IL-36γ (IL-1F9) Is a Biomarker for Psoriasis Skin Lesions

In recent years, different genes and proteins have been highlighted as potential biomarkers for psoriasis, one of the most common inflammatory skin diseases worldwide. However, most of these markers are not only psoriasis-specific but also found in other inflammatory disorders. We performed an unsupervised cluster analysis of gene expression profiles in 150 psoriasis patients and other inflammatory skin diseases (atopic dermatitis, lichen planus, contact eczema, and healthy controls). We identified a cluster of IL-17/tumor necrosis factor-alpha (TNF alpha)-associated genes specifically expressed in psoriasis, among which IL-36 gamma was the most outstanding marker. In subsequent immunohistological analyses, IL-36 gamma was confirmed to be expressed in psoriasis lesions only. IL-36 gamma peripheral blood serum levels were found to be closely associated with disease activity, and they decreased after anti-TNF alpha-treatment. Furthermore, IL-36 gamma immunohistochemistry was found to be a helpful marker in the histological differential diagnosis between psoriasis and eczema in diagnostically challenging cases. These features highlight IL-36 gamma as a valuable biomarker in psoriasis patients, both for diagnostic purposes and measurement of disease activity during the clinical course. Furthermore, IL-36 gamma might also provide a future drug target, because of its potential amplifier role in TNF alpha- and IL-17 pathways in psoriatic skin inflammation.