Talamonti Marina, Galluzzo Marco, Zangrilli Arianna, Papoutsaki Marina, Egan Colin Gerard, Bavetta Mauro, Tambone Sara, Fargnoli Maria Concetta, Bianchi Luca
Department of Dermatology, University of Rome Tor Vergata, Rome, Italy.
Third Department of Dermatology, A. Syggros Hospital, Athens, Greece.
Mol Diagn Ther. 2017 Jun;21(3):295-301. doi: 10.1007/s40291-017-0261-4.
The genetic basis of predisposition to psoriasis is recognised; however, the response to psoriasis treatment in patients with different genetic predisposition is poorly understood.
To analyse the presence of the HLA-C*06:02 polymorphism in psoriatic patients treated with adalimumab.
Genomic DNA was extracted from whole blood of 122 patients with moderate-to-severe psoriasis treated with adalimumab for 3 years. Genotyping was performed using PCR. Disease severity was assessed by the Psoriasis Area and Severity Index (PASI) at day 0 and after 1, 3, 6, 12, 24 and 36 months. Logistic regression was used to evaluate the association between dependent variables (including HLA-C*06:02 status) and achievement of PASI 50, 75 and 90.
No difference was observed after adalimumab treatment between C06:02 positive (HLA-C06:02-POS) patients (n = 46) and C06:02 negative (HLA-C06:02-NEG) patients (n = 76) over the 3-year follow-up period in terms of PASI response or time-course when PASI response was achieved. However, a small, but non-statistically significant difference was noted between genotypes for PASI 50 at 1 month (HLA-C06:02-NEG: 44.7% vs. HLA-C06:02-POS: 56.5%) and at 3 months (HLA-C06:02-NEG: 71.1% vs. HLA-C06:02-POS: 80.4%). Simple logistic regression analysis did not reveal an association between independent variables (including C*06:02 status) and PASI response; however, multivariate regression revealed that gender (females better than males) was associated with achievement of PASI 50 at month 1 (OR 0.34, 95% CI 0.16-0.72, p = 0.005) and of PASI 75 at 3 months (OR 0.36, 95% CI 0.16-0.8, p = 0.012).
Adalimumab reduced long-term severity in patients with moderate-severe psoriasis, independent of their HLA-C*06:02 status.
银屑病易感性的遗传基础已得到认可；然而，对于具有不同遗传易感性的患者对银屑病治疗的反应了解甚少。
分析接受阿达木单抗治疗的银屑病患者中HLA-C*06:02多态性的存在情况。
从122例接受阿达木单抗治疗3年的中重度银屑病患者的全血中提取基因组DNA。采用聚合酶链反应（PCR）进行基因分型。在第0天以及1、3、6、12、24和36个月时，通过银屑病面积和严重程度指数（PASI）评估疾病严重程度。采用逻辑回归评估因变量（包括HLA-C*06:02状态）与达到PASI 50、75和90之间的关联。
在3年的随访期内，阿达木单抗治疗后，C06:02阳性（HLA-C06:02-POS）患者（n = 46）和C06:02阴性（HLA-C06:02-NEG）患者（n = 76）在PASI反应或达到PASI反应的时间进程方面没有差异。然而，在第1个月（HLA-C06:02-NEG：44.7% 对 HLA-C06:02-POS：56.5%）和第3个月（HLA-C06:02-NEG：71.1% 对 HLA-C06:02-POS：80.4%）时，PASI 50的基因型之间存在微小但无统计学意义的差异。简单逻辑回归分析未显示自变量（包括C*06:02状态）与PASI反应之间存在关联；然而，多变量回归显示，性别（女性优于男性）与第1个月达到PASI 50（比值比0.34，95%置信区间0.16 - 0.72，p = 0.005）和第3个月达到PASI 75（比值比0.36，95%置信区间0.16 - 0.8，p = 0.012）相关。
阿达木单抗可降低中重度银屑病患者的长期严重程度，与他们的HLA-C*06:02状态无关。
