ABSTRACT
BACKGROUND: Psoriasis has a global prevalence of 1-3%, with variations observed across different ethnic groups and geographical areas. Disease susceptibility and response to anti-tumor necrosis factor-α (TNFα) drugs suggest different genetic regulatory mechanisms which may include NLR family pyrin domain containing 3 (NLRP3) polymorphism. Evaluation of the NLRP3 gene polymorphism, the serum level of CRP and TNFα in psoriasis patients and assessment of the NLRP3 (rs10754558) gene polymorphism, CRP and TNFα with disease severity and their role as biomarkers for response to Methotrexate and Adalimumab in psoriasis. The study had a total of 75 patients diagnosed with psoriasis vulgaris, who were compared to a control group of 75 healthy individuals. RESULTS: There was a highly significant difference in NLRP3 genotypes and alleles distribution between psoriasis patients and controls (P = 0.002,0.004). The heterozygote genotype GC (OR = 3.67,95%CI:1.75-7.68, P = 0.0006), was linked with increased risk of psoriasis. Additionally, The GC genotype was significantly associated with nonresponse to psoriasis therapy (OR = 11.7,95%CI:3.24-42.28, P = 0.0002). Regarding serum CRP and TNFα levels, there was a highly statistically significant difference between psoriasis patients and controls (P < 0.0001), and there was also a highly statistically significant difference between responders and non-responders in psoriasis patients regarding PASI 50 (P < 0.0001). CONCLUSIONS: The NLRP3 (rs10754558) genotypes GC was associated with the severe form of psoriasis and with nonresponse to psoriasis medication. Therefore, NLRP3 (rs10754558) gene polymorphism is an important prognostic biomarker in psoriasis patients. The serum TNFα can be used as a predictor for response to therapy in psoriasis patients. More research for evaluation of role of the NLRP3 gene polymorphism in the genetic risks and treatment outcomes associated with psoriasis is still required.
Subject(s)
Adalimumab , Methotrexate , NLR Family, Pyrin Domain-Containing 3 Protein , Polymorphism, Single Nucleotide , Psoriasis , Tumor Necrosis Factor-alpha , Humans , Psoriasis/genetics , Psoriasis/drug therapy , NLR Family, Pyrin Domain-Containing 3 Protein/genetics , Adalimumab/therapeutic use , Methotrexate/therapeutic use , Female , Tumor Necrosis Factor-alpha/genetics , Male , Adult , Middle Aged , Genotype , Genetic Predisposition to Disease , Treatment Outcome , C-Reactive Protein/metabolism , Biomarkers/blood , Alleles , Severity of Illness Index , Gene FrequencyABSTRACT
Omega-3 fatty acids and sublingual immunotherapy have a considerable interest in the potential therapeutic value in asthmatic patients. The aim of the study was to compare the efficacy of omega-3 fatty acids and sublingual immunotherapy in treating patients with bronchial asthma and evaluate the value of IL17A as a marker for effective treatment. The effect on asthma control test (ACT), peak expiratory flow rate (PEFR), forced expiratory volume in the first second (FEV1) and serum interleukin 17A (IL17A) in patients with mild to moderate persistent asthma were measured. A total of 48 patients were enrolled and divided into two groups. Group A included 24 patients treated with sublingual immunotherapy for 6 months and group B, 24 patients given omega-3 fatty acids for 3 months. Serum level of IL17A was measured by Enzyme linked immunosorbent assay (ELISA). A statistically significant difference was demonstrated in each parameter between before and after treatment (p < 001, for each). Comparison between omega-3 fatty acids and sublingual immunotherapy as regards ACT, PEFR, and FEV1and IL17A showed that omega-3 fatty acids treatment was better than sublingual immunotherapy in decreasing IL17A, but both were effective in decreasing PEFR, FEV1 and ACT. In conclusion, administration of omega-3 fatty acids and sublingual immunotherapy are promising in management of asthma.