DECREASED PERCENTAGES OF CIRCULATING PLASMABLASTS, T FOLLICULAR HELPER CELLS AND CXCR5+ TH17 CELLS ASSOCIATE WITH SECUKINUMAB-INDUCED REMISSION IN PATIENTS WITH PSORIASIS AND PSORIATIC ARTHRITIS

Presenter
  • Athanasios Mavropoulos (Greece)
Lecture Time
17:05 - 17:11

Abstract

Background and Aims

Th17 and Tfh cells, sustain tissue inflammation and autoantibody production respectively in rheumatoid arthritis (RA). Tfh cells co-expressing Th17 markers (CXCR5+Th17), incorporate both pathogenic roles and are amplified in RA. We have previously shown that secukinumab, an anti-IL-17A biologic, decreases nuclear antigen-specific autoantibodies, plasmablasts and Tfh cells in patients with psoriatic disease (PSD). Our aim was to explore whether these cells can serve as predictive biomarkers of secukinumab-induced remission in PSD.

Methods

PBMCs were isolated from 12 psoriasis and 8 psoriatic arthritis (PsA) patients at baseline and 6-months following secukinumab administration. Disease activity and response to biological treatment was assessed using PASI and DAS28-CRP criteria respectively. Tfh cells, CXCR5+Th17 cells and plasmablasts were analyzed flow cytometrically using fluorochrome-conjugated monoclonal antibodies against conventional cell surface markers.

Results

8 out of 12 psoriasis and 4 out of 8 PsA patients were classified as complete responders (CRs). In the CR group, the frequency of CXCR5+Th17 cells (gated as CCR6+ cells within CXCR5+CD4+ cells), was significantly reduced at 6 months compared to baseline (p<0.01). In contrast, there was no significant difference between baseline and 6-month levels in the non-responder group (NR). The percentages of CXCR5+Th17 cells at baseline positively correlated with PASI and DAS28-CRP scores. Reduced percentages of CXCR5+Th17, Tfh cells and plasmablasts at 6 months (as compared to baseline levels) were associated with low PASI scores in psoriasis CRs.

Conclusions

High levels of CXCR5+Th17, Tfh cells and plasmablasts can be indicative of an impartial clinical response to secukinumab in psoriatic disease.

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