Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Dermatology and Venereology, Baise People's Hospital, Baise, China.
Exp Dermatol. 2024 Jan;33(1):e14958. doi: 10.1111/exd.14958. Epub 2023 Nov 27.
Cases of atopic dermatitis (AD)-like rash induced by IL-17A inhibitor secukinumab treatment (SI-AD) have been recently reported in psoriasis patients. To identify immune and inflammatory factors expression in SI-AD. A panel of 15 immune and inflammatory factors in peripheral blood samples from various groups, including patients with patients with SI-AD, psoriasis with secukinumab (S-stable), advanced psoriasis patients (Advanced) and healthy controls (HC). Interleukin-10 (IL-10), IL-4 and IL-17A were detected in skin tissue biopsy samples by immunohistochemistry and real-time quantitative polymerase chain reaction. The immunoglobulin E levels in the SI-AD patients exceeded normal values. The IL-10 levels in SI-AD patients were higher than those in S-stable patients, advanced patients and HC. The IL-4 levels in SI-AD patients were higher than that in S-stable patients and HC. The IL-17A levels in SI-AD patients were higher than those in advanced psoriasis patients and HC, but no significant differences were observed between SI-AD patients and S-stable patients. IL-10 and IL-4 levels were higher in AD-like rashes than in healthy skin, while IL-17A did not differ significantly between the two. Upon discontinuing secukinumab, and switching to oral cyclosporine, antihistamines, Janus kinase 1 inhibitor and topical glucocorticoids, SI-AD patients experienced significant improvement in their skin lesions. Upon reexamination, all 15 immune and inflammatory factors returned to normal levels. Immune shift from Th17 towards Th2 may occur in SI-AD, as indicated by abnormal expression of multiple immune and inflammatory factors observed in peripheral blood and skin tissues.
最近有报道称，在接受白细胞介素 17A 抑制剂司库奇尤单抗（SI-AD）治疗的银屑病患者中出现了特应性皮炎（AD）样皮疹。为了确定 SI-AD 中免疫和炎症因子的表达。在来自不同组别的外周血样本中检测了 15 种免疫和炎症因子的表达，包括 SI-AD 患者、接受司库奇尤单抗治疗的银屑病患者（S-稳定）、进展期银屑病患者（进展期）和健康对照者（HC）。采用免疫组化和实时定量聚合酶链反应检测皮肤组织活检样本中的白细胞介素-10（IL-10）、IL-4 和 IL-17A。SI-AD 患者的免疫球蛋白 E 水平超过正常值。SI-AD 患者的 IL-10 水平高于 S-稳定患者、进展期患者和 HC。SI-AD 患者的 IL-4 水平高于 S-稳定患者和 HC。SI-AD 患者的 IL-17A 水平高于进展期银屑病患者和 HC，但 SI-AD 患者与 S-稳定患者之间无显著差异。AD 样皮疹中的 IL-10 和 IL-4 水平高于健康皮肤，而两者之间的 IL-17A 水平无显著差异。停用司库奇尤单抗并换用口服环孢素、抗组胺药、Janus 激酶 1 抑制剂和局部糖皮质激素后，SI-AD 患者的皮肤病变明显改善。再次检查时，所有 15 种免疫和炎症因子均恢复正常水平。外周血和皮肤组织中观察到多种免疫和炎症因子表达异常，表明 SI-AD 中可能发生 Th17 向 Th2 的免疫偏移。
