Paradoxical Psoriasis Induced by Anti-TNFα Treatment: Evaluation of Disease-Specific Clinical and Genetic Markers
Abstract
:1. Introduction
2. Results
2.1. Clinical-Pathologic Characteristics of the Patients Analyzed
2.2. Genotyping Analysis
3. Discussion
4. Materials and Methods
4.1. Sample Collection and DNA Extraction
4.2. Genotyping Analysis
4.3. Statistical Analysis
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
PP | Paradoxical psoriasis |
TNF-α | Tumor necrosis factor-alpha |
IBD | Inflammatory bowel diseases |
IFN | Interferon |
pDCs | Plasmacytoid dendritic cells |
FH | Family history |
IL23R | Interleukin 23 Receptor |
HLA | Human leucocyte antigen |
IFIH1 | Interferon induced with helicase C domain 1 |
SNPs | Single nucleotide polymorphisms |
PASI | Psoriasis area severity index |
DLQI | Life quality index |
OR | Odds ratio |
CI | Confidence interval |
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Characteristics a | Total (n = 53) | IBD Patients with PP (n = 16) | IBD Patients without PP (n = 37) | p Value * |
---|---|---|---|---|
Sex | ||||
Male | 30 (56.5%) | 3 (18.8%) | 27 (73.0%) | |
Female | 23 (43.4%) | 13 (81.3%) | 10 (27.0%) | <0.001 |
Mean age at diagnosis (Mean ± Standard error) | 11.0 (±0.5) | 10.5 (±0.7) | 11.2 (±0.6) | 0.5 |
Type of IBD | ||||
Crohn’s disease | 37 (69.8%) | 14 (87.5%) | 23 (62.2%) | |
Ulcerative colitis | 16 (30.2%) | 2 (12.5%) | 14 (37.8%) | 0.07 |
Family history for IBD | ||||
Yes | 11 (20.7%) | 4 (25.0%) | 7 (18.9%) | |
No | 42 (79.3%) | 12 (75.0%) | 30 (81.1%) | 0.6 |
Comorbidities | ||||
Yes | 5 (9.4%) | 4 (25.0%) | 1 (2.7%) | |
No | 48 (90.6%) | 12 (75.0%) | 36 (97.3%) | 0.01 |
Biological drug | ||||
adalimumab | 12 (22.6%) | 11 (68.7%) | 1 (2.7%) | |
infliximab | 41 (77.4%) | 5 (31.3%) | 36 (97.3%) | <0.001 |
Characteristics a | Total (n = 108) | Psoriatic Patients with PP (n = 23) | Psoriatic Patients without PP (n = 85) | p Value * |
---|---|---|---|---|
Sex | ||||
Male | 72 (66.7%) | 14 (60.9%) | 58 (68.2%) | |
Female | 36 (33.3%) | 9 (39.1%) | 27 (31.8%) | 0.5 |
Mean age at diagnosis (Mean ± Standard error) | 30.6 (±1.5) | 25.6 (±2.9) | 32 (±1.7) | 0.08 |
Degree of psoriasis | ||||
Mild | 8 (7.5%) | 0 (0.0%) | 8 (9.5%) | |
Moderate | 10 (9.3%) | 0 (0.0%) | 10 (11.9%) | |
Severe | 89 (83.2%) | 23 (100%) | 66 (78.6%) | 0.05 |
Arthropathic psoriasis | ||||
Yes | 60 (55.6%) | 14 (60.9%) | 46 (54.1%) | |
No | 48 (44.4%) | 9 (39.1%) | 39 (45.9%) | 0.6 |
Family history for psoriasis | ||||
Yes | 50 (51.0%) | 11 (47.8%) | 39 (52.0%) | |
