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Bui A, Orcales F, Kranyak A, Chung BY, Haran K, Smith P, Johnson C, Liao W. The Role of Genetics on Psoriasis Susceptibility, Comorbidities, and Treatment Response. Dermatol Clin 2024; 42:439-469. [PMID: 38796275 DOI: 10.1016/j.det.2024.02.005] [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] [Indexed: 05/28/2024]
Abstract
This review highlights advances made in psoriasis genetics, including findings from genome-wide association studies, exome-sequencing studies, and copy number variant studies. The impact of genetic variants on various comorbidities and therapeutic responses is discussed.
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Affiliation(s)
- Audrey Bui
- Lake Erie College of Osteopathic Medicine, 5000 Lakewood Ranch Boulevard, Bradenton, FL 34211, USA; Department of Dermatology, University of California San Francisco, 2340 Sutter Street, Box 0808, N431, San Francisco, CA 95115, USA
| | - Faye Orcales
- Department of Dermatology, University of California San Francisco, 2340 Sutter Street, Box 0808, N431, San Francisco, CA 95115, USA
| | - Allison Kranyak
- Department of Dermatology, University of California San Francisco, 2340 Sutter Street, Box 0808, N431, San Francisco, CA 95115, USA
| | - Bo-Young Chung
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, 22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang-si Gyeonggi-do, 14068, Republic of Korea
| | - Kathryn Haran
- Department of Dermatology, University of California San Francisco, 2340 Sutter Street, Box 0808, N431, San Francisco, CA 95115, USA
| | - Payton Smith
- Department of Dermatology, University of California San Francisco, 2340 Sutter Street, Box 0808, N431, San Francisco, CA 95115, USA
| | - Chandler Johnson
- Department of Dermatology, University of California San Francisco, 2340 Sutter Street, Box 0808, N431, San Francisco, CA 95115, USA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, 2340 Sutter Street, Box 0808, N431, San Francisco, CA 95115, USA.
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Al-Sofi RF, Bergmann MS, Nielsen CH, Andersen V, Skov L, Loft N. The Association between Genetics and Response to Treatment with Biologics in Patients with Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, and Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis. Int J Mol Sci 2024; 25:5793. [PMID: 38891983 PMCID: PMC11171831 DOI: 10.3390/ijms25115793] [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: 04/22/2024] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Genetic biomarkers could potentially lower the risk of treatment failure in chronic inflammatory diseases (CID) like psoriasis, psoriatic arthritis (PsA), rheumatoid arthritis (RA), and inflammatory bowel disease (IBD). We performed a systematic review and meta-analysis assessing the association between single nucleotide polymorphisms (SNPs) and response to biologics. Odds ratio (OR) with 95% confidence interval (CI) meta-analyses were performed. In total, 185 studies examining 62,774 individuals were included. For the diseases combined, the minor allele of MYD88 (rs7744) was associated with good response to TNFi (OR: 1.24 [1.02-1.51], 6 studies, 3158 patients with psoriasis or RA) and the minor alleles of NLRP3 (rs4612666) (OR: 0.71 [0.58-0.87], 5 studies, 3819 patients with RA or IBD), TNF-308 (rs1800629) (OR: 0.71 [0.55-0.92], 25 studies, 4341 patients with psoriasis, RA, or IBD), FCGR3A (rs396991) (OR: 0.77 [0.65-0.93], 18 studies, 2562 patients with psoriasis, PsA, RA, or IBD), and TNF-238 (rs361525) (OR: 0.57 [0.34-0.96]), 7 studies, 818 patients with psoriasis, RA, or IBD) were associated with poor response to TNFi together or infliximab alone. Genetic variants in TNFα, NLRP3, MYD88, and FcRγ genes are associated with response to TNFi across several inflammatory diseases. Most other genetic variants associated with response were observed in a few studies, and further validation is needed.
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Affiliation(s)
- Rownaq Fares Al-Sofi
- Department of Dermatology and Allergy, Copenhagen University Hospital—Herlev and Gentofte, 1165 Copenhagen, Denmark
- Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, 2730 Herlev, Denmark
| | - Mie Siewertsen Bergmann
- Department of Dermatology and Allergy, Copenhagen University Hospital—Herlev and Gentofte, 1165 Copenhagen, Denmark
- Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, 2730 Herlev, Denmark
| | - Claus Henrik Nielsen
- Center for Rheumatology and Spine Diseases, Institute for Inflammation Research, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark
| | - Vibeke Andersen
- Institute of Regional Health Research, University of Southern Denmark, 5230 Odense, Denmark
- Molecular Diagnostics and Clinical Research Unit, Department of Internal Medicine, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark
- Institute of Molecular Medicine, University of Southern Denmark, 5230 Odense, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Copenhagen University Hospital—Herlev and Gentofte, 1165 Copenhagen, Denmark
- Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, 2730 Herlev, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1172 Copenhagen, Denmark
| | - Nikolai Loft
- Department of Dermatology and Allergy, Copenhagen University Hospital—Herlev and Gentofte, 1165 Copenhagen, Denmark
- Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, 2730 Herlev, Denmark
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Krušič M, Jezernik G, Potočnik U. Gene Ontology Analysis Highlights Biological Processes Influencing Responsiveness to Biological Therapy in Psoriasis. Pharmaceutics 2023; 15:2024. [PMID: 37631238 PMCID: PMC10459906 DOI: 10.3390/pharmaceutics15082024] [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: 05/29/2023] [Revised: 06/27/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
Psoriasis is a chronic, immune-mediated and inflammatory skin disease. Although various biological drugs are available for psoriasis treatment, some patients have poor responses or do not respond to treatment. The aim of the present study was to highlight the molecular mechanism of responsiveness to current biological drugs for psoriasis treatment. To this end, we reviewed previously published articles that reported genes associated with treatment response to biological drugs in psoriasis, and gene ontology analysis was subsequently performed using the Cytoscape platform. Herein, we revealed a statistically significant association between NF-kappaB signaling (p value = 3.37 × 10-9), regulation of granulocyte macrophage colony-stimulating factor production (p value = 6.20 × 10-6), glial cell proliferation (p value = 2.41 × 10-5) and treatment response in psoriatic patients. To the best of our knowledge, we are the first to directly associate glial cells with treatment response. Taken together, our study revealed gene ontology (GO) terms, some of which were previously shown to be implicated in the molecular pathway of psoriasis, as novel GO terms involved in responsiveness in psoriatic disease patients.
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Affiliation(s)
- Martina Krušič
- Center for Human Molecular Genetics and Pharmacogenomics, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia; (M.K.); (G.J.)
| | - Gregor Jezernik
- Center for Human Molecular Genetics and Pharmacogenomics, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia; (M.K.); (G.J.)
| | - Uroš Potočnik
- Center for Human Molecular Genetics and Pharmacogenomics, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia; (M.K.); (G.J.)
- Faculty of Chemistry and Chemical Engineering, University of Maribor, Smetanova ulica 17, 2000 Maribor, Slovenia
- Department for Science and Research, University Clinical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia
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Argyropoulou M, Trigoni A, Kaffenberger J, Stergianou D, Damoraki G, Mingiani E, Micha S, Krispinsky A, Meltzanidou P, Kanni T, Lazaridou E, Giamarellos-Bourboulis EJ. Impact of Single Nucleotide Polymorphisms of the Promoter of the TNF Gene on Adalimumab Treatment Responses in Hidradenitis Suppurativa. Dermatology 2023; 239:746-752. [PMID: 37331331 DOI: 10.1159/000531558] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/12/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Results of randomized clinical trials show great variation in response to treatment with adalimumab (ADA) in hidradenitis suppurativa (HS). This varied response may be associated with genetic polymorphisms. OBJECTIVES The aim of the study was to study the association between carriage of single nucleotide polymorphisms (SNPs) in the promoter of the tumor necrosis factor (TNF) gene and their response to ADA. METHODS Patients with moderate to severe HS who received ADA treatment for at least 12 weeks were enrolled. SNPs were analyzed with PCR-restriction fragment length polymorphism. Hidradenitis Suppurativa Clinical Response (HiSCR) score, International Hidradenitis Suppurativa Severity Scoring System 4 (IHS4) score, inflammatory lesion (AN) count, and draining tunnel (dT) count were collected at weeks 0, 12, 24, 36, and 48. RESULTS HiSCR response after 12 weeks of ADA treatment was 71.8% among carriers of the common GGG haplotype and 50.0% among carriers of minor frequency SNP haplotypes (p: 0.031; odds ratio: 0.39). This significant difference persisted until week 36. Carriers of minor frequency SNP haplotypes also had a lower relative decrease of the AN count at weeks 12 and 24; the dT count and IHS4 were not statistically different between the two groups. CONCLUSIONS Carriage of at least one minor frequency SNP haplotype of the promoter of the TNF gene is associated with a decreased response to ADA. This association may have an impact on treatment decision-making.
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Affiliation(s)
- Maria Argyropoulou
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Trigoni
- 2nd Department of Dermatology and Venereology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Dimitra Stergianou
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Damoraki
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Elissavet Mingiani
- 2nd Department of Dermatology and Venereology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Styliani Micha
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Andrew Krispinsky
- Department of Dermatology, The Ohio State University, Columbus, Ohio, USA
| | - Parthena Meltzanidou
- 2nd Department of Dermatology and Venereology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodora Kanni
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Elizabeth Lazaridou
- 2nd Department of Dermatology and Venereology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Berna-Rico E, Perez-Bootello J, Abbad-Jaime de Aragon C, Gonzalez-Cantero A. Genetic Influence on Treatment Response in Psoriasis: New Insights into Personalized Medicine. Int J Mol Sci 2023; 24:9850. [PMID: 37372997 PMCID: PMC10298473 DOI: 10.3390/ijms24129850] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Psoriasis is a chronic inflammatory disease with an established genetic background. The HLA-Cw*06 allele and different polymorphisms in genes involved in inflammatory responses and keratinocyte proliferation have been associated with the development of the disease. Despite the effectiveness and safety of psoriasis treatment, a significant percentage of patients still do not achieve adequate disease control. Pharmacogenetic and pharmacogenomic studies on how genetic variations affect drug efficacy and toxicity could provide important clues in this respect. This comprehensive review assessed the available evidence for the role that those different genetic variations may play in the response to psoriasis treatment. One hundred fourteen articles were included in this qualitative synthesis. VDR gene polymorphisms may influence the response to topical vitamin D analogs and phototherapy. Variations affecting the ABC transporter seem to play a role in methotrexate and cyclosporine outcomes. Several single-nucleotide polymorphisms affecting different genes are involved with anti-TNF-α response modulation (TNF-α, TNFRSF1A, TNFRSF1B, TNFAIP3, FCGR2A, FCGR3A, IL-17F, IL-17R, and IL-23R, among others) with conflicting results. HLA-Cw*06 has been the most extensively studied allele, although it has only been robustly related to the response to ustekinumab. However, further research is needed to firmly establish the usefulness of these genetic biomarkers in clinical practice.
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Affiliation(s)
- Emilio Berna-Rico
- Department of Dermatology, Hospital Universitario Ramón y Cajal, IRYCIS, Colmenar Viejo km 9.100, 28034 Madrid, Spain; (J.P.-B.); (C.A.-J.d.A.)
| | - Javier Perez-Bootello
- Department of Dermatology, Hospital Universitario Ramón y Cajal, IRYCIS, Colmenar Viejo km 9.100, 28034 Madrid, Spain; (J.P.-B.); (C.A.-J.d.A.)
| | - Carlota Abbad-Jaime de Aragon
- Department of Dermatology, Hospital Universitario Ramón y Cajal, IRYCIS, Colmenar Viejo km 9.100, 28034 Madrid, Spain; (J.P.-B.); (C.A.-J.d.A.)
| | - Alvaro Gonzalez-Cantero
- Department of Dermatology, Hospital Universitario Ramón y Cajal, IRYCIS, Colmenar Viejo km 9.100, 28034 Madrid, Spain; (J.P.-B.); (C.A.-J.d.A.)
