Journal
DERMATOLOGY
Volume 219, Issue 3, Pages 250-258Publisher
KARGER
DOI: 10.1159/000238305
Keywords
Biological drugs; Psoriasis; Regulatory T cells; Forkhead box P3 transcription factor; Flow cytometry; Reverse transcription polymerase chain reaction
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Funding
- Regione Piemonte - Progetto per la Ricerca Sanitaria Finalizzata Anno 2008 - BIS
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Background: Regulatory T-cell (T-reg) modulation is one of the potential mechanisms of anti-tumour-necrosis-factor biological agents. However, literature data on psoriasis patients are lacking. Objective: To analyse the circulating CD4+CD25(bright)FOXP3+ subset in 30 patients with psoriasis vulgaris/arthropathic psoriasis treated with biologicals and to investigate its relationship with the clinical response. Methods: The CD25(bright)FOXP3+ expression within the CD4+ subset was determined by multi-parameter flow cytometry at baseline and during treatment. FOXP3 mRNA expression was analysed by real-time reverse transcription PCR. Results: A response was obtained in 16/17 patients (91.1%) with increased CD25(bright)FOXP3+ values and in only 3/11 patients (27.3%) who showed a CD25(bright)FOXP3+ decrease during biological treatment (p = 0.0001). Responders showed significantly higher values than did non-responders as from the first 2 months of treatment (p = 0.0032). A significantly higher posttreatment expression of mRNA FOXP3 was observed in responders compared to non-responders. Conclusion: Biological drugs induce a circulating T-reg up-regulation in a significant percentage of patients; such an increase is an early predictive marker of response. Copyright (C) 2009 S. Karger AG, Basel
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