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Mediators of Inflammation
Volume 2014, Article ID 236060, 11 pages
http://dx.doi.org/10.1155/2014/236060
Clinical Study

Immunologic Biomarkers for Clinical and Therapeutic Management of Psoriasis

1Clinical Pathology & Microbiology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy
2Dermatology, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy
3Clinical Dermatology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy
4Anatomic Pathology, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy

Received 6 March 2014; Revised 26 June 2014; Accepted 26 June 2014; Published 20 July 2014

Academic Editor: Anshu Agrawal

Copyright © 2014 P. Cordiali-Fei et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The therapeutic management of psoriasis includes conventional treatments as well as the new generation of highly effective TNF-α inhibitors. However, psoriasis has proven to be a complex therapeutic challenge and treatment failures are not uncommon. Thus, laboratory biomarkers of disease progression/therapeutic efficacy may greatly help in the clinical management of psoriasis. Aims. To identify laboratory biomarkers for clinical management and therapeutic monitoring of psoriasis. Methods. An observational study performed on 59 patients, presenting moderate to severe psoriasis, undergoing treatment with anti-TNF-α agents (etanercept, adalimumab, and infliximab). Soluble and cellular immune/inflammatory parameters were assessed at baseline and after 12 and 24 weeks of treatment. Results. Clinical efficacy was achieved in 88% of the subjects at 12 weeks, reaching 90% after 24 weeks. IL-6 and IL-22, which were elevated at baseline, were significantly reduced, in association with a significant decrease of CLA+ T cells and an increase of Treg lymphocytes. T, B, and NK cell subsets and T cell response to recall antigens did not show any evidence of immune suppression. Conclusions. Immune/inflammatory parameters including IL-6 and IL-22, CLA+ T cells, and Treg lymphocytes may prove to be valuable laboratory tools for the clinical and therapeutic monitoring of psoriasis.