A.C.); (A.K.); (A.E.)
| | - Victoria S. Solomka
- State Research Center of Dermatovenereology and Cosmetology, Korolenko St., 3, bldg 6, 107076 Moscow, Russia; (A.E.K.); (O.G.A.); (D.G.D.); (V.S.S.); (A.A.K.)
| | - Alexey A. Kubanov
- State Research Center of Dermatovenereology and Cosmetology, Korolenko St., 3, bldg 6, 107076 Moscow, Russia; (A.E.K.); (O.G.A.); (D.G.D.); (V.S.S.); (A.A.K.)
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Jaganjac M, Milkovic L, Gegotek A, Cindric M, Zarkovic K, Skrzydlewska E, Zarkovic N. The relevance of pathophysiological alterations in redox signaling of 4-hydroxynonenal for pharmacological therapies of major stress-associated diseases. Free Radic Biol Med 2020; 157:128-153. [PMID: 31756524 DOI: 10.1016/j.freeradbiomed.2019.11.023] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/04/2019] [Accepted: 11/17/2019] [Indexed: 02/07/2023]
Abstract
Modern analytical methods combined with the modern concepts of redox signaling revealed 4-hydroxy-2-nonenal (4-HNE) as particular growth regulating factor involved in redox signaling under physiological and pathophysiological circumstances. In this review current knowledge of the relevance of 4-HNE as "the second messenger of reactive oxygen species" (ROS) in redox signaling of representative major stress-associated diseases is briefly summarized. The findings presented allow for 4-HNE to be considered not only as second messenger of ROS, but also as one of fundamental factors of the stress- and age-associated diseases. While standard, even modern concepts of molecular medicine and respective therapies in majority of these diseases target mostly the disease-specific symptoms. 4-HNE, especially its protein adducts, might appear to be the bioactive markers that would allow better monitoring of specific pathophysiological processes reflecting their complexity. Eventually that could help development of advanced integrative medicine approach for patients and the diseases they suffer from on the personalized basis implementing biomedical remedies that would optimize beneficial effects of ROS and 4-HNE to prevent the onset and progression of the illness, perhaps even providing the real cure.
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Affiliation(s)
- Morana Jaganjac
- Qatar Analytics & BioResearch Lab, Anti Doping Lab Qatar, Sport City Street, Doha, Qatar
| | - Lidija Milkovic
- Rudjer Boskovic Institute, Laboratory for Oxidative Stress, Div. of Molecular Medicine, Bijenicka 54, Zagreb, Croatia
| | - Agnieszka Gegotek
- Department of Analytical Chemistry, Medical University of Bialystok, Mickiewicza 2D, 15-222, Bialystok, Poland
| | - Marina Cindric
- University of Zagreb, School of Medicine, Div. of Pathology, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb, Croatia
| | - Kamelija Zarkovic
- University of Zagreb, School of Medicine, Div. of Pathology, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb, Croatia
| | - Elzbieta Skrzydlewska
- Department of Analytical Chemistry, Medical University of Bialystok, Mickiewicza 2D, 15-222, Bialystok, Poland
| | - Neven Zarkovic
- Rudjer Boskovic Institute, Laboratory for Oxidative Stress, Div. of Molecular Medicine, Bijenicka 54, Zagreb, Croatia.
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Paroutoglou K, Papadavid E, Christodoulatos GS, Dalamaga M. Deciphering the Association Between Psoriasis and Obesity: Current Evidence and Treatment Considerations. Curr Obes Rep 2020; 9:165-178. [PMID: 32418186 DOI: 10.1007/s13679-020-00380-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Obesity and psoriasis represent chronic inflammatory states that are interconnected in a vicious cycle, sharing also a degree of synergy. In this review, we aim to decipher the various lines of evidence supporting the bidirectional association between psoriasis and obesity highlighting their pathophysiologic connections as well as we attempt to strategize a therapeutic holistic approach for obese psoriatic patients. RECENT FINDINGS Recent meta-analyses have shown that (1) genetically higher BMI increased the odds of psoriasis occurrence; (2) obesity is associated with higher incidence and prevalence of psoriasis as well as psoriasis severity; (3) obesity is associated with lower efficacy to anti-TNF agents and may predict biologic treatment discontinuation; and (4) weight loss through diet and physical exercise may improve pre-existing psoriasis and prevent from de novo psoriasis. Methotrexate, acitretin, and cyclosporine could worsen hypertension, liver steatosis, and dyslipidemia. Since infliximab and ustekinumab are weight adjusted, they may be ideal drugs to treat obese psoriatic patients. IL-17 inhibitors are very effective independently from body weight; however, they tend to present better clearance rates in normal weight patients. There is a paucity on weight data regarding the efficacious IL-23 inhibitors. Apremilast may induce weight loss as an adverse effect presenting also some beneficial metabolic actions. Finally, simvastatin and some antidiabetic drugs could decrease psoriasis severity. More mechanistic, observational studies and well-conducted RCTs are necessary to decipher the enigmatic link between psoriasis and obesity, and to provide evidence-based specific guidelines for the screening and management of obese psoriatic patients.
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Affiliation(s)
- Kyriaki Paroutoglou
- 2nd Department of Dermatology and Venereology, School of Medicine, National and Kapodistrian University of Athens, Attikon General University Hospital, 1 Rimini Street, Chaidari, 12462, Athens, Greece
| | - Evangelia Papadavid
- 2nd Department of Dermatology and Venereology, School of Medicine, National and Kapodistrian University of Athens, Attikon General University Hospital, 1 Rimini Street, Chaidari, 12462, Athens, Greece
| | - Gerasimos Socrates Christodoulatos
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens Medical School, 27 Mikras Asias Street, Goudi, 11527, Athens, Greece
| | - Maria Dalamaga
- 2nd Department of Dermatology and Venereology, School of Medicine, National and Kapodistrian University of Athens, Attikon General University Hospital, 1 Rimini Street, Chaidari, 12462, Athens, Greece.
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens Medical School, 27 Mikras Asias Street, Goudi, 11527, Athens, Greece.
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Pathogenesis of psoriasis in the "omic" era. Part II. Genetic, genomic and epigenetic changes in psoriasis. Postepy Dermatol Alergol 2020; 37:283-298. [PMID: 32774210 PMCID: PMC7394158 DOI: 10.5114/ada.2020.96243] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 05/06/2020] [Indexed: 12/22/2022] Open
Abstract
Psoriasis is a multifactorial disease in which genetic, environmental and epigenetic factors regulating gene expression play a key role. In the “genomic era”, genome-wide association studies together with target genotyping platforms performed in different ethnic populations have found more than 50 genetic susceptible markers associated with the risk of psoriasis which have been identified so far. Up till now, the strongest association with the risk of the disease has been proved for HLA-C*06 gene. The majority of other psoriasis risk SNPs are situated near the genes encoding molecules involved in adaptive and innate immunity, and skin barrier function. Many contemporary studies indicate that the epigenetic changes: histone modification, promoter methylations, long non-coding and micro-RNA hyperexpression are considered as factors contributing to psoriasis pathogenesis as they regulate abnormal keratinocyte differentiation and proliferation, aberrant keratinocytes – inflammatory cells communication, neoangiogenesis and chronic inflammation. The circulating miRNAs detected in the blood may become specific markers in the diagnosis, prognosis and response to the treatment of the disease. The inhibition of expression in selected miRNAs may be a new promising therapy option for patients with psoriasis.
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Zhu Y, Ma Y, Zu W, Song J, Wang H, Zhong Y, Li H, Zhang Y, Gao Q, Kong B, Xu J, Jiang F, Wang X, Li S, Liu C, Liu H, Lu T, Chen Y. Identification of N-Phenyl-7 H-pyrrolo[2,3- d]pyrimidin-4-amine Derivatives as Novel, Potent, and Selective NF-κB Inducing Kinase (NIK) Inhibitors for the Treatment of Psoriasis. J Med Chem 2020; 63:6748-6773. [PMID: 32479083 DOI: 10.1021/acs.jmedchem.0c00055] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A series of N-phenyl-7H-pyrrolo[2,3-d]pyrimidin-4-amine derivatives with NF-κB inducing kinase (NIK) inhibitory activity were obtained through structure-based drug design and synthetic chemistry. Among them, 4-(3-((7H-pyrrolo[2,3-d]pyrimidin-4-yl)amino)-4-morpholinophenyl)-2-(thiazol-2-yl)but-3-yn-2-ol (12f) was identified as a highly potent NIK inhibitor, along with satisfactory selectivity. The pharmacokinetics of 12f and its ability to inhibit interleukin 6 secretion in BEAS-2B cells were better than compound 1 developed by Amgen. Oral administration of different doses of 12f in an imiquimod-induced psoriasis mouse model showed effective alleviation of psoriasis, including invasive erythema, swelling, skin thickening, and scales. The underlying pathological mechanism involved attenuation of proinflammatory cytokine and chemokine gene expression, and the infiltration of macrophages after the treatment of 12f. This work provides a foundation for the development of NIK inhibitors, highlighting the potential of developing NIK inhibitors as a new strategy for the treatment of psoriasis.
