Immunologic Biomarkers for Clinical and Therapeutic Management of Psoriasis

Abstract

Background. The therapeutic management of psoriasis includes conventional treatments as well as the new generation of highly effective TNF-α inhibitors. However, psoriasis has proven to be a complex therapeutic challenge and treatment failures are not uncommon. Thus, laboratory biomarkers of disease progression/therapeutic efficacy may greatly help in the clinical management of psoriasis. Aims. To identify laboratory biomarkers for clinical management and therapeutic monitoring of psoriasis. Methods. An observational study performed on 59 patients, presenting moderate to severe psoriasis, undergoing treatment with anti-TNF-α agents (etanercept, adalimumab, and infliximab). Soluble and cellular immune/inflammatory parameters were assessed at baseline and after 12 and 24 weeks of treatment. Results. Clinical efficacy was achieved in 88% of the subjects at 12 weeks, reaching 90% after 24 weeks. IL-6 and IL-22, which were elevated at baseline, were significantly reduced, in association with a significant decrease of CLA+ T cells and an increase of Treg lymphocytes. T, B, and NK cell subsets and T cell response to recall antigens did not show any evidence of immune suppression. Conclusions. Immune/inflammatory parameters including IL-6 and IL-22, CLA+ T cells, and Treg lymphocytes may prove to be valuable laboratory tools for the clinical and therapeutic monitoring of psoriasis.

The Effects of a Self-Care Program on Promoting Self-Care Behaviors in Patients with Psoriasis

“…Considering a 10% loss to followup, 99% confidence interval, and 95% statistical power for the self-score difference before and after training, the following equation was used: (1) …”

“…Psoriasis is a chronic genetic inflammatory hypoproliferative disease with flaked layers (1)(2)(3)(4). The exact cause of this disease is not fully understood yet (5).…”

“…The exact cause of this disease is not fully understood yet (5). It is equally prevalent in men and women (1), affecting 1% -3% of the population worldwide (6), 3% of the American population (2), and 9% of the Iranians population (7). Moderate to severe psoriasis is associated with diseases, such as cardiovascular diseases, metabolic syndrome (1), anger, anxiety, frustration (5), increased risk of mortality (8), diabetes, hypertension, dyslipidemia (9), obesity (3), and reduced quality of life (10).…”

Effect of Sitagliptin on glycemic profiles and their correlation with PASI score in patients with plaque psoriasis

“…Improvement in hyperglycemia may be attributed to a reduction in TNF-α level by sitagliptin treatment (since TNF-α may interfere with insulin signaling and responsiveness in many cells such a s hepatic cells, fatty cells or skeletal muscles [23,24]. A decrease in IL-6 and TNF-α concentration by sitagliptin treatment may lead to upregulation of adiponectin which is regarded as important sensitizer for insulin secretion and cardio protective factors for atherogenesis and inflammatory process [25,26].…”

Clinical Efficacy and Safety of Anti-IL-17 Agents for the Treatment of Patients with Psoriasis

“…Scientists have achieved great improvement in biotherapy treatment for psoriasis, which is based on the new awareness of pathogenesis of psoriasis. There are different kinds of biotherapy for psoriasis, including monoclonal antibodies, recombinant human cytokines and fusion proteins [7][8][9].…”