- Faculty of Medicine, Universidad Francisco de Vitoria, 28223 Madrid, Spain
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Membrive-Jiménez C, Pérez-Ramírez C, Arias-Santiago S, Richetta AG, Ottini L, Pineda-Lancheros LE, Ramírez-Tortosa MDC, Jiménez-Morales A. Impact of Functional Polymorphisms on Drug Survival of Biological Therapies in Patients with Moderate-to-Severe Psoriasis. Int J Mol Sci 2023; 24:ijms24108703. [PMID: 37240048 DOI: 10.3390/ijms24108703] [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: 03/29/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Biological therapies (BTs) indicated for psoriasis are highly effective; however, not all patients obtain good results, and loss of effectiveness is the main reason for switching. Genetic factors may be involved. The objective of this study was to evaluate the influence of single-nucleotide polymorphisms (SNPs) on the drug survival of tumor necrosis factor inhibitors (anti-TNF) medications and ustekinumab (UTK) in patients diagnosed with moderate-to-severe psoriasis. We conducted an ambispective observational cohort study that included 379 lines of treatment with anti-TNF (n = 247) and UTK (132) in 206 white patients from southern Spain and Italy. The genotyping of the 29 functional SNPs was carried out using real-time polymerase chain reaction (PCR) with TaqMan probes. Drug survival was evaluated with Cox regression and Kaplan-Meier curves. The multivariate analysis showed that the HLA-C rs12191877-T (hazard ratio [HR] = 0.560; 95% CI = 0.40-0.78; p = 0.0006) and TNF-1031 (rs1799964-C) (HR = 0.707; 95% CI = 0.50-0.99; p = 0.048) polymorphisms are associated with anti-TNF drug survival, while TLR5 rs5744174-G (HR = 0.589; 95% CI = 0.37-0.92; p = 0.02), CD84 rs6427528-GG (HR = 0.557; 95% CI = 0.35-0.88; p = 0.013) and PDE3A rs11045392-T together with SLCO1C1 rs3794271-T (HR = 0.508; 95% CI = 0.32-0.79; p = 0.002) are related to UTK survival. The limitations are the sample size and the clustering of anti-TNF drugs; we used a homogeneous cohort of patients from 2 hospitals only. In conclusion, SNPs in the HLA-C, TNF, TLR5, CD84, PDE3A, and SLCO1C1 genes may be useful as biomarkers of drug survival of BTs indicated for psoriasis, making it possible to implement personalized medicine that will reduce financial healthcare costs, facilitate medical decision-making and improve patient quality of life. However, further pharmacogenetic studies need to be conducted to confirm these associations.
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Affiliation(s)
- Cristina Membrive-Jiménez
- Pharmacogenetics Unit, Pharmacy Service, University Hospital Virgen de las Nieves, Avenida. de las Fuerzas Armadas 2, 18004 Granada, Spain
| | - Cristina Pérez-Ramírez
- Department of Biochemistry and Molecular Biology II, Faculty of Pharmacy, Campus Universitario de Cartuja, University of Granada, 18011 Granada, Spain
| | | | - Antonio Giovanni Richetta
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties Sapienza, University of Rome, 00161 Rome, Italy
| | - Laura Ottini
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Laura Elena Pineda-Lancheros
- Pharmacogenetics Unit, Pharmacy Service, University Hospital Virgen de las Nieves, Avenida. de las Fuerzas Armadas 2, 18004 Granada, Spain
| | - Maria Del Carmen Ramírez-Tortosa
- Department of Biochemistry and Molecular Biology II, Faculty of Pharmacy, Campus Universitario de Cartuja, University of Granada, 18011 Granada, Spain
| | - Alberto Jiménez-Morales
- Pharmacogenetics Unit, Pharmacy Service, University Hospital Virgen de las Nieves, Avenida. de las Fuerzas Armadas 2, 18004 Granada, Spain
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Wang CY, Wang CW, Chen CB, Chen WT, Chang YC, Hui RCY, Chung WH. Pharmacogenomics on the Treatment Response in Patients with Psoriasis: An Updated Review. Int J Mol Sci 2023; 24:ijms24087329. [PMID: 37108492 PMCID: PMC10138383 DOI: 10.3390/ijms24087329] [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: 12/31/2022] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
The efficacy and the safety of psoriasis medications have been proved in trials, but unideal responses and side effects are noted in clinical practice. Genetic predisposition is known to contribute to the pathogenesis of psoriasis. Hence, pharmacogenomics gives the hint of predictive treatment response individually. This review highlights the current pharmacogenetic and pharmacogenomic studies of medical therapy in psoriasis. HLA-Cw*06 status remains the most promising predictive treatment response in certain drugs. Numerous genetic variants (such as ABC transporter, DNMT3b, MTHFR, ANKLE1, IL-12B, IL-23R, MALT1, CDKAL1, IL17RA, IL1B, LY96, TLR2, etc.) are also found to be associated with treatment response for methotrexate, cyclosporin, acitretin, anti-TNF, anti-IL-12/23, anti-IL-17, anti-PDE4 agents, and topical therapy. Due to the high throughput sequencing technologies and the dramatic increase in sequencing cost, pharmacogenomic tests prior to treatment by whole exome sequencing or whole genome sequencing may be applied in clinical in the future. Further investigations are necessary to manifest potential genetic markers for psoriasis treatments.
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Affiliation(s)
- Ching-Ya Wang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Chuang-Wei Wang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- Cancer Vaccine & Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen 361028, China
| | - Chun-Bing Chen
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Cancer Vaccine & Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen 361028, China
- Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung 204, Taiwan
| | - Wei-Ti Chen
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen 361028, China
| | - Ya-Ching Chang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Rosaline Chung-Yee Hui
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Dermatology, Chang Gung Memorial Hospital, Keelung Branch, Keelung 204, Taiwan
| | - Wen-Hung Chung
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Cancer Vaccine & Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen 361028, China
- Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung 204, Taiwan
- Department of Dermatology, Chang Gung Memorial Hospital, Keelung Branch, Keelung 204, Taiwan
- Department of Dermatology, Beijing Tsinghua Chang Gung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 100190, China
- Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, China
- Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
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Laserna-Mendieta EJ, Salvador-Martín S, Arias A, López-Cauce B, Marín-Jiménez I, Menchén LA, Marín-Rubio L, Ontañón Rodríguez J, López-Fernández LA, Lucendo AJ. Single nucleotide polymorphisms in ADAM17, IL23R and SLCO1C1 genes protect against infliximab failure in adults with Crohn's disease. Biomed Pharmacother 2023; 159:114225. [PMID: 36621146 DOI: 10.1016/j.biopha.2023.114225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND To predict primary failure of infliximab (IFX) therapy in Crohn's disease (CD) and to identify patients who maintain long-term effectiveness to IFX is currently not feasible. Some genetic variations are proposed as potential biomarkers. AIM We assessed a set of single nucleotide polymorphisms (SNPs) in genes related to the IFX mechanism of action and the presence of HLA-DQA1 * 05 allele on the primary response and long-term durability in CD patients. METHODS A multi-centre cross-sectional study of IFX-exposed adult patients with CD was undertaken. Treatment persistence and time to failure were co-primary endpoints. DNA from the 131 patients was genotyped. Association between SNPs and clinical variables with IFX persistence was assessed. RESULTS Failure to IFX was documented in 65 (49.6%) out of 131 patients. IFX persistence was associated either with carrying the TT genotype in ADAM17 rs10929587 (ORa=0.2; 95%CI=0.1-0.8; p = 0.021), or the CC genotype in SLCO1C1 rs3794271 (ORa=0.2; 95%CI=0.1-0.7; p = 0.008), according to multivariate logistic regression. In contrast, previous bowel resection increased the risk of IFX failure (ORa=2.8; 95%CI=1.1-7.3; p = 0.025). Cox regression analysis confirmed these findings and also identified IL23R rs10489629-TT (HRa 0.41; 95%CI=0.22-0.75; p = 0.004) and concomitant immunosuppressants (HRa 0.46; 95%CI=0.27-0.77; p = 0.003) as protection from IFX failure. However, no association between HLA-DQA1 * 05 allele and persistence of IFX therapy was found, with similar failure rates among carriers and non-carriers (52.8% vs. 47.4%, respectively; p = 0.544). CONCLUSIONS SNPs rs10929587-TT in ADAM17, rs10489629-TT in IL23R and rs3794271-CC in SLCO1C1, together with no previous bowel surgery and concomitant immunosuppression, were identified as protection from failure to IFX.
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Affiliation(s)
- E J Laserna-Mendieta
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain; Laboratory Medicine Department, Hospital Universitario de La Princesa, Madrid, Spain; Instituto de Investigación Sanitaria La Princesa (IIS-Princesa), Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Spain.
| | - S Salvador-Martín
- Department of Pharmacy, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - A Arias
- Instituto de Investigación Sanitaria La Princesa (IIS-Princesa), Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Spain; Research Unit, Hospital General Mancha Centro, Alcázar de San Juan, Spain
| | - B López-Cauce
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Department of Gastroenterology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - I Marín-Jiménez
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Department of Gastroenterology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - L A Menchén
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Department of Gastroenterology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - L Marín-Rubio
- Laboratory Medicine Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - J Ontañón Rodríguez
- Laboratory Medicine Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - L A López-Fernández
- Department of Pharmacy, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - A J Lucendo
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain; Instituto de Investigación Sanitaria La Princesa (IIS-Princesa), Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Spain; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Madrid, Spain.
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Camela E, Potestio L, Ruggiero A, Ocampo-Garza SS, Fabbrocini G, Megna M. Towards Personalized Medicine in Psoriasis: Current Progress. Psoriasis (Auckl) 2022; 12:231-250. [PMID: 36071793 PMCID: PMC9444142 DOI: 10.2147/ptt.s328460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/13/2022] [Indexed: 12/14/2022] Open
Abstract
Although innovative targeted therapies have positively revolutionized psoriasis treatment shifting treatment goals to complete or almost complete skin clearance, primary or secondary lack of efficacy is still possible. Hence, identifying robust biomarkers that reflect the various clinical psoriasis phenotypes would allow stratify patients in subgroups or endotypes, and tailor treatments according to the characteristics of each individual (precision medicine). To sum up the current progress in personalized medicine for psoriasis, we performed a review on the available evidence on biomarkers predictive of response to psoriasis treatments, with focus on phototherapy and systemic agents. Relevant literature published in English was searched for using the following databases from the last five years up to March 20, 2022: PubMed, Embase, Google Scholar, EBSCO, MEDLINE, and the Cochrane library. Currently, more evidence exists towards biologicals, as justified by the huge health care costs as compared to phototherapy or conventional systemic drugs. Among them, most of the studies focused on anti-TNF and IL12/23, with still few on IL17 (mainly secukinumab). The most discussed biomarker gene is the HLA-C*02:06 status that has been shown to be associated with psoriasis, and also differential response to biologicals. Although its positivity is associated with great response to MTX, debatable results were retrieved concerning both anti-TNF and IL12/23 while it seems not to affect secukinumab response. Personalized treatment in psoriasis would provide excellent outcome minimizing the risk of side effects. To date, although several candidates were proposed and assessed, the scarcity and heterogeneity of the results do not allow the identification of the gold-standard biomarker per each treatment. Anyway, the creation of a more comprehensive panel would be more reliable for the treatment decision process.
