Molecular improvement of IL-23 inhibition revealed by single-cell RNA sequencing in concurrent psoriasis and systemic lupus erythematosus
Psoriasis and systemic lupus erythematosus (SLE) are chronic inflammatory diseases with rare coexistence, sharing the IL-23/IL-17 axis as a pathogenic pathway. A 42-year-old male with both conditions was successfully treated with the IL-23 inhibitor guselkumab, improving psoriasis without worsening SLE over 2.5 years. Single-cell RNA sequencing of skin biopsies revealed a decrease in T17 cells and IL-17-related transcripts post-treatment. Gene Set Enrichment Analysis showed reduced IFN-? and IFN-a responses, indicating broader inflammatory modulation. This study suggests IL-23 inhibitors may be a promising treatment for concurrent psoriasis and SLE, pending larger cohort validation. Overall design: Skin biopsy samples were collected from a patient with concurrent psoriasis and SLE, including non-lesional, pre-treatment lesional, and post-treatment lesional skin after 12 weeks of IL-23 inhibitor therapy. Single-cell RNA sequencing was performed to analyze gene expression, focusing on T-cell subsets and inflammatory pathways. Gene Set Enrichment Analysis was used to identify differentially regulated pathways, particularly IFN responses, pre- and post-treatment.