Krawczyk Agata, Strzałka-Mrozik Barbara, Wcisło-Dziadecka Dominika, Kimsa-Dudek Magdalena, Kruszniewska-Rajs Celina, Gola Joanna
Department of Nutrigenomics and Bromatology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Poland.
Department of Cosmetology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Poland.
Arch Med Sci. 2021 Mar 26;19(4):1080-1091. doi: 10.5114/aoms/113027. eCollection 2023.
The primary goal of psoriasis treatment is to reduce the inflammatory response and associated complications. In severe cases of psoriasis that are resistant to local treatment (e.g., keratolytic preparations) and at least two types of general treatment methods (e.g., retinoids and cyclosporine A), biological therapy is used. This study aimed to assess the systemic effects of adalimumab at a given stage of treatment in patients with psoriatic arthritis and evaluate how the drug can improve the clinical condition of the patients.
The study group consisted of patients with diagnosed psoriatic arthritis, while the control group consisted of individuals from whom peripheral blood mononuclear cells were obtained. The effects of the administration of adalimumab were assessed by analyzing the gene expression using oligonucleotide microarrays.
The apoptosis process was found to be one of the overrepresented categories (the PANTHER classification system 13.1 program, overrepresentation test, < 0.05). The dermatological indexes decreased, indicating an improvement in the clinical conditions of the patients 3 months after the first dose of adalimumab.
We found that adalimumab affects apoptosis, which is crucial in the development and course of psoriasis. The differential gene expression in peripheral blood mononuclear cells of patients with psoriatic arthritis indicated the potential systemic effects of adalimumab therapy. The analyses of dermatological (the Psoriasis Area and Severity Index, body surface area and Dermatology Life Quality Index) and inflammatory (Biernacki's reaction) parameters revealed the effectiveness of the therapy.
银屑病治疗的主要目标是减轻炎症反应及相关并发症。在对局部治疗（如角质溶解剂）和至少两种全身治疗方法（如维甲酸和环孢素A）耐药的重度银屑病病例中，采用生物疗法。本研究旨在评估阿达木单抗在银屑病关节炎患者治疗的特定阶段的全身效应，并评估该药物如何改善患者的临床状况。
研究组由确诊为银屑病关节炎的患者组成，对照组由获取外周血单个核细胞的个体组成。通过使用寡核苷酸微阵列分析基因表达来评估阿达木单抗给药的效果。
发现凋亡过程是过度富集的类别之一（PANTHER分类系统13.1程序，过度富集检验，<0.05）。皮肤学指标下降，表明在首次给予阿达木单抗3个月后患者的临床状况有所改善。
我们发现阿达木单抗影响凋亡，而凋亡在银屑病的发生和病程中至关重要。银屑病关节炎患者外周血单个核细胞中的差异基因表达表明阿达木单抗治疗具有潜在的全身效应。对皮肤学（银屑病面积和严重程度指数、体表面积和皮肤病生活质量指数）和炎症（比尔纳茨基反应）参数的分析揭示了该疗法的有效性。