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Affiliation(s)
- Elisa Camela
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
- Correspondence: Elisa Camela, Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy, Tel +39 - 081 - 7462457, Fax +39 - 081 - 7462442, Email
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Sonia Sofia Ocampo-Garza
- Dermatology Department, Universidad Autónoma de Nuevo León, University Hospital ¨Dr. José Eleuterio González¨, Monterrey, Nuevo León, México
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Ren Y, Wang L, Dai H, Qiu G, Liu J, Yu D, Liu J, Lyu CZ, Liu L, Zheng M. Genome-wide association analysis of anti-TNF-α treatment response in Chinese patients with psoriasis. Front Pharmacol 2022; 13:968935. [PMID: 36059983 PMCID: PMC9437453 DOI: 10.3389/fphar.2022.968935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/28/2022] [Indexed: 11/22/2022] Open
Abstract
Background: TNF-α inhibitors are effective biological agents for treating psoriasis, but the treatment responses differ across patients. This study aimed to identify genetic biomarkers of anti-TNF-α response in Chinese psoriasis patients using a genome-wide association approach. Methods: We recruited two independent cohorts of Chinese psoriasis patients administered etanercept biosimilar (with or without methotrexate). We identified 61 and 87 good responders (PASI improvement ≥75%), 19 and 10 poor responders (PASI improvement <50%) after 24 weeks treatment in the two cohorts, respectively. Then we performed genome-wide association studies (GWAS) on anti-TNF-α response in each cohort independently, followed by a fixed-effects inverse-variance meta-analysis in the 148 good and 29 poor responders. Results: We tested genetic associations with >3 million genetic variants in either cohort. Meta-analysis identified significant associations within seven loci at p < 10−5, which also showed consistent association evidence in the two cohorts. These seven loci include rs2431355 (OR = 6.65, p = 4.46 × 10−7, IQGAP2-F2RL2 on 5q13.3), rs11801616 (OR = 0.11, p = 1.75 × 10−6, SDC3 on 1p35.2), rs3754679 (OR = 0.17, p = 7.71 × 10−6, CNOT11 on 2q11.2), rs13166823 (OR = 0.09, p = 3.71 × 10−6, IRF1-AS1 on 5q31.1), rs10220768 (OR = 5.49, p = 1.48 × 10−6, NPAP1 on 15q11.2), rs4796752 (OR = 5.56, p = 1.49 × 10−6, KRT31 on 17q21.2), and rs13045590 (OR = 0.08, p = 9.67 × 10−7, CTSZ on 20q13.3). Of the seven SNPs, six SNPs showed significant eQTL effect (p < 1 × 10−6) for several genes in multiple tissues. Conclusion: These results suggest novel biological mechanisms and potential biomarkers for the response to anti-TNF therapies. These findings warrant further validation.
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Affiliation(s)
- Yunqing Ren
- Department of Dermatology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
- Department of Dermatology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ling Wang
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Huatuo Dai
- Department of Dermatology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
- Department of Dermatology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Guiying Qiu
- Department of Dermatology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
- Department of Dermatology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jipeng Liu
- Department of Dermatology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Dianhe Yu
- Department of Dermatology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
- Department of Dermatology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jianjun Liu
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cheng-Zhi Lyu
- Department of Dermatology, Dalian Dermatosis Hospital, Dalian, China
| | - Lunfei Liu
- Department of Dermatology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Department of Dermatology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
- *Correspondence: Lunfei Liu, ; Min Zheng,
| | - Min Zheng
- Department of Dermatology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- *Correspondence: Lunfei Liu, ; Min Zheng,
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11
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Ho SS, Tsai TF. Associations between HLA-Cw1 and Systemic Treatment Response of Asian Psoriasis Patients. Mol Diagn Ther 2022; 26:541-549. [DOI: 10.1007/s40291-022-00603-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
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Lin YK, Wang CY, Huang YH, Chang YC, Chen CB, Wang CW, Hui RCY, Chung WH. Psoriasis Patients with Specific HLA-Cw Alleles and Lower Plasma IL-17 Level Show Improved Response to Topical Lindioil Treatment. Pharmgenomics Pers Med 2022; 15:515-524. [PMID: 35592551 PMCID: PMC9113440 DOI: 10.2147/pgpm.s351452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Lindioil, a medicine refined from indigo naturalis (a herb used in Chinese medicine), is effective in treating severe psoriasis; however, responses vary across individual patients. We aim to investigate genetic predispositions associated with treatment response to topical Lindioil among patients with psoriasis and correlations with plasma cytokine patterns. Patients and Methods We enrolled 72 psoriasis patients treated with Lindioil ointment and analyzed the human leukocyte antigen class C (HLA-Cw) genotypes and plasma cytokine expression patterns. We developed regression models of treatment response, defined as Psoriasis Area and Severity Index (PASI) 75, to examine correlations among HLA-Cw alleles, cytokine levels, and treatment response to Lindioil. Results Patients harboring HLA-Cw*06:02 were significantly more likely to respond to Lindioil (P = 0.02, odds ratio [OR]: 6.88), whereas Lindoil was ineffective in those harboring HLA-Cw*01:02 (P = 0.01, OR: 0.28). Patients who were HLA-Cw*06:02-positive or HLA-Cw*01:02-negative had better PASI scores and body surface area (BSA) improvement (73.3% vs 44.4%, P<0.001) following an 8-week treatment period. Psoriasis patients achieving PASI 75 after 8 weeks presented with lower baseline plasma interleukin-17 (IL-17) levels than those who did not achieve PASI 75 (PASI 75: 11.28 pg/mL vs PASI <75: 15.82 pg/mL, P = 0.05). Conclusion Our findings suggest that the presence of the HLA-Cw*06:02 or HLA-Cw*01:02 alleles and plasma IL-17 levels are predictive markers of treatment response to Lindioil ointment in patients with psoriasis.
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Affiliation(s)
- Yin-Ku Lin
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Ya Wang
- Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Huei Huang
- Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ya-Ching Chang
- Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Bing Chen
- Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan
- Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Linkou, Taiwan
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, People’s Republic of China
- Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan
- Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chuang-Wei Wang
- Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
- Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan
- Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Linkou, Taiwan
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, People’s Republic of China
| | - Rosaline Chung-Yee Hui
- Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Hung Chung
- Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
- Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan
- Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Linkou, Taiwan
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, People’s Republic of China
- Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan
- Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Dermatology, Beijing Tsinghua Chang Gung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People’s Republic of China
- School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
- Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan
- Correspondence: Wen-Hung Chung, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fusing St, Taoyuan, 333, Taiwan, Tel +886 3-3281200 #8495, Fax +886 3-3281200 #2206, Email ;
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Membrive Jiménez C, Pérez Ramírez C, Sánchez Martín A, Vieira Maroun S, Arias Santiago S, Ramírez Tortosa MC, Jiménez Morales A. Clinical Application of Pharmacogenetic Markers in the Treatment of Dermatologic Pathologies. Pharmaceuticals (Basel) 2021; 14:ph14090905. [PMID: 34577605 PMCID: PMC8471650 DOI: 10.3390/ph14090905] [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: 07/13/2021] [Revised: 08/25/2021] [Accepted: 09/01/2021] [Indexed: 02/07/2023] Open
Abstract
Dermatologic pathologies are the fourth most common cause of non-fatal disease worldwide; however, they produce a psychosocial, economic, and occupational impact equal to or greater than other chronic conditions. The most prevalent are actinic keratosis, followed by basal-cell carcinoma, in a lesser proportion acne vulgaris, psoriasis, and hidradenitis suppurativa, among others, and more rarely dermatitis herpetiformis. To treat actinic keratosis and basal-cell carcinoma, 5-fluorouracil (5-FU) 0.5% is administered topically with good results, although in certain patients it produces severe toxicity. On the other hand, dapsone is a drug commonly used in inflammatory skin conditions such as dermatitis herpetiformis; however, it occasionally causes hemolytic anemia. Additionally, biologic drugs indicated for the treatment of moderate-to-severe psoriasis and hidradenitis suppurativa have proved to be effective and safe; nevertheless, a small percentage of patients do not respond to treatment with biologics in the long term or they are ineffective. This interindividual variability in response may be due to alterations in genes that encode proteins involved in the pathologic environment of the disease or the mechanism of action of the medication. Pharmacogenetics studies the relationship between genetic variations and drug response, which is useful for the early identification of non-responsive patients and those with a higher risk of developing toxicity upon treatment. This review describes the pharmacogenetic recommendations with the strongest evidence at present for the treatments used in dermatology, highlighting those included in clinical practice guides. Currently, we could only find pharmacogenetic clinical guidelines for 5-FU. However, the summary of product characteristics for dapsone contains a pharmacogenetic recommendation from the United States Food and Drug Administration. Finally, there is an enormous amount of information from pharmacogenetic studies in patients with dermatologic pathologies (mainly psoriasis) treated with biologic therapies, but they need to be validated in order to be included in clinical practice guides.
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Affiliation(s)
- Cristina Membrive Jiménez
- Pharmacy Service, Pharmacogenetics Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
| | - Cristina Pérez Ramírez
- Pharmacy Service, Pharmacogenetics Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
- Center of Biomedical Research, Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, Avda. del Conocimiento s/n., Armilla, 18016 Granada, Spain;
- Correspondence:
| | - Almudena Sánchez Martín
- Pharmacy Service, Pharmacogenetics Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
| | - Sayleth Vieira Maroun
- Pharmacy Service, Pharmacogenetics Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
| | | | - María Carmen Ramírez Tortosa
- Center of Biomedical Research, Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, Avda. del Conocimiento s/n., Armilla, 18016 Granada, Spain;
| | - Alberto Jiménez Morales
- Pharmacy Service, Pharmacogenetics Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
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TaaI/Cdx-2 AA Variant of VDR Defines the Response to Phototherapy amongst Patients with Psoriasis. Life (Basel) 2021; 11:life11060567. [PMID: 34208603 PMCID: PMC8234577 DOI: 10.3390/life11060567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/23/2021] [Accepted: 06/14/2021] [Indexed: 11/17/2022] Open
Abstract
1,25-dihydroxyvitamin-D3 plays a central role in the immune system via binding to the vitamin D receptor. VDR polymorphisms have been associated with multiple autoimmune disorders, including psoriasis. Until now, five VDR polymorphisms, FokI, ApaI, BsmI, TaqI and TaaI/Cdx2, have been studied in psoriasis, with contradicting results. Therefore, this study aimed to evaluate the association of VDR polymorphisms with susceptibility to psoriasis, effectiveness of NB-UVB phototherapy and concentration of proinflammatory cytokines and vitamin D amongst the Polish population. VDR polymorphisms were analyzed by PCR-RFLP or real-time PCR. We found that the frequency of the TaaI/Cdx-2 GG genotype was significantly higher in psoriasis patients and was associated with regulation of IL-17 and IL-23 concentration. Moreover, TaaI/Cdx-2 AA might have a significant effect on the response to phototherapy amongst patients with psoriasis. Our results suggest that VDR is a susceptibility factor for psoriasis development. Moreover, TaaI/Cdx-2 variants have a significant effect on the response to phototherapy amongst patients with psoriasis and regulation of inflammatory response via decrease of IL-17 and IL-23 level after UVB phototherapy in the Polish population. Results of our study provide some evidence in support of the hypothesis that the vitamin D signaling pathway may be of relevance for pathogenesis and treatment of psoriasis.
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Daprá V, Ponti R, Lo Curcio G, Archetti M, Dini M, Gavatorta M, Quaglino P, Fierro MT, Bergallo M. Functional study of TNF-α promoter polymorphisms in psoriasis. Ital J Dermatol Venerol 2021; 157:146-153. [PMID: 33982552 DOI: 10.23736/s2784-8671.21.06979-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND TNF-α is an important mediator in the pathogenesis of psoriasis and polymorphisms influence its transcription and could be implicated in psoriasis risk and modify certain aspects of disease, such as age at onset of psoriasis vulgaris and disease severity. Six TNF-α single nucleotide polymorphisms (SNPs) in promoter region has been identified and studied but with discordant results. The aim of this study was to evaluate whether the polymorphisms in TNF-α (-238 (rs361525), -308 (rs1800629), -857 (rs1799724), -1031 (rs1799964)) are associated with gravity, prurity, early onset or response to drug therapy in psoriasis in Caucasian Italian patients. METHODS 58 psoriasis patients from Turin PSOCARE, 23 with psoriasis vulgaris and 35 with psoriatic arthritis were studied. Ready to used master mix for allelic discrimination of rs1800629, rs361525 and rs1799964 respectively. RESULTS Our data showed a significant association between the -857(G) variant and both VAS-itch (p=0,03) and VAS-pain index (p=0,006), OR=0,2 (0,04-0,98) and OR=0,12 (0,02-0,59). No significant association between the genotypes or alleles of TNF-α SNPs as been observed with other clinic-pathologic parameters or etanercept response. CONCLUSIONS Our data suggest that -857 CC genotype could be involved in pain and itch severity in psoriasis patients.