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Affiliation(s)
- Yuqin Zhu
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
| | - Yuxiang Ma
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, P. R. China
| | - Weidong Zu
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
| | - Jianing Song
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
| | - Hua Wang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, P. R. China
| | - You Zhong
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, P. R. China
| | - Hongmei Li
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
| | - Yanmin Zhang
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
| | - Qianqian Gao
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
| | - Bo Kong
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
| | - Junyu Xu
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
| | - Fei Jiang
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
| | - Xinren Wang
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
| | - Shuwen Li
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
| | - Chenhe Liu
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
| | - Haichun Liu
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
| | - Tao Lu
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, P. R. China
| | - Yadong Chen
- School of Sciences, China Pharmaceutical University, 639 Longmian Avenue, Nanjing 211198, P. R. China
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Li J, Li X, He F, Zhao X, Hou R, Lin H, Shen J, Wu X, Liao Q, Xing J, Yi G, Li X, Zhang K. Cross-sectional study reveals thatHLA-C*07:02 is a potential biomarker of early onset/lesion severityof psoriasis. Exp Dermatol 2020; 29:639-646. [PMID: 32506489 DOI: 10.1111/exd.14127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 04/22/2020] [Accepted: 06/02/2020] [Indexed: 12/18/2022]
Abstract
Psoriasis is a common chronic autoimmune skin disease, with T cells playing a predominant role in its pathogenesis.Here, we aimed to investigate the relation of T cell repertoires (TCR) and major histocompatibility complex (MHC) in psoriatic patients to further understand mechanisms in disease pathogenesis.We conducted a cross-sectional study involving 9 pairs of monozygotic twins with inconsistent psoriasis and examined the TCR diversity and MHC haplotype ofthe individuals using multiple-PCR and high-throughput sequencing. Additionally, 665 psoriatic patients were applied to validate the relation of human leukocyte antigen (HLA)-class I allele HLA-C*07:02 and early onset or lesion severity of psoriasis.The immune diversity was lower in psoriatic patients compared with unaffected individuals within the twin pairs, although the difference was not significant.The clonotypes of TCR significantly decreased in psoriatic patients with high PASI score and early onset. HLA-C*07:02, a haplotype associated with psoriasis, was positively correlated with the diversity of the TCRV gene. Moreover, HLA-C*07:02 clustered in patients with high PASI and early onset. In the replication stage, we found that the PASI and onset age in psoriasis with HLA-C*07:02 were significantly different from those without HLA-C*07:02 and without HLA-C*06:02. Our observations indicate that HLA-C*07:02 is positively correlated with the diversity of TCRV gene in psoriasis, and maybe a potential biomarker of early onset/severe lesions of psoriasis.
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Affiliation(s)
- Junqin Li
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China
| | - Xiaofang Li
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China
| | - Fusheng He
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China
| | - Xincheng Zhao
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China
| | - Ruixia Hou
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China
| | - Haoxiang Lin
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China
| | - Juan Shen
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China
| | - Xueli Wu
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China
| | - Qijun Liao
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China
| | - Jianxiao Xing
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China
| | - Guohua Yi
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China
| | - Xinhua Li
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China
| | - Kaiming Zhang
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China
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Immunopathogenesis of Progressive Scarring Trachoma: Results of a 4-Year Longitudinal Study in Tanzanian Children. Infect Immun 2020; 88:IAI.00629-19. [PMID: 31964744 PMCID: PMC7093124 DOI: 10.1128/iai.00629-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 01/15/2020] [Indexed: 12/25/2022] Open
Abstract
Trachoma is initiated during childhood following repeated conjunctival infection with Chlamydia trachomatis, which causes a chronic inflammatory response in some individuals that leads to scarring and in-turning of the eyelids in later life. There is currently no treatment to halt the progression of scarring trachoma due to an incomplete understanding of disease pathogenesis. A cohort study was performed in northern Tanzania in 616 children aged 6 to 10 years at enrollment. Every 3 months for 4 years, children were examined for clinical signs of trachoma, and conjunctival swabs were collected for C. trachomatis detection and to analyze the expression of 46 immunofibrogenic genes. Trachoma is initiated during childhood following repeated conjunctival infection with Chlamydia trachomatis, which causes a chronic inflammatory response in some individuals that leads to scarring and in-turning of the eyelids in later life. There is currently no treatment to halt the progression of scarring trachoma due to an incomplete understanding of disease pathogenesis. A cohort study was performed in northern Tanzania in 616 children aged 6 to 10 years at enrollment. Every 3 months for 4 years, children were examined for clinical signs of trachoma, and conjunctival swabs were collected for C. trachomatis detection and to analyze the expression of 46 immunofibrogenic genes. Data were analyzed in relation to progressive scarring status between baseline and the final time point. Genes that were significantly associated with scarring progression included those encoding proinflammatory chemokines (CXCL5, CCL20, CXCL13, and CCL18), cytokines (IL23A, IL19, and IL1B), matrix modifiers (MMP12 and SPARCL1), immune regulators (IDO1, SOCS3, and IL10), and a proinflammatory antimicrobial peptide (S100A7). In response to C. trachomatis infection, IL23A and PDGF were significantly upregulated in scarring progressors relative to in nonprogressors. Our findings highlight the importance of innate proinflammatory signals from the epithelium and implicate interleukin 23A (IL-23A)-responsive cells in driving trachomatous scarring, with potential key mechanistic roles for PDGFB, MMP12, and SPARCL1 in orchestrating fibrosis.
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Filiz B, Yıldırım M, Hekimler Öztürk K, Şirin FB, Çelik S, Erturan İ, Korkmaz S, Orhan H. Evaluation of interleukin-23 receptor (IL-23R) gene polymorphisms and serum IL-23 levels in patients with psoriasis. Turk J Med Sci 2019; 49:1386-1394. [PMID: 31648514 PMCID: PMC7018327 DOI: 10.3906/sag-1904-48] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 06/30/2019] [Indexed: 01/01/2023] Open
Abstract
Background/aim IL-23R gene polymorphisms and the association of these polymorphisms with serum IL-23 levels were investigated in patients with psoriasis in the current study. Materials and methods Sixty-seven patients with psoriasis who were admitted to our dermatology outpatient clinic and 67 healthy controls were included in the study. Polymorphisms of the IL-23R gene were determined by KASP-PCR method, and serum IL-23 levels were determined by ELISA method. Results The distribution of IL-23R gene polymorphisms rs2201841, rs11209026, rs7530511, rs1343152, and rs11465804 was not significantly different in the patient and control groups. The AA genotype of the rs2201841 locus in males and the GA genotype in females, as well as the AA genotype of the rs1343152 locus in males and the CA genotype in females, were statistically significant in patients with psoriasis. The mean serum IL-23 level was significantly lower in the patient group (42.62 ± 5.96) compared to the control groups (75.76 ± 13.24). Conclusion IL-23R gene polymorphisms including rs2201841, rs11209026, rs7530511, rs11465804, and rs1343152 were not found to be significantly related to psoriasis. Different genetic polymorphisms may play a role in the development of psoriasis in female and male populations. Ethnic differences between different populations may have led to differences in the distribution of polymorphisms in the current study with compared to other published studies. Additionally, many different genes, polymorphisms, and environmental factors that have an effect on the development of psoriasis may affect the disease process.
