Psoriasis Patients with Specific HLA-Cw Alleles and Lower Plasma IL-17 Level Show Improved Response to Topical Lindioil Treatment

Yin-Ku Lin; Ching-Ya Wang; Yu-Huei Huang; Ya-Ching Chang; Chun-Bing Chen; Chuang-Wei Wang; Rosaline Chung-Yee Hui; Wen-Hung Chung

doi:10.2147/PGPM.S351452

Psoriasis Patients with Specific HLA-Cw Alleles and Lower Plasma IL-17 Level Show Improved Response to Topical Lindioil Treatment

Pharmgenomics Pers Med. 2022 May 13:15:515-524. doi: 10.2147/PGPM.S351452. eCollection 2022.

Authors

Yin-Ku Lin^{1

2}, Ching-Ya Wang^{3

4}, Yu-Huei Huang^{3

4}, Ya-Ching Chang^{3

4}, Chun-Bing Chen^{3

4

5

6

7

8

9}, Chuang-Wei Wang^#^{3

5

6

7}, Rosaline Chung-Yee Hui^#^{3

4}, Wen-Hung Chung^#^{3

5

6

7

8

9

10

11

12}

Affiliations

¹ Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan.
² School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
³ Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.
⁴ College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁵ Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan.
⁶ Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Linkou, Taiwan.
⁷ Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, People's Republic of China.
⁸ Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan.
⁹ Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan.
¹⁰ Department of Dermatology, Beijing Tsinghua Chang Gung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People's Republic of China.
¹¹ School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
¹² Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan.

^# Contributed equally.

Abstract

Purpose: Lindioil, a medicine refined from indigo naturalis (a herb used in Chinese medicine), is effective in treating severe psoriasis; however, responses vary across individual patients. We aim to investigate genetic predispositions associated with treatment response to topical Lindioil among patients with psoriasis and correlations with plasma cytokine patterns.

Patients and methods: We enrolled 72 psoriasis patients treated with Lindioil ointment and analyzed the human leukocyte antigen class C (HLA-Cw) genotypes and plasma cytokine expression patterns. We developed regression models of treatment response, defined as Psoriasis Area and Severity Index (PASI) 75, to examine correlations among HLA-Cw alleles, cytokine levels, and treatment response to Lindioil.

Results: Patients harboring HLA-Cw*06:02 were significantly more likely to respond to Lindioil (P = 0.02, odds ratio [OR]: 6.88), whereas Lindoil was ineffective in those harboring HLA-Cw*01:02 (P = 0.01, OR: 0.28). Patients who were HLA-Cw*06:02-positive or HLA-Cw*01:02-negative had better PASI scores and body surface area (BSA) improvement (73.3% vs 44.4%, P<0.001) following an 8-week treatment period. Psoriasis patients achieving PASI 75 after 8 weeks presented with lower baseline plasma interleukin-17 (IL-17) levels than those who did not achieve PASI 75 (PASI 75: 11.28 pg/mL vs PASI <75: 15.82 pg/mL, P = 0.05).

Conclusion: Our findings suggest that the presence of the HLA-Cw*06:02 or HLA-Cw*01:02 alleles and plasma IL-17 levels are predictive markers of treatment response to Lindioil ointment in patients with psoriasis.

Keywords: HLA-Cw*01:02; HLA-Cw*06:02; IL-17; Lindioil; indigo naturalis; psoriasis.

Grants and funding

This work was supported in part by grants from the Ministry of Science and Technology, Taiwan (MOST 106-2314-B-182A-037-MY3, 107-2320-B-182A-002-MY3, 108-2622-B-182A-003-CC2, 108-2314-B-182A-104-MY3, 108-2320-B-182A-024-MY2, 108-2314-B-182A-006-MY3, and 109-2326-B-182A-001-, 110-2320-B-182A-014 -MY3) and Chang Gung Memorial Hospital (CLRPG3J0011-3, CMRPG3I0381-2, CORPG1J0011~3, CORPG3J0321-3, and CMRPG3K0561-2).