Cordiali-Fei P, Bianchi L, Bonifati C, Trento E, Ruzzetti M, Francesconi F, Bultrini S, D'Agosto G, Bordignon V, Francavilla V, Tripiciano A, Chiricozzi A, Campione E, Cavallotti C, Orlandi A, Berardesca E, Di Carlo A, Chimenti S, Ensoli F
Clinical Pathology & Microbiology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
Dermatology, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy.
Mediators Inflamm. 2014;2014:236060. doi: 10.1155/2014/236060. Epub 2014 Jul 20.
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.
To identify laboratory biomarkers for clinical management and therapeutic monitoring of psoriasis.
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.
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.
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.
银屑病的治疗管理包括传统治疗以及新一代高效的肿瘤坏死因子-α（TNF-α）抑制剂。然而，银屑病已被证明是一个复杂的治疗挑战，治疗失败并不罕见。因此，疾病进展/治疗效果的实验室生物标志物可能对银屑病的临床管理有很大帮助。
确定用于银屑病临床管理和治疗监测的实验室生物标志物。
对59例中度至重度银屑病患者进行了一项观察性研究，这些患者正在接受抗TNF-α药物（依那西普、阿达木单抗和英夫利昔单抗）治疗。在基线以及治疗12周和24周后评估可溶性和细胞免疫/炎症参数。
12周时88%的受试者取得了临床疗效，24周后达到90%。基线时升高的白细胞介素-6（IL-6）和白细胞介素-22（IL-22）显著降低，同时皮肤淋巴细胞相关抗原（CLA）+T细胞显著减少，调节性T（Treg）淋巴细胞增加。T、B和自然杀伤（NK）细胞亚群以及T细胞对回忆抗原的反应未显示任何免疫抑制迹象。
包括IL-6、IL-22、CLA+T细胞和Treg淋巴细胞在内的免疫/炎症参数可能被证明是用于银屑病临床和治疗监测的有价值的实验室工具。
