Potential Blood Biomarkers Predicting Treatment Response in Psoriasis: A Systematic Review and Meta-Analysis

Area of Science:

• Immunodermatology
• Biomarker Discovery
• Translational Medicine

Background:

• Psoriasis is a chronic immune-mediated disease driven by the IL-23/Th17 pathway.
• Treatment response to systemic therapies varies, necessitating biomarker identification for personalized medicine.

Purpose of the Study:

• To evaluate circulating blood-derived biomarkers associated with treatment response in psoriasis patients.
• To identify potential predictors for systemic therapy efficacy in psoriasis.

Main Methods:

• Systematic literature search (MEDLINE, Web of Science) following PRISMA guidelines.
• Meta-analysis and exploratory pooled p-value analysis of 26 eligible studies.
• Risk of bias assessment using QUIPS and PROBAST.

Main Results:

• No significant differences in baseline cytokines (IL-17A, TNF-α, IL-6, IL-12, IL-23) between responders and non-responders.
• Exploratory analysis revealed recurrent signals for downstream IL-23/Th17 biomarkers: beta-defensin-2 (BD-2), IL-17A, and IL-17F.
• Most included studies exhibited moderate to high risk of bias.

Conclusions:

• Downstream IL-23/Th17 biomarkers (BD-2, IL-17 isoforms) show exploratory associations with systemic treatment response in psoriasis.
• Current findings do not establish superior predictive performance over upstream biomarkers.
• No soluble circulating biomarker is validated for routine clinical selection of psoriasis therapies.