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Affiliation(s)
- Başak Filiz
- Department of Dermatology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Mehmet Yıldırım
- Department of Dermatology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Kuyaş Hekimler Öztürk
- Department of Medical Genetics, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Fevziye Burcu Şirin
- Department of Biochemistry, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Seda Çelik
- Department of Biochemistry, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - İjlal Erturan
- Department of Dermatology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Selma Korkmaz
- Department of Dermatology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Hikmet Orhan
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Süleyman Demirel University Isparta, Turkey
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Li J, Lin H, Hou R, Shen J, Li X, Xing J, He F, Wu X, Zhao X, Sun L, Fan X, Niu X, Liu Y, Liu R, An P, Qu T, Chang W, Wang Q, Zhou L, Li J, Wang Z, Jiao J, Wang Y, Wang G, Liang N, Liang J, Liang Y, Hou H, Shi Y, Yang X, Li J, Dang E, Yin G, Yang X, Zhang G, Gao Q, Fang X, Li X, Zhang K. Multi-omics study in monozygotic twins confirm the contribution of de novo mutation to psoriasis. J Autoimmun 2019; 106:102349. [PMID: 31629629 DOI: 10.1016/j.jaut.2019.102349] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 10/03/2019] [Accepted: 10/07/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Genome-wide association studies have identified over 120 risk loci for psoriasis. However, most of the variations are located in non-coding region with high frequency and small effect size. Pathogenetic variants are rarely reported except HLA-C*0602 with the odds ratio being approximately 4.0 in Chinese population. Although rare variations still account for a small proportion of phenotypic variances in complex diseases, their effect on phenotypes is large. Recently, more and more studies focus on the low-frequency functional variants and have achieved a certain amount of success. METHOD Whole genome sequencing and sanger sequencing was performed on 8 MZ twin pairs discordant for psoriasis to scan and verified the de novo mutations (DNMs). Additionally, 665 individuals with about 20 years' medical history versus 2054 healthy controls and two published large population studies which had about 8 years' medical history (including 10,727 cases versus 10,582 controls) were applied to validate the enrichment of rare damaging mutations in two DNMs genes. Besides, to verify the pathogenicity of candidate DNM in C3, RNA-sequencing for CD4+, CD8+ T cells of twins and lesion, non-lesion skin of psoriasis patients were carried out. Meanwhile, the enzyme-linked immunosorbent assay kit was used to detect the level of C3, C3b in the supernatant of peripheral blood. RESULT A total of 27 DNMs between co-twins were identified. We found six of eight twins carry HLA-C∗0602 allele which have large effects on psoriasis. And it is interesting that a missense mutation in SPRED1 and a splice region mutation in C3 are found in the psoriasis individuals in the other two MZ twin pairs without carrying HLA-C*0602 allele. In the replication stage, we found 2 loss-of-function (LOF) variants of C3 only in 665 cases with about 20 years' medical history and gene-wise analysis in 665 cases and 2054 controls showed that the rare missense mutations in C3 were enriched in cases (OR = 1.91, P = 0.0028). We further scanned the LOF mutations of C3 in two published studies (about 8 years' medical history), and found one LOF mutation in the case without carrying HLA-C*0602. In the individual with DNM in C3, RNA sequencing showed the expression level of C3 in skin was significant higher than healthy samples in public database (TPM fold change = 1.40, P = 0.000181) and ELISA showed protein C3 in peripheral blood was higher (~2.2-fold difference) than the other samples of twins without DNM in C3. CONCLUSION To the best of our knowledge, this is the first report that DNM in C3 is the likely pathological mutations, and it provided a better understanding of the genetic etiology of psoriasis and additional treatments for this disease.
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Affiliation(s)
- Junqin Li
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Haoxiang Lin
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China.
| | - Ruixia Hou
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Juan Shen
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China.
| | - Xiaofang Li
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Jianxiao Xing
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Fusheng He
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Xueli Wu
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China.
| | - Xincheng Zhao
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Liangdan Sun
- Department of Dermatology at No. 1 Hospital, Anhui Medical University, Hefei, 230032, China.
| | - Xing Fan
- Department of Dermatology at No. 1 Hospital, Anhui Medical University, Hefei, 230032, China.
| | - Xuping Niu
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Yanmin Liu
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Ruifeng Liu
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Peng An
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Tong Qu
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Wenjuan Chang
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Qiang Wang
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Ling Zhou
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Jiao Li
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Ziyuan Wang
- Shanxi Medical University, No. 56 Xinjian South Road, Taiyuan, 030001, China.
| | - Juanjuan Jiao
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Ying Wang
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Gang Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No. 15 Changle Road West, Xi'an, 710032, China.
| | - Nannan Liang
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Jiannan Liang
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Yanyang Liang
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Hui Hou
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Yu Shi
- Department of Hematology, Oncology and Tumor Immunology Charité University Medicine Berlin, Campus Virchow Hospital, Berlin, Germany.
| | - Xiaohong Yang
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Juan Li
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Erle Dang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No. 15 Changle Road West, Xi'an, 710032, China.
| | - Guohua Yin
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Xukui Yang
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China.
| | - Guiping Zhang
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China.
| | - Qiang Gao
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China.
| | - Xiaodong Fang
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China.
| | - Xinhua Li
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
| | - Kaiming Zhang
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan City Center Hospital, No. 5 Dong San Dao Xiang, Jiefang Road, Taiyuan, 030009, China.
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Pathophysiology of Atopic Dermatitis and Psoriasis: Implications for Management in Children. CHILDREN-BASEL 2019; 6:children6100108. [PMID: 31590274 PMCID: PMC6826460 DOI: 10.3390/children6100108] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 12/15/2022]
Abstract
Atopic dermatitis (AD) and psoriasis are chronic inflammatory skin diseases associated with a significant cutaneous and systemic burden of disease as well as a poor health-related quality of life. Here, we review the complex pathophysiology of both AD and psoriasis and discuss the implications for treatment with current state-of-the-art and emerging topical and systemic therapies. Both AD and psoriasis are caused by a complex combination of immune dysregulation, skin-barrier disruption, genetic factors, and environmental influences. Previous treatments for both diseases were limited to anti-inflammatory agents that broadly suppress inflammation. Emerging insights into relevant pathways, including recognition of the role of T-helper type 2 driven inflammation in AD and T-helper 1 and 17 driven inflammation in psoriasis, have led to a therapeutic revolution. There are a number of novel treatment options available for AD and psoriasis with many more currently under investigation.
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Psoriatic arthritis: From pathogenesis to pharmacologic management. Pharmacol Res 2019; 148:104394. [PMID: 31505253 DOI: 10.1016/j.phrs.2019.104394] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/06/2019] [Accepted: 08/08/2019] [Indexed: 12/13/2022]
Abstract
The pathogenesis of psoriatic arthritis (PSA) is still a matter of debate. A favourable genetic background is interwoven with environmental triggering factors in a complex network. Shared antigens and the recirculation of immune cells may account for the clinical manifestations, involving both cutaneous and articular sites. A favourable genetic background has been demonstrated in many genomic and proteomic studies, being associated to polymorphic variants of the genes coding for Major Histocompatibility Complex I and cytokine pathways. In genetic-predisposed individuals, triggering factors, like infections, dysbiosis or mechanic stress may promote the development of the disease. The subsequent activation of the innate and adaptive immune system, following the stimulation of Toll-like Receptors, culminates in the expansion of dendritic cells, macrophages, CD4+ and CD8+ T cells, neutrophils, monocytes, Natural Killer lymphocytes and other cells with the final inflammation and damage of skin, joint and enthesis. Particularly, the activation of CD4+ T helper 17 lymphocytes represents a crucial point in the pathogenesis of the disease. The participation of the visceral adipose tissue may amplify the inflammatory process by means of the synthesis of pro-inflammatory adipokines. Current therapeutic algorithms address the variety of clinical manifestations with a tailored strategy aiming to achieve the best control of the symptoms with minimal side effects. Conventional immunosuppressive drugs, biologic agents and synthetic small molecules offer different attack routes and may be chosen individually or in combination according to the phenotype of the disease.
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Abstract
Research on psoriasis pathogenesis has largely increased knowledge on skin biology in general. In the past 15 years, breakthroughs in the understanding of the pathogenesis of psoriasis have been translated into targeted and highly effective therapies providing fundamental insights into the pathogenesis of chronic inflammatory diseases with a dominant IL-23/Th17 axis. This review discusses the mechanisms involved in the initiation and development of the disease, as well as the therapeutic options that have arisen from the dissection of the inflammatory psoriatic pathways. Our discussion begins by addressing the inflammatory pathways and key cell types initiating and perpetuating psoriatic inflammation. Next, we describe the role of genetics, associated epigenetic mechanisms, and the interaction of the skin flora in the pathophysiology of psoriasis. Finally, we include a comprehensive review of well-established widely available therapies and novel targeted drugs.
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Extra-adrenal glucocorticoid synthesis at epithelial barriers. Genes Immun 2019; 20:627-640. [PMID: 30692606 DOI: 10.1038/s41435-019-0058-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 01/02/2019] [Indexed: 01/08/2023]
Abstract
Epithelial barriers play an important role in the exchange of nutrients, gases, and other signals between our body and the outside world. However, they protect it also from invasion by potential pathogens. Defective epithelial barriers and associated overshooting immune responses are the basis of many different inflammatory disorders of the skin, the lung, and the intestinal mucosa. The anti-inflammatory activity of glucocorticoids has been efficiently used for the treatment of these diseases. Interestingly, epithelia in these tissues are also a rich source of endogenous glucocorticoids, suggesting that local glucocorticoid synthesis is part of a tissue-specific regulatory circuit. In this review, we summarize current knowledge about the extra-adrenal glucocorticoid synthesis at the epithelial barriers of the intestine, lung and the skin, and discuss their relevance in the pathogenesis of inflammatory diseases and as therapeutic targets.
