Differential effects of phototherapy, adalimumab and betamethasone/calcipotriol on effector and regulatory T cells in psoriasis

I S Kotb, B J Lewis, R N Barker, A D Ormerod

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Psoriasis is a chronic T cell-mediated skin disease with marked social and economic burdens. Current treatments are unsatisfactory, with unpredictable remission times and incompletely understood modes of action. Recent advances in our understanding of the pathogenesis of psoriasis identify the imbalance between CD4+ T effector cells, particularly the T helper (Th) 17 subset, and regulatory T cells (Treg) as key to the development of psoriatic lesions, and therefore a novel therapeutic target.

OBJECTIVES: To quantify in patients the effects of three commonly used psoriasis treatment modalities on the Th1, Th2, Th17 and Treg subsets, and test whether any change correlates with clinical response.

METHODS: Using flow cytometry to enumerate Th1, Th2, Th17 and Treg subsets in blood and skin of psoriatic patients before and after receiving any of the following treatments; narrow band UVB (NB-UVB), adalimumab and topical betamethasone/calcipotriol combination (Dovobet® ).

RESULTS: All patients responded clinically to treatments. NB-UVB significantly increased the numbers of circulating and skin Treg, while, by contrast, adalimumab reduced Th17 cells in these compartments, and Dovobet had dual effects by both increasing Treg and reducing Th17 cells.

CONCLUSIONS: The differential effects reported here for the above-mentioned treatment modalities could be exploited to optimize or design therapeutic strategies to better overcome the inflammatory drivers and restore the Th17/Treg balance in psoriasis. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)127-135
Number of pages9
JournalBritish Journal of Dermatology
Volume179
Issue number1
Early online date26 Apr 2018
DOIs
Publication statusPublished - Jul 2018

Fingerprint

Betamethasone
Phototherapy
Regulatory T-Lymphocytes
Psoriasis
Th17 Cells
Therapeutics
Skin
Adalimumab
calcipotriene
Skin Diseases
Flow Cytometry
Economics
T-Lymphocytes

Keywords

  • Journal Article
  • psoriasis
  • Th17/Treg subsets
  • Dovobet®
  • NB_UVB
  • adalimumbab

Cite this

Differential effects of phototherapy, adalimumab and betamethasone/calcipotriol on effector and regulatory T cells in psoriasis. / Kotb, I S; Lewis, B J; Barker, R N; Ormerod, A D.

In: British Journal of Dermatology, Vol. 179, No. 1, 07.2018, p. 127-135.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Psoriasis is a chronic T cell-mediated skin disease with marked social and economic burdens. Current treatments are unsatisfactory, with unpredictable remission times and incompletely understood modes of action. Recent advances in our understanding of the pathogenesis of psoriasis identify the imbalance between CD4+ T effector cells, particularly the T helper (Th) 17 subset, and regulatory T cells (Treg) as key to the development of psoriatic lesions, and therefore a novel therapeutic target.OBJECTIVES: To quantify in patients the effects of three commonly used psoriasis treatment modalities on the Th1, Th2, Th17 and Treg subsets, and test whether any change correlates with clinical response.METHODS: Using flow cytometry to enumerate Th1, Th2, Th17 and Treg subsets in blood and skin of psoriatic patients before and after receiving any of the following treatments; narrow band UVB (NB-UVB), adalimumab and topical betamethasone/calcipotriol combination (Dovobet{\circledR} ).RESULTS: All patients responded clinically to treatments. NB-UVB significantly increased the numbers of circulating and skin Treg, while, by contrast, adalimumab reduced Th17 cells in these compartments, and Dovobet had dual effects by both increasing Treg and reducing Th17 cells.CONCLUSIONS: The differential effects reported here for the above-mentioned treatment modalities could be exploited to optimize or design therapeutic strategies to better overcome the inflammatory drivers and restore the Th17/Treg balance in psoriasis. This article is protected by copyright. All rights reserved.",
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author = "Kotb, {I S} and Lewis, {B J} and Barker, {R N} and Ormerod, {A D}",
note = "I.S.K. thanks the Egyptian Government for financial support through the Egyptian Cultural Bureau Office. This work was partially supported by a National Health Service endowment grant RG12745 to A.D.O. and I.S.K. We thank Linda Lawson,the biologics nurse, all the staff members at the dermatology department and the participants.",
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AU - Barker, R N

AU - Ormerod, A D

N1 - I.S.K. thanks the Egyptian Government for financial support through the Egyptian Cultural Bureau Office. This work was partially supported by a National Health Service endowment grant RG12745 to A.D.O. and I.S.K. We thank Linda Lawson,the biologics nurse, all the staff members at the dermatology department and the participants.

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N2 - BACKGROUND: Psoriasis is a chronic T cell-mediated skin disease with marked social and economic burdens. Current treatments are unsatisfactory, with unpredictable remission times and incompletely understood modes of action. Recent advances in our understanding of the pathogenesis of psoriasis identify the imbalance between CD4+ T effector cells, particularly the T helper (Th) 17 subset, and regulatory T cells (Treg) as key to the development of psoriatic lesions, and therefore a novel therapeutic target.OBJECTIVES: To quantify in patients the effects of three commonly used psoriasis treatment modalities on the Th1, Th2, Th17 and Treg subsets, and test whether any change correlates with clinical response.METHODS: Using flow cytometry to enumerate Th1, Th2, Th17 and Treg subsets in blood and skin of psoriatic patients before and after receiving any of the following treatments; narrow band UVB (NB-UVB), adalimumab and topical betamethasone/calcipotriol combination (Dovobet® ).RESULTS: All patients responded clinically to treatments. NB-UVB significantly increased the numbers of circulating and skin Treg, while, by contrast, adalimumab reduced Th17 cells in these compartments, and Dovobet had dual effects by both increasing Treg and reducing Th17 cells.CONCLUSIONS: The differential effects reported here for the above-mentioned treatment modalities could be exploited to optimize or design therapeutic strategies to better overcome the inflammatory drivers and restore the Th17/Treg balance in psoriasis. This article is protected by copyright. All rights reserved.

AB - BACKGROUND: Psoriasis is a chronic T cell-mediated skin disease with marked social and economic burdens. Current treatments are unsatisfactory, with unpredictable remission times and incompletely understood modes of action. Recent advances in our understanding of the pathogenesis of psoriasis identify the imbalance between CD4+ T effector cells, particularly the T helper (Th) 17 subset, and regulatory T cells (Treg) as key to the development of psoriatic lesions, and therefore a novel therapeutic target.OBJECTIVES: To quantify in patients the effects of three commonly used psoriasis treatment modalities on the Th1, Th2, Th17 and Treg subsets, and test whether any change correlates with clinical response.METHODS: Using flow cytometry to enumerate Th1, Th2, Th17 and Treg subsets in blood and skin of psoriatic patients before and after receiving any of the following treatments; narrow band UVB (NB-UVB), adalimumab and topical betamethasone/calcipotriol combination (Dovobet® ).RESULTS: All patients responded clinically to treatments. NB-UVB significantly increased the numbers of circulating and skin Treg, while, by contrast, adalimumab reduced Th17 cells in these compartments, and Dovobet had dual effects by both increasing Treg and reducing Th17 cells.CONCLUSIONS: The differential effects reported here for the above-mentioned treatment modalities could be exploited to optimize or design therapeutic strategies to better overcome the inflammatory drivers and restore the Th17/Treg balance in psoriasis. This article is protected by copyright. All rights reserved.

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