Assessment of tumor necrosis factor alpha and interleukinـ10 in obese psoriatic patients before and after using apremilast
DOI:
https://doi.org/10.66344/jpad.v34i1.2610Keywords:
Apremilast, ILـ10, Obesity, TNFـα, Pustular psoriasis.Abstract
Background Psoriasis is one of the most prevalent chronic inflammatory skin conditions; its prevalence ranges from 1 to 3%. Tumor necrosis factor-alpha (TNF-α), a cytokine that enhances inflammation, is overexpressed in synovium and skin plaques in psoriasis. TNF-α plays a critical role in the pathogenesis of psoriasis. IL-10 is the most crucial cytokine for reducing excessive immune responses and decreasing pro-inflammatory reactions in all autoimmune disorders.
Objective To evaluate the effect of Apremilast on ILـ10, TNFـα, and BMI in obese psoriatic patients.
Methods Thirty patients included in this investigative study to measure the concentrations of TNFـα, ILـ10 and BMI, before and after receiving Apremilast. TNFـα and ILـ10 were examined by ELISA technique.
Results The present work found that the concentration of TNF-α before receiving Apremilast was 286.80 pg/ml, and after six months from baseline, it was reduced to 131.08 pg/ml (P<0.01). Also, IL-10 before using Apremilast was 69.28 pg/ml, and after six months of treatment it increased to 112.57 ±7.89, which was statistically significant (P<0.01). There were no statistically significant differences in BMI (P>0.05).
Conclusion Apremilast significantly reduced the inflammatory cytokine TNF-α and increased the anti-inflammatory cytokine IL-10, leading to improvement in psoriasis lesions. It also reduced Body Mass Index in obese psoriatic patients.
References
1. Boehncke W, Schön M. Disease burden and epidemiology. Lancet. 2015;386:983-94.
2. Abdulridha SH, Kadhim DJ, Razzak SAA. Beliefs about Medicines among a Sample of Iraqi patients with Psoriasis. Innov Pharm. 2021;12(1):10.24926/iip.v12i1.3584..
3. Flytström I. Different aspects of psoriasis etiology and treatment. 2012 May 14.
4. Afra T, Razmi TM, Dogra S. Apremilast in psoriasis and beyond: big hopes on a small molecule. Indian Dermatol Online J. 2019;10(1):1.
5. Milakovic M, Gooderham MJ. Phosphodiesterase-4 inhibition in psoriasis. Psoriasis: Targets and Therapy. 2021:21-9.
6. Gao JC, Wu AG, Contento MN, Maher JM, Cline A. Apremilast in the Treatment of Plaque Psoriasis: Differential Use in Psoriasis. Clin Cosm Investig Dermatol. 2022:395-402.
7. Yost J, Gudjonsson JE. The role of TNF inhibitors in psoriasis therapy: new implications for associated comorbidities. F1000 medicine reports. 2009;1.
8. Kane D, FitzGerald O. Tumor necrosis factor-α in psoriasis and psoriatic arthritis: A clinical, genetic, and histopathologic perspective. Curr Rheumatol Rep. 2004;6(4):292-8.
9. Iyer SS, Cheng G. Role of interleukin 10 transcriptional regulation in inflammation and autoimmune disease. Crit Rev Immunol. 2012;32(1):23-63.
10. Abdulridha SH, Kadhim DJ, Razzak SAA. Assessment of Quality of Life in a Sample of Iraqi Patients with Psoriasis. Iraqi J Pharm Sci. 2020;29(2):161-8.
11. Puig L. Obesity and psoriasis: body weight and body mass index influence the response to biological treatment. J Eur Acad Dermatol Venereol. 2011;25(9):1007-11.
12. SAS S. Statistical Analysis System, User’s Guide. Statistical. Version 9.6. SAS Inst Inc Cary NC USA. 2018.
13. Mavropoulos A, Zafiriou E, Simopoulou T, Brotis AG, Liaskos C, Roussaki-Schulze A, et al. Apremilast increases IL-10-producing regulatory B cells and decreases proinflammatory T cells and innate cells in psoriatic arthritis and psoriasis. Rheumatol. 2019;58(12):2240-50.
14. Schafer PH, Chen P, Fang L, Wang A, Chopra R. The pharmacodynamic impact of apremilast, an oral phosphodiesterase 4 inhibitor, on circulating levels of inflammatory biomarkers in patients with psoriatic arthritis: substudy results from a phase III, randomized, placebo-controlled trial (PALACE 1). J Immunol Res. 2015.
15. Gialouri CG, Evangelatos G, Fragoulis GE. Choosing the Appropriate Target for the Treatment of Psoriatic Arthritis: TNFα, IL-17, IL-23 or JAK Inhibitors?. Mediterranean J Rheumatol. 2022;33(Suppl 1):150.
16. Armstrong AW, Puig L, Joshi A, Skup M, Williams D, Li J, et al. Comparison of biologics and oral treatments for plaque psoriasis: a meta-analysis. JAMA Dermatol. 2020;156(3):258-69.
17. Sbidian E, Chaimani A, Garcia-Doval I, Doney L, Dressler C, Hua C, et al. Systemic pharmacological treatments for chronic plaque psoriasis: a network meta‐analysis. Cochrane Database Syst Rev. 2022;5(5):CD011535..
18. Ferguson LD, Cathcart S, Rimmer D, Semple G, Brooksbank K, Paterson C, et al. Effect of the phosphodiesterase 4 inhibitor apremilast on cardiometabolic outcomes in psoriatic disease—results of the Immune Metabolic Associations in Psoriatic Arthritis study. Rheumatol. 2022;61(3):1026-34.
19. Iskandar I, Parisi R, Griffiths C, Ashcroft D, Atlas GP. Systematic review examining changes over time and variation in the incidence and prevalence of psoriasis by age and gender. Br J Dermatol. 2021;184(2):243-58.
20. Tollefson MM, Crowson CS, McEvoy MT, Kremers HM. Incidence of psoriasis in children: a population-based study. J Am Acad Dermatol. 2010;62(6):979-87.
Published
Issue
Section
License
Copyright (c) 2024 Haitham Mohammed, Adil A. Noaimi, Halla G. Mahmood
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submission declaration
Authors retain the copyright to their work and grant the 'Journal of Pakistan Association of Dermatologists (JPAD)' the right of first publication under a Creative Commons Attribution 4.0 International (CC BY 4.0) license. This license allows others to share, adapt, and reuse the work for any purpose, including commercial use, as long as appropriate credit is given to the original authors and the journal.
By submitting a manuscript, authors confirm that the work has not been published previously (except as an abstract, lecture, or academic thesis), is not under review elsewhere, and has been approved by all authors and relevant authorities. Once accepted, the article will be openly accessible under the CC BY 4.0 license, ensuring wide dissemination and reuse with proper attribution.