No | 48 (49.0%) | 12 (52.2%) | 36 (48.0%) | 0.7 |
Comorbidities | ||||
Yes | 64 (65.3%) | 16 (69.6%) | 48 (64.0%) | |
No | 34 (34.7%) | 7 (30.4%) | 27 (36.0%) | 0.6 |
Biological drug | ||||
adalimumab | 93 (86.1%) | 23 (100%) | 70 (82.4%) | |
infliximab | 3 (2.8%) | 0 (0.0%) | 3 (3.5%) | |
etanercept | 8 (7.4%) | 0 (0.0%) | 8 (9.4%) | |
golimumab | 4 (3.7%) | 0 (0.0%) | 4 (4.7%) | 0.2 |
Gene | SNP | Genotype | IBD Patients with PP (n = 16) | IBD Patients without PP (n = 37) | p Value * |
---|---|---|---|---|---|
n (%) | n (%) | ||||
HLA-Cw06 | rs10484554 | C/C | 12 (75.0%) | 28 (75.7%) | 0.6 |
C/ | 4 (25.0%) | 7 (18.9%) | |||
T/T | 0 (0.0%) | 2 (5.4%) | |||
Per-allele | OR 0.8 (95% CI 0.3–2.6) p = 0.8 | ||||
IL23R | rs11209026 | G/G | 12 (75.0%) | 34 (91.9%) | 0.09 |
G/A | 4 (25.0%) | 3 (8.1%) | |||
A/A | 0 (0.0%) | 0 (0.0%) | |||
Per-allele | OR 3.8 (95% CI 0.7–19.4) p = 0.1 | ||||
IL23R | rs10789229 | T/T | 11 (68.7%) | 21 (56.8%) | 0.2 |
T/C | 1 (6.3%) | 10 (27.0%) | |||
C/C | 4 (25.0%) | 6 (16.2%) | |||
Per-allele | OR 0.9 (95% CI 0.4–2.0) p = 0.9 | ||||
TNF± | rs1799964 | T/T | 5 (31.2%) | 26 (70.3%) | 0.008 |
T/C | 9 (56.3%) | 11 (29.7%) | |||
C/C | 2 (12.5%) | 0 (0.0%) | |||
Per-allele | OR 5.3 (95% CI 1.6–17.2) p = 0.006 | ||||
TNF± | rs1800629 | G/G | 16 (100%) | 35 (94.6 %) | 0.3 |
G/A | 0 (0.0%) | 2 (5.4%) | |||
A/A | 0 (0.0%) | 0 (0.0%) | |||
Per allele | - | ||||
IFIH1 | rs1990760 | T/T | 7 (43.7) | 15 (40.5%) | 0.6 |
T/C | 7 (43.8%) | 13 (35.1%) | |||
C/C | 2 (12.5%) | 9 (24.3%) | |||
Per allele | OR 0.8 (95% CI 0.3–1.7) p = 0.5 |
Gene | SNP | Genotype | IBD Patients with PP (n = 16) | Psoriatic Patients without PP (n = 85) | p Value * |
---|---|---|---|---|---|
n (%) | n (%) | ||||
HLA-Cw06 | rs10484554 | C/C | 12 (75.0%) | 34 (40.0%) | 0.02 |
C/T | 4 (25.0%) | 41 (48.2%) | |||
T/T | 0 (0.0%) | 10 (11.8%) | |||
Per-allele | OR 0.2 (95%CI 0.1–0.7) p = 0.01 | ||||
IL23R | rs11209026 | G/G | 12 (75.0%) | 74 (87.1%) | 0.2 |
G/A | 4 (25.0%) | 11 (12.9%) | |||
A/A | 0 (0.0%) | 0 (0.0%) | |||
Per-allele | OR 2.2 (95%CI 0.6–8.2) p = 0.2 | ||||
IL23R | rs10789229 | T/T | 11 (68.7%) | 33 (38.8%) | 0.01 |
T/C | 1 (6.3%) | 40 (47.1%) | |||
C/C | 4 (25.0%) | 12 (14.1%) | |||
Per-allele | OR 0.7 (95%CI 0.9–1.5) p = 0.3 | ||||
TNF± | rs1799964 | T/T | 5 (31.2%) | 50 (58.8%) | 0.04 |
T/C | 9 (56.3%) | 33 (38.8%) | |||
C/C | 2 (12.5%) | 2 (2.4%) | |||
Per-allele | OR 3 (95%CI 1.2–7.5) p = 0.02 | ||||
TNF± | rs1800629 | G/G | 16 (100%) | 77 (90.6%) | 0.4 |
G/A | 0 (0.0%) | 7 (8.2%) | |||
