Krembil Research Institute, UHN, 5-KD405, Krembil Discovery Tower, 60 Leonard Ave, Toronto, M5T 2S8, Canada.
Faculty of Medicine, Craig L Dobbin Genetics Research Centre, Memorial University, Suite 3M500, 300 Prince Philip Drive, St. John's, NL, A1B3V6, Canada.
Sci Rep. 2020 Dec 10;10(1):21703. doi: 10.1038/s41598-020-78866-2.
Biological therapies have dramatically improved the therapeutic landscape of psoriatic arthritis (PsA); however, 40-50% of patients are primary non-responders with response rates declining significantly with each successive biological therapy. Therefore, there is a pressing need to develop a coherent strategy for effective initial and subsequent selection of biologic agents. We interrogated 40 PsA patients initiating either tumour necrosis factor inhibitors (TNFi) or interleukin-17A inhibitors (17Ai) for active PsA. Patients achieving low disease activity according to the Disease Activity Index for PsA (DAPSA) at 3 months were classified as responders. Baseline and 3-month CD4 transcript profiling were performed, and novel signaling pathways were identified using a multi-omics profiling and integrative computational analysis approach. Using transcriptomic data at initiation of therapy, we identified over 100 differentially expressed genes (DEGs) that differentiated IL-17Ai response from non-response and TNFi response from non-response. Integration of cell-type-specific DEGs with protein-protein interactions and further comprehensive pathway enrichment analysis revealed several pathways. Rho GTPase signaling pathway exhibited a strong signal specific to IL-17Ai response and the genes, RAC1 and ROCKs, are supported by results from prior research. Our detailed network and pathway analyses have identified the rewiring of Rho GTPase pathways as potential markers of response to IL17Ai but not TNFi. These results need further verification.
生物疗法极大地改善了银屑病关节炎(PsA)的治疗前景;然而,仍有 40-50%的患者为原发性无应答者,且每种生物疗法的应答率都显著下降。因此,迫切需要制定一个连贯的策略,以有效选择初始和后续的生物制剂。我们对 40 名患有活动性银屑病关节炎的患者进行了研究,这些患者开始使用肿瘤坏死因子抑制剂(TNFi)或白细胞介素-17A 抑制剂(17Ai)治疗。根据银屑病关节炎疾病活动指数(DAPSA),在 3 个月时达到低疾病活动的患者被归类为应答者。对患者进行了基线和 3 个月的 CD4 转录谱分析,并使用多组学分析和综合计算分析方法鉴定了新的信号通路。通过对治疗开始时的转录组数据进行分析,我们发现了 100 多个差异表达基因(DEGs),这些基因可以区分白细胞介素-17Ai 的应答与非应答,以及 TNFi 的应答与非应答。将细胞类型特异性 DEGs 与蛋白质-蛋白质相互作用整合,并进一步进行全面的通路富集分析,揭示了几个通路。Rho GTPase 信号通路表现出强烈的 IL-17Ai 应答特异性,基因 RAC1 和 ROCKs 也得到了先前研究结果的支持。我们详细的网络和通路分析表明,Rho GTPase 通路的重排可能是对白细胞介素-17Ai 而非 TNFi 应答的潜在标志物。这些结果需要进一步验证。