Kitano Tasuku, Horii Motoki, Kudo Kenta, Nishio Jiro, Fujii Ko, Fushida Natsumi, Mizumaki Kie, Hamaguchi Yasuhito, Matsushita Takashi
Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
J Dermatol. 2025 Aug;52(8):1297-1303. doi: 10.1111/1346-8138.17804. Epub 2025 Jun 20.
Psoriasis is a chronic inflammatory skin disease driven by immune dysregulation. This study explores the role of B cells, particularly cytokine-producing subsets, in psoriasis pathogenesis. Although T cells, particularly Th17, have been well documented in psoriasis, recent evidence suggests that B cells contribute to the disease process. Flow cytometry analysis of 50 psoriasis patients and 20 healthy controls revealed a significant increase in IL-6-producing effector B cells (Beffs) and a decrease in IL-10-producing regulatory B cells (Bregs) in psoriasis patients. As IL-6 is pro-inflammatory and IL-10 is anti-inflammatory, this imbalance likely exacerbates inflammation in psoriasis. The study also examined the effects of guselkumab, an IL-23 inhibitor, on cytokine-producing B cells. The frequency of IL-6-producing Beffs in the blood was significantly (p < 0.05) elevated in patients with psoriasis compared with that in healthy controls. In contrast, the frequency of IL-10-producing Bregs in the blood was significantly (p < 0.05) decreased in patients with psoriasis compared with that in healthy controls. In 10 biologic-naïve psoriasis patients, guselkumab significantly reduced IL-6-producing Beffs 4 weeks posttreatment, corresponding with a marked decrease in the Psoriasis Area and Severity Index (PASI). However, IL-10-producing Bregs showed no significant change over this period, suggesting that regulatory B cell recovery may require a longer timeframe or additional stimuli. These findings highlight the potential of B cells as biomarkers for disease activity and therapeutic response in psoriasis. The observed cytokine imbalance suggests that targeting B cell-mediated inflammation could be a novel therapeutic avenue. Further research is needed to assess long-term Breg dynamics and their role in maintaining immune homeostasis in psoriasis. This study reinforces the importance of both effector and regulatory B cells in psoriasis and suggests that monitoring their balance may improve disease characterization and treatment strategies.
银屑病是一种由免疫失调驱动的慢性炎症性皮肤病。本研究探讨B细胞，特别是产生细胞因子的亚群，在银屑病发病机制中的作用。尽管T细胞，特别是Th17细胞，在银屑病中已有充分记载，但最近的证据表明B细胞也参与了疾病进程。对50例银屑病患者和20例健康对照进行的流式细胞术分析显示，银屑病患者中产生IL-6的效应B细胞（Beffs）显著增加，而产生IL-10的调节性B细胞（Bregs）减少。由于IL-6具有促炎作用，IL-10具有抗炎作用，这种失衡可能会加剧银屑病中的炎症。该研究还检测了IL-23抑制剂古塞库单抗对产生细胞因子的B细胞的影响。与健康对照相比，银屑病患者血液中产生IL-6的Beffs频率显著升高（p < 0.05）。相反，与健康对照相比，银屑病患者血液中产生IL-10的Bregs频率显著降低（p < 0.05）。在10例未使用过生物制剂的银屑病患者中，古塞库单抗在治疗4周后显著降低了产生IL-6的Beffs，同时银屑病面积和严重程度指数（PASI）明显下降。然而，在此期间产生IL-10的Bregs没有显著变化，这表明调节性B细胞的恢复可能需要更长的时间或额外的刺激。这些发现突出了B细胞作为银屑病疾病活动和治疗反应生物标志物的潜力。观察到的细胞因子失衡表明，针对B细胞介导的炎症可能是一种新的治疗途径。需要进一步研究来评估长期的Breg动态及其在维持银屑病免疫稳态中的作用。本研究强化了效应B细胞和调节性B细胞在银屑病中的重要性，并表明监测它们的平衡可能会改善疾病特征和治疗策略。
