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. 2024 Jul 19;46(7):7719-7729.
doi: 10.3390/cimb46070457.

Inflammatory Cytokines and Clinical Outcome Following Biological Therapy in Adult Bio-Naïve Psoriasis Patients

Teodora-Larisa Florian  1 , Ioan-Alexandru Florian  2 , Stefan Cristian Vesa  3 , Lehel Beni  2 , Meda Orăsan  4
Affiliations

Inflammatory Cytokines and Clinical Outcome Following Biological Therapy in Adult Bio-Naïve Psoriasis Patients

Teodora-Larisa Florian et al. Curr Issues Mol Biol. .

Abstract

Inflammatory cytokines may hold the key to the clinical evolution of psoriasis. The aims of this study are to find a correlation between levels of inflammatory cytokines such as TNF-α, IL-23, IL-17A, and IL-17F and disease duration and severity scores in psoriasis; to test if the decrease in any of the aforementioned cytokines is correlated with an amelioration in disease severity scores; and to analyze if any of the four biologic agents used are linked with a greater decrease in overall cytokine levels. We enrolled 23 adult patients under treatment with ixekizumab, secukinumab, guselkumab, or adalimumab and measured psoriasis disease severity scores PASI (Psoriasis Area Severity Index) and DLQI (Dermatology Life Quality Index), as well as the levels of the aforementioned cytokines at the start of therapy and after 3 months of continuous treatment. Inclusion criteria were the presence of psoriasis, age above 18 years and the need to initiate biological therapy (lack of response to standard treatment). Biological therapies resulted in an amelioration of PASI and DLQI scores, as well as levels of TNF-α, IL-23 and IL-17F. Disease duration and PASI and DLQI scores did not correlate with cytokine levels except DLQI and IL-23 score, in a paradoxically inversely proportional manner. IL-23, in particular, could be a useful biomarker for checking treatment response in psoriasis.

Keywords: IL-23; biological therapy; inflammatory cytokines; psoriasis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Box plot graphs for the following: (A) red blood cell sedimentation rate (ESR) at the onset of biological therapy (blue) and at 3 months of treatment (orange); (B) C-reactive protein (CRP) at the start of biological therapy (blue) and 3 months of treatment (orange), respectively. According to the Wilcoxon signed rank test, the differences between each of the 2 measurements were statistically significant (p < 0.000). Ordinate: (A) the value of ESR in mm/h; (B) CRP value in mg/dL. Dots represent outliers.
Figure 2
Figure 2
Box plot graphs for (A) serum level of tumor necrosis factor alpha (TNF-α) at the start of biological therapy (blue), respectively, and at 3 months of treatment (orange), respectively. According to the Wilcoxon signed rank test, the differences between the 2 measurements showed a trend towards significance (p = 0.068 < 0.1). Ordinate: TNF-α level in pg/dL; (B) serum level of interleukin 23 (IL-23) at the start of biological therapy (blue), respectively, at 3 months of treatment (orange). According to the Wilcoxon signed rank test, the differences between the 2 measurements were statistically significant (p < 0.000). Ordinate: level IL-23 in pg/dL; (C) serum level of interleukin 17A (IL-17A) at the start of biological therapy (blue), respectively, at 3 months of treatment (orange). According to the Wilcoxon signed rank test, the differences between the 2 measurements were insignificant (p = 0.417). Ordinate: level IL-17A in pg/dL; (D) serum level of interleukin 17F (IL-17F) at the start of biological therapy (blue), respectively, at 3 months of treatment (orange). According to the Wilcoxon signed rank test, the differences between the 2 measurements showed a trend towards significance (p = 0.098 < 0.1). Ordinate: IL-17F level in pg/dL. Dots represent outliers.
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