A/A | 0 (0.0%) | 1 (1.2%) | |||
Per-allele | - | ||||
IFIH1 | rs1990760 | T/T | 7 (43.7%) | 29 (34.1%) | 0.5 |
T/C | 7 (43.8%) | 34 (40.0%) | |||
C/C | 2 (12.5%) | 22 (25.9%) | |||
Per-allele | OR 0.7 (95%CI 0.3–1.4) p = 0.3 |
Gene | SNP | Genotype | IBD Patients with PP (n = 11) | Psoriatic Patients with PP (n = 23) | p Value * |
---|---|---|---|---|---|
n (%) | n (%) | ||||
HLA-Cw06 | rs10484554 | C/C | 9 (81.8%) | 9 (39.1%) | 0.05 |
C/T | 2 (18.2%) | 9 (39.1%) | |||
T/T | 0 (0.0%) | 5 (21.8%) | |||
Per-allele | OR 0.2 (95%CI 0.04–0.8) p = 0.03 | ||||
IL23R | rs11209026 | G/G | 9 (81.8%) | 22 (95.6%) | 0.18 |
G/A | 2 (18.2%) | 1 (4.4%) | |||
A/A | 0 (0.0%) | 0 (0.0%) | |||
Per-allele | OR 4.9 (95%CI 0.4–60.9) p = 0.2 | ||||
IL23R | rs10789229 | T/T | 8 (72.7%) | 11 (47.8%) | 0.08 |
T/C | 0 (0.0%) | 8 (34.8%) | |||
C/C | 3 (27.3%) | 4 (17.4%) | |||
Per-allele | OR 0.8 (95%CI 0.3–2) p = 0.6 | ||||
TNF± | rs1799964 | T/T | 4 (36.4%) | 13 (56.5%) | 0.55 |
T/C | 5 (45.5%) | 7 (30.4%) | |||
C/C | 2 (18.1%) | 3 (13.1%) | |||
Per-allele | OR 1.6 (95% CI 0.6–4.3) p = 0.3 | ||||
TNF± | rs1800629 | G/G | 11 (100%) | 21 (91.3%) | 0.6 |
G/A | 0 (0.0%) | 1 (4.4%) | |||
A/A | 0 (0.0%) | 1 (4.3%) | |||
Per-allele | - | ||||
IFIH1 | rs1990760 | T/T | 4 (36.3%) | 8 (34.8%) | 1 |
T/C | 5 (45.5%) | 11 (47.8%) | |||
C/C | 2 (18.2%) | 4 (17.4%) | |||
Per-allele | OR 1 (95%CI 0.3–2.7) p = 1 |
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Bucalo, A.; Rega, F.; Zangrilli, A.; Silvestri, V.; Valentini, V.; Scafetta, G.; Marraffa, F.; Grassi, S.; Rogante, E.; Piccolo, A.; et al. Paradoxical Psoriasis Induced by Anti-TNFα Treatment: Evaluation of Disease-Specific Clinical and Genetic Markers. Int. J. Mol. Sci. 2020, 21, 7873. https://doi.org/10.3390/ijms21217873
Bucalo A, Rega F, Zangrilli A, Silvestri V, Valentini V, Scafetta G, Marraffa F, Grassi S, Rogante E, Piccolo A, et al. Paradoxical Psoriasis Induced by Anti-TNFα Treatment: Evaluation of Disease-Specific Clinical and Genetic Markers. International Journal of Molecular Sciences. 2020; 21(21):7873. https://doi.org/10.3390/ijms21217873
Chicago/Turabian StyleBucalo, Agostino, Federica Rega, Arianna Zangrilli, Valentina Silvestri, Virginia Valentini, Giorgia Scafetta, Federica Marraffa, Sara Grassi, Elena Rogante, Arianna Piccolo, and et al. 2020. "Paradoxical Psoriasis Induced by Anti-TNFα Treatment: Evaluation of Disease-Specific Clinical and Genetic Markers" International Journal of Molecular Sciences 21, no. 21: 7873. https://doi.org/10.3390/ijms21217873