P05 Evaluation of changes in serum cytokine (TNFα, IFNα2, IFNγ, IL-1β, IL-6, IL-8, IL-10, IL-10, IL-12p70, IL-17A, IL-18, IL-23, IL-23, IL-33, and MCP-1) values in biologic-naive psoriasis patients during biologic agent use

Abstract Psoriasis is an immune-mediated chronic inflammatory skin disease. Proinflammatory cytokines have an important role in the pathogenesis. Current treatments mainly act on TNF-α, IL-12, IL-17 or IL-23 pathways. It is thought that determination of cytokine levels before treatment can be used as useful biomarkers for monitoring disease activity and personalized treatment selection. The aim of this study is to contribute to the establishment of biomarkers that can help predict disease severity, treatment response and disease prognosis in patients with psoriasis and also compare healthy controls. We analysed the changes in serum levels of cytokines (TNFα, IFNα2, IFNγ, IL-1β, IL-6, IL-8, IL-10, IL-10, IL-12p70, IL-17A, IL-18, IL-23, IL-23, IL-33, MCP-1) before and 4 months after treatment with biological agents in 40 bio-naive psoriasis patients and 15 healthy subjects. Flow cytometry method [LEGENDplex™ Multi-Analyte Flow Assay Kit Human Inflammation Panel 1, 13 Plex with V-bottom Plate (BioLegend, San Diego, CA, USA)] was used for the determination of cytokine levels. Clinical and demographic information, including PASI (psoriasis area and severity index) and DQLS (Dermatology Quality of Life Scale) scores were recorded. In addition, acute phase reactants (CRP, ESR, ferritin, albümin) were measured before and after 4 months of treatment. The data obtained were analysed using NCSS 2007 software. PASI and DQLS scores at the fourth month of treatment were found to be significantly lower compared with the onset (P = 0.000, P = 0.0001, respectively). When cytokine values were analysed; IFN-γ levels of the patients increased after treatment (P = 0.007). Pre-treatment IL-33 and IL-1β levels of the patients were lower than healthy subjects (P = 0.045), but there was no difference between the mean levels of these cytokines before and after treatment. Among the biologic agents, IL-17A levels were found to be lower only in patients using secukinumab (P = 0.022). Pre-treatment and post-treatment IL-17A difference of the secukinumab group was higher than the other drugs (P = 0.004, P = 0.009), while no statistical difference was observed between the other biologic agents (P > 0.05). There was no correlation between age at disease onset, PASI and DQLS and cytokine levels. The ESR, CRP, and ferritin values of the patients were higher than the healthy controls before treatment (P = 0.011, P = 0.022, and P = 0.037, respectively). However, only ESR decreased after treatment in psoriasis patients (P = 0.027). In this study, no significant differences were found in serum cytokine levels. However, the literature shows that while serum levels may remain unchanged, tissue levels can be significantly different. Future studies should include cytokine analyses in both serum and tissue levels.