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Lee KY, Leung KS, Tang NLS, Wong MH. Discovering Genetic Factors for psoriasis through exhaustively searching for significant second order SNP-SNP interactions. Sci Rep 2018; 8:15186. [PMID: 30315195 PMCID: PMC6185942 DOI: 10.1038/s41598-018-33493-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 09/28/2018] [Indexed: 12/24/2022] Open
Abstract
In this paper, we aim at discovering genetic factors of psoriasis through searching for statistically significant SNP-SNP interactions exhaustively from two real psoriasis genome-wide association study datasets (phs000019.v1.p1 and phs000982.v1.p1) downloaded from the database of Genotypes and Phenotypes. To deal with the enormous search space, our search algorithm is accelerated with eight biological plausible interaction patterns and a pre-computed look-up table. After our search, we have discovered several SNPs having a stronger association to psoriasis when they are in combination with another SNP and these combinations may be non-linear interactions. Among the top 20 SNP-SNP interactions being found in terms of pairwise p-value and improvement metric value, we have discovered 27 novel potential psoriasis-associated SNPs where most of them are reported to be eQTLs of a number of known psoriasis-associated genes. On the other hand, we have inferred a gene network after selecting the top 10000 SNP-SNP interactions in terms of improvement metric value and we have discovered a novel long distance interaction between XXbac-BPG154L12.4 and RNU6-283P which is not a long distance haplotype and may be a new discovery. Finally, our experiments with the synthetic datasets have shown that our pre-computed look-up table technique can significantly speed up the search process.
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Affiliation(s)
- Kwan-Yeung Lee
- Department of Computer Science and Engineering, the Chinese University of Hong Kong, Hong Kong, China.
| | - Kwong-Sak Leung
- Department of Computer Science and Engineering, the Chinese University of Hong Kong, Hong Kong, China
| | - Nelson L S Tang
- Department of Chemical Pathology, the Chinese University of Hong Kong, Hong Kong, China.
| | - Man-Hon Wong
- Department of Computer Science and Engineering, the Chinese University of Hong Kong, Hong Kong, China
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Psoriasis and Respiratory Comorbidities: The Added Value of Fraction of Exhaled Nitric Oxide as a New Method to Detect, Evaluate, and Monitor Psoriatic Systemic Involvement and Therapeutic Efficacy. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3140682. [PMID: 30345297 PMCID: PMC6174805 DOI: 10.1155/2018/3140682] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 07/25/2018] [Accepted: 08/12/2018] [Indexed: 02/06/2023]
Abstract
Psoriasis is a chronic inflammatory systemic disease characterized by a wide range of comorbidities. Respiratory comorbidities are currently poorly characterized and with discordant results. The systemic state of inflammation caused by psoriasis acts de novo on respiratory tissues and amplifies preexisting inflammation from asthma or chronic obstructive pulmonary disease. Because the lungs act as a gas exchanger between the internal and external environment, the impact of chronic psoriasis inflammation may be easily assessed through the analysis of exhaled breath. The fraction of exhaled nitric oxide test (FeNO) is a potential noninvasive solution that can provide quantitative and qualitative indices of respiratory airway inflammation. FeNO is routinely used to screen and manage asthmatic patients. Recent pilot studies contain encouraging data that underscore its possible use with systemic inflammatory nonpulmonary diseases, such as psoriasis. FeNO may therefore be a useful tool to evaluate underestimated airway inflammation and at the same time globally evaluate the impact of systemically antipsoriatic therapies.
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Kim HN, Han K, Song SW, Lee JH. Hypertension and risk of psoriasis incidence: An 11-year nationwide population-based cohort study. PLoS One 2018; 13:e0202854. [PMID: 30142208 PMCID: PMC6108501 DOI: 10.1371/journal.pone.0202854] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 08/12/2018] [Indexed: 01/03/2023] Open
Abstract
Psoriasis is a chronic inflammatory skin disease that is characterized by T-cell mediated immune response, and has been known to increase the risk of developing hypertension. However, the risk of psoriasis in patients with hypertension is not clear. Therefore, we investigated the risk of psoriasis in patients with hypertension. A total of 256,356 adults (42,726 in the hypertension group and 213,630 in the control group) were followed from 2003 to 2013 in a nationwide population-based cohort study. During the follow-up, 9,254 participants (3.6%) were found to have psoriasis (2,152 [5.0%] in the hypertension group and 7,102 [3.3%] in the control group). The hypertension group had a higher risk of psoriasis incidence (hazard ratio [HR] 1.54, 95% confidence interval [CI] 1.47-1.61, P < 0.001), and the association remained significant after adjusting for comorbidities of diabetes and dyslipidemia, antihypertensive medication and nonsteroidal anti-inflammatory drug use, and sociodemographic factors (HR 1.18, 95% CI 1.08-1.28, P < 0.001). In conclusion, hypertension was significantly associated with an increased risk of psoriasis incidence. Further studies are needed to confirm whether hypertension is associated with the incidence of psoriasis.
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Affiliation(s)
- Ha-Na Kim
- Department of Family Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang-Wook Song
- Department of Family Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji Hyun Lee
- Department of Dermatology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- * E-mail:
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Lin Y, Liu L, Sheng Y, Shen C, Zheng X, Zhou F, Yang S, Yin X, Zhang X. A catalog of potential putative functional variants in psoriasis genome-wide association regions. PLoS One 2018; 13:e0196635. [PMID: 29715312 PMCID: PMC5929547 DOI: 10.1371/journal.pone.0196635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/15/2018] [Indexed: 01/20/2023] Open
Abstract
Psoriasis is a common inflammatory skin disease, with considerable genetic contribution. Genome-wide association studies have successfully identified a number of genomic regions for the risk of psoriasis. However, it is challenging to pinpoint the functional causal variants and then further decipher the genetic mechanisms underlying each region. In order to prioritize potential functional causal variants within psoriasis susceptibility regions, we integrated the genetic association findings and functional genomic data publicly available, i.e. histone modifications in relevant immune cells. We characterized a pervasive enrichment pattern of psoriasis variants in five core histone marks across immune cells/tissues. We discovered that genetic alleles within psoriasis association regions might influence gene expression levels through significantly affecting the binding affinities of 17 transcription factors. We established a catalog of 654 potential functional causal variants for psoriasis and suggested that they significantly overlapped with causal variants for autoimmune diseases. We identified potential causal variant rs79824801 overlay with the peaks of five histone marks in primary CD4+ T cells. Its alternative allele affected the binding affinity of transcription factor IKZF1. This study highlights the complex genetic architecture and complicated mechanisms for psoriasis. The findings will inform the functional experiment design for psoriasis.
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Affiliation(s)
- Yan Lin
- Institute of Dermatology, Department of Dermatology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Department of Dermatology, The Fourth Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Key lab of Dermatology, Ministry of Education, Anhui Medical University and State Key lab of Dermatology Incubation, Hefei, Anhui, China
| | - Lu Liu
- Institute of Dermatology, Department of Dermatology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Key lab of Dermatology, Ministry of Education, Anhui Medical University and State Key lab of Dermatology Incubation, Hefei, Anhui, China
| | - Yujun Sheng
- Institute of Dermatology, Department of Dermatology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Key lab of Dermatology, Ministry of Education, Anhui Medical University and State Key lab of Dermatology Incubation, Hefei, Anhui, China
| | - Changbing Shen
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Xiaodong Zheng
- Institute of Dermatology, Department of Dermatology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Key lab of Dermatology, Ministry of Education, Anhui Medical University and State Key lab of Dermatology Incubation, Hefei, Anhui, China
| | - Fusheng Zhou
- Institute of Dermatology, Department of Dermatology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Key lab of Dermatology, Ministry of Education, Anhui Medical University and State Key lab of Dermatology Incubation, Hefei, Anhui, China
| | - Sen Yang
- Institute of Dermatology, Department of Dermatology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Key lab of Dermatology, Ministry of Education, Anhui Medical University and State Key lab of Dermatology Incubation, Hefei, Anhui, China
| | - Xianyong Yin
- Institute of Dermatology, Department of Dermatology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Key lab of Dermatology, Ministry of Education, Anhui Medical University and State Key lab of Dermatology Incubation, Hefei, Anhui, China
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Xuejun Zhang
- Institute of Dermatology, Department of Dermatology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Key lab of Dermatology, Ministry of Education, Anhui Medical University and State Key lab of Dermatology Incubation, Hefei, Anhui, China
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Wang J, Ke R, Shi W, Yan X, Wang Q, Zhang Q, Chai L, Li M. Association between psoriasis and asthma risk: A meta-analysis. Allergy Asthma Proc 2018; 39:103-109. [PMID: 29490768 DOI: 10.2500/aap.2018.39.4109] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Psoriasis has been shown to be related to an increased risk of asthma, although the results remain inconclusive. Therefore, we performed a meta-analysis to determine whether psoriasis increases the risk of asthma. METHODS A comprehensive search of medical literature data bases was conducted through May 2017. The pooled odds ratios (OR) and corresponding 95% confidence intervals (CI) were calculated. RESULTS A total of six studies with 66,772 psoriasis cases and 577,415 controls were included. Our meta-analysis showed that psoriasis was significantly associated with the increased risk of asthma (OR 1.32 [95% CI, 1.20-1.46]). The older age patients with psoriasis (≥50 years) (OR 1.64 [95% CI, 1.44-1.88]) had a higher risk of asthma susceptibility compared with the younger patients (20-49 years old) (OR 1.25 [95% CI 1.09-1.44]). Subgroup analysis by ethnicity indicated a significant increase in asthma risk in both Asian populations (OR 1.35 [95% CI, 1.18-1.54]) and white populations (OR 1.27 [95% CI, 1.05-1.54]) with psoriasis compared with those without psoriasis. CONCLUSION Results of this meta-analysis indicated that the patients with psoriasis had a higher risk of asthma susceptibility, especially among the older patients with psoriasis.
