Department of Dermatology, Xiangya Hospital, Central South University, 410008 Changsha, Hunan, China.
Department of Pharmacy, Xiangya Hospital, Central South University, 410008 Changsha, Hunan, China.
Front Biosci (Landmark Ed). 2022 Sep 28;27(9):266. doi: 10.31083/j.fbl2709266.
Psoriasis vulgaris is an immune-mediated inflammatory skin disease. Although the pathogenesis of psoriasis is unclear, genetic susceptibility, such as , is believed to be a major risk factor. However, there is a paucity of knowledge regarding the relationship between genetics and the response to systemic treatment of psoriasis. We hypothesized that genetic variations in human leukocyte antigen () genes may act as predictors of acitretin treatment in psoriasis. The aim of our study was to explore the presence of gene variants in patients with moderate-to-severe psoriasis receiving acitretin treatment.
A total of 100 Han Chinese patients with psoriasis completed the study. 24 patients including 16 responders and 8 non-responders underwent deep sequencing by MHC targeted region capture and 76 samples were genotyped by Sanger sequencing (SBT) based typing for validation.
Regressions with adjustment for age, sex, body mass index (BMI), and baseline psoriasis area and severity index (PASI) revealed that two alleles (, ) were associated with the response to acitretin. The -positive patients showed a better response to acitretin compared to the -negative patients (relative risk (RR) = 10.34, 95% confidence interval (CI): 2.62-40.77, = 0.001), and the -positive patients manifested a better response to acitretin when compared to the -negative patients (RR = 21.01, 95% CI: 2.53-174.27, = 0.005).
Our observations support the potential role of and as pharmacogenetic markers of the acitretin response in patients with psoriasis.
寻常型银屑病是一种免疫介导的炎症性皮肤病。虽然银屑病的发病机制尚不清楚，但遗传易感性，如 ，被认为是主要的危险因素。然而，关于遗传与银屑病系统治疗反应之间的关系知之甚少。我们假设人类白细胞抗原（HLA）基因中的遗传变异可能是银屑病阿维 A 酯治疗的预测因子。本研究旨在探讨接受阿维 A 酯治疗的中重度银屑病患者是否存在 HLA 基因变异。
共有 100 名汉族银屑病患者完成了这项研究。24 例患者（包括 16 例应答者和 8 例无应答者）接受了 MHC 靶向区域捕获的深度测序，76 例样本通过 Sanger 测序（SBT）进行基因分型，以验证 分型。
调整年龄、性别、体重指数（BMI）和基线银屑病面积和严重程度指数（PASI）后进行回归分析显示，两个 HLA 等位基因（，）与阿维 A 酯的应答相关。HLA-阳性患者对阿维 A 酯的应答优于 HLA-阴性患者（相对风险（RR）=10.34，95%置信区间（CI）：2.62-40.77，=0.001），HLA-阳性患者对阿维 A 酯的应答优于 HLA-阴性患者（RR=21.01，95%CI：2.53-174.27，=0.005）。
我们的观察结果支持 HLA 和 作为银屑病患者阿维 A 酯反应的药物遗传学标志物的潜在作用。
