Adverse Events and Immune Response in Psoriasis Patients Receiving Interleukin-17 Inhibitors.

Area of Science:

• Immunology
• Dermatology
• Microbiology

Background:

• Interleukin-17 (IL-17) inhibitors are effective psoriasis treatments but increase infection risk, notably oral candidiasis.
• Identifying predictive markers for IL-17 inhibitor adverse events is crucial for patient safety.

Purpose of the Study:

• To identify predictive markers for infections and inflammatory bowel disease flares in patients treated with IL-17 inhibitors.
• To characterize the functional immune response during IL-17 inhibitor therapy.

Main Methods:

• A whole-blood stimulation system (TruCulture®) was used to analyze immune responses.
• Patients with psoriasis receiving IL-17 inhibitors (n=36) or adalimumab (n=24) were monitored over 52 weeks.
• Samples (swabs, blood, feces) were collected at baseline, week 12, and week 52.

Main Results:

• Baseline oral Candida albicans colonization predicted increased risk of oral candidiasis during IL-17 inhibitor therapy.
• No oral candidiasis cases occurred in the adalimumab group.
• Gut inflammation (fecal calprotectin) and Staphylococcus aureus colonization remained stable.
• IL-17 inhibitors induced an anti-inflammatory state and enhanced TLR3-mediated antiviral responses compared to adalimumab.

Conclusions:

• Screening for oral Candida albicans colonization before IL-17 inhibitor initiation is a valuable risk stratification and early intervention strategy.
• Understanding immune responses can optimize the use of IL-17 inhibitors in psoriasis management.