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Affiliation(s)
- Jian Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P.R. China
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Bin Huraib G, Al Harthi F, Arfin M, Rizvi S, Al-Asmari A. The Protein Tyrosine Phosphatase Nonreceptor 22 ( PTPN22) R620W Functional Polymorphism in Psoriasis. CLINICAL MEDICINE INSIGHTS-ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2018; 11:1179544117751434. [PMID: 29348710 PMCID: PMC5768248 DOI: 10.1177/1179544117751434] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 12/07/2017] [Indexed: 12/14/2022]
Abstract
Background: Psoriasis is a complex autoimmune disease caused by the interaction of genetic and environmental factors. PTPN22 gene polymorphism has been reported to affect psoriasis susceptibility; however, no data are available for Middle Eastern populations. Objective: The aim of this study was to investigate the association of PTPN22 (1858C/T) R620W polymorphism with psoriasis in a Saudi cohort. Methods: Saudi subjects (n = 306) including patients with psoriasis (n = 106) and matched controls (n = 200) were studied for PTPN22 variants using tetra-primer amplification refractory mutation system-polymerase chain reaction method. The frequencies of alleles and genotypes of PTPN22 (1858C/T) polymorphism were compared between patients and controls. Results: The frequency of CT genotype of PTPN22 (1858C/T) polymorphism was significantly higher, whereas that of CC genotype was lower in patients with psoriasis than in controls (P < .001, relative risk [RR] = 7.151). The homozygous genotype TT was absent in both the patients and healthy controls. The frequency of allele T encoding tryptophan (W) was significantly increased (P < .001, RR = 5.76), whereas that of allele C encoding arginine (R) decreased in psoriasis cases as compared with controls (P < .001, RR = 0.173) indicating that individuals carrying allele T are more susceptible to psoriasis than noncarriers. Conclusions: PTPN22 (1858C/T) polymorphism is positively associated with susceptibility of psoriasis in Saudis and can be developed as biomarker for evaluating psoriasis risk. However, further studies on PTPN22 polymorphism in larger samples from different geographical areas and ethnicity are warranted.
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Affiliation(s)
- Ghaleb Bin Huraib
- Department of Dermatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Fahad Al Harthi
- Department of Dermatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Misbahul Arfin
- Scientific Research Center, Medical Services Department for Armed Forces, Riyadh, Saudi Arabia
| | - Sadaf Rizvi
- Scientific Research Center, Medical Services Department for Armed Forces, Riyadh, Saudi Arabia
| | - Abdulrahaman Al-Asmari
- Scientific Research Center, Medical Services Department for Armed Forces, Riyadh, Saudi Arabia
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Abstract
Nail psoriasis is often found in patients with plaque psoriasis and can greatly impact quality of life. This is particularly true in more severe cases, as it affects the structure and function of the patient's nail. Treatment for nail psoriasis is often challenging, involving topical medications, injections, and systematic therapies. This article aims to give an overview of the varied clinical presentations of nail psoriasis and the current treatments available for patients with this condition. Risks and efficacies of these treatments will be evaluated to determine the best treatment protocols.
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Affiliation(s)
| | | | - Morgan Rabach
- Mount Sinai Department of Dermatology, New York, New York
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Nirula A, Nilsen J, Klekotka P, Kricorian G, Erondu N, Towne JE, Russell CB, Martin DA, Budelsky AL. Effect of IL-17 receptor A blockade with brodalumab in inflammatory diseases. Rheumatology (Oxford) 2017; 55:ii43-ii55. [PMID: 27856660 DOI: 10.1093/rheumatology/kew346] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 08/23/2016] [Indexed: 12/12/2022] Open
Abstract
IL-17 cytokines are expressed by a variety of cells and mediate host defence against extracellular pathogens. IL-17 is upregulated at sites of inflammation and can synergize with other cytokines, such as TNF-α, to amplify the inflammatory response. Activation of these signalling pathways has been hypothesized to contribute to the underlying pathogenesis of several inflammatory diseases, including psoriasis, RA, PsA and asthma. Thus the IL-17 signalling pathway is an attractive target for the development of therapeutic agents to modulate aberrant inflammatory responses. This review of the clinical development of therapeutic agents that target IL-17 signalling pathways in inflammatory diseases focuses on brodalumab, a human anti-IL-17 receptor A mAb. The cumulative findings of early clinical studies with anti-IL-17 agents, including brodalumab, secukinumab and ixekizumab, provide strong evidence for the role of IL-17 signalling in the pathophysiology of certain inflammatory diseases and support the potential use of these agents in treating these diseases.
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Vangipuram R, Alikhan A. Apremilast for the management of moderate to severe plaque psoriasis. Expert Rev Clin Pharmacol 2017; 10:349-360. [PMID: 28276777 DOI: 10.1080/17512433.2017.1293519] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Psoriasis is a chronic inflammatory skin disease characterized by erythematous plaques on extensor surfaces, scalp, and back. Current therapies for psoriasis are limited by route of administration, side effects, and cost. Apremilast is the first oral phosphodiesterase inhibitor approved for moderate-to-severe plaque psoriasis. It is a small molecule inhibitor of phosphodiesterase-4, and decreases the inflammatory activity associated with psoriasis. Areas covered: This review will discuss the pharmacology of apremilast, mechanism of action, results from key clinical trials, and its use in managing psoriasis. Currently approved treatments are also discussed. Expert commentary: The advantages of apremilast include convenient oral administration and dosing, a favorable safety and tolerability profile, and significant efficacy in moderate-to-severe plaque psoriasis.