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Affiliation(s)
- Valentina Daprá
- Pediatric Laboratory, Department of Pediatrics, Regina Margherita Children's Hospital, University of Turin, Turin, Italy.,Dermatology Section, Department of Medical Sciences, University of Turin, Turin, Italy.,BioMole srl, Academic Spin-off University of Turin, Turin, Italy
| | - Renata Ponti
- Dermatology Section, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Giada Lo Curcio
- Pediatric Laboratory, Department of Pediatrics, Regina Margherita Children's Hospital, University of Turin, Turin, Italy
| | - Marialaura Archetti
- Pediatric Laboratory, Department of Pediatrics, Regina Margherita Children's Hospital, University of Turin, Turin, Italy
| | - Maddalena Dini
- Pediatric Laboratory, Department of Pediatrics, Regina Margherita Children's Hospital, University of Turin, Turin, Italy
| | - Martina Gavatorta
- Pediatric Laboratory, Department of Pediatrics, Regina Margherita Children's Hospital, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Dermatology Section, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Maria Teresa Fierro
- Dermatology Section, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Massimiliano Bergallo
- Pediatric Laboratory, Department of Pediatrics, Regina Margherita Children's Hospital, University of Turin, Turin, Italy - .,Dermatology Section, Department of Medical Sciences, University of Turin, Turin, Italy.,BioMole srl, Academic Spin-off University of Turin, Turin, Italy
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Membrive Jiménez C, Pérez Ramírez C, Sánchez Martín A, Vieira Maroun S, Arias Santiago SA, Ramírez Tortosa MDC, Jiménez Morales A. Influence of Genetic Polymorphisms on Response to Biologics in Moderate-to-Severe Psoriasis. J Pers Med 2021; 11:293. [PMID: 33921427 PMCID: PMC8069496 DOI: 10.3390/jpm11040293] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/29/2021] [Accepted: 04/02/2021] [Indexed: 12/12/2022] Open
Abstract
Psoriasis is a chronic inflammatory skin pathology of autoimmune origin and unknown etiology. There are various therapies for treating it, including a wide range of biopharmaceuticals indicated in moderate-to-severe psoriasis. Depending on their therapeutic target, they are classified as tumor necrosis factor inhibitors (anti-TNF) or cytokine inhibitors (interleukin-12, 23, and 17 antagonists). Although they have proved effective and safe, in clinical practice, many patients show a short- and long-term suboptimal response and even varying degrees of toxicity. This variability in response may be influenced by genetic factors, such as polymorphisms in the genes involved in the pathological environment, metabolism or mechanism of action of the drug that could affect the effectiveness and toxicity of biological therapies. This review assesses pharmacogenetic studies of the impact of genetic factors on response to biopharmaceuticals and toxicity in patients diagnosed with moderate-to-severe psoriasis. The results suggest that polymorphisms detected in the HLA genes, in genes that encode cytokines (TNF, IL genes, TNFAIP3), transporters (PDE3A-SLCO1C1, SLC12A8), receptors (TNFRSF1B, CD84, FCGR2A and FCGR3A, IL17RA, IL23R, TLR genes, PGLYRP4) and associated proteins (TNFAIP3, LY96, TIRAP, FBXL19), as well as other genes implicated in the pathogenesis of psoriasis (CDKAL1, CARD14, PTTG1, MAP3K1, ZNF816A, GBP6, CTNNA2, HTR2A, CTLA4, TAP1) can be used in the future as predictive markers of treatment response and/or toxicity with biological therapies in patients diagnosed with moderate-to-severe psoriasis, tailoring treatment to the individual patient.
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Affiliation(s)
- Cristina Membrive Jiménez
- Pharmacogenetics Unit, Pharmacy Service, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
| | - Cristina Pérez Ramírez
- Pharmacogenetics Unit, Pharmacy Service, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
- Department of Biochemistry, Faculty of Pharmacy, Campus Universitario de Cartuja, University of Granada, 18071 Granada, Spain;
| | - Almudena Sánchez Martín
- Pharmacogenetics Unit, Pharmacy Service, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
| | - Sayleth Vieira Maroun
- Pharmacogenetics Unit, Pharmacy Service, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
| | | | | | - Alberto Jiménez Morales
- Pharmacogenetics Unit, Pharmacy Service, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
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Galluzzo M, Manfreda V, Petruzzellis A, Bianchi L, Talamonti M. The value of genotyping patients for the presence of HLA-C in the personalized treatment of psoriasis. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2021. [DOI: 10.1080/23808993.2021.1878022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Marco Galluzzo
- Dermatology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
- Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Valeria Manfreda
- Dermatology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
| | | | - Luca Bianchi
- Dermatology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Marina Talamonti
- Dermatology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
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Pharmacogenetics Update on Biologic Therapy in Psoriasis. ACTA ACUST UNITED AC 2020; 56:medicina56120719. [PMID: 33419370 PMCID: PMC7766592 DOI: 10.3390/medicina56120719] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/06/2020] [Accepted: 12/17/2020] [Indexed: 02/06/2023]
Abstract
Background and objectives: Psoriasis is a chronic immune-mediated skin disease caused by several complex factors, both environmental and genetic, many of which are still not fully understood. Nowadays, several groups of biological drugs are being used for psoriasis treatment. Although these therapies are very effective, they show significant variability in efficacy among individuals. Therefore, there is a need for biomarkers to predict treatment outcomes in order to guide personalized therapeutic decisions. Pharmacogenetics is the study of variations in DNA sequences related to drug response. Materials and Methods: In this article, we review pharmacogenetics studies on the treatment of moderate-to-severe psoriasis focusing on anti-interleukin (IL) 12/23 (ustekinumab) and anti-IL17 drugs (secukinumab and ixekizumab), as well as recent studies concerning anti-TNF drugs. Results: Several polymorphisms have been studied over the years in reference to anti-TNF drugs; some of the most recent studies included the performance of a genome-wide association study (GWAS) and pharmacogenetics studies focused on the optimization of a treatment regimen. Various polymorphisms in different genes have been related to ustekinumab response; among them, the most commonly studied is the HLA-C*06:02 allele. Conclusions: Although not confirmed in some studies, most studies have shown that patients carrying this allele present a significantly higher response rate to ustekinumab. Some polymorphisms have been studied in patients treated with anti-IL17 drugs, mostly related to secukinumab; however, up to now, no association has been found between any of these polymorphisms and response. Nevertheless, further studies involving larger cohorts are needed in order to confirm these results before the implementation of this biomarker in clinical practice.
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Ovejero‐Benito MC, Muñoz‐Aceituno E, Sabador D, Almoguera B, Prieto‐Pérez R, Hakonarson H, Coto‐Segura P, Carretero G, Reolid A, Llamas‐Velasco M, Abad‐Santos F, Daudén E. Genome‐wide association analysis of psoriasis patients treated with anti‐TNF drugs. Exp Dermatol 2020; 29:1225-1232. [DOI: 10.1111/exd.14215] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/01/2020] [Accepted: 10/09/2020] [Indexed: 02/06/2023]
Affiliation(s)
- María C. Ovejero‐Benito
- Clinical Pharmacology Department Hospital Universitario de la Princesa Instituto Teófilo Hernando Universidad Autónoma de Madrid (UAM) Instituto de Investigación Sanitaria la Princesa (IIS‐IP) Madrid Spain
| | - Ester Muñoz‐Aceituno
- Dermatology Department Hospital Universitario de la Princesa Instituto de Investigación Sanitaria La Princesa (IIS‐IP) Madrid Spain
| | - David Sabador
- Clinical Pharmacology Department Hospital Universitario de la Princesa Instituto Teófilo Hernando Universidad Autónoma de Madrid (UAM) Instituto de Investigación Sanitaria la Princesa (IIS‐IP) Madrid Spain
| | - Berta Almoguera
- Hospital Universitario Fundación Jiménez Díaz (HUFJD). CIBERER Madrid Spain
- Center for Applied Genomics The Children's Hospital of Philadelphia Philadelphia PA USA
| | - Rocío Prieto‐Pérez
- Clinical Pharmacology Department Hospital Universitario de la Princesa Instituto Teófilo Hernando Universidad Autónoma de Madrid (UAM) Instituto de Investigación Sanitaria la Princesa (IIS‐IP) Madrid Spain
| | - Hakon Hakonarson
- Center for Applied Genomics The Children's Hospital of Philadelphia Philadelphia PA USA
- Department of Pediatrics The Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | | | - Gregorio Carretero
- Dermatology Department Hospital Universitario de Gran Canaria Dr. Negrín Las Palmas de Gran Canaria Spain
| | - Alejandra Reolid
- Dermatology Department Hospital Universitario de la Princesa Instituto de Investigación Sanitaria La Princesa (IIS‐IP) Madrid Spain
| | - Mar Llamas‐Velasco
- Dermatology Department Hospital Universitario de la Princesa Instituto de Investigación Sanitaria La Princesa (IIS‐IP) Madrid Spain
| | - Francisco Abad‐Santos
- Clinical Pharmacology Department Hospital Universitario de la Princesa Instituto Teófilo Hernando Universidad Autónoma de Madrid (UAM) Instituto de Investigación Sanitaria la Princesa (IIS‐IP) Madrid Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) Instituto de Salud Carlos III Madrid Spain
| | - Esteban Daudén
- Dermatology Department Hospital Universitario de la Princesa Instituto de Investigación Sanitaria La Princesa (IIS‐IP) Madrid Spain
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Paradoxical Psoriasis Induced by Anti-TNFα Treatment: Evaluation of Disease-Specific Clinical and Genetic Markers. Int J Mol Sci 2020; 21:ijms21217873. [PMID: 33114187 PMCID: PMC7660646 DOI: 10.3390/ijms21217873] [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: 09/29/2020] [Revised: 10/14/2020] [Accepted: 10/21/2020] [Indexed: 02/08/2023] Open
Abstract
Paradoxical psoriasis (PP) may occur during treatment with anti-tumor necrosis factor-alpha (TNF-α) drugs in various chronic immune-mediated diseases, mainly inflammatory bowel diseases (IBD) and psoriasis. In this study, clinical and genetic characteristics of PP arising in IBD and psoriatic patients were investigated to identify disease-specific markers of the paradoxical effect. A total of 161 IBD and psoriatic patients treated with anti-TNF-α drugs were included in the study. Of these patients, 39 developed PP. All patients were characterized for the main clinical–pathologic characteristics and genotyped for six candidate single nucleotide polymorphisms (SNPs) selected for their possible role in PP susceptibility. In IBD patients, the onset of PP was associated with female sex, presence of comorbidities, and use of adalimumab. IBD patients with PP had a higher frequency of the TNF-α rs1799964 rare allele (p = 0.006) compared with cases without the paradoxical effect, and a lower frequency of the human leucocyte antigen (HLA)-Cw06 rs10484554 rare allele (p = 0.03) compared with psoriatic patients with PP. Overall, these findings point to specific clinical and genetic characteristics of IBD patients with PP and provide data showing that genetic variability may be related to the paradoxical effect of anti-TNF-α drugs with possible implications into clinical practice.
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21
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The HLA-Cw6 Dilemma: Is It Really an Outcome Predictor in Psoriasis Patients under Biologic Therapy? A Monocentric Retrospective Analysis. J Clin Med 2020; 9:jcm9103140. [PMID: 32998429 PMCID: PMC7600180 DOI: 10.3390/jcm9103140] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023] Open
Abstract
HLA-Cw6 is one of the most strongly associated psoriasis susceptibility alleles. Data regarding correlation between HLA-Cw6 status and biologic treatment outcomes are divergent. The aim of our study in our cohort of psoriatic patients was to explore if the HLA-Cw6 status influences the response rate to biologic therapies at 16 and 48 weeks. One hundred and one psoriatic patients eligible for biologic therapies were enrolled. HLA-C*06 alleles were detected from their blood samples. The effectiveness of antipsoriatic treatments was reported as 90% Psoriasis Area and Severity Index reduction (PASI90). All biologics showed efficacy at week 16, without significant differences between one another. HLA-Cw6 status did not seem to affect baseline characteristics, or treatment response at week 16. At week 48, IL-12/23 and IL-17 targeting drugs were more effective on Cw6-positive patients than on Cw6-negative patients. Conversely, TNF-targeting drugs seemed to be more effective on Cw6- negative patients than on Cw6-positive patients. The HLA-Cw6 test could well deserve to be integrated into the clinical laboratory work-up supporting the choice of the correct biologic.
