Study Investigates Secukinumab’s Effects on Cytokines in Patients With Psoriasis

In patients with psoriasis, secukinumab plays a vital role in antagonizing and decreasing the expression of several serum cytokines.

Milan Lipowski/AdobeStock

A recent study¹ sought to examine the effects of the drug on important serum cytokines, such as IL-17A, IL-22, and IL-23, which play a role in the disease’s pathogenesis. Researchers also examined the correlation of these effects on patients’ severity of disease. Wu et al. wrote that, “the relationship with disease severity and changes before and after drug treatment are not fully established.”

Patients (n=27) enrolled in the study were required to either have a moderate to severe case of psoriasis (n=12) or serve as health controls (n=15). Healthy patients were age and sex matched to the patients with confirmed psoriasis diagnoses. They were also required to have a medical history exempt from biologics or systemic therapies at least 3 months prior to inclusion and from underlying comorbidities, including cardiovascular disease, diabetes, hyperlipidemia, or obesity.

Researchers examined each patients’ Psoriasis and Area Severity Index (PASI) score, as well as other factors such as age and disease duration. Prior to being treated withsecukinumab, the average PASI score of participants with psoriasis was 21.6 ± 11.

Using an enzyme-linked immunosorbent assay, researchers examined the roles of the following serum cytokines and their associations (listed in parenthesis):

• IL)-1β (intrinsic immunity)
• IL-1RA (intrinsic immunity)
• IL-6 (neutrophils)
• IL-18 (neutrophils)
• Growth regulated oncogene alpha, or GROα (neutrophils)
• Tumor necrosis factor, or TNF,-α (Th1)
• Interferon, or IFN,-γ (Th1)
• IL-23 (Th17) (Th2)
• IL-17A (Th17) (Th2)
• IL-22 (Th17) (Th2)
• Thymus activation regulated chemokine, or TARC (Th2)
• IL-13 (Th2)
• Defensin beta 2, or DEFB2, (Th2)
• Vascular endothelial growth factor, or VEGF,-A (angiogenesis)
• IL-10 (angiogenesis)
• IFN-γ (sepsis)
• Procalcitonin (sepsis)

They used an enzyme calibrator at 450-nm wavelength to measure the concentration of each serum cytokine.

By the conclusion of the study, researchers had found a significant decrease in PASI score among patients with psoriasis, with the concluding average PASI score resting at less than 1—a greater than 21-point decrease from baseline.

As a result, they found that IL-18 was positively correlated with PASI score. Furthermore, IL-17A and IFN-γ were positively correlated with patient age and disease duration.

Expression levels of several serum cytokines, including IL-6, GROα, VEGF-A, IFN-γ, TNF-α, IL-17A and IL-23, were significantly lower at the conclusion of the study when compared to baseline levels. Additionally, after treatment, patients with psoriasis had higher levels of expression of IFN-γ, VEGF-A, TARC, IL-13, and DEFB2 than healthy control patients.

“Secukinumab clears skin lesions by antagonizing IL-17A and simultaneously decreasing the expression levels of IL-6, GRO α, VEGF-A, IFN-γ, TNF-α, IL-17A, and IL-23,” according to Wu et al.

Reference

1. Wu L, Qiao Z, Tian J, Lin J, Hou S, Liu X. The effect of secukinumab treatment for psoriasis on serum cytokines and correlation with disease severity. Skin Res Technol. 2023;29(7). doi:10.1111/srt.13405