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Affiliation(s)
- Ramya Vangipuram
- a Dermatology Clinical Research Fellow , Center for Clinical Studies , Webster , TX , USA
| | - Ali Alikhan
- b Department of Dermatology , University of Cincinnati Medical Center , Cincinnati , OH , USA
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Pathogenesis and immunotherapy in cutaneous psoriasis: what can rheumatologists learn? Curr Opin Rheumatol 2017; 29:71-78. [DOI: 10.1097/bor.0000000000000358] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Gál B, Dulic S, Kiss M, Groma G, Kovács L, Kemény L, Bata-Csörgő Z. Increased circulating anti-α6-integrin autoantibodies in psoriasis and psoriatic arthritis but not in rheumatoid arthritis. J Dermatol 2016; 44:370-374. [DOI: 10.1111/1346-8138.13667] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 09/22/2016] [Indexed: 01/13/2023]
Affiliation(s)
- Brigitta Gál
- Department of Dermatology and Allergology; University of Szeged; Szeged Hungary
| | - Sonja Dulic
- Department of Rheumatology; University of Szeged; Szeged Hungary
| | - Mária Kiss
- Department of Dermatology and Allergology; University of Szeged; Szeged Hungary
| | - Gergely Groma
- MTA-SZTE, Dermatological Research Group; Szeged Hungary
| | - László Kovács
- Department of Rheumatology; University of Szeged; Szeged Hungary
| | - Lajos Kemény
- Department of Dermatology and Allergology; University of Szeged; Szeged Hungary
- MTA-SZTE, Dermatological Research Group; Szeged Hungary
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Prieto-Pérez R, Solano-López G, Cabaleiro T, Román M, Ochoa D, Talegón M, Baniandrés O, López-Estebaranz JL, de la Cueva P, Daudén E, Abad-Santos F. New polymorphisms associated with response to anti-TNF drugs in patients with moderate-to-severe plaque psoriasis. THE PHARMACOGENOMICS JOURNAL 2016; 18:70-75. [DOI: 10.1038/tpj.2016.64] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 12/15/2015] [Accepted: 05/02/2016] [Indexed: 12/29/2022]
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Stawczyk-Macieja M, Rębała K, Szczerkowska-Dobosz A, Wysocka J, Cybulska L, Kapińska E, Haraś A, Miniszewska P, Nowicki R. Evaluation of Psoriasis Genetic Risk Based on Five Susceptibility Markers in a Population from Northern Poland. PLoS One 2016; 11:e0163185. [PMID: 27658291 PMCID: PMC5033405 DOI: 10.1371/journal.pone.0163185] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 09/02/2016] [Indexed: 11/18/2022] Open
Abstract
Psoriasis genetic background depends on polygenic and multifactorial mode of inheritance. As in other complex disorders, the estimation of the disease risk based on individual genetic variants is impossible. For this reason, recent investigations have been focused on combinations of known psoriasis susceptibility markers in order to improve the disease risk evaluation. Our aim was to compare psoriasis genetic risk score (GRS) for five susceptibility loci involved in the immunological response (HLA-C, ERAP1, ZAP70) and in the skin barrier function (LCE3, CSTA) between patients with chronic plaque psoriasis (n = 148) and the control group (n = 146). A significantly higher number of predisposing alleles was observed in patients with psoriasis in comparison to healthy individuals (6.1 vs. 5.2, respectively; P = 8.8×10−7). The statistical significance was even more profound when GRS weighted by logarithm odds ratios was evaluated (P = 9.9×10−14). Our results demonstrate the developed panel of five susceptibility loci to be more efficient in predicting psoriasis risk in the Polish population and to possess higher sensitivity and specificity for the disease than any of the markers analyzed separately, including the most informative HLA-C*06 allele.
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Affiliation(s)
- Marta Stawczyk-Macieja
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
- * E-mail:
| | - Krzysztof Rębała
- Department of Forensic Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Aneta Szczerkowska-Dobosz
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - Joanna Wysocka
- Department of Forensic Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Lidia Cybulska
- Department of Forensic Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Ewa Kapińska
- Department of Forensic Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Agnieszka Haraś
- Department of Forensic Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Paulina Miniszewska
- Department of Forensic Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Roman Nowicki
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
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Kellen R, Silverberg NB, Lebwohl M. Efficacy and safety of ustekinumab in adolescents. Pediatric Health Med Ther 2016; 7:109-120. [PMID: 29388600 PMCID: PMC5683279 DOI: 10.2147/phmt.s75836] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The biologic agent ustekinumab is a human monoclonal antibody that binds to the p40 subunit shared by interleukins (ILs) 12 and 23. The antibody is able to prevent binding of cytokines to the IL-12Rβ1 cell surface receptor and therefore may prevent IL-23 driven activation of the IL-23/Th 17 axis of inflammation. The anti-inflammatory activity has been beneficial in adult psoriasis. Ustekinumab has been approved in the United States for the treatment of adults with psoriasis and psoriatic arthritis. Approval in children and adolescents has not been granted by the US Food and Drug Administration. Subcutaneous injections of ustekinumab are administered at baseline, week 4 and every 12 weeks thereafter, a regimen that is particularly appealing to young patients who do not like more frequent injections at home. The product is attractive because, although it works through an immune system mechanism, the selective activity is such that the drug has not been associated with many of the side effects attributed to other immunosuppressive medications. Case reports of ustekinumab for pediatric psoriasis have shown promising results, and the recent Phase III CADMUS trial tested the agent in adolescents aged 12-17 years with psoriasis, using standard dose 0.75 mg/kg (≤60 kg), 45 mg (>60-≤100 kg), and 90 mg (>100 kg) or half-standard dosing 0.375 mg/kg (≤60 kg), 22.5 mg (>60-≤100 kg), and 45 mg (>100 kg) with a loading dosage at week 0 and week 4. Psoriasis area and severity index-75 was achieved in more than three-quarters of patients in full and half dosing by 12 weeks, and psoriasis area and severity index-90 in 54.1% and 61.1% of half and full dosage by 12 weeks, respectively. Ustekinumab was generally well tolerated in adolescents, with some patients developing antibodies, and nasopharyngitis being the major adverse event. Ustekinumab is a promising agent in adolescent psoriasis that appears to be well tolerated. The best monitoring plan and usage in younger patients still remain to be defined.
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Affiliation(s)
- Roselyn Kellen
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nanette B Silverberg
- Department of Dermatology, Mount Sinai St Luke’s-Roosevelt Hospital, New York, NY, USA
- Beth Israel Medical Centers, New York, NY, USA
| | - Mark Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Andrographolide alleviates imiquimod-induced psoriasis in mice via inducing autophagic proteolysis of MyD88. Biochem Pharmacol 2016; 115:94-103. [DOI: 10.1016/j.bcp.2016.06.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 06/01/2016] [Indexed: 12/27/2022]
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Brito-Luna MJ, Villanueva-Quintero DG, Sandoval-Talamantes AK, Fafutis-Morris M, Graciano-Machuca O, Sanchez-Hernandez PE, Alvarado-Navarro A. Correlation of IL-12, IL-22, and IL-23 in patients with psoriasis and metabolic syndrome. Preliminary report. Cytokine 2016; 85:130-6. [PMID: 27344023 DOI: 10.1016/j.cyto.2016.06.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/20/2016] [Accepted: 06/15/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND Psoriasis is an autoimmune skin disease characterised by proliferation of keratinocytes, primarily due to cytokines Th1 and Th17. This profile is involved in pathogenesis of metabolic syndrome, a frequently found comorbidity in patients with psoriasis. OBJECTIVE In this study we determine the correlation of levels of pro-inflammatory cytokines TNF-α, IL-23, IL-12, and IL-22 in patients with psoriasis with and without metabolic syndrome and clinically healthy controls. METHODS We included 55 patients with plaque psoriasis: 30 with metabolic syndrome (PPMS), 25 without metabolic syndrome (PP), 15 healthy subjects (HS) and 15 with metabolic syndrome (MS). Quantification of serum levels of IL-12, TNF-α, IL-22, and IL-23 was done by ELISA. RESULTS We observed that serum levels of IL-12 were more elevated in PP group, while the lowest levels of TNF-α were seen in HS group. IL-22 was found to be higher in PP than in PPMS (p<0.05). PP patients with PASI scores rating as severe showed higher levels of IL-12. TNF-α level analysis showed significant differences in HS group compared with the others; levels of this cytokine were lower in patients with PP and moderate PASI scores than in MS group (p<0.05). We found no correlation between cytokine levels and psoriasis or between cytokines and PASI scores. In PP group, a positive correlation was observed between IL-23 and fasting glucose (r=0.432, p<0.05), as well as a negative correlation between IL-23, IL-22, and IL-12 versus waist circumference (r=-0.504, r=-0.556 and r=-0.511, respectively; p<0.05). CONCLUSIONS Psoriasis is not just a skin disorder, but rather a condition with systemic implications, with intervention of pro-inflammatory cytokines that contribute to metabolic syndrome and other comorbidities, which in turn increases the risk of developing cardiovascular disease.