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Tavakolpour S, Darvishi M, Ghasemiadl M. Pharmacogenetics: A strategy for personalized medicine for autoimmune diseases. Clin Genet 2019; 93:481-497. [PMID: 29194620 DOI: 10.1111/cge.13186] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 11/24/2017] [Accepted: 11/24/2017] [Indexed: 12/12/2022]
Abstract
For many years, a considerable number of patients with autoimmune diseases (ADs) have suffered from a lack of drug response and drug-related toxicity. Despite the emergence of new therapeutic options such as biological agents, patients continue to struggle with these problems. Unfortunately, new challenges, including the paradoxical effects of biological drugs, have complicated the situation. In recent decades, efforts have been made to predict drug response as well as drug-related side effects. Thanks to the many advances in genetics, evaluation of markers to predict drug response/toxicity before the initiation of treatment may be an avenue toward personalizing treatments. Implementing pharmacogenetics and pharmacogenomics in the clinic could improve clinical care; however, obstacles remain to effective personalized medicine for ADs. The present study attempted to clarify the concept of pharmacogenetics/pharmacogenomics for ADs. After an overview on the pathogenesis of the most common types of treatments, this paper focuses on pharmacogenetic studies related to the selected ADs. Bridging the gap between pharmacogenetics and personalized medicine is also discussed. Moreover, the advantages, disadvantages and recommendations related to making personalized medicine practical for ADs have been addressed.
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Affiliation(s)
- S Tavakolpour
- Genomic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Medical Genetics, Tehran University of Medical Sciences, Tehran, Iran
| | - M Darvishi
- Infectious Diseases and Tropical Medicine Research Center (IDTMRC), Department of Aerospace and Subaquatic Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - M Ghasemiadl
- Department of Medical Genetics, Tehran University of Medical Sciences, Tehran, Iran
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Song Y, Chen L, Li Y, Lin Q, Liu W, Zhang L. Knockdown of TRAF3IP2 suppresses the expression of VEGFA and the proliferation of keratinocytes and vascular endothelial cells. Heliyon 2019; 5:e01642. [PMID: 31193034 PMCID: PMC6513784 DOI: 10.1016/j.heliyon.2019.e01642] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/17/2018] [Accepted: 04/30/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To investigate the expression level of TRAF3IP2 in psoriasis lesion, and to explore the functional roles of TRAF3IP2 on proliferation, apoptosis, cytokine expression and secretion of both keratinocytes and vascular endothelial cells in vitro. METHODS The expression of TRAF3IP2 in skin samples of patients with psoriasis was analyzed by immunohistochemistry and qRT-PCR. To identify the effect of TRAF3IP2 knockdown on HaCaT and HUVEC cells, a plasmid vector expressing siRNA targeting TRAF3IP2 mRNA was designed and transfected into cells with Lipofectamine 2000. The levels of cytokines were identified using the ELISA Kits and qRT-PCR. Furthermore, cell proliferation, cell cycle and apoptosis were examined by using MTT, PI and Annexin V-FITC/7AAD assays, respectively. Furthermore, the expression of apoptosis-related proteins (Cleaved-Caspase 3, Caspase 3 and Bax) were detected by western blotting. RESULTS TRAF3IP2 was significantly upregulated in psoriasis lesion. TRAF3IP2 knockdown reduced the expression of vascular endothelial growth factor A (VEGFA) and the release of IL-6, and IL-8, but had no effect on IL-23 in both HaCaT and HUVEC cells. In addition, knockdown of TRAF3IP2 significantly inhibited cell proliferation through blocking the cell cycle in the G2/M phase. Moreover, knockdown of TRAF3IP2 increased the expression of Caspase 3, Cleaved-Caspase 3 and Bax, which was supported by the increased apoptosis of both HaCaT and HUVEC cells. CONCLUSION Taken together, these results indicated that TRAF3IP2 might play a contributive role in the pathogenesis of psoriasis and may serve as a new target for the treatment of psoriasis. VEGF related pathways may be involved in the mechanism beneath.
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Yan KX, Zhang YJ, Han L, Huang Q, Zhang ZH, Fang X, Zheng ZZ, Yawalkar N, Chang YL, Zhang Q, Jin L, Qian DF, Li XY, Wu MS, Xu QH, Zhang XJ, Xu JH. TT genotype of rs10036748 in TNIP1 shows better response to methotrexate in a Chinese population: a prospective cohort study. Br J Dermatol 2019; 181:778-785. [PMID: 31020648 DOI: 10.1111/bjd.17704] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Methotrexate (MTX) is an efficacious treatment for psoriasis; however, its widespread application is limited by its unpredictable efficacy. OBJECTIVES To investigate the association of clinical factors and variants of psoriasis susceptibility genes with clinical responses to MTX in a prospective cohort. METHODS A total of 221 patients with psoriasis were recruited. Patients who achieved Psoriasis Area and Severity Index (PASI) improvement ≥ 75% at week 12 were defined as responders, whereas those with PASI improvement < 50% were defined as nonresponders. In 90 screening patients, genetic variants for 18 single-nucleotide polymorphisms in 14 susceptibility genes, and HLA-Cw6 status were initially compared for responders and nonresponders. Statistically significant associations in genetic variants were verified in all 221 patients. RESULTS Overall, 49% and 45% of patients achieved PASI 75 improvement during screening and verification stages, respectively. Concomitant arthritis with psoriasis and high body mass index (BMI) negatively affect the efficacy of MTX. TT genotype of rs10036748 in TNIP1 was significantly associated with PASI 75 response at week 12 (54% and 37%, P < 0·05). A significantly higher PASI 90 response was observed in patients with TT genotype of rs10036748 (27% vs. 12%, P < 0·01) and TC/TT genotype of rs4112788 in LCE3D (25% vs. 13%, P < 0·05) at week 12 compared with those who had other genotypes. After adjustment for all confounding factors, only BMI (P < 0·05), arthritis (P < 0·05) and genotype of rs10036748 (P < 0·05) were significantly associated with clinical responses to MTX. CONCLUSIONS Patients with psoriasis with TT genotype of rs10036748 in TNIP1, with lower BMI, without arthritis will achieve a better response to MTX.
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Affiliation(s)
- K X Yan
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Y J Zhang
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - L Han
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Q Huang
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Z H Zhang
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - X Fang
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Z Z Zheng
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - N Yawalkar
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, 3012, Switzerland
| | - Y L Chang
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Q Zhang
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - L Jin
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - D F Qian
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - X Y Li
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - M S Wu
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Q H Xu
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - X J Zhang
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - J H Xu
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
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Ovejero-Benito MC, Muñoz-Aceituno E, Reolid A, Fisas LH, Llamas-Velasco M, Prieto-Pérez R, Abad-Santos F, Daudén E. Polymorphisms associated with anti-TNF drugs response in patients with psoriasis and psoriatic arthritis. J Eur Acad Dermatol Venereol 2019; 33:e175-e177. [PMID: 30653751 DOI: 10.1111/jdv.15431] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M C Ovejero-Benito
- Clinical Pharmacology Department, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Instituto de Investigación Sanitaria la Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), c/Diego de León n 62, 28006, Madrid, Spain
| | - E Muñoz-Aceituno
- Dermatology Department, Instituto de Investigación Sanitaria la Princesa (IIS-IP), Hospital Universitario de la Princesa, c/Diego de León n 62, 28006, Madrid, Spain
| | - A Reolid
- Dermatology Department, Instituto de Investigación Sanitaria la Princesa (IIS-IP), Hospital Universitario de la Princesa, c/Diego de León n 62, 28006, Madrid, Spain
| | - L H Fisas
- Clinical Pharmacology Department, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Instituto de Investigación Sanitaria la Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), c/Diego de León n 62, 28006, Madrid, Spain
| | - M Llamas-Velasco
- Dermatology Department, Instituto de Investigación Sanitaria la Princesa (IIS-IP), Hospital Universitario de la Princesa, c/Diego de León n 62, 28006, Madrid, Spain
| | - R Prieto-Pérez
- Clinical Pharmacology Department, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Instituto de Investigación Sanitaria la Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), c/Diego de León n 62, 28006, Madrid, Spain
| | - F Abad-Santos
- Clinical Pharmacology Department, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Instituto de Investigación Sanitaria la Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), c/Diego de León n 62, 28006, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, c/Diego de León n 62, 28006, Madrid, Spain
| | - E Daudén
- Dermatology Department, Instituto de Investigación Sanitaria la Princesa (IIS-IP), Hospital Universitario de la Princesa, c/Diego de León n 62, 28006, Madrid, Spain
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Singh S, Kalb RE, de Jong EMGJ, Shear NH, Lebwohl M, Langholff W, Hopkins L, Srivastava B, Armstrong AW. Effect of Age of Onset of Psoriasis on Clinical Outcomes with Systemic Treatment in the Psoriasis Longitudinal Assessment and Registry (PSOLAR). Am J Clin Dermatol 2018; 19:879-886. [PMID: 30267377 PMCID: PMC6267545 DOI: 10.1007/s40257-018-0388-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Our objective was to compare therapeutic response among patients with early-onset psoriasis (EOP) and late-onset psoriasis (LOP) receiving adalimumab, etanercept, infliximab, ustekinumab, or methotrexate in the Psoriasis Longitudinal Assessment and Registry (PSOLAR). METHODS Patients were grouped by age of onset: EOP (age ≤ 40 years) or LOP (age > 40 years). Repeated-measures analysis with logistic regression was used to calculate the adjusted odds ratio (AOR; adjusted for baseline characteristics) for achieving a Physician's Global Assessment score of cleared/minimal (PGA 0/1) or a percentage of body surface area involved with psoriasis < 3% (%BSA < 3) or %BSA < 1 for all patients; similar sensitivity analyses were performed for each treatment group. RESULTS Of 7511 patients, 5479 (72.9%) had EOP. The LOP group had a higher likelihood of achieving PGA 0/1 after treatment than did the EOP group in all patients (AOR 1.14 [95% confidence interval (CI) 1.05-1.25]; p = 0.0019); the same was true in subgroups of etanercept-treated (AOR 1.38 [95% CI 1.14-1.66]; p = 0.0010) and methotrexate-treated (AOR 1.62 [95% CI 1.16-2.26]; p = 0.0049) patients. No significant difference was found between the EOP and LOP groups with regard to the likelihood of achieving %BSA < 3 or %BSA < 1 among all patients. However, LOP patients were more likely than EOP patients to achieve %BSA < 3 or %BSA < 1 in subgroups treated with infliximab (AOR 1.45 [95% CI 1.09-1.93; p = 0.0103] and AOR 1.36 [95% CI 1.03-1.78; p = 0.0290], respectively) and etanercept (AOR 1.30 [95% CI 1.06-1.61; p = 0.0123] and AOR 1.34 [95% CI 1.09-1.64; p = 0.0053], respectively). CONCLUSION Our real-world data from PSOLAR indicate that there are differences in some patient characteristics between EOP and LOP and that patients with EOP are less likely than those with LOP to respond to certain systemic treatments. (ClinicalTrials.gov identifier: NCT00508547).
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Affiliation(s)
- Sanminder Singh
- Davis School of Medicine, University of California, Sacramento, CA, USA
| | - Robert E Kalb
- State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Elke M G J de Jong
- Radboud University Medical Center and Radboud University, Nijmegen, The Netherlands
| | - Neil H Shear
- Sunnybrook Health Sciences Center, University of Toronto Medical School, Toronto, ON, Canada
| | - Mark Lebwohl
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Lori Hopkins
- Janssen Scientific Affairs, LLC, Horsham, PA, USA
| | | | - April W Armstrong
- Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Keith Administration Building, Room 510, Los Angeles, CA, 90089, USA.
