Alterations of the Gut Microbiome in Psoriasis before and after Treated with Secukinumab

Psoriasis is a chronic inflammatory skin disease linked to immune system. Despite its prevalence, the precise aetiology and pathogenesis of psoriasis remain elusive. This study aimed to assess the efficacy and safety of Secukinumab while exploring its impact on the intestinal microbiota in patients with moderate-to-severe plaque psoriasis.

We recruited 60 healthy controls and 110 patients with moderate-to-severe plaque psoriasis who attended outpatient clinics between June 2022 and June 2023. Clinical data (gender, age, BMI, PASI score, PGA, DLQI, Itch NRS, and STAI score) and faecal samples were collected from all groups. Faecal samples underwent PacBio Full-Length Diversity Sequencing and subsequent informatics analysis.

Patients were randomly assigned to two groups: Before Secukinumab treatment group (BT, n = 55), After 24 weeks of Secukinumab treatment group (AT, n = 55). Control group (Con) consisting of healthy individuals matched for age, sex, and body mass index (n = 60). Following 24 weeks of Secukinumab treatment, significant reductions in PASI score, PGA, DLQI, Itch NRS, and STAI score were observed in psoriatic patients (P < 0.05). The microbial diversity and composition in the AT group exhibited substantial alterations compared to the BT and Con groups, typified by an elevated abundance of Agathobacter and Anaerobutyricum and a diminished presence of Bacteroides and Phocaeicola.

The changes in gut microbiota occur at a slower pace than cutaneous manifestations, necessitating prolonged follow-up and microbiome-based investigations in Secukinumab-treated psoriasis patients to substantiate its therapeutic efficacy.