Association between IL-17F, IL-17RA Gene Polymorphisms and Response to Biological Drugs in Psoriasis and Beyond

Abstract

Psoriasis is a systemic inflammatory disease that associates with multiple comorbidities. It involves complex interactions between environmental factors and polygenic predisposition. The IL-17 family is one of the main actors in the pathogenesis of psoriasis. Secondary nonresponse is common, especially during the long-term use of TNF-α inhibitors, but it is not uncommon even for newer biologics, such as IL-17 inhibitors. Identification of clinically useful biomarkers of treatment efficacy and safety would enable optimal treatment selection, improve patient quality of life and outcome, and reduce healthcare costs. To our knowledge, this is the first study to evaluate the relationship between genetic polymorphism of IL-17F (rs763780) and IL-17RA (rs4819554) and response to biological treatment and other clinical data in bio-naive and secondary non-responders psoriasis patients in Romania and Southeastern Europe. We performed a prospective, longitudinal, analytical cohort study of 81 patients diagnosed with moderate-to-severe chronic plaque psoriasis who received biological treatments for the first time. Of the 79 patients treated with TNF-α inhibitors, 44 experienced secondary nonresponse. All patients were genotyped for the two SNPs in IL-17F and IL-17RA genes. The rs763780 polymorphism in the IL-17F gene could be an attractive candidate biomarker for predicting which patients will respond to anti-TNF-α therapies. Another emergent association of rs4819554 in IL-17RA with the risk of nail psoriasis and a higher BMI in moderate-to-severe plaque psoriasis patients is described.

Keywords: IL-17F; IL-17RA; biological treatment; psoriasis; rs4819554; rs763780.

Figure 1

Heatmap of association between response to anti-TNF-α agents (adalimumab, etanercept, infliximab) and rs763780 in IL-17F gene, TT, and CC/CT genotypes. Response to treatment was evaluated by a percentual reduction in the baseline PASI score at 12, 24, 36, and 48 weeks.

Figure 2

Heatmap of the lack of association between response to anti-TNF-α agents (adalimumab, etanercept, infliximab) and rs4819554 in IL-17RA gene, GG, and GA/AA genotypes. Response to treatment was evaluated by a percentual reduction in the baseline PASI score at 12, 24, 36, and 48 weeks.