Document Detail


Effective treatment of psoriasis with etanercept is linked to suppression of IL-17 signaling, not immediate response TNF genes.
MedLine Citation:
PMID:  19895991     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: TNF inhibitors have revolutionized the treatment of psoriasis vulgaris as well as psoriatic and rheumatoid arthritis and Crohn disease. Despite our understanding that these agents block TNF, their complex mechanism of action in disease resolution is still unclear.
OBJECTIVE: To analyze globally the genomic effects of TNF inhibition in patients with psoriasis, and to compare genomic profiles of patients who responded or did not respond to treatment.
METHODS: In a clinical trial using etanercept TNF inhibitor to treat psoriasis vulgaris (n = 15), Affymetrix gene arrays were used to analyze gene profiles in lesional skin at multiple time points during drug treatment (baseline and weeks 1, 2, 4, and 12) compared with nonlesional skin. Patients were stratified as responders (n = 11) or nonresponders (n = 4) on the basis of histologic disease resolution. Cluster analysis was used to define gene sets that were modulated with similar magnitude and velocity over time.
RESULTS: In responders, 4 clusters of downregulated genes and 3 clusters of upregulated genes were identified. Genes downmodulated most rapidly reflected direct inhibition of myeloid lineage immune genes. Upregulated genes included the stable dendritic cell population genes CD1c and CD207 (langerin). Comparison of responders and nonresponders revealed rapid downmodulation of innate IL-1beta and IL-8 sepsis cascade cytokines in both groups, but only responders downregulated IL-17 pathway genes to baseline levels.
CONCLUSION: Although both responders and nonresponders to etanercept inactivated sepsis cascade cytokines, response to etanercept is dependent on inactivation of myeloid dendritic cell genes and inactivation of the T(H)17 immune response.
Authors:
Lisa C Zaba; Mayte Suárez-Fariñas; Judilyn Fuentes-Duculan; Kristine E Nograles; Emma Guttman-Yassky; Irma Cardinale; Michelle A Lowes; James G Krueger
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  124     ISSN:  1097-6825     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-09     Completed Date:  2009-11-24     Revised Date:  2010-12-03    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1022-10.e1-395     Citation Subset:  AIM; IM    
Affiliation:
Laboratory for Investigative Dermatology, Rockefeller University, New York, NY 10065, USA.
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents, Non-Steroidal / administration & dosage,  therapeutic use*
Dendritic Cells / drug effects*,  immunology,  metabolism
Down-Regulation / drug effects,  genetics,  immunology
Gene Expression / drug effects
Gene Expression Profiling
Humans
Immunoglobulin G / administration & dosage,  therapeutic use*
Interferon-gamma / antagonists & inhibitors,  immunology,  metabolism
Interleukin-17 / antagonists & inhibitors,  immunology*,  metabolism
Interleukin-1beta / antagonists & inhibitors,  immunology,  metabolism
Interleukin-8 / antagonists & inhibitors,  immunology,  metabolism
Myeloid Cells / drug effects*,  immunology,  metabolism
Oligonucleotide Array Sequence Analysis
Psoriasis / drug therapy*,  genetics,  immunology
Receptors, Tumor Necrosis Factor / administration & dosage,  therapeutic use*
Signal Transduction
Skin / drug effects,  immunology,  pathology
T-Lymphocytes, Helper-Inducer / drug effects*,  immunology,  metabolism
Tumor Necrosis Factor-alpha / antagonists & inhibitors
Up-Regulation / drug effects,  genetics,  immunology
Grant Support
ID/Acronym/Agency:
GM07739/GM/NIGMS NIH HHS; K23 AR052404-01A1/AR/NIAMS NIH HHS; M01 RR000102-410438/RR/NCRR NIH HHS; UL1RR024143/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Immunoglobulin G; 0/Interleukin-17; 0/Interleukin-1beta; 0/Interleukin-8; 0/Receptors, Tumor Necrosis Factor; 0/Tumor Necrosis Factor-alpha; 185243-69-0/TNFR-Fc fusion protein; 82115-62-6/Interferon-gamma

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