SERUM CYTOKINES AND BIOUMORAL IMMUNOLOGICAL CHARACTERIZATION OF PSORIATIC PATIENTS IN LONG TERM ETANERCEPT TREATMENT

The purpose of this study is to evaluate blood cytokines and immunological parameters in psoriatic patients during long-term treatment with etanereept. Forty-five subjects of both sexes affected by psoriasis with or without arthritis entered the study and were treated with etanercept according to international standard protocols. Biochemical blood analysis was carried out at baseline and during follow-up every second month. In particular, the following parameters were kept under control: antinuclear antibodies, anti-nDNA antibodies, anti-histone antibodies, blood cell count, circulating lymphocyte subtypes (CD3, CD4, CD8, CD16, CD19) and IgE. Cytokine profiles (IL-1-alpha, IL-1-beta, IL-6, IL-8, IL-10, IL-12, INF, TNF-alpha) were also evaluated in blood samples during the treatment up to I year of follow-up. A significant decrease in PASI score (p<0.01) and in several cytokine levels was observed, particularly in IL-1, IL-6, IFN-gamma (p<0.01) and to a lesser extent in TNF-alpha (p<0.05). No statistically significant changes were recorded after 1 year of follow-up in blood immunological parameters, in particular in ANA titre, CD4/CD8 ratio, IgE levels, CD16, CD19 and eosinophils count. In conclusion, long-term treatment with etanercept leads not only to a significant improvement in PASI score, but also to significant changes (reduction) in several proinflammatory and modulatory cytokines involved in the pathogenesis of the disease; on the other hand, there are no effects on immunological or bioumoral parameters showing that etanercept modulates rather than suppresses the physiological responses during psoriasis treatment.