Effect of Narrow Band Ultraviolet B Therapy versus Methotrexate on Serum Levels of Interleukin-17 and Interleukin-23 in Egyptian Patients with Severe Psoriasis

Abstract

Background. There is raised interest in the involvement of interleukin-(IL-)23/T-helper 17 cells (Th17) axis in the pathogenesis of psoriasis. Objectives. To compare the effect of narrow band ultraviolet B (NB-UVB) and methotrexate (MTX) therapy on serum levels of IL-17 and IL-23 in psoriatic patients. Methods. Thirty patients with severe plaque psoriasis were included: 15 patients received NB-UVB three times weekly (group I) and 15 patients received MTX 0.3 mg/kg per week (group II), both for 8 weeks. Before and after treatment, serum levels of IL-17 and IL-23 were investigated by ELISA technique and psoriasis area and severity index (PASI) was calculated. Results. After treatment, all patients showed a reduction in their PASI score, IL-17 and IL-23 serum levels with a nonsignificant difference between both therapeutic modalities (P value >0.05). A positive correlation was detected between the percent of reduction of IL-17, IL-23 and the percent of reduction of PASI score for patients receiving both treatments. No correlation was found between the percent of reduction of IL-17, IL-23 and duration of disease or age of all patients in this study. Conclusion. Interleukin-17 and IL-23 serum level may serve as a potential biomarker for predicting the prognosis and therapeutic response of NB-UVB or MTX in treating psoriasis.

Serum Interleukin 23 in Psoriatic Arthritis Patients: Relation to disease activity, physical function and health related quality of life

“…The increased serum level of IL-23 in PsA patients compared to the levels in controls probably reflects the contribution of IL-23 to the pathogenesis of PsA via the IL-23/IL-17 axis, which ultimately leads to psoriatic plaques, pannus formation, joint erosion and new bone formation [2,35,36]. In this context several studies have found elevated serum IL-23 levels in patients with SpA, PsO and PsA [37][38][39][40][41][42]. Therefore, close control of inflammation by anti-IL-23 drugs may turn off the disease activity and consequently the structural damage [5,9,10,43].…”

IL17A (rs2275913 G>A) and IL17F (rs2397084 T>C) Gene Polymorphisms: Relation to Psoriasis Risk and Response to Methotrexate.

“…(Rentenaar et al 2004) [18] Furthermore, methotrexate therapy was shown to be associated with reduction of serum interleukin-17 and 23 levels in psoriasis patients. (Elghandour et al 2013) [19] It was suggested that methotrexate suppresses IL17 mRNA expression thereby decreasing IL-17 production. (Li et al 2012) [4] A signi cant percentage of our patients achieved a PASI 75 response.…”

“…It is possible that certain gene polymorphisms involved in the pathogenesis of psoriasis may allow to select patients likely to respond to methotrexate. (Warren et al 2009) [5] IL-17A and IL-17F genes are located on chromosome 6p12. (Park et al 2005;Prieto-Perez et al 2015) [6,7] Several IL17 gene polymorphisms have been described in literature and were associated with risk of developing several autoimmune, in ammatory and infectious diseases.…”

Achieving sustained minimal disease activity with methotrexate in early interleukin 23-driven early psoriatic arthritis

“…Our results correspond with other studies in other diseases treated with MTX monotherapy, such as juvenile idiopathic arthritis, rheumatoid arthritis (RA) or psoriasis, which also found a pre-existent higher concentration of TNFα in non-responders, 20 or lack of effect of MTX monotherapy on IL-23 or IL-17 serum or plasma concentrations. 29 30 Together, this may explain why MTX is not effective in patients with PsA with primarily IL-23-driven disease. Surprisingly, we also found consistently higher serum levels of the anti-inflammatory cytokine IL-10 in our non-responders.…”