MALT1 reflects inflammatory cytokines, disease activity, and its chronological change could estimate treatment response to infliximab in Crohn's disease patients

Abstract

Background Mucosa‐associated lymphoid tissue lymphoma translocation protein 1 (MALT1) mediates the immunity and inflammatory response in multiple ways to be intimately involved in the progression of autoimmune diseases. This study intended to explore the linkage of MALT1 with inflammation, disease activity, and its change with infliximab treatment response in Crohn's disease (CD) patients. Methods MALT1 in peripheral blood mononuclear cell samples from 72 active CD patients (at baseline, 2 weeks [W2], W6, and W12 after infliximab treatment), 20 remissive CD patients (after enrollment), and 20 healthy controls (after enrollment) were detected by RT‐qPCR. Results MALT1 was highest in active CD patients, followed by remissive CD patients, and lowest in healthy controls (p < 0.001). MALT1 was positively linked with C‐reactive protein (p = 0.001), erythrocyte sedimentation rate (p = 0.014), clinical disease activity index (p = 0.003), tumor necrosis factor (TNF)‐α (p = 0.006), interleukin (IL)‐1β (p = 0.049), and IL‐17A (p = 0.004), but not other clinical characteristics (all p > 0.05) in active CD patients. After infliximab treatment, MALT1 was decreased from baseline to W12 in active CD patients (p < 0.001), especially in responders (p < 0.001), but not in nonresponders (p = 0.053). The reduction of MALT1 at W6 (p = 0.049) and W12 (p = 0.004) was associated with a good treatment response to infliximab in active CD patients. Moreover, the response rate or MALT1 at any time point was not different between active CD patients with and without TNFi history (all p > 0.05). Conclusion MALT1 reflects aggravated inflammation and disease activity. Meanwhile, the decrement of MALT1 from baseline to W12 could reflect infliximab treatment response in CD patients.

Blood MALT1 expression could help predict treatment outcomes in psoriasis patients, especially in those receiving biologics

“…21 Recently, several clinical studies have displayed an increase in MALT1 in autoimmune disease patients. 17,22,23 However, rare studies report the dysregulation of MALT1 in psoriasis patients. In accordance with these previous studies, 17,22,23 the present study also figured out that blood MALT1 was increased in psoriasis patients compared with disease controls and healthy controls.…”

“…17,22,23 However, rare studies report the dysregulation of MALT1 in psoriasis patients. In accordance with these previous studies, 17,22,23 the present study also figured out that blood MALT1 was increased in psoriasis patients compared with disease controls and healthy controls. The potential reasons could be that (1) MALT1 might regulate the c-Jun pathway to facilitate the hyperproliferation of keratinocytes and the production of chemokines to induce psoriasis.…”

“…The relationship of MALT1 with clinical features in several autoimmune diseases has been revealed by previous studies. 17,18,20 According to a study, MALT1 is positively related to C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and clinical disease activity index (CDAI) in CD patients. 17 In addition, another study discovers that MALT1 reflects increased disease activity of RA with a positive correlation with CRP, ESR, and Disease Activity Score-28 (DAS28) in RA patients.…”

“…17,18,20 According to a study, MALT1 is positively related to C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and clinical disease activity index (CDAI) in CD patients. 17 In addition, another study discovers that MALT1 reflects increased disease activity of RA with a positive correlation with CRP, ESR, and Disease Activity Score-28 (DAS28) in RA patients. 18 In this study, it was found that blood MALT1 was positively correlated with BMI and PASI score in psoriasis patients.…”

“…Moreover, MALT1 regulates the caspase recruitment domain protein (CARD)4‐induced production of cytokines and chemokines in keratinocytes, which further causes psoriasis 16 . Clinically, several studies have reported the role of MALT1 in reflecting treatment response to conventional synthetic disease‐modifying antirheumatic drugs and tumor necrosis factor (TNF) inhibitors in several autoimmune disease patients, including Crohn's disease (CD), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) 17–20 . However, relevant evidence regarding psoriasis patients is scarce.…”