Adalimumab and methotrexate affect the concentrations of regulatory cytokines (interleukin-10, transforming growth factor-β1, and interleukin-35) in patients with plaque psoriasis

Effects of Biologic Therapy on Laboratory Indicators of Cardiometabolic Diseases in Patients with Psoriasis

Psoriasis is associated with cardiometabolic and cardiovascular diseases. Biologic therapy targeting tumor necrosis factor (TNF)-α, interleukin (IL)-23, and IL-17 may improve not only psoriasis but also cardiometabolic diseases. We retrospectively evaluated whether biologic therapy improved various indicators of cardiometabolic disease. Between January 2010 and September 2022, 165 patients with psoriasis were treated with biologics targeting TNF-α, IL-17, or IL-23. The patients' body mass index; serum levels of HbA1c, total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol, triglyceride (TG), and uric acid (UA); and systolic and diastolic blood pressures were recorded at weeks 0, 12, and 52 of the treatment. Baseline psoriasis area and severity index (week 0) positively correlated with TG and UA levels but negatively correlated with HDL-C levels, which increased at week 12 of IFX treatment compared to those at week 0. UA levels decreased at week 12 after ADA treatment compared with week 0. HDL-C levels decreased 52 weeks after IXE treatment. In patients treated with TNF-α inhibitors, HDL-C levels increased at week 12, and UA levels decreased at week 52, compared to week 0. Thus, the results at two different time points (at weeks 12 and 52) were inconsistent. However, the results still indicated that TNF-α inhibitors may improve hyperuricemia and dyslipidemia.

Methotrexate and cardiovascular prevention: an appraisal of the current evidence

New evidence continues to accumulate regarding a significant association between excessive inflammation and dysregulated immunity (local and systemic) and the risk of cardiovascular events in different patient cohorts. Whilst research has sought to identify novel atheroprotective therapies targeting inflammation and immunity, several marketed drugs for rheumatological conditions may serve a similar purpose. One such drug, methotrexate, has been used since 1948 for treating cancer and, more recently, for a wide range of dysimmune conditions. Over the last 30 years, epidemiological and experimental studies have shown that methotrexate is independently associated with a reduced risk of cardiovascular disease, particularly in rheumatological patients, and exerts several beneficial effects on vascular homeostasis and blood pressure control. This review article discusses the current challenges with managing cardiovascular risk and the new frontiers offered by drug discovery and drug repurposing targeting inflammation and immunity with a focus on methotrexate. Specifically, the article critically appraises the results of observational, cross-sectional and intervention studies investigating the effects of methotrexate on overall cardiovascular risk and individual risk factors. It also discusses the putative molecular mechanisms underpinning the atheroprotective effects of methotrexate and the practical advantages of using methotrexate in cardiovascular prevention, and highlights future research directions in this area.

Pro-inflammatory versus anti-inflammatory cytokines in psoriatic patients (case-control study)

BACKGROUND

Psoriasis (PsO) is a systemic autoimmune disease. Many pro-inflammatory and anti-inflammatory biomarkers have been associated with the pathogenetic process of psoriasis. IL-35 act as an anti-inflammatory cytokine through downregulation of TH-17 cell development and cytokine production. So, IL-35 might be utilized as potential future therapeutic agent for psoriasis.

AIMS

To investigate the association between inflammatory (IL-17, TNF-α, IFN-γ) and anti-inflammatory cytokines (IL-35, TGF-β) in psoriasis patients.

PATIENTS AND METHODS

A case-control study enrolled two groups: (Group I: 40 patients with psoriasis) and (Group II: 40 healthy age and sex-matched subjects). Full history was taken from all cases along with full dermatologic examination. The assessment of psoriasis severity was conducted by using PASI score. Assessment of inflammatory (IL-17, TNF-α, IFN-γ) and anti-inflammatory cytokines (IL-35, TGF-β) was performed by using ELISA technique.

