title: Autoimmunogenicity during anti-TNF therapy in patients with psoriasis and psoriatic arthritis.
abstract: BACKGROUND
  The tumor necrosis factor (TNF-α) was initially described as lymphotoxin or cachectin. The discovery of therapies blocking the action of TNF-α, in 1988, started a new era in the therapy. One of often reported adverse effects related to the use of TNF-α antagonists is induction of the formation of autologous antibodies and antibodies neutralizing anti-TNF drugs. The development of anti-TNF-induced lupus or classical drug-induced lupus is more rarely reported.
  
  
  OBJECTIVE
  To evaluate the presence and the level of anti-nuclear antibodies in patients with psoriasis and psoriatic arthritis and the influence of anti-TNF therapy used on the concentration of antinuclear antibody (ANA).
  
  
  METHODS
  A total of 28 subjects were included in the study. 71.4% of subjects were diagnosed with psoriatic arthritis and 28.6% with plaque psoriasis.
  
  
  RESULTS
  Among the patients with plaque psoriasis, the antinuclear antibodies were found in 25% of subjects and in 80% of patients with psoriatic arthritis. After the treatment an increase in the titer or appearance of antibodies was found in 66.7% in the infliximab group, 18.2% in the etanercept group and 54.7% in the adalimumab group. No subjects developed symptoms of drug-induced systemic lupus.
  
  
  CONCLUSIONS
  Our findings have shown that all anti-TNF therapies induced ANA in psoriatic arthritis and psoriatic patients. Considering a mild course of lupus induced by anti-TNF treatment and, usually intrinsic, resolution of symptoms, the biological therapy still appears as a safe treatment for patients.
authors.affiliation: Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland. Head of the Department: Prof. Anna Wojas-Pelc MD, PhD.
authors.forename: Magdalena M
authors.initials: MM
authors.lastname: Pirowska
authors.affiliation: Department of Health and Medical Science, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland. Head of the Department: Prof. Jerzy Jaśkiewicz MD, PhD.
authors.forename: Anna
authors.initials: A
authors.lastname: Goździalska
authors.affiliation: Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland. Head of the Department: Prof. Anna Wojas-Pelc MD, PhD.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Lipko-Godlewska
authors.affiliation: Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland. Head of the Department: Prof. Anna Wojas-Pelc MD, PhD.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Obtułowicz
authors.affiliation: Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland. Head of the Department: Prof. Anna Wojas-Pelc MD, PhD.
authors.forename: Joanna
authors.initials: J
authors.lastname: Sułowicz
authors.affiliation: Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland. Head of the Department: Prof. Anna Wojas-Pelc MD, PhD.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Podolec
authors.affiliation: Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland. Head of the Department: Prof. Anna Wojas-Pelc MD, PhD.
authors.forename: Anna
authors.initials: A
authors.lastname: Wojas-Pelc
keywords: anti-tumor necrosis factor therapy; anti-tumor necrosis factor-induced lupus; drug-induced lupus; psoriasis; psoriatic arthritis