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Affiliation(s)
- M J Brito-Luna
- Jalisco Dermatology Institute "Dr. José Barba Rubio", Secretary of Health, Jalisco, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - D G Villanueva-Quintero
- Jalisco Dermatology Institute "Dr. José Barba Rubio", Secretary of Health, Jalisco, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - A K Sandoval-Talamantes
- Centre for Research in Immunology and Dermatology, Health Sciences University Centre, University of Guadalajara, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - M Fafutis-Morris
- Centre for Research in Immunology and Dermatology, Health Sciences University Centre, University of Guadalajara, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - O Graciano-Machuca
- Centre for Research in Immunology and Dermatology, Health Sciences University Centre, University of Guadalajara, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - P E Sanchez-Hernandez
- Immunology Laboratory, Department of Physiology, Health Sciences University Centre, University of Guadalajara, México, Sierra Mojada 950, Col. Independencia, CP 44340 Guadalajara, Jalisco, Mexico.
| | - A Alvarado-Navarro
- Centre for Research in Immunology and Dermatology, Health Sciences University Centre, University of Guadalajara, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
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Jensen P, Christensen R, Zachariae C, Geiker NR, Schaadt BK, Stender S, Hansen PR, Astrup A, Skov L. Long-term effects of weight reduction on the severity of psoriasis in a cohort derived from a randomized trial: a prospective observational follow-up study. Am J Clin Nutr 2016; 104:259-65. [PMID: 27334236 DOI: 10.3945/ajcn.115.125849] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 05/13/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Weight reduction may reduce the severity of psoriasis, but little is known about the long-term effects. OBJECTIVE We aimed to investigate long-term effects of weight reduction in psoriasis. DESIGN We previously conducted a randomized trial (n = 60) involving patients with psoriasis who were allocated to a control group or a low-energy diet (LED) group. Here we followed the participants for an additional 48-wk period. In total, 56 patients with psoriasis [mean ± SD body mass index (in kg/m(2)): 34.4 ± 5.3] underwent a 64-wk weight-loss program consisting of an initial 16-wk randomized phase with an LED for 8 wk and 8 wk of normal food intake combined with 2 LED products/d, followed by a 48-wk period of weight maintenance with the latter diet. After the randomization phase, the control group received the same 8 + 8-wk LED intervention, and all patients were then followed for 48 wk while on the weight-loss maintenance diet. The main outcome was the Psoriasis Area and Severity Index (PASI), and secondary outcome was the Dermatology Life Quality Index (DLQI). RESULTS For the present study, 56 patients were eligible, 38 agreed to participate, and 32 completed. After the 16-wk LED-only period, the mean weight loss was -15.0 kg (95% CI: -16.6, -13.4 kg), and PASI and DLQI were reduced by -2.3 (95% CI: -3.1, -1.5) and -2.3 (95% CI: -3.2, -1.4), respectively. At week 64, the mean weight loss compared with baseline was -10.1 kg (95% CI: -12.0, -8.1 kg), and PASI and DLQI were maintained at -2.9 (95% CI: -3.9, -1.9) and -1.9 (95% CI: -3.0, -0.9), respectively. CONCLUSION Long-term weight loss in patients with psoriasis has long-lasting positive effects on the severity of psoriasis. This trial was registered at clinicaltrials.gov as NCT01137188.
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Affiliation(s)
| | - Robin Christensen
- Musculoskeletal Statistics Unit, Parker Institute, Department of Rheumatology, Frederiksberg Hospital and
| | | | - Nina Rw Geiker
- Nutrition Research Unit, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | | | | | - Peter R Hansen
- Cardiology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark; and
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Vassilatou E, Papadavid E, Papastamatakis P, Alexakos D, Koumaki D, Katsimbri P, Hadjidakis D, Dimitriadis G, Rigopoulos D. No association of psoriasis with autoimmune thyroiditis. J Eur Acad Dermatol Venereol 2016; 31:102-106. [PMID: 27324349 DOI: 10.1111/jdv.13767] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 03/11/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Common autoimmune diseases tend to coexist in the same patients. Few studies have examined the possible association between autoimmune thyroiditis and psoriasis or psoriatic arthritis (PsA), with inconsistent results. OBJECTIVE To investigate the prevalence of autoimmune thyroiditis in psoriatic patients with or without PsA, living in an iodine-sufficient area. METHODS We studied prospectively, 114 psoriatic patients with disease duration of 5-38 years, 30 of them with PsA, and 286 age- and body mass index (BMI)-matched subjects without psoriasis or known thyroid disease or autoimmune disease. A detailed medical history was obtained from all participants and clinical examination and laboratory evaluation was performed. Psoriasis severity was assessed with Psoriasis Area and Severity Index (PASI). Autoimmune thyroiditis was defined by the presence of positive autoantibodies to thyroid peroxidase and/or thyroglobulin. RESULTS There was no difference in the prevalence of autoimmune thyroiditis between psoriatic patients and controls (20.2% vs. 19.6%). The prevalence of autoimmune thyroiditis in male and female psoriatic patients was similar (9.6% and 10.5% respectively), in contrast to the increased, as expected, prevalence in female vs. male controls (14.7% vs. 4.9%, P < 0.01). Detected cases with hypothyroidism due to autoimmune thyroiditis were similar in psoriatic patients and controls (7.9% and 7.0% respectively). Autoimmune thyroiditis in psoriatic patients was not related with age of psoriasis onset, psoriasis duration, PASI score, PsA and obesity. CONCLUSION These data support that psoriatic patients with or without PsA do not have an increased risk for autoimmune thyroiditis.
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Affiliation(s)
- E Vassilatou
- Endocrine Unit, 2nd Department of Internal Medicine-Propaedeutic and Research Center, Athens University Medical School, "Attikon" University Hospital, Athens, Greece
| | - E Papadavid
- 2nd Department of Dermatology and Venereology, Athens University Medical School, "Attikon" University Hospital, Athens, Greece
| | - P Papastamatakis
- 2nd Department of Dermatology and Venereology, Athens University Medical School, "Attikon" University Hospital, Athens, Greece
| | - D Alexakos
- Endocrine Unit, 2nd Department of Internal Medicine-Propaedeutic and Research Center, Athens University Medical School, "Attikon" University Hospital, Athens, Greece
| | - D Koumaki
- 2nd Department of Dermatology and Venereology, Athens University Medical School, "Attikon" University Hospital, Athens, Greece
| | - P Katsimbri
- Rheumatology Unit, 4th Department of Internal Medicine, Athens University Medical School, "Attikon" University Hospital, Athens, Greece
| | - D Hadjidakis
- Endocrine Unit, 2nd Department of Internal Medicine-Propaedeutic and Research Center, Athens University Medical School, "Attikon" University Hospital, Athens, Greece.,2nd Department of Internal Medicine-Propaedeutic and Research Center, Athens University Medical School, "Attikon" University Hospital, Athens, Greece
| | - G Dimitriadis
- 2nd Department of Internal Medicine-Propaedeutic and Research Center, Athens University Medical School, "Attikon" University Hospital, Athens, Greece
| | - D Rigopoulos
- 2nd Department of Dermatology and Venereology, Athens University Medical School, "Attikon" University Hospital, Athens, Greece
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Chun K, Afshar M, Audish D, Kabigting F, Paik A, Gallo R, Hata T. Hepatitis C may enhance key amplifiers of psoriasis. J Eur Acad Dermatol Venereol 2016; 31:672-678. [PMID: 27184185 DOI: 10.1111/jdv.13578] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 11/27/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Multiple studies have noted an association between hepatitis C and psoriasis, but it is not known whether psoriasis is a result of treatment modalities for hepatitis C or a result of hepatitis C alone. OBJECTIVE To examine the relationship between psoriasis and hepatitis C by measuring the expression of cathelicidin, TLR9 and IFNγ in psoriatic lesional and non-lesional skin in HCV-positive and negative psoriatic patients. METHODS Two 2 mm punch biopsies of lesional and non-lesional skin in 10 patients who were HCV-negative psoriatics and seven HCV-positive psoriatics were used to measure cathelicidin, TLR9 and IFNγ mRNA expression by quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR). RESULTS The mRNA levels of cathelicidin, TLR9 and IFNγ were significantly higher in both non-lesional and lesional skin of HCV-positive patients with psoriasis as compared to HCV-negative psoriatic patients. Additionally, the IFNγ level in lesional skin of HCV-positive psoriatic patients was higher than the IFNγ level seen in non-lesional skin of those same patients. CONCLUSION These findings suggest that HCV infection upregulates these inflammatory cytokines, possibly increasing susceptibility to developing psoriasis.
