Adverse Events and Immune Response in Psoriasis Patients Receiving Interleukin-17 Inhibitors.

IF 3.7 4区 医学 Q1 DERMATOLOGY
Christopher Willy Schwarz, Charlotte Näslund-Koch, Claus Zachariae, Jakob Benedict Seidelin, Susanne Dam Nielsen, Sisse Rye Ostrowski, Karen Marie Thyssen Astvad, Inger Brock, Lars Iversen, Mads Kirchheiner Rasmussen, Nikolai Loft, Lone Skov
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Abstract

Interleukin-17 inhibitors are effective in psoriasis; however, they are associated with an increased risk of infections, particularly oral candidiasis, and new-onset/flares of inflammatory bowel disease. This study aimed to identify predictive markers for these adverse events and to describe the functional immune response in patients treated with interleukin-17 inhibitors using a whole-blood stimulation system (TruCulture®). Patients with psoriasis initiating an interleukin-17 inhibitor (n = 36) or adalimumab (n = 24) were enrolled. Patients attended visits at baseline, week 12, and week 52, during which skin and mucosal swabs, and faecal and blood samples were collected. Baseline oral Candida albicans colonization with no clinical symptoms was associated with an increased risk of oral candidiasis during the first year of interleukin-17 inhibitor therapy, with no cases of oral candidiasis observed in the adalimumab group. Gut inflammation, measured by faecal calprotectin, remained stable in both the adalimumab and interleukin-17 inhibitor group. Colonization with Staphylococcus aureus did not change during treatment. It was found that interleukin-17 inhibitors induced an anti-inflammatory state and potentially more active toll-like receptor 3-mediated antiviral responses compared with adalimumab. In conclusion, screening for oral Candida albicans colonization prior to initiation of interleukin-17 inhibitor therapy may be a useful strategy for risk stratification and early intervention.

Abstract Image

银屑病患者接受白介素-17抑制剂的不良事件和免疫反应。
白细胞介素-17抑制剂对银屑病有效;然而,它们与感染风险增加有关,特别是口腔念珠菌病,以及炎症性肠病的新发/发作。本研究旨在确定这些不良事件的预测标记物,并描述使用全血刺激系统(trucculture®)接受白素-17抑制剂治疗的患者的功能性免疫反应。纳入了开始使用白细胞介素-17抑制剂(n = 36)或阿达木单抗(n = 24)的银屑病患者。患者在基线、第12周和第52周就诊,在此期间收集皮肤和粘膜拭子、粪便和血液样本。在白细胞介素-17抑制剂治疗的第一年,基线口腔白色念珠菌定植无临床症状与口腔念珠菌病的风险增加相关,阿达木单抗组未观察到口腔念珠菌病病例。在阿达木单抗和白细胞介素-17抑制剂组中,通过粪便钙保护蛋白测量的肠道炎症保持稳定。金黄色葡萄球菌的定植在治疗期间没有改变。研究发现,与阿达木单抗相比,白细胞介素-17抑制剂可诱导抗炎状态和可能更活跃的toll样受体3介导的抗病毒反应。总之,在开始白细胞介素-17抑制剂治疗之前,筛查口腔白色念珠菌定植可能是一种有用的风险分层和早期干预策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta dermato-venereologica
Acta dermato-venereologica 医学-皮肤病学
CiteScore
4.90
自引率
2.80%
发文量
210
审稿时长
6-12 weeks
期刊介绍: Acta Dermato-Venereologica publishes high-quality manuscripts in English in the field of Dermatology and Venereology, dealing with new observations on basic dermatological and venereological research, as well as clinical investigations. Each volume also features a number of Review articles in special areas, as well as short Letters to the Editor to stimulate debate and to disseminate important clinical observations. Acta Dermato-Venereologica has rapid publication times and is amply illustrated with a large number of colour photographs.
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