GSE171012
Transcriptomic profiling of plaque psoriasis and cutaneous T cell subsets during treatment with secukinumab
The IL-17A inhibitor secukinumab is efficacious for the treatment of psoriasis. To better understand its mechanism of action, we investigated its impact on psoriatic lesions from 15 moderate-to-severe plaque psoriasis patients undergoing secukinumab treatment. We characterized the longitudinal transcriptomic changes of whole lesional skin tissue as well as cutaneous CD4+ and CD8+ T effector cells and CD4+ T regulatory cells across 12 weeks of treatment. Secukinumab was clinically effective and reduced disease-associated overexpression of IL17A, IL17F, IL23A, IL23R, and IFNG in whole tissue as soon as 2 weeks after initiation of treatment. IL17A overexpression in T cell subsets, primarily CD8+ T cells, was also reduced. While secukinumab treatment resolved 89-97% of psoriasis-associated expression differences in bulk tissue and T cell subsets by week 12 of treatment, we observed expression differences involved in interferon signaling and metallothionein synthesis that remained unresolved at this time point as well as potential treatment-associated expression differences involved in IL-15 signaling. These changes were accompanied by shifts in broader immune cell composition based on deconvolution of RNA-seq data. In conclusion, our study reveals several phenotypic and cellular changes within the lesion that underlie clinical improvement from secukinumab. Overall design: We biopsied lesional skin from psoriatic patients before secukinumab treatment and at 2, 4, and 12 weeks of treatment for comparison with skin biopsies from 13 healthy subjects. We performed RNA-seq on bulk skin tissue as well as on CD8+ T cells, CD4 T effectors, and CD4+ Tregs sorted from these biopsies