Psoriasis Patients with Specific HLA-Cw Alleles and Lower Plasma IL-17 Level Show Improved Response to Topical Lindioil Treatment

Abstract

Yin-Ku Lin,1,2 Ching-Ya Wang,3,4 Yu-Huei Huang,3,4 Ya-Ching Chang,3,4 Chun-Bing Chen,3– 9 Chuang-Wei Wang,3,5– 7,* Rosaline Chung-Yee Hui,3,4,* Wen-Hung Chung3,5– 12,* 1Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan; 2School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; 4College of Medicine, Chang Gung University, Taoyuan, Taiwan; 5Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan; 6Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Linkou, Taiwan; 7Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, People’s Republic of China; 8Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan; 9Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan; 10Department of Dermatology, Beijing Tsinghua Chang Gung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People’s Republic of China; 11School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 12Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan*These authors contributed equally to this workCorrespondence: Wen-Hung Chung, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fusing St, Taoyuan, 333, Taiwan, Tel [phone] #8495, Fax [phone] #2206, Email [email protected]; [email protected]: Lindioil, a medicine refined from indigo naturalis (a herb used in Chinese medicine), is effective in treating severe psoriasis; however, responses vary across individual patients. We aim to investigate genetic predispositions associated with treatment response to topical Lindioil among patients with psoriasis and correlations with plasma cytokine patterns.Patients and Methods: We enrolled 72 psoriasis patients treated with Lindioil ointment and analyzed the human leukocyte antigen class C (HLA-Cw) genotypes and plasma cytokine expression patterns. We developed regression models of treatment response, defined as Psoriasis Area and Severity Index (PASI) 75, to examine correlations among HLA-Cw alleles, cytokine levels, and treatment response to Lindioil.Results: Patients harboring HLA-Cw*06:02 were significantly more likely to respond to Lindioil (P = 0.02, odds ratio [OR]: 6.88), whereas Lindoil was ineffective in those harboring HLA-Cw*01:02 (P = 0.01, OR: 0.28). Patients who were HLA-Cw*06:02-positive or HLA-Cw*01:02-negative had better PASI scores and body surface area (BSA) improvement (73.3% vs 44.4%, P< 0.001) following an 8-week treatment period. Psoriasis patients achieving PASI 75 after 8 weeks presented with lower baseline plasma interleukin-17 (IL-17) levels than those who did not achieve PASI 75 (PASI 75: 11.28 pg/mL vs PASI < 75: 15.82 pg/mL, P = 0.05).Conclusion: Our findings suggest that the presence of the HLA-Cw*06:02 or HLA-Cw*01:02 alleles and plasma IL-17 levels are predictive markers of treatment response to Lindioil ointment in patients with psoriasis.Keywords: HLA-Cw*06:02, HLA-Cw*01:02, indigo naturalis, Lindioil, IL-17, psoriasis

Keywords

• hla-cw*06:02
• hla-cw*01:02
• indigo naturalis
• lindioil
• il-17
• psoriasis