Leptin: a gender and obesity-related marker predictive of metabolic comorbidities and therapeutic response to anti-IL-23 biologic drugs in psoriatic patients

IntroductionPsoriasis is a chronic immune-mediated inflammatory skin disorder, frequently associated with comorbidities such as obesity, which can exacerbate its severity and hinder treatment efficacy. Psoriasis pathogenesis involves complex interactions among genetic, environmental, hormonal factor...

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Main Authors: Roberta Belli, Anna Dattolo, Francesca Sampogna, Emanuela Gubinelli, Daniela Lulli, Gaia Moretta, Emanuele Scala, Luca Sanna, Matteo Megna, Maria Vittoria Cannizzaro, Melania Parisi, Cecilia Luordi, Claudia Scarponi, Maria Quaranta, Maria Grazia Lolli, Lorena Silvestri, Paolo Gisondi, Giampiero Girolomoni, Sabatino Pallotta, Cristina Albanesi, Laura Mercurio, Stefania Madonna
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Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1607312/full
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author Roberta Belli
Anna Dattolo
Francesca Sampogna
Emanuela Gubinelli
Daniela Lulli
Gaia Moretta
Emanuele Scala
Luca Sanna
Matteo Megna
Maria Vittoria Cannizzaro
Melania Parisi
Cecilia Luordi
Claudia Scarponi
Maria Quaranta
Maria Grazia Lolli
Lorena Silvestri
Paolo Gisondi
Giampiero Girolomoni
Sabatino Pallotta
Cristina Albanesi
Laura Mercurio
Stefania Madonna
author_facet Roberta Belli
Anna Dattolo
Francesca Sampogna
Emanuela Gubinelli
Daniela Lulli
Gaia Moretta
Emanuele Scala
Luca Sanna
Matteo Megna
Maria Vittoria Cannizzaro
Melania Parisi
Cecilia Luordi
Claudia Scarponi
Maria Quaranta
Maria Grazia Lolli
Lorena Silvestri
Paolo Gisondi
Giampiero Girolomoni
Sabatino Pallotta
Cristina Albanesi
Laura Mercurio
Stefania Madonna
author_sort Roberta Belli
collection DOAJ
description IntroductionPsoriasis is a chronic immune-mediated inflammatory skin disorder, frequently associated with comorbidities such as obesity, which can exacerbate its severity and hinder treatment efficacy. Psoriasis pathogenesis involves complex interactions among genetic, environmental, hormonal factors, and is characterized by dysregulated immune responses. In this study, we investigated the relationship between obesity and psoriasis, exploring the impact of circulating levels of adipokines on disease severity, comorbidities, and treatment response to anti-IL-17 and anti-IL-23 biologics.MethodsWe conducted an observational study that included 91 patients with psoriasis eligible for biological therapy, as well as 26 healthy controls. Disease severity was assessed using PASI, along with the measurement of body composition. Serum samples were analyzed for the measurement of adipokine levels and lipid profiles. Clinical parameters, bioelectrical impedance analysis (BIA), serum adipokine levels (leptin, visfatin, adiponectin) and lipid profile were assessed at baseline and after 16 weeks of biologic treatments.ResultsClinical parameters and adiposity-related indices were analyzed in 76 patients at both T0 and 16 weeks of anti-IL-17 and anti-IL-23 biological treatments, while serum adipokine levels were assessed in 66 patients. Psoriatic patients exhibited higher body mass index (BMI), waist circumference, fat mass (FM), and levels of visfatin (a pro-inflammatory adipokine), whereas adiponectin levels (an anti-inflammatory adipokine) were lower compared to controls. Circulating leptin (a pro-inflammatory adipokine) was significantly higher in female psoriatic patients and showed a positive correlation with the PASI score. Leptin also positively correlated with adiposity indices, while adiponectin showed negative correlations. Furthermore, in women, leptin levels were also associated with psoriatic arthritis, hypertension and, at lower extent, with type II diabetes. Finally, treatment with anti-IL-23 led to a reduction in visfatin levels in female psoriatic patients and resulted in a significant decrease in fat mass percentage in men. Notably, higher baseline leptin levels were associated with the failure to achieve an 90% improvement in baseline PASI at W16 of anti-IL-23 biologic treatments.ConclusionsThis study highlights significant sex-specific differences in the relationships between adipokines, body composition indices, psoriasis severity, comorbidities, and clinical outcome to therapies. Leptin, in particular, may serve as a predictive biomarker for response to anti-IL-23 therapies.