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Affiliation(s)
- K Chun
- Department of Dermatology, University of California, San Diego, CA, USA
| | - M Afshar
- Department of Dermatology, University of California, San Diego, CA, USA
| | - D Audish
- Department of Dermatology, University of California, San Diego, CA, USA
| | - F Kabigting
- Department of Dermatology, University of California, San Diego, CA, USA
| | - A Paik
- Department of Dermatology, University of California, San Diego, CA, USA
| | - R Gallo
- Department of Dermatology, University of California, San Diego, CA, USA
| | - T Hata
- Department of Dermatology, University of California, San Diego, CA, USA
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Nishikawa R, Nagai H, Bito T, Ikeda T, Horikawa T, Adachi A, Matsubara T, Nishigori C. Genetic prediction of the effectiveness of biologics for psoriasis treatment. J Dermatol 2016; 43:1273-1277. [DOI: 10.1111/1346-8138.13412] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 03/08/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Rika Nishikawa
- Division of Dermatology; Department of Internal Related; Faculty of Medicine; Kobe University Graduate School of Medicine; Kobe Japan
| | - Hiroshi Nagai
- Division of Dermatology; Department of Internal Related; Faculty of Medicine; Kobe University Graduate School of Medicine; Kobe Japan
| | - Toshinori Bito
- Division of Dermatology; Department of Internal Related; Faculty of Medicine; Kobe University Graduate School of Medicine; Kobe Japan
- Bito Dermatology Clinic; Kobe Japan
| | - Tetsuya Ikeda
- Department of Dermatology; Kobe City Hospital Organization Kobe Medical Center West Hospital; Kobe Japan
| | | | - Atsuko Adachi
- Department of Dermatology; Hyogo Prefectural Kakogawa Medical Center; Kakogawa Japan
| | | | - Chikako Nishigori
- Division of Dermatology; Department of Internal Related; Faculty of Medicine; Kobe University Graduate School of Medicine; Kobe Japan
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49
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Indhumathi S, Rajappa M, Chandrashekar L, Ananthanarayanan PH, Thappa DM, Negi VS. Investigation of association of the IL-12B and IL-23R genetic variations with psoriatic risk in a South Indian Tamil cohort. Hum Immunol 2015; 77:54-62. [PMID: 26472011 DOI: 10.1016/j.humimm.2015.10.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 10/02/2015] [Accepted: 10/11/2015] [Indexed: 01/23/2023]
Abstract
BACKGROUND Psoriasis is a T-cell mediated chronic systemic inflammatory skin disease. Emerging evidences suggest the interleukin (IL)-12B and IL-23R genes encoding the common p40 subunit of IL-12 and IL-23 are the key cytokines in T-helper (Th)1 and Th17 differentiation and function. Certain allelic variants of these genes significantly influence the risk of psoriasis. Hence we undertook to study the association of IL-12B and IL-23R gene polymorphisms with disease susceptibility in South Indian Tamil patients with psoriasis. METHODS 360 psoriatics and 360 healthy controls were included in this case control study. IL-12B gene (rs3212227) and IL-23R gene (rs2201841, rs10889677 and rs11805303) polymorphisms were typed by using TaqMan 5'allele discrimination assay and cytokine levels were assayed by ELISA. RESULTS We observed that the patients carrying the risk genotypes of IL-12B (rs3212227) and IL-23R (rs2201841) conferred an increased susceptibility to psoriasis. We did not find any significant association between IL-23R (rs10889677 and rs11805303) gene polymorphisms and psoriasis risk in South Indian Tamil population. We did not observe any significant difference in haplotypes between the psoriasis cases and controls. We observed a significant increase in the mean IL-23 levels in psoriatics and the higher levels of IL-23 were found in the minor variant genotype CC when compared with that of heterozygous CT and major variant TT genotypes of rs2201841. Individual genotypes of rs10889677 and rs11805303 and IL-12 (rs3212227) were not significantly associated with their plasma levels. CONCLUSION Our results suggest that IL-12B (rs3212227) and IL-23R (rs2201841) polymorphisms confer increased risk of psoriasis in our ethnic South Indian Tamils.
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Affiliation(s)
- S Indhumathi
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Medha Rajappa
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
| | - Laxmisha Chandrashekar
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - P H Ananthanarayanan
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - D M Thappa
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - V S Negi
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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50
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Lebwohl M, Strober B, Menter A, Gordon K, Weglowska J, Puig L, Papp K, Spelman L, Toth D, Kerdel F, Armstrong AW, Stingl G, Kimball AB, Bachelez H, Wu JJ, Crowley J, Langley RG, Blicharski T, Paul C, Lacour JP, Tyring S, Kircik L, Chimenti S, Callis Duffin K, Bagel J, Koo J, Aras G, Li J, Song W, Milmont CE, Shi Y, Erondu N, Klekotka P, Kotzin B, Nirula A. Phase 3 Studies Comparing Brodalumab with Ustekinumab in Psoriasis. N Engl J Med 2015; 373:1318-28. [PMID: 26422722 DOI: 10.1056/nejmoa1503824] [Citation(s) in RCA: 581] [Impact Index Per Article: 64.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Early clinical studies suggested that the anti-interleukin-17 receptor A monoclonal antibody brodalumab has efficacy in the treatment of psoriasis. METHODS In two phase 3 studies (AMAGINE-2 and AMAGINE-3), patients with moderate-to-severe psoriasis were randomly assigned to receive brodalumab (210 mg or 140 mg every 2 weeks), ustekinumab (45 mg for patients with a body weight ≤100 kg and 90 mg for patients >100 kg), or placebo. At week 12, patients receiving brodalumab were randomly assigned again to receive a brodalumab maintenance dose of 210 mg every 2 weeks or 140 mg every 2 weeks, every 4 weeks, or every 8 weeks; patients receiving ustekinumab continued to receive ustekinumab every 12 weeks, and patients receiving placebo received 210 mg of brodalumab every 2 weeks. The primary aims were to evaluate the superiority of brodalumab over placebo at week 12 with respect to at least a 75% reduction in the psoriasis area-and-severity index score (PASI 75) and a static physician's global assessment (sPGA) score of 0 or 1 (clear or almost clear skin), as well as the superiority of brodalumab over ustekinumab at week 12 with respect to a 100% reduction in PASI score (PASI 100). RESULTS At week 12, the PASI 75 response rates were higher with brodalumab at the 210-mg and 140-mg doses than with placebo (86% and 67%, respectively, vs. 8% [AMAGINE-2] and 85% and 69%, respectively, vs. 6% [AMAGINE-3]; P<0.001); the rates of sPGA scores of 0 or 1 were also higher with brodalumab (P<0.001). The week 12 PASI 100 response rates were significantly higher with 210 mg of brodalumab than with ustekinumab (44% vs. 22% [AMAGINE-2] and 37% vs. 19% [AMAGINE-3], P<0.001). The PASI 100 response rates with 140 mg of brodalumab were 26% in AMAGINE-2 (P=0.08 for the comparison with ustekinumab) and 27% in AMAGINE-3 (P=0.007). Rates of neutropenia were higher with brodalumab and with ustekinumab than with placebo. Mild or moderate candida infections were more frequent with brodalumab than with ustekinumab or placebo. Through week 52, the rates of serious infectious episodes were 1.0 (AMAGINE-2) and 1.3 (AMAGINE-3) per 100 patient-years of exposure to brodalumab. CONCLUSIONS Brodalumab treatment resulted in significant clinical improvements in patients with moderate-to-severe psoriasis. (Funded by Amgen; AMAGINE-2 and AMAGINE-3 ClinicalTrials.gov numbers, NCT01708603 and NCT01708629.).
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Affiliation(s)
- Mark Lebwohl
- From the Icahn School of Medicine at Mount Sinai, New York (M.L., L.K.); University of Connecticut School of Medicine, Farmington (B.S.); Probity Medical Research (B.S., L.S., D.T.) and XLR8 Medical Research (D.T.), Windsor, ON, K Papp Medical Research (K.P.), Waterloo, ON, and Dalhousie University, Halifax, NS (R.G.L.) - all in Canada; Baylor University Medical Center, Dallas (A.M.); Northwestern University, Feinberg School of Medicine, Chicago (K.G.); Niepubliczny Zakład Opieki Zdrowotnej multiMedica, Wrocław (J.W.), and Lubelskie Centrum Diagnostyczne, Świdnik (T.B.) - both in Poland; Hospital de la Santa Creu i Sant Pau, Barcelona (L.P.); Veracity Clinical Research, Woolloongabba, QLD, Australia (L.S.); Florida Academic Dermatology Center, Miami (F.K.); University of Colorado, Denver (A.W.A.); Medizinische Universität Wien, Vienna, Austria (G.S.); Massachusetts General Hospital and Harvard Medical School, Boston (A.B.K.); Sorbonne Paris Cité Université Paris Diderot, Assistance Publique-Hôpitaux de Paris Hôpital Saint Louis, Paris (H.B.), Paul Sabatier University, Toulouse (C.P.), and University Hospital of Nice, Nice (J.-P.L.) - all in France; Kaiser Permanente Los Angeles Medical Center, Los Angeles (J.J.W.), Bakersfield Dermatology and Skin Cancer Medical Group, Bakersfield (J.C.), University of California, San Francisco, San Francisco (J.K.), and Amgen, Thousand Oaks (G.A., J.L., W.S., C.E.M., Y.S., N.E., P.K., B.K., A.N.) - all in California.; University of Texas Health Science Center, Houston (S.T.); DermResearch, Louisville, KY (L.K.); University of Rome Tor Vergata, Rome (S.C.); University of Utah Medical Center, Salt Lake City (K.C.D.); and the Psoriasis Treatment Center of Central New Jersey, East Windsor (J.B.)
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