Blood Cell Biomarkers of Inflammation and Cytokine Levels as Predictors of Response to Biologics in Patients with Psoriasis

• Published in: International journal of molecular sciences Vol. 24; no. 7; p. 6111
• Main Authors: Andersen, Clara Sophie Bramsen, Kvist-Hansen, Amanda, Siewertsen, Mie, Enevold, Christian, Hansen, Peter Riis, Kaur-Knudsen, Diljit, Zachariae, Claus, Nielsen, Claus Henrik, Loft, Nikolai, Skov, Lone
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 24.03.2023; MDPI
• Subjects: Adalimumab - pharmacology; Adalimumab - therapeutic use; Biological markers; Biological products; Biological Products - pharmacology; Biological Products - therapeutic use; biologics; Biomarkers; Blood; Blood Cells; blood cytokines; Blood levels; Cardiovascular disease; Care and treatment; Cytokines; Dermatologic agents; Dermatology; Formulae, receipts, prescriptions; Humans; Inflammation; Inflammation - drug therapy; Inhibitors; Interleukin 12; Interleukin 17; Interleukin 23; Interleukin 6; Interleukin 6 receptors; Leukocytes (neutrophilic); Lymphocytes; Monoclonal antibodies; neutrophil-to-lymphocyte ratio; Patients; Pharmaceutical industry; predictive biomarkers; Psoriasis; Psoriasis - drug therapy; Regression analysis; response to treatment; Tumor Necrosis Factor-alpha; Tumor necrosis factor-TNF; Tumor necrosis factor-α; γ-Interferon; Denmark; United States; Switzerland; response to treatment; predictive biomarkers; neutrophil-to-lymphocyte ratio; biologics; blood cytokines; psoriasis
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms24076111

For people with psoriasis, biomarkers aiding in the personalization of treatment with biologics are needed. We examined the usefulness of several biomarkers of inflammation in this respect. The neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the systemic immune-inflammation index (SII) were measured in patients with psoriasis initiating TNF-α inhibitors ( = 131), IL-17/IL-17R inhibitors ( = 65), or IL-23/IL-12/23 inhibitors ( = 50). The blood levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, interferon (IFN)-γ, IL-17A, IL-6, soluble IL-6 receptor (sIL-6R), and soluble IL-6 signal transducer (sIL-6ST) were measured in patients initiating adalimumab ( = 62) or IL-17/IL-17R inhibitors ( = 24). Treatment response was defined by a psoriasis area and severity index (PASI) ≤ 2 three months after treatment initiation. Responders to TNF-α inhibitors had a lower NLR at baseline than non-responders (median and interquartile range (IQR) 2.15 (1.67-2.86) vs. 2.54 (1.88-3.55); = 0.04). Responders to treatment with adalimumab had lower IL-6 levels at baseline than non-responders (0.99 (0.42-1.4) vs. 1.62 (0.96-2.41) pg/mL; = 0.02). For the majority of patients, the IL-17A, IL-1β, and IFN-γ levels were below quantification limits. NLR and IL-6 may serve as predictive biomarkers of treatment response to TNF-α inhibitor therapy in patients with psoriasis.