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spelling doaj-art-fd3a3a00a58344f590b48c1f2c5b04972025-08-20T03:13:11ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-07-011610.3389/fimmu.2025.16073121607312Leptin: a gender and obesity-related marker predictive of metabolic comorbidities and therapeutic response to anti-IL-23 biologic drugs in psoriatic patientsRoberta Belli0Anna Dattolo1Francesca Sampogna2Emanuela Gubinelli3Daniela Lulli4Gaia Moretta5Emanuele Scala6Luca Sanna7Matteo Megna8Maria Vittoria Cannizzaro9Melania Parisi10Cecilia Luordi11Claudia Scarponi12Maria Quaranta13Maria Grazia Lolli14Lorena Silvestri15Paolo Gisondi16Giampiero Girolomoni17Sabatino Pallotta18Cristina Albanesi19Laura Mercurio20Stefania Madonna21Laboratory of Experimental Immunology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalyLaboratory of Experimental Immunology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalyIstituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalyDepartment of Dermatology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalyLaboratory of Experimental Immunology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalyDepartment of Dermatology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalyLaboratory of Experimental Immunology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalyLaboratory of Experimental Immunology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalySection of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, ItalyDermatology Section, Department of Medicine, University of Verona, Verona, ItalySection of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, ItalyLaboratory of Experimental Immunology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalyLaboratory of Experimental Immunology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalySection of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, ItalyLaboratory of Experimental Immunology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalyIstituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalyDermatology Section, Department of Medicine, University of Verona, Verona, ItalyDermatology Section, Department of Medicine, University of Verona, Verona, ItalyDepartment of Dermatology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalyLaboratory of Experimental Immunology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalyLaboratory of Experimental Immunology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalyLaboratory of Experimental Immunology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, ItalyIntroductionPsoriasis is a chronic immune-mediated inflammatory skin disorder, frequently associated with comorbidities such as obesity, which can exacerbate its severity and hinder treatment efficacy. Psoriasis pathogenesis involves complex interactions among genetic, environmental, hormonal factors, and is characterized by dysregulated immune responses. In this study, we investigated the relationship between obesity and psoriasis, exploring the impact of circulating levels of adipokines on disease severity, comorbidities, and treatment response to anti-IL-17 and anti-IL-23 biologics.MethodsWe conducted an observational study that included 91 patients with psoriasis eligible for biological therapy, as well as 26 healthy controls. Disease severity was assessed using PASI, along with the measurement of body composition. Serum samples were analyzed for the measurement of adipokine levels and lipid profiles. Clinical parameters, bioelectrical impedance analysis (BIA), serum adipokine levels (leptin, visfatin, adiponectin) and lipid profile were assessed at baseline and after 16 weeks of biologic treatments.ResultsClinical parameters and adiposity-related indices were analyzed in 76 patients at both T0 and 16 weeks of anti-IL-17 and anti-IL-23 biological treatments, while serum adipokine levels were assessed in 66 patients. Psoriatic patients exhibited higher body mass index (BMI), waist circumference, fat mass (FM), and levels of visfatin (a pro-inflammatory adipokine), whereas adiponectin levels (an anti-inflammatory adipokine) were lower compared to controls. Circulating leptin (a pro-inflammatory adipokine) was significantly higher in female psoriatic patients and showed a positive correlation with the PASI score. Leptin also positively correlated with adiposity indices, while adiponectin showed negative correlations. Furthermore, in women, leptin levels were also associated with psoriatic arthritis, hypertension and, at lower extent, with type II diabetes. Finally, treatment with anti-IL-23 led to a reduction in visfatin levels in female psoriatic patients and resulted in a significant decrease in fat mass percentage in men. Notably, higher baseline leptin levels were associated with the failure to achieve an 90% improvement in baseline PASI at W16 of anti-IL-23 biologic treatments.ConclusionsThis study highlights significant sex-specific differences in the relationships between adipokines, body composition indices, psoriasis severity, comorbidities, and clinical outcome to therapies. Leptin, in particular, may serve as a predictive biomarker for response to anti-IL-23 therapies.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1607312/fullpsoriasisobesityadipokinesanti-IL-17 biologicsanti-IL-23 biologicsgender
spellingShingle Roberta Belli
Anna Dattolo
Francesca Sampogna
Emanuela Gubinelli
Daniela Lulli
Gaia Moretta
Emanuele Scala
Luca Sanna
Matteo Megna
Maria Vittoria Cannizzaro
Melania Parisi
Cecilia Luordi
Claudia Scarponi
Maria Quaranta
Maria Grazia Lolli
Lorena Silvestri
Paolo Gisondi
Giampiero Girolomoni
Sabatino Pallotta
Cristina Albanesi
Laura Mercurio
Stefania Madonna
Leptin: a gender and obesity-related marker predictive of metabolic comorbidities and therapeutic response to anti-IL-23 biologic drugs in psoriatic patients
Frontiers in Immunology
psoriasis
obesity
adipokines
anti-IL-17 biologics
anti-IL-23 biologics
gender
title Leptin: a gender and obesity-related marker predictive of metabolic comorbidities and therapeutic response to anti-IL-23 biologic drugs in psoriatic patients
title_full Leptin: a gender and obesity-related marker predictive of metabolic comorbidities and therapeutic response to anti-IL-23 biologic drugs in psoriatic patients
title_fullStr Leptin: a gender and obesity-related marker predictive of metabolic comorbidities and therapeutic response to anti-IL-23 biologic drugs in psoriatic patients
title_full_unstemmed Leptin: a gender and obesity-related marker predictive of metabolic comorbidities and therapeutic response to anti-IL-23 biologic drugs in psoriatic patients
title_short Leptin: a gender and obesity-related marker predictive of metabolic comorbidities and therapeutic response to anti-IL-23 biologic drugs in psoriatic patients
title_sort leptin a gender and obesity related marker predictive of metabolic comorbidities and therapeutic response to anti il 23 biologic drugs in psoriatic patients
topic psoriasis
obesity
adipokines
anti-IL-17 biologics
anti-IL-23 biologics
gender
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1607312/full
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