title: Immunologic biomarkers for clinical and therapeutic management of psoriasis.
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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Clinical Pathology & Microbiology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Cordiali-Fei
authors.affiliation: Dermatology, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Bianchi
authors.affiliation: Clinical Dermatology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Bonifati
authors.affiliation: Clinical Pathology & Microbiology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Trento
authors.affiliation: Dermatology, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Ruzzetti
authors.affiliation: Clinical Dermatology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Francesconi
authors.affiliation: Clinical Pathology & Microbiology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bultrini
authors.affiliation: Clinical Pathology & Microbiology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: D'Agosto
authors.affiliation: Clinical Pathology & Microbiology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Bordignon
authors.affiliation: Clinical Pathology & Microbiology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Francavilla
authors.affiliation: Clinical Pathology & Microbiology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Tripiciano
authors.affiliation: Dermatology, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Chiricozzi
authors.affiliation: Dermatology, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Campione
authors.affiliation: Clinical Dermatology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Cavallotti
authors.affiliation: Anatomic Pathology, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Orlandi
authors.affiliation: Clinical Dermatology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Berardesca
authors.affiliation: Clinical Dermatology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Di Carlo
authors.affiliation: Dermatology, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Chimenti
authors.affiliation: Clinical Pathology & Microbiology, San Gallicano Dermatology Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ensoli
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood*; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000627:therapeutic use; D000069285:Infliximab; D015850:Interleukin-6 / Q000097:blood; D007378:Interleukins / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000097:blood* / Q000188:drug therapy / Q000276:immunology*; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage / Q000627:therapeutic use; D050378:T-Lymphocytes, Regulatory / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000097:blood; D000097043:Interleukin-22
chemical_list: D000068879:Adalimumab; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D015415:Biomarkers; D000068800:Etanercept; D007074:Immunoglobulin G; D000069285:Infliximab; D015850:Interleukin-6; D007378:Interleukins; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000097043:Interleukin-22