Association of Pathogenic Th17 Cells with the Disease Severity and Its Potential Implication for Biological Treatment Selection in Psoriasis Patients

Psoriasis is an inflammatory autoimmune disease characterized by cutaneous lesions in plaques. It has been proposed that the immune response has a key role in the disease progression. Particularly, the Th17 cells through IL-17 can contribute to maintain the inflammatory process. The pathogenic Th17...

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Main Authors: Cristina Aguilar-Flores, Octavio Castro-Escamilla, Elizabeth M. Ortega-Rocha, César Maldonado-García, Fermín Jurado-Santa Cruz, Gibrán Pérez-Montesinos, Alicia Lemini-López, Laura C. Bonifaz
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Mediators of Inflammation
Online Access:http://dx.doi.org/10.1155/2020/8065147
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author Cristina Aguilar-Flores
Octavio Castro-Escamilla
Elizabeth M. Ortega-Rocha
César Maldonado-García
Fermín Jurado-Santa Cruz
Gibrán Pérez-Montesinos
Alicia Lemini-López
Laura C. Bonifaz
author_facet Cristina Aguilar-Flores
Octavio Castro-Escamilla
Elizabeth M. Ortega-Rocha
César Maldonado-García
Fermín Jurado-Santa Cruz
Gibrán Pérez-Montesinos
Alicia Lemini-López
Laura C. Bonifaz
author_sort Cristina Aguilar-Flores
collection DOAJ
description Psoriasis is an inflammatory autoimmune disease characterized by cutaneous lesions in plaques. It has been proposed that the immune response has a key role in the disease progression. Particularly, the Th17 cells through IL-17 can contribute to maintain the inflammatory process. The pathogenic Th17 phenotype has been described in human diseases and associated with high severity in inflammatory experimental models. However, it is not clear if the pathogenic phenotype could be present in the skin and peripheral blood as well as its possible association to severity in psoriasis. In the lesional skin, we found high infiltration of Th17 cells and the pathogenic phenotype, finding a correlation between the frequency of Th17 cells and the Psoriasis Area and Severity Index (PASI) score. In peripheral blood, we observed a pool of Th17 lymphocytes with potential to acquire pathogenic features. Interestingly, the percentage of pathogenic Th17 cells (CD4+ RORγt+ IFN-γ+) correlates with disease severity. Moreover, we distinguished three groups of patients based on their IL-17/IFN-γ production by Th17 lymphocytes, which seems to be related with a dynamic or stable potential to express these cytokines. Remarkably, we evaluated the cytokine production by Th17 cells as an immunological marker for the adequate selection of biologic therapy. We found that patients analyzed by this immunological approach and treated with antibodies against IL-17 and TNFα showed great improvement depicted by reduction in PASI and Dermatology Life Quality Index (DLQI) score as well as the percentage of Body Surface Area (BSA). Altogether, our results highlight the importance of the assessment of the pathogenic phenotype in Th17 cells as an immune personalized analysis with the potential to support the therapy choice in the clinical practice.
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spelling doaj-art-7612dc06f32845c298ba013aace17f2f2025-08-20T02:07:16ZengWileyMediators of Inflammation0962-93511466-18612020-01-01202010.1155/2020/80651478065147Association of Pathogenic Th17 Cells with the Disease Severity and Its Potential Implication for Biological Treatment Selection in Psoriasis PatientsCristina Aguilar-Flores0Octavio Castro-Escamilla1Elizabeth M. Ortega-Rocha2César Maldonado-García3Fermín Jurado-Santa Cruz4Gibrán Pérez-Montesinos5Alicia Lemini-López6Laura C. Bonifaz7Unidad de Investigación Médica en Inmunoquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI (CMNSXXI), Instituto Mexicano del Seguro Social, Mexico City 06720, MexicoUnidad de Investigación Médica en Inmunoquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI (CMNSXXI), Instituto Mexicano del Seguro Social, Mexico City 06720, MexicoUnidad de Investigación Médica en Inmunoquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI (CMNSXXI), Instituto Mexicano del Seguro Social, Mexico City 06720, MexicoCentro Dermatológico “Dr. Ladislao de la Pascua”, Secretaria de Salud de la Ciudad de México, Mexico City 06780, MexicoCentro Dermatológico “Dr. Ladislao de la Pascua”, Secretaria de Salud de la Ciudad de México, Mexico City 06780, MexicoCentro Dermatológico “Dr. Ladislao de la Pascua”, Secretaria de Salud de la Ciudad de México, Mexico City 06780, MexicoServicio de Dermatología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, MexicoUnidad de Investigación Médica en Inmunoquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI (CMNSXXI), Instituto Mexicano del Seguro Social, Mexico City 06720, MexicoPsoriasis is an inflammatory autoimmune disease characterized by cutaneous lesions in plaques. It has been proposed that the immune response has a key role in the disease progression. Particularly, the Th17 cells through IL-17 can contribute to maintain the inflammatory process. The pathogenic Th17 phenotype has been described in human diseases and associated with high severity in inflammatory experimental models. However, it is not clear if the pathogenic phenotype could be present in the skin and peripheral blood as well as its possible association to severity in psoriasis. In the lesional skin, we found high infiltration of Th17 cells and the pathogenic phenotype, finding a correlation between the frequency of Th17 cells and the Psoriasis Area and Severity Index (PASI) score. In peripheral blood, we observed a pool of Th17 lymphocytes with potential to acquire pathogenic features. Interestingly, the percentage of pathogenic Th17 cells (CD4+ RORγt+ IFN-γ+) correlates with disease severity. Moreover, we distinguished three groups of patients based on their IL-17/IFN-γ production by Th17 lymphocytes, which seems to be related with a dynamic or stable potential to express these cytokines. Remarkably, we evaluated the cytokine production by Th17 cells as an immunological marker for the adequate selection of biologic therapy. We found that patients analyzed by this immunological approach and treated with antibodies against IL-17 and TNFα showed great improvement depicted by reduction in PASI and Dermatology Life Quality Index (DLQI) score as well as the percentage of Body Surface Area (BSA). Altogether, our results highlight the importance of the assessment of the pathogenic phenotype in Th17 cells as an immune personalized analysis with the potential to support the therapy choice in the clinical practice.http://dx.doi.org/10.1155/2020/8065147
spellingShingle Cristina Aguilar-Flores
Octavio Castro-Escamilla
Elizabeth M. Ortega-Rocha
César Maldonado-García
Fermín Jurado-Santa Cruz
Gibrán Pérez-Montesinos
Alicia Lemini-López
Laura C. Bonifaz
Association of Pathogenic Th17 Cells with the Disease Severity and Its Potential Implication for Biological Treatment Selection in Psoriasis Patients
Mediators of Inflammation
title Association of Pathogenic Th17 Cells with the Disease Severity and Its Potential Implication for Biological Treatment Selection in Psoriasis Patients
title_full Association of Pathogenic Th17 Cells with the Disease Severity and Its Potential Implication for Biological Treatment Selection in Psoriasis Patients
title_fullStr Association of Pathogenic Th17 Cells with the Disease Severity and Its Potential Implication for Biological Treatment Selection in Psoriasis Patients
title_full_unstemmed Association of Pathogenic Th17 Cells with the Disease Severity and Its Potential Implication for Biological Treatment Selection in Psoriasis Patients
title_short Association of Pathogenic Th17 Cells with the Disease Severity and Its Potential Implication for Biological Treatment Selection in Psoriasis Patients
title_sort association of pathogenic th17 cells with the disease severity and its potential implication for biological treatment selection in psoriasis patients
url http://dx.doi.org/10.1155/2020/8065147
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