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

doi:10.1111/bjd.16336

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 journal › Article › peer-review

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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 language	English
Pages (from-to)	127-135
Number of pages	9
Journal	British Journal of Dermatology
Volume	179
Issue number	1
Early online date	26 Apr 2018
DOIs	https://doi.org/10.1111/bjd.16336
Publication status	Published - Jul 2018

Bibliographical 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.

Keywords

Journal Article
psoriasis
Th17/Treg subsets
Dovobet®
NB_UVB
adalimumbab

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10.1111/bjd.16336Licence: Unspecified

Accepted Manuscript
This is the pre-peer reviewed version of the following article: Kotb, I. , Lewis, B. , Barker, R. and Ormerod, A. (2018), Differential effects of phototherapy, adalimumab and betamethasone–calcipotriol on effector and regulatory T cells in psoriasis. Br J Dermatol, 179: 127-135. , which has been published in final form at DOI: 10.1111/bjd.16336. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Accepted author manuscript, 920 KBLicence: Unspecified

Cite this

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

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{\textregistered} ).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.",

keywords = "Journal Article, psoriasis, Th17/Treg subsets, Dovobet{\textregistered}, NB_UVB, adalimumbab",

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.",

year = "2018",

month = jul,

doi = "10.1111/bjd.16336",

language = "English",

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pages = "127--135",

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T1 - Differential effects of phototherapy, adalimumab and betamethasone/calcipotriol on effector and regulatory T cells in psoriasis

AU - Kotb, I S

AU - Lewis, B J

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.

PY - 2018/7

Y1 - 2018/7

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.

KW - Journal Article

KW - psoriasis

KW - Th17/Treg subsets

KW - Dovobet®

KW - NB_UVB

KW - adalimumbab

U2 - 10.1111/bjd.16336

DO - 10.1111/bjd.16336

M3 - Article

C2 - 29330859

SN - 0007-0963

VL - 179

SP - 127

EP - 135

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 1

ER -

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

Abstract

Bibliographical note

Keywords

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