Vliv dlouhodobé terapie adalimumabu na biomarkery systémového zánětu u psoriázy

The Influence of Long Term Therapy with Adalimumab on Biomarkers of Systemic Inflammation in Psoriasis

Patients with psoriasis are at increased risk of atherosclerosis, which is characterized by endothelial dysfunction associated with systemic inflammation. It appears that anti-tumor necrosis alpha treatment may reduce this risk. The purpose of this study was to measure serum marker levels associated with systemic inflammation in patients with psoriasis compared to healthy subjects and to further evaluate the change in their levels after 3 months and 2 years of treatment with adalimumab. We investigated four biomarkers: highly sensitive C-reactive protein (hsCRP), oxidized low density lipoproteins (OxLDL), E-selectin and Interleukin 22 (IL-22). These markers were determined in healthy volunteers and in 28 patients with moderate to severe psoriasis before and after 3 and 24 months of adalimumab treatment. Patients with psoriasis had elevated markers levels compared to controls. After 3 months of treatment, E-selectin decreased significantly (p < 0.001), same as IL-22 (p < 0.001). HsCRP also decreased, but statistically insignificantly, OxLDLs were slightly higher than originally. After 24 months, 17 patients were still treated with adalimumab. In these patients, HsCRP (p < 0.05), E-selectin (p < 0.001) and IL-22 (p < 0.001) were significantly reduced. The OxLDL value remained elevated. A steady decrease in E-selectin, hsCRP and IL-22 after 24 months confirms that adalimumab suppresses systemic inflammation. Key words: adalimumab – biomarkers – psoriasis

Keywords:

adalimumab – biomarkers – Psoriasis – systemic inflammation

Autoři: S. Gkalpakiotis ¹; P. Arenberger ¹; S. Tivadar ¹; P. Gkalpakioti ¹; J. Potočková ²; P. Kraml ²
Působiště autorů: Dermatovenerologická klinika, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, přednosta prof. MUDr. Petr Arenberger, DrSc, MBA, FCMA ¹; Interní klinika, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, přednosta prof. MUDr. Ivan Rychlik, CSc., FASN, FERA ²
Vyšlo v časopise: Čes-slov Derm, 96, 2021, No. 4, p. 179-185
Kategorie: Terapie, farmakologie a klinické studie

Souhrn

Pacienti s psoriázou jsou vystaveni zvýšenému riziku aterosklerózy, která je charakterizovaná endotelovou dysfunkcí spojenou se systémovým zánětem. Zdá se, že léčba anti-tumor nekrotizujícím faktorem alfa (anti-TNF-a) může toto riziko snížit. Účelem studie bylo změřit hladiny sérových markerů asociovaných se systémovým zánětem u pacientů s psoriázou v porovnaní se zdravými jedinci a dále zhodnotit změnu jejich hladin po 3 měsících a 2 letech při léčbě anti-TNF alfa adalimumabem. Zkoumali jsme čtyři biomarkery: vysoce senzitivní C-reaktivní protein (hsCRP), oxidovaný lipoprotein s nízkou hustotou (OxLDL), E-selektin a Interleukin 22 (IL-22). Tyto markery byly stanoveny u zdravých dobrovolníků a u 28 pacientů se středně těžkou až těžkou psoriázou před léčbou a po 3 a 24 měsících léčby adalimumabem. Pacienti s psoriázou měli zvýšené hladiny markerů ve srovnání s kontrolní skupinou. Po 3 měsících léčby významně poklesl E-selektin (p < 0,001), stejně tak IL-22 (p < 0,001). HsCRP pokleslo také, ale statisticky nevýznamně, OxLDL byl lehce vyšší než původně. Po 24 měsících bylo 17 pacientů stále léčeno adalimumabem. U těchto pacientů hsCRP (p < 0,05), E-selektin (p < 0,001) a IL-22 (p < 0,001) byly signifikantně snížené. Hodnota OxLDL zůstala zvýšena. Stabilní pokles E-selektinu, hsCRP a IL-22 po 24 měsících potvrzuje, že adalimumab potlačuje systémový zánět.

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