RESULTS

There was a statistically significant increase of mean level of TNF-α, IL-17, and IFN-γ among psoriasis cases in comparison with controls. The mean level of TGF-β and IL-35 was statistically significantly reduced among the psoriasis cases in comparison with controls. TNF-α, IL-17, and IFN-γ showed a significant strong positive association in between and statistically significant strong negative relationship with IL-35 and TGF-β.

CONCLUSION

IL-35 has a significant role in the pathogenetic process of PsO, and it serves as a potential future therapeutic agent for psoriasis. The current results could be used as a clue for the utilization of inflammatory (IL-17, TNF-α, IFN-γ) versus anti-inflammatory cytokines (IL-35, TGF-β) in psoriasis patients as a diagnostic biomarker for severity of cases with psoriasis.

Interleukin-35 in autoimmune dermatoses: Current concepts

Interleukin-35 (IL-35) is a lately observed cytokine and is part of the IL-12 cytokine family. IL-35 includes two subunits, p35 and Epstein-Barr virus-induced gene 3, and activates subsequent signaling pathways by binding to receptors to mediate signal transduction, thereby modulating the immunoregulatory functions of T cells, B cells, macrophages, and other immune cell types. Although there is currently limited research on the roles of IL-35 in human autoimmunity, many studies have demonstrated that IL-35 may mediate immunosuppression. Therefore, it plays an essential role in some autoimmune dermatoses, including systemic lupus erythematosus, psoriasis, systemic sclerosis, and dermatomyositis. We will introduce the structure and biological characteristics of IL-35 and summarize its effects on the occurrence and development of autoimmune dermatoses in this article. It is suggested that IL-35 is a possible target for therapy in the aforementioned diseases.

Cytokine alterations in psoriasis: an updated review

INTRODUCTION

Psoriasis is a chronic immune-mediated disease affecting 125 million people globally. It is characterized by erythematous plaques in the skin, covered by silvery scales. However, non-cutaneous manifestations (e.g., joint symptoms in psoriatic arthritis) and a high prevalence of other immune-mediated diseases such as inflammatory bowel diseases reflect its systemic nature. So far, research on psoriasis pathogenesis has improved our knowledge of the roles of the immune system, and cytokines play significant roles in immune responses.

AREAS COVERED

Herein, we review cytokine changes in psoriasis patients. Moreover, we will investigate the possible relationships between disease severity and cytokines alongside describing cytokine alterations in psoriasis patients with other comorbidities. Lastly, we will discuss the biologics and their effects on cytokines in psoriasis patients.

EXPERT OPINION

Psoriasis could develop various clinical types and clinical manifestations in people. It is an immune-mediated disease, and these manifestations are associated with different impaired cytokines. Imbalanced cytokines could lead to abnormal keratinocytes, neovascularization, and inflammation in psoriasis patients. So, a better understanding of the cytokine roles can help one choose a specific cytokine-targeting biologic to treat psoriasis. Moreover, these cytokines may be used as a severity marker for following up with these patients.

Assessing the expression of immunosuppressive cytokines in the newly diagnosed systemic lupus Erythematosus patients: a focus on B cells

BACKGROUND

The immunosuppressive effects of regulatory B-cells (Bregs) and their immunosuppressive cytokines on immune responses in autoimmune disorders, mainly systemic lupus erythematosus (SLE), have been recently established. Therefore, the purpose of this article has been the exploration of the expressions of cytokines produced by B cells in newly diagnosed SLE patients.

RESULTS

The findings demonstrated that the gene expression of IL-10, TGF-β, IL-35, PD-L1, and FasL was significantly up-regulated in SLE patients compared to healthy subjects (P < 0.05). Additionally, the results revealed that serum levels of IL-10, TGF-β, IL-35, PD-L1 were remarkably increased in patients with SLE compared to healthy subjects (P < 0.0001). However, serum levels of IL-10 and TGF-β decreased significantly with increasing SLEDAI score in studied patients (P < 0.05).

CONCLUSION

It was concluded that the release of anti-inflammatory cytokines, particularly IL-10 and TGF-β, might inhibit immune responses and autoreactive immune cells in a compensatory manner in SLE patients with mild to moderate disease activity.