Effects of Cyclosporine on Palmoplantar Pustulosis and Serum Expression of IL-17, IL-23, and TNF-α

Abstract

Introduction This study aimed to investigate the effects of cyclosporine on palmoplantar pustulosis (PPP) and serum expression of IL-17, IL-23, and TNF-α. Methods Patients with PPP ( n = 48) were recruited and treated with cyclosporine alone. The Palmoplantar Pustulosis Area and Severity Index score was obtained, and ELISA was employed to detect the serum IL-17, IL-23, and TNF-α expression before treatment and after 8 weeks of treatment. Results Complete remission was achieved in 16.7% of the patients, remission in 45.8%, an improvement in 31.3%, and the treatment was ineffective in 6.25%, yielding an overall effectiveness of 62.5%. Adverse effects included hypertension ( n = 6), frequent urination and enuresis nocturna ( n = 6), gastrointestinal discomfort ( n = 6), hypertrichosis ( n = 3), and increased creatinine ( n = 1). While serum IL-17, IL-23, and TNF-α concentrations were reduced after 8 weeks of treatment, the reductions were greatest for IL-23 and TNF-α, whereas the reduction in IL-17 was not significant. Conclusion Cyclosporine is a safe and effective treatment for PPP with few adverse effects, which might be related to the regulation of IL-23 and TNF-α.

Palmoplantar Pustulosis: A Systematic Review of Risk Factors and Therapies

“… 58 , 59 Two other clinical trials showed clinical improvement and PPPASI 60 in 45.8% of patients after 15 days to 6 months of treatment with ciclosporin at 3 mg/kg. 60 , 61 Colchicine led to no significant improvement of PPP in 2 RCTs over 6 weeks and 3 months 62 , 63 Dimethylfumarate combined with PUVA resulted in PPPASI 90 in 81.8% of patients at week 38 in one clinical trial, and there was no significant difference from treatment using acitretin + PUVA. 55 ( Table 3 ).…”

Evaluation of expression pattern of selected genes associated with IL12/23 signaling paths in psoriatic patients during cyclosporine A therapy

“…In turn, Jin et al indicates that CsA does not have a significant effect on IL‐17 levels, while the decrease in TNF‐α and IL23 levels was statistically significant after 56 days of treatment (Jin, Chen, Mou, & Xia, ). It can therefore be concluded that cyclosporin A drug therapy affects IL12/23‐induced signaling pathways.…”