Abstract
Interleukin (IL) 23 (p19/p40) plays a