血清白细胞介素-6水平升高预示着中度至重度银屑病患者治疗中断的风险：一项为期6年的真实世界队列研究。
Elevated serum IL-6 levels predict treatment interruption in patients with moderate to severe psoriasis: a 6-year real-world cohort study.
发表日期：2023 Aug 25
作者：
Natália Ribeiro de Magalhães Alves, Patrícia Shu Kurizky, Licia Maria Henrique da Mota, Cleandro Pires de Albuquerque, Juliana Tomaz Esper, Aridne Souza Costa Campos, Vitoria Pereira Reis, Henrique Metzker Ferro, Natalia Gil-Jaramillo, Joaquim Pedro Brito-de-Sousa, Luana Cabral Leão Leal, Otávio de Toledo Nóbrega, Carla Nunes de Araújo, Agenor de Castro Moreira Dos Santos Júnior, Gladys Aires Martins, Olindo Assis Martins Filho, Ciro Martins Gomes
来源：
CYTOKINE & GROWTH FACTOR REVIEWS
摘要：
关于银屑病的治疗的实际一手数据不足，尤其是关于可溶性生物标志物作为结果预测因子的作用。作者评估了Th1/Th17血清细胞因子与临床特征作为银屑病治疗药物生存预测因子的效用。作者连续纳入了中重度银屑病患者，并进行了为期6年的随访。使用细胞计数测定法测量了干扰素-α、肿瘤坏死因子-α、白细胞介素（IL）-2、IL-4、IL-6、IL-10和IL-17A。同时评估了临床数据。作者使用Cox比例风险模型计算了药物生存的风险比（HR）。作者纳入了262名患者，其中大部分使用全身免疫抑制剂或生物制剂。在多变量模型中，通过皮肤科生活质量指数测量的生活质量低（HR = 1.04；95% CI 1.01‒1.07；p = 0.012）和高基线IL-6（HR = 1.99；95% CI 1.29‒3.08；p = 0.002）与治疗中断有关。任何队列研究的主要限制在于无法检测临床评估中未发现的混杂因素的存在。生活质量低和高基线血清IL-6水平可预测中重度银屑病患者的治疗中断。虽然IL-6在皮肤环境中并不是最重要的炎症途径介质，但它是一个有趣的生物标志物候选者，可用于预测银屑病的治疗反应。版权所有 © 2023 Sociedade Brasileira de Dermatologia. Elsevier España，S.L.U.发表的所有权利保留。
Real-world, primary data on the treatment of psoriasis are scarce, especially concerning the role of soluble biomarkers as outcome predictors.The authors evaluated the utility of Th1/Th17 serum cytokines along with clinical characteristics as predictors of drug survival in the treatment of psoriasis.The authors consecutively included participants with moderate to severe psoriasis who were followed up for 6 years. Baseline interferon-α, tumor necrosis factor-α, and interleukin (IL)-2, IL-4, IL-6, IL-10, and IL-17A were measured using a cytometric bead array; clinical data were assessed. The authors calculated hazard ratios (HRs) for drug survival using a Cox proportional hazards model.The authors included 262 patients, most of whom used systemic immunosuppressants or biologics. In the multivariate model, poor quality of life measured by the Dermatology Life Quality Index (HR = 1.04; 95% CI 1.01‒1.07; p = 0.012) and elevated baseline IL-6 (HR = 1.99; 95% CI 1.29‒3.08; p = 0.002) were associated with treatment interruption.The main limitation of any cohort study is the presence of confounders that could not be detected in clinical evaluation.Poor quality of life and elevated baseline serum IL-6 level predicted treatment interruption in patients with moderate to severe psoriasis. Although IL-6 is not the most important mediator of the inflammatory pathway in the skin environment, it is an interesting biomarker candidate for predicting psoriasis treatment response.Copyright © 2023 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U. All rights reserved.