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Psoriasis in Skin of Color: Insights into the Epidemiology, Clinical Presentation, Genetics, Quality-of-Life Impact, and Treatment of Psoriasis in Non-White Racial/Ethnic Groups. Am J Clin Dermatol 2018; 19:405-423. [PMID: 29209945 DOI: 10.1007/s40257-017-0332-7] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Psoriasis is a chronic inflammatory skin condition affecting diverse racial/ethnic groups throughout the world. Large population-based studies suggest that psoriasis occurs most often in individuals of European ancestry, followed by black and Hispanic individuals, although the true prevalence of psoriasis in non-white individuals is likely underestimated. Despite similarities in psoriasis between ethnic groups, there are notable differences in the presentation, quality-of-life impact, and treatment of psoriasis with important implications for the management of non-white individuals. Overall, heterogeneity in psoriasis susceptibility alleles, in combination with cultural and socioeconomic factors, may explain these differences. In this article, we review the epidemiology, clinical presentation, genetic polymorphisms, quality-of-life impact, and treatment nuances of psoriasis in patients with skin of color.
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IL12B , IL23A , IL23R and HLA-C*06 genetic variants in psoriasis susceptibility and response to treatment. Hum Immunol 2018; 79:213-217. [DOI: 10.1016/j.humimm.2018.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 02/05/2018] [Accepted: 02/07/2018] [Indexed: 02/06/2023]
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Ovejero-Benito MC, Muñoz-Aceituno E, Reolid A, Saiz-Rodríguez M, Abad-Santos F, Daudén E. Pharmacogenetics and Pharmacogenomics in Moderate-to-Severe Psoriasis. Am J Clin Dermatol 2018; 19:209-222. [PMID: 28921458 DOI: 10.1007/s40257-017-0322-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Pharmacogenetics is the study of variations in DNA sequence related to drug response. Moreover, the evolution of biotechnology and the sequencing of human DNA have allowed the creation of pharmacogenomics, a branch of genetics that analyzes human genes, the RNAs and proteins encoded by them, and the inter-and intra-individual variations in expression and function in relation to drug response. Pharmacogenetics and pharmacogenomics are being used to search for biomarkers that can predict response to systemic treatments, including those for moderate-to-severe psoriasis. Psoriasis is a chronic inflammatory disease with an autoimmune contribution. Although its etiology remains unknown, genetic, epigenetic, and environmental factors play a role in its development. Diverse systemic and biologic therapies are used to treat moderate-to-severe psoriasis. However, these treatments are not curative, and patients exhibit a wide range of responses to them. Moderate-to-severe psoriasis is usually treated with systemic immunomodulators such as acitretin, ciclosporin, and methotrexate. Anti-tumor necrosis factor (TNF) drugs (adalimumab, etanercept, or infliximab) are the first-line treatment for patients resistant to conventional systemic therapies. Although these therapies are very efficient, around 30-50% of patients have inadequate response. Ustekinumab is a monoclonal antibody that targets interleukin (IL)-12 and IL-23 and is used for moderate-to-severe psoriasis. New drugs (apremilast, brodalumab, guselkumab, ixekizumab, and secukinumab) have recently been approved for psoriasis. However, response rates to systemic treatments for moderate-to-severe psoriasis range from 35 to 80%, so it is necessary to identify non-invasive biomarkers that could help predict treatment outcomes of these therapies and individualize care for patients with psoriasis. These biomarkers could improve patient quality of life and reduce health costs and potential side effects. Pharmacogenetic studies have identified potential biomarkers for response to biologic treatments for moderate-to-severe psoriasis. These biomarkers need to be validated in clinical trials involving large cohorts of patients before they can be translated to the clinic. We review pharmacogenetics and pharmacogenomics studies for the treatment of moderate-to-severe plaque psoriasis.
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Abstract
Psoriasis is a multifactorial disease with a strong genetic background. HLA-Cw6 is one of the most strongly associated psoriasis susceptibility alleles. It is repeatedly observed to affect disease course, phenotypic features, severity, comorbidities and treatment outcomes. To the best of our knowledge, the roles of HLA-Cw6 in psoriasis have not yet been thoroughly reviewed. The worldwide frequency of the HLA-Cw6 allele varies greatly, with it being generally higher in white people than in Asians. The allele is associated with type I early-onset psoriasis. Stress, obesity and streptococcal pharyngitis are commonly observed in HLA-Cw6-positive patients. Phenotypically, HLA-Cw6 has been found to be associated with guttate psoriasis. In addition, patients carrying the allele are more likely to have arm, leg and trunk involvement, and the Koebner phenomenon. Patients with psoriatic arthritis with HLA-Cw6 more often have early onset and tend to show cutaneous symptoms before musculoskeletal symptoms. HLA-Cw6-positive patients have been shown in several studies to be more responsive to methotrexate and ustekinumab. However, this difference in ustekinumab efficacy was only moderate in a post-hoc analysis of a pivotal phase III study. HLA-Cw6 positivity also tends to be less frequent in high-need patients who fail conventional therapy. Small studies have also investigated the role of HLA-Cw6 in remission of psoriasis during pregnancy, and with the comorbidities of photosensitivity and atherosclerosis. Given the diverse nature of psoriasis pathogenesis, as well as the difference of HLA-Cw6 positivity in different ethnic groups, more studies are needed to confirm the role of HLA-Cw6 in psoriasis.
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Affiliation(s)
- L Chen
- Lake Erie College of Osteopathic Medicine, Bradenton, PA, U.S.A
| | - T-F Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei City, Taiwan
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Talamonti M, Galluzzo M, Zangrilli A, Papoutsaki M, Egan CG, Bavetta M, Tambone S, Fargnoli MC, Bianchi L. HLA-C*06:02 Does Not Predispose to Clinical Response Following Long-Term Adalimumab Treatment in Psoriatic Patients: A Retrospective Cohort Study. Mol Diagn Ther 2018; 21:295-301. [PMID: 28130758 DOI: 10.1007/s40291-017-0261-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The genetic basis of predisposition to psoriasis is recognised; however, the response to psoriasis treatment in patients with different genetic predisposition is poorly understood. OBJECTIVE To analyse the presence of the HLA-C*06:02 polymorphism in psoriatic patients treated with adalimumab. METHODS Genomic DNA was extracted from whole blood of 122 patients with moderate-to-severe psoriasis treated with adalimumab for 3 years. Genotyping was performed using PCR. Disease severity was assessed by the Psoriasis Area and Severity Index (PASI) at day 0 and after 1, 3, 6, 12, 24 and 36 months. Logistic regression was used to evaluate the association between dependent variables (including HLA-C*06:02 status) and achievement of PASI 50, 75 and 90. RESULTS No difference was observed after adalimumab treatment between C*06:02 positive (HLA-C*06:02-POS) patients (n = 46) and C*06:02 negative (HLA-C*06:02-NEG) patients (n = 76) over the 3-year follow-up period in terms of PASI response or time-course when PASI response was achieved. However, a small, but non-statistically significant difference was noted between genotypes for PASI 50 at 1 month (HLA-C*06:02-NEG: 44.7% vs. HLA-C*06:02-POS: 56.5%) and at 3 months (HLA-C*06:02-NEG: 71.1% vs. HLA-C*06:02-POS: 80.4%). Simple logistic regression analysis did not reveal an association between independent variables (including C*06:02 status) and PASI response; however, multivariate regression revealed that gender (females better than males) was associated with achievement of PASI 50 at month 1 (OR 0.34, 95% CI 0.16-0.72, p = 0.005) and of PASI 75 at 3 months (OR 0.36, 95% CI 0.16-0.8, p = 0.012). CONCLUSION Adalimumab reduced long-term severity in patients with moderate-severe psoriasis, independent of their HLA-C*06:02 status.
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Affiliation(s)
- Marina Talamonti
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy.
| | - Marco Galluzzo
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Arianna Zangrilli
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Marina Papoutsaki
- Third Department of Dermatology, A. Syggros Hospital, Athens, Greece
| | | | - Mauro Bavetta
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Sara Tambone
- Department of Dermatology, University of L'Aquila, L'Aquila, Italy
| | | | - Luca Bianchi
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
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32
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Ovejero-Benito MC, Prieto-Pérez R, Llamas-Velasco M, Muñoz-Aceituno E, Reolid A, Saiz-Rodríguez M, Belmonte C, Román M, Ochoa D, Talegón M, Cabaleiro T, Daudén E, Abad-Santos F. Polymorphisms associated with adalimumab and infliximab response in moderate-to-severe plaque psoriasis. Pharmacogenomics 2018; 19:7-16. [DOI: 10.2217/pgs-2017-0143] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim: This study evaluated the influence of pharmacogenetics in psoriatic patients treated with adalimumab and/or infliximab. Materials & methods: Prospective observational study evaluating the association of 124 polymorphisms with the response to adalimumab or infliximab (PASI75) in patients with moderate-to-severe plaque psoriasis at 3 months (n = 95) and 6 months of treatment (n = 90). Significant SNPs for univariate analysis were subjected to multivariate analysis. Results: Five SNPs were associated with PASI75 at 3 months: rs6661932 (IVL), rs2546890 (IL-12B), rs2145623 (NFKBIA), rs9304742 (ZNF816A) and rs645544 (SLC9A8). Furthermore, rs1061624 (TNFR1B) was associated with PASI75 at 6 months. Conclusion: Nevertheless, these biomarkers should be validated in large-scale studies before implementation in clinical practice.
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Affiliation(s)
- María C Ovejero-Benito
- Department of Clinical Pharmacology, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IIS-IP), E28006, Madrid, Spain
| | - Rocío Prieto-Pérez
- Department of Clinical Pharmacology, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IIS-IP), E28006, Madrid, Spain
| | - Mar Llamas-Velasco
- Department of Dermatology, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria la Princesa (IIS-IP), E28006, Madrid, Spain
| | - Ester Muñoz-Aceituno
- Department of Dermatology, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria la Princesa (IIS-IP), E28006, Madrid, Spain
| | - Alejandra Reolid
- Department of Dermatology, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria la Princesa (IIS-IP), E28006, Madrid, Spain
| | - Miriam Saiz-Rodríguez
- Department of Clinical Pharmacology, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IIS-IP), E28006, Madrid, Spain
| | - Carmen Belmonte
- Department of Clinical Pharmacology, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IIS-IP), E28006, Madrid, Spain
| | - Manuel Román
- Department of Clinical Pharmacology, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IIS-IP), E28006, Madrid, Spain
- SCReN Spanish Clinical Research Network, UICEC del Hospital de La Princesa; Servicio de Farmacología Clínica, E28006, Madrid, Spain
| | - Dolores Ochoa
- Department of Clinical Pharmacology, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IIS-IP), E28006, Madrid, Spain
- SCReN Spanish Clinical Research Network, UICEC del Hospital de La Princesa; Servicio de Farmacología Clínica, E28006, Madrid, Spain
| | - María Talegón
- Department of Clinical Pharmacology, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IIS-IP), E28006, Madrid, Spain
| | - Teresa Cabaleiro
- Department of Clinical Pharmacology, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IIS-IP), E28006, Madrid, Spain
| | - Esteban Daudén
- Department of Dermatology, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria la Princesa (IIS-IP), E28006, Madrid, Spain
| | - Francisco Abad-Santos
- Department of Clinical Pharmacology, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IIS-IP), E28006, Madrid, Spain
- SCReN Spanish Clinical Research Network, UICEC del Hospital de La Princesa; Servicio de Farmacología Clínica, E28006, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, E28029, Madrid, Spain
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van Vugt LJ, van den Reek JMPA, Coenen MJH, de Jong EMGJ. A systematic review of pharmacogenetic studies on the response to biologics in patients with psoriasis. Br J Dermatol 2017. [PMID: 28646581 DOI: 10.1111/bjd.15753] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Biologics are indicated for treating moderate-to-severe psoriasis. As the number of biologics registered for the treatment of psoriasis increases, so does the need for biomarkers to guide personalized therapeutic decisions. Genetic variants might serve as predictors for treatment response, a field of research known as pharmacogenetics. OBJECTIVES To assess which genetic variants are associated with response to biologics in patients with psoriasis according to current literature. METHODS A systematic search was performed in Embase, MEDLINE, the Cochrane Library and Web of Science. In total, 26 papers were included in this systematic review; 24 original studies and two meta-analyses. Quality was assessed using a predesigned form and risk of bias was assessed using the Newcastle-Ottawa Scale. RESULTS The majority of studies reported a candidate gene approach, focusing on polymorphisms in genes related to the therapeutic target or to psoriasis susceptibility. Studied populations were small and results were divergent, especially for studies investigating tumour necrosis factor inhibitors. The evidence for the role of HLA-Cw6 in ustekinumab efficacy shows minimal heterogeneity, with a higher response rate among patients who were positive for HLA-Cw6 reported across three of five studies. CONCLUSIONS Pharmacogenetic studies in psoriasis have generated divergent results. Replication of findings in larger cohorts is required. Large-scale hypothesis-free searches for genetic biomarkers are needed to uncover the complete genetic background of outcomes for treatment with biologics.
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Affiliation(s)
- L J van Vugt
- Department of Dermatology, Radboud University Medical Centre, Nijmegen, the Netherlands.,Radboud Institute for Health Sciences (RIHS), Nijmegen, the Netherlands
| | - J M P A van den Reek
- Department of Dermatology, Radboud University Medical Centre, Nijmegen, the Netherlands.,Radboud Institute for Health Sciences (RIHS), Nijmegen, the Netherlands
| | - M J H Coenen
- Radboud Institute for Health Sciences (RIHS), Nijmegen, the Netherlands.,Department of Human Genetics, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - E M G J de Jong
- Department of Dermatology, Radboud University Medical Centre, Nijmegen, the Netherlands.,Radboud Institute for Health Sciences (RIHS), Nijmegen, the Netherlands.,Radboud University, Nijmegen, the Netherlands
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Moy AP, Murali M, Kroshinsky D, Horn TD, Nazarian RM. T-helper immune phenotype may underlie ‘paradoxical’ tumour necrosis factor-α inhibitor therapy-related psoriasiform dermatitis. Clin Exp Dermatol 2017; 43:19-26. [DOI: 10.1111/ced.13227] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2017] [Indexed: 12/17/2022]
Affiliation(s)
- A. P. Moy
- Pathology Service; Dermatopathology Unit; Massachusetts General Hospital and Harvard Medical School; Boston MA USA
| | - M. Murali
- Department of Medicine; Massachusetts General Hospital and Harvard Medical School; Boston MA USA
| | - D. Kroshinsky
- Department of Dermatology; Massachusetts General Hospital and Harvard Medical School; Boston MA USA
| | - T. D. Horn
- Pathology Service; Dermatopathology Unit; Massachusetts General Hospital and Harvard Medical School; Boston MA USA
- Department of Dermatology; Massachusetts General Hospital and Harvard Medical School; Boston MA USA
| | - R. M. Nazarian
- Pathology Service; Dermatopathology Unit; Massachusetts General Hospital and Harvard Medical School; Boston MA USA
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Murdaca G, Negrini S, Magnani O, Penza E, Pellecchio M, Puppo F. Impact of pharmacogenomics upon the therapeutic response to etanercept in psoriasis and psoriatic arthritis. Expert Opin Drug Saf 2017; 16:1173-1179. [DOI: 10.1080/14740338.2017.1361404] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Giuseppe Murdaca
- Department of Internal Medicine, Scleroderma Unit, Clinical Immunology Unit, University of Genova and Hospital Polyclinic San Martino, Genova, Italy
| | - Simone Negrini
- Department of Internal Medicine, Scleroderma Unit, Clinical Immunology Unit, University of Genova and Hospital Polyclinic San Martino, Genova, Italy
| | - Ottavia Magnani
- Department of Internal Medicine, Scleroderma Unit, Clinical Immunology Unit, University of Genova and Hospital Polyclinic San Martino, Genova, Italy
| | - Elena Penza
- Department of Internal Medicine, Scleroderma Unit, Clinical Immunology Unit, University of Genova and Hospital Polyclinic San Martino, Genova, Italy
| | - Marco Pellecchio
- Department of Internal Medicine, Scleroderma Unit, Clinical Immunology Unit, University of Genova and Hospital Polyclinic San Martino, Genova, Italy
| | - Francesco Puppo
- Department of Internal Medicine, Scleroderma Unit, Clinical Immunology Unit, University of Genova and Hospital Polyclinic San Martino, Genova, Italy
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36
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Loft ND, Skov L, Iversen L, Gniadecki R, Dam TN, Brandslund I, Hoffmann HJ, Andersen MR, Dessau RB, Bergmann AC, Andersen NM, Andersen PS, Bank S, Vogel U, Andersen V. Associations between functional polymorphisms and response to biological treatment in Danish patients with psoriasis. THE PHARMACOGENOMICS JOURNAL 2017; 18:494-500. [DOI: 10.1038/tpj.2017.31] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 05/17/2017] [Accepted: 05/26/2017] [Indexed: 12/11/2022]
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37
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Ovejero-Benito MC, Prieto-Pérez R, Llamas-Velasco M, Belmonte C, Cabaleiro T, Román M, Ochoa D, Talegón M, Saiz-Rodríguez M, Daudén E, Abad-Santos F. Polymorphisms associated with etanercept response in moderate-to-severe plaque psoriasis. Pharmacogenomics 2017; 18:631-638. [PMID: 28470127 DOI: 10.2217/pgs-2017-0014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AIM Few studies have evaluated the influence of pharmacogenetics in psoriatic patients treated with etanercept. MATERIALS & METHODS We evaluated the association between 124 polymorphisms with the response to etanercept in patients with moderate-to-severe plaque psoriasis at 3 months (n = 78) and 6 months of treatment (n = 68). RESULTS The results of the multivariate analysis showed an association between polymorphisms rs13437088 (HLA-B/MICA), rs96844 (MAP3K1), rs2431697 (PTTG1), rs9304742 (ZNF816A) and the response to etanercept at 3 months. Besides polymorphisms rs928655 (GBP6) and rs2546890 (IL12B) were associated to response at 6 months. CONCLUSIONS Nevertheless, these biomarkers should be validated in large-scale studies before its implementation in clinical practice.
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Affiliation(s)
- María C Ovejero-Benito
- Clinical Pharmacology Department, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - Rocío Prieto-Pérez
- Clinical Pharmacology Department, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - Mar Llamas-Velasco
- Dermatology Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - Carmen Belmonte
- Clinical Pharmacology Department, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - Teresa Cabaleiro
- Clinical Pharmacology Department, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Ministerio de Economía, Industria y Competitividad, Madrid, Spain
| | - Manuel Román
- Clinical Pharmacology Department, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - Dolores Ochoa
- Clinical Pharmacology Department, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - María Talegón
- Clinical Pharmacology Department, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - Miriam Saiz-Rodríguez
- Clinical Pharmacology Department, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - Esteban Daudén
- Dermatology Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - Francisco Abad-Santos
- Clinical Pharmacology Department, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Ministerio de Economía, Industria y Competitividad, Madrid, Spain.,Spanish Clinical Research Network (SCReN) UICEC del Hospital de La Princesa; Servicio de Farmacología Clínica, Madrid, Spain
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38
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Aractingi S. Classifying skin diseases: Until where should we go? Exp Dermatol 2017; 26:681-682. [PMID: 27714915 DOI: 10.1111/exd.13230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2016] [Indexed: 11/27/2022]
Abstract
New molecular mapping techniques appear to allow clinicians to design treatments in some cases of resisting cancers. Such sensitive analysis were already able to depict molecular pathways of several inflammatory skin diseases. An accompanying article by Garzorz-Stark et al. show how these tools could improve the classification of skin inflammatory diseases now based on clinical and pathological features. At last, the final aim of these tools is to predict treatment response in a patient. The utility of "precision" or personalized medicine in cutaneous inflammatory diseases could join the furrow drawn in cancer.
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Affiliation(s)
- Sélim Aractingi
- Université Paris 5 Descartes, Department of Dermatology, Hôpital Cochin, ApHp and Inserm UMRS938, Paris, France
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van den Reek J, Coenen M, van de L'Isle Arias M, Zweegers J, Rodijk-Olthuis D, Schalkwijk J, Vermeulen S, Joosten I, van de Kerkhof P, Seyger M, Zeeuwen P, de Jong E. Polymorphisms inCD84,IL12BandTNFAIP3are associated with response to biologics in patients with psoriasis. Br J Dermatol 2017; 176:1288-1296. [DOI: 10.1111/bjd.15005] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2016] [Indexed: 12/11/2022]
Affiliation(s)
- J.M.P.A. van den Reek
- Department of Dermatology; Radboud University Medical Center; Radboud Institutes for Molecular Life Sciences (RIMLS) and Health Sciences (RIHS); Nijmegen the Netherlands
| | - M.J.H. Coenen
- Department of Human Genetics; Radboud University Medical Center; Radboud Institutes for Molecular Life Sciences (RIMLS) and Health Sciences (RIHS); Nijmegen the Netherlands
| | - M. van de L'Isle Arias
- Department of Dermatology; Radboud University Medical Center; Radboud Institutes for Molecular Life Sciences (RIMLS) and Health Sciences (RIHS); Nijmegen the Netherlands
| | - J. Zweegers
- Department of Dermatology; Radboud University Medical Center; Radboud Institutes for Molecular Life Sciences (RIMLS) and Health Sciences (RIHS); Nijmegen the Netherlands
| | - D. Rodijk-Olthuis
- Department of Dermatology; Radboud University Medical Center; Radboud Institutes for Molecular Life Sciences (RIMLS) and Health Sciences (RIHS); Nijmegen the Netherlands
| | - J. Schalkwijk
- Department of Dermatology; Radboud University Medical Center; Radboud Institutes for Molecular Life Sciences (RIMLS) and Health Sciences (RIHS); Nijmegen the Netherlands
| | - S.H. Vermeulen
- Department of Health Evidence; Radboud University Medical Center; Radboud Institutes for Molecular Life Sciences (RIMLS) and Health Sciences (RIHS); Nijmegen the Netherlands
| | - I. Joosten
- Department of Immunology; Radboud University Medical Center; Radboud Institutes for Molecular Life Sciences (RIMLS) and Health Sciences (RIHS); Nijmegen the Netherlands
| | - P.C.M. van de Kerkhof
- Department of Dermatology; Radboud University Medical Center; Radboud Institutes for Molecular Life Sciences (RIMLS) and Health Sciences (RIHS); Nijmegen the Netherlands
| | - M.M.B. Seyger
- Department of Dermatology; Radboud University Medical Center; Radboud Institutes for Molecular Life Sciences (RIMLS) and Health Sciences (RIHS); Nijmegen the Netherlands
| | - P.L.J.M. Zeeuwen
- Department of Dermatology; Radboud University Medical Center; Radboud Institutes for Molecular Life Sciences (RIMLS) and Health Sciences (RIHS); Nijmegen the Netherlands
| | - E.M.G.J. de Jong
- Department of Dermatology; Radboud University Medical Center; Radboud Institutes for Molecular Life Sciences (RIMLS) and Health Sciences (RIHS); Nijmegen the Netherlands
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40
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Talamonti M, D’Adamio S, Bianchi L, Galluzzo M. The Role of Pharmacogenetics in Chronic Plaque Psoriasis: Update of the Literature. Mol Diagn Ther 2017; 21:467-480. [DOI: 10.1007/s40291-017-0274-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Optimizing adalimumab treatment in psoriasis with concomitant methotrexate (OPTIMAP): study protocol for a pragmatic, single-blinded, investigator-initiated randomized controlled trial. Trials 2017; 18:52. [PMID: 28148280 PMCID: PMC5288945 DOI: 10.1186/s13063-017-1777-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 01/02/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The introduction of anti-tumor necrosis factor medications has revolutionized the treatment of psoriasis with achievement of treatment goals (Psoriasis Area and Severity Index score 75, remission) that are not usually met with conventional systemics. Nevertheless, some patients continue to experience persistent disease activity or treatment failure over time. Strategies to optimize treatment outcomes include the use of concomitant methotrexate, which has demonstrated beneficial effects on pharmacokinetics and treatment efficacy in psoriasis and other inflammatory diseases. METHODS This is an investigator-initiated, multicenter randomized controlled trial (RCT) designed to compare the combination treatment of adalimumab and methotrexate with adalimumab monotherapy in patients with psoriasis. The primary outcome is adalimumab drug survival at week 49. Other outcomes include improvement in disease severity and quality of life, tolerability, and safety. Moreover, anti-adalimumab antibodies and adalimumab serum concentrations will be measured and correlations between genotypes and clinical outcomes will be assessed. Patient recruitment started in March 2014. Up to now, 36 patients have been randomized. Many more patients have been (pre)screened. A total of 93 patients is desired to meet an adequate sample size. In our experience, the main limitation for recruitment is prior adalimumab therapy and intolerability or toxicity for methotrexate in the past. DISCUSSION OPTIMAP is the first RCT to examine combination therapy with adalimumab and methotrexate in a psoriasis population. With data derived from this study we expect to provide valuable clinical data on long-term treatment outcomes. These data will be supported by assessment of the impact of concomitant methotrexate on adalimumab pharmacokinetics. Furthermore, the influence of several single nucleotide polymorphisms on adalimumab response will be analyzed in order to support the development of a more personalized approach for this targeted therapy. TRIAL REGISTRATION NTR4499 . Registered on 7 April 2014.
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Prieto-Pérez R, Llamas-Velasco M, Cabaleiro T, Solano-López G, Márquez B, Román M, Ochoa D, Talegón M, Daudén E, Abad-Santos F. Pharmacogenetics of ustekinumab in patients with moderate-to-severe plaque psoriasis. Pharmacogenomics 2017; 18:157-164. [DOI: 10.2217/pgs-2016-0122] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim/Materials & methods: Few studies have evaluated the influence of pharmacogenetics in psoriatic patients treated with ustekinumab. We evaluated 121 polymorphisms to study a possible association between these SNPs and the response to ustekinumab (PASI75 at 4 months; n = 69). Results/Conclusion: The adjusted results (false discovery rate) showed an association between five SNPs in TNFRSF1A, HTR2A, NFKBIA, ADAM33 and IL13 genes, and poor response to ustekinumab. Furthermore, six SNPs in CHUK, C17orf51, ZNF816A, STAT4, SLC22A4 and Corf72 genes were associated with better response to ustekinumab. However, there was no significant association between response to ustekinumab and SNPs in HLA-C as it has been recently described. Finally, a higher weight was obtained in nonresponders than responders (p = 0.018). Further studies would be necessary to be closer to personalized medicine.
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Affiliation(s)
- Rocío Prieto-Pérez
- Clinical Pharmacology Service, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IP), Madrid, Spain
| | - Mar Llamas-Velasco
- Dermatology Service, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria la Princesa (IP), Madrid, Spain
| | - Teresa Cabaleiro
- Clinical Pharmacology Service, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IP), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Guillermo Solano-López
- Dermatology Service, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria la Princesa (IP), Madrid, Spain
| | - Beatriz Márquez
- Clinical Biochemistry Service, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Manuel Román
- Clinical Pharmacology Service, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IP), Madrid, Spain
| | - Dolores Ochoa
- Clinical Pharmacology Service, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IP), Madrid, Spain
| | - María Talegón
- Clinical Pharmacology Service, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IP), Madrid, Spain
| | - Esteban Daudén
- Dermatology Service, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria la Princesa (IP), Madrid, Spain
| | - Francisco Abad-Santos
- Clinical Pharmacology Service, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria la Princesa (IP), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
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Gibellini L, De Biasi S, Bianchini E, Bartolomeo R, Fabiano A, Manfredini M, Ferrari F, Albertini G, Trenti T, Nasi M, Pinti M, Iannone A, Salvarani C, Cossarizza A, Pellacani G. Anti-TNF-α Drugs Differently Affect the TNFα-sTNFR System and Monocyte Subsets in Patients with Psoriasis. PLoS One 2016; 11:e0167757. [PMID: 27936119 PMCID: PMC5147951 DOI: 10.1371/journal.pone.0167757] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/18/2016] [Indexed: 11/19/2022] Open
Abstract
TNF-α has a central role in the development and maintenance of psoriatic plaques, and its serum levels correlate with disease activity. Anti-TNF-α drugs are, however, ineffective in a relevant percentage of patients for reasons that are currently unknown. To understand whether the response to anti-TNF-α drugs is influenced by the production of anti-drug antibodies or by the modulation of the TNFα-TNFα receptor system, and to identify changes in monocyte phenotype and activity, we analysed 119 psoriatic patients who either responded or did not respond to different anti-TNF-α therapies (adalimumab, etanercept or infliximab), and measured plasma levels of TNF-α, TNF-α soluble receptors, drug and anti-drug antibodies. Moreover, we analyzed the production of TNF-α and TNF-α soluble receptors by peripheral blood mononuclear cells (PBMCs), and characterized different monocyte populations. We found that: i) the drug levels varied between responders and non-responders; ii) anti-infliximab antibodies were present in 15% of infliximab-treated patients, while anti-etanercept or anti-adalimumab antibodies were never detected; iii) plasma TNF-α levels were higher in patients treated with etanercept compared to patients treated with adalimumab or infliximab; iv) PBMCs from patients responding to adalimumab and etanercept produced more TNF-α and sTNFRII in vitro than patients responding to infliximab; v) PBMCs from patients not responding to infliximab produce higher levels of TNF-α and sTNFRII than patients responding to infliximab; vi) anti- TNF-α drugs significantly altered monocyte subsets. A complex remodelling of the TNFα-TNFα receptor system thus takes place in patients treated with anti-TNF-α drugs, that involves either the production of anti-drug antibodies or the modulation of monocyte phenotype or inflammatory activity.
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Affiliation(s)
- Lara Gibellini
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Sara De Biasi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Bianchini
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Regina Bartolomeo
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Antonella Fabiano
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Manfredini
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Federica Ferrari
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Giuseppe Albertini
- Dermatologic Unit, IRCCS - Santa Maria Nuova Hospital, Reggio Emilia, Italy
| | - Tommaso Trenti
- Department of Clinical Pathology - NOCSAE Baggiovara, Modena, Italy
| | - Milena Nasi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marcello Pinti
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Iannone
- Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlo Salvarani
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Reumatology Unit, IRCCS - Santa Maria Nuova Hospital, Reggio Emilia, Italy
| | - Andrea Cossarizza
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
- * E-mail:
| | - Giovanni Pellacani
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Coates LC, FitzGerald O, Helliwell PS, Paul C. Psoriasis, psoriatic arthritis, and rheumatoid arthritis: Is all inflammation the same? Semin Arthritis Rheum 2016. [DOI: 10.1016/j.semarthrit.2016.05.012%20online] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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45
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Coates LC, FitzGerald O, Helliwell PS, Paul C. Psoriasis, psoriatic arthritis, and rheumatoid arthritis: Is all inflammation the same? Semin Arthritis Rheum 2016. [DOI: 10.1016/j.semarthrit.2016.05.012 online] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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46
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Coates LC, FitzGerald O, Helliwell PS, Paul C. Psoriasis, psoriatic arthritis, and rheumatoid arthritis: Is all inflammation the same? Semin Arthritis Rheum 2016; 46:291-304. [PMID: 27388027 DOI: 10.1016/j.semarthrit.2016.05.012] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 05/23/2016] [Accepted: 05/27/2016] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To review the pathophysiology, co-morbidities, and therapeutic options for psoriasis, psoriatic arthritis and rheumatoid arthritis in order to further understand the similarities and differences in treatment paradigms in the management of each disease. New targets for individualized therapeutic decisions are also identified with the aim of improving therapeutic outcome and reducing toxicity. SEARCH STRATEGY Using the PubMed database, we searched literature published from 2000 to 2015 using combinations of the key words "psoriasis," "psoriatic arthritis," "rheumatoid arthritis," "pathogenesis," "immunomodulation," and "treatment." INCLUSION AND EXCLUSION CRITERIA This was a non-systematic review and there were no formal inclusion and exclusion criteria. DATA EXTRACTION Abstracts identified in the search were screened for relevance and articles considered appropriate evaluated further. References within these selected articles were also screened. Information was extracted from 198 articles for inclusion in this report. DATA SYNTHESIS There was no formal data synthesis. Articles were reviewed and summarized according to disease area (psoriasis, psoriatic arthritis, and rheumatoid arthritis). HEADLINE RESULTS The pathophysiology of psoriasis, psoriatic arthritis, and rheumatoid arthritis involves chronic inflammation mediated by pro-inflammatory cytokines. Dysfunction in integrated signaling pathways affecting different constituents of the immune system result in varying clinical features in the three diseases. Co-morbidities, including cardiovascular disease, malignancies, and non-alcoholic fatty liver disease are increased. Increased understanding of the immunopathogenesis allowed development of targeted treatments; however, despite a variety of potentially predictive genetic, protein and cellular biomarkers, there is still significant unmet need in these three inflammatory disorders.
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Affiliation(s)
- Laura C Coates
- Faculty of Medicine and Health, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Harehills Lane, Leeds LS7 4SA, UK
| | - Oliver FitzGerald
- Department of Rheumatology, St Vincent's University Hospital and Conway Institute, University College, Dublin, Ireland
| | - Philip S Helliwell
- Faculty of Medicine and Health, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Harehills Lane, Leeds LS7 4SA, UK.
| | - Carle Paul
- Larrey Hospital, Paul Sabatier University, Toulouse, France
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Gene polymorphisms as predictors of response to biological therapies in psoriasis patients. Pharmacol Res 2016; 113:71-80. [DOI: 10.1016/j.phrs.2016.07.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 07/14/2016] [Accepted: 07/16/2016] [Indexed: 12/12/2022]
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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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HLA-Cw6 allele, NFkB1 and NFkBIA polymorphisms play no role in predicting response to etanercept in psoriatic patients. Pharmacogenet Genomics 2016; 26:423-7. [DOI: 10.1097/fpc.0000000000000233] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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50
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TNF-α Promoter Polymorphisms Predict the Response to Etanercept More Powerfully than that to Infliximab/Adalimumab in Spondyloarthritis. Sci Rep 2016; 6:32202. [PMID: 27578555 PMCID: PMC5006048 DOI: 10.1038/srep32202] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/03/2016] [Indexed: 12/18/2022] Open
Abstract
While previous studies have researched in association analyses between TNFα promoter polymorphisms and responses to TNF blockers in spondyloarthritis patients, their results were conflicting. Therefore, we aimed to determine whether TNFα promoter polymorphisms could predict response to TNF blockers and find the source of heterogeneity. Data were extracted and analyzed from published articles and combined with our unpublished data. We found that the greatest potential sources of heterogeneity in the results were gender ratio, disease type, continents, and TNF blockers. Then Stratification analysis showed that the TNFα -308 G allele and the -238 G allele predicted a good response to TNF blockers (OR = 2.64 [1.48-4.73]; 2.52 [1.46-4.37]). However, G alleles of TNFα -308 and -238 could predict the response to etanercept (OR = 4.02 [2.24-7.23]; 5.17 [2.29-11.67]) much more powerfully than the response to infiliximab/adalimumab (OR = 1.68 [1.02-2.78]; 1.28 [0.57-2.86]). TNFα -857 could not predict the response in either subgroup. Cumulative meta-analysis performed in ankylosing spondylitis patients presented the odds ratio decreased with stricter response criteria. In conclusion, TNFα -308 A/G and -238 A/G are more powerful to predict the response to Etanercept and it is dependent on the criteria of response.
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