Daniele Stefano G, Eldirany Sherif A, Damiani Giovanni, Ho Minh, Bunick Christopher G
MD-PhD Program, Yale School of Medicine, New Haven, Connecticut, USA.
Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, USA.
JID Innov. 2024 Jan 20;4(2):100261. doi: 10.1016/j.xjidi.2024.100261. eCollection 2024 Mar.
IL-23 is central to psoriasis pathogenesis. Biologics targeting IL-23 are important therapies against psoriasis. IL-23 inhibitors risankizumab, tildrakizumab, and guselkumab bind the IL-23 p19 subunit, whereas ustekinumab binds p40; however, the structural composition of the IL-23-binding epitopes and how these molecular properties relate to clinical efficacy are not known. Utilizing epitope data derived from hydrogen-deuterium exchange or crystallographic experiments, we mapped inhibitor epitope locations, hydrophobicity, and surface charge onto the IL-23 surface. Molecular properties of each inhibitor epitope, including solvent-accessible surface area, were correlated to binding affinity, kinetic values, and clinical efficacy scores for plaque psoriasis through linear regression analysis. Each IL-23 inhibitor binds an epitope with a unique size, composition, and location except for a 10-residue overlap region outside of the IL-23 receptor epitope. We observed strong correlations between epitope surface area and K and k but not k. Epitope surface area, K, and k were further associated with short-term (10-16 weeks) and long-term (44-60 weeks) clinical efficacy according to PASI-90 responses, with risankizumab demonstrating highest efficacy among IL-23 biologics. In contrast, k, epitope hydrophobicity, polarity, and charge content did not correlate with efficacy. These data exemplify how molecular principles of medications within a therapeutic class can explain their differential clinical responses.
白细胞介素-23(IL-23)在银屑病发病机制中起核心作用。靶向IL-23的生物制剂是治疗银屑病的重要疗法。IL-23抑制剂瑞莎珠单抗、替拉珠单抗和古塞库单抗结合IL-23的p19亚基,而优特克单抗结合p40;然而,IL-23结合表位的结构组成以及这些分子特性与临床疗效的关系尚不清楚。利用来自氢-氘交换或晶体学实验的表位数据,我们将抑制剂表位位置、疏水性和表面电荷映射到IL-23表面。通过线性回归分析,将每个抑制剂表位的分子特性(包括溶剂可及表面积)与斑块状银屑病的结合亲和力、动力学值和临床疗效评分相关联。除了IL-23受体表位外的一个10个残基的重叠区域外,每种IL-23抑制剂都结合一个具有独特大小、组成和位置的表位。我们观察到表位表面积与K和k之间有很强的相关性,但与k没有相关性。根据银屑病面积和严重程度指数90(PASI-90)反应,表位表面积、K和k与短期(10 - 16周)和长期(44 - 60周)临床疗效进一步相关,瑞莎珠单抗在IL-23生物制剂中显示出最高疗效。相比之下,k、表位疏水性、极性和电荷含量与疗效无关。这些数据例证了治疗类别内药物的分子原理如何能够解释它们不同的临床反应。