title: Circulating CD4+CD25 bright FOXP3+ T cells are up-regulated by biological therapies and correlate with the clinical response in psoriasis patients.
abstract: BACKGROUND
  Regulatory T-cell (T(reg)) modulation is one of the potential mechanisms of anti-tumour-necrosis-factor biological agents. However, literature data on psoriasis patients are lacking.
  
  
  OBJECTIVE
  To analyse the circulating CD4+CD25(bright)FOXP3+ subset in 30 patients with psoriasis vulgaris/arthropathic psoriasis treated with biologicals and to investigate its relationship with the clinical response.
  
  
  METHODS
  The CD25(bright)FOXP3+ expression within the CD4+ subset was determined by multi-parameter flow cytometry at baseline and during treatment. FOXP3 mRNA expression was analysed by real-time reverse transcription PCR.
  
  
  RESULTS
  A response was obtained in 16/17 patients (91.1%) with increased CD25(bright)FOXP3+ values and in only 3/11 patients (27.3%) who showed a CD25(bright)FOXP3+ decrease during biological treatment (p = 0.0001). Responders showed significantly higher values than did non-responders as from the first 2 months of treatment (p = 0.0032). A significantly higher posttreatment expression of mRNA FOXP3 was observed in responders compared to non-responders.
  
  
  CONCLUSIONS
  Biological drugs induce a circulating T(reg) up-regulation in a significant percentage of patients; such an increase is an early predictive marker of response.
authors.affiliation: Department of Medical Sciences and Human Oncology, Dermatology Section, 1st Dermatologic Clinic, Turin University, Turin, Italy. pietro.quaglino@unito.it
authors.forename: P
authors.initials: P
authors.lastname: Quaglino
authors.forename: M
authors.initials: M
authors.lastname: Ortoncelli
authors.forename: A
authors.initials: A
authors.lastname: Comessatti
authors.forename: R
authors.initials: R
authors.lastname: Ponti
authors.forename: M
authors.initials: M
authors.lastname: Novelli
authors.forename: M
authors.initials: M
authors.lastname: Bergallo
authors.forename: C
authors.initials: C
authors.lastname: Costa
authors.forename: S
authors.initials: S
authors.lastname: Cicchelli
authors.forename: P
authors.initials: P
authors.lastname: Savoia
authors.forename: M G
authors.initials: MG
authors.lastname: Bernengo
mesh_terms: D000328:Adult; D000368:Aged; D001685:Biological Factors / Q000627:therapeutic use; D015704:CD4 Antigens / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D051858:Forkhead Transcription Factors / Q000096:biosynthesis / Q000235:genetics / Q000276:immunology*; D006801:Humans; D053645:Interleukin-2 Receptor alpha Subunit / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy / Q000276:immunology* / Q000378:metabolism; D012333:RNA, Messenger / Q000235:genetics*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013601:T-Lymphocytes / Q000276:immunology*; D016896:Treatment Outcome; D015854:Up-Regulation / Q000235:genetics*
chemical_list: D001685:Biological Factors; D015704:CD4 Antigens; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D053645:Interleukin-2 Receptor alpha Subunit; D012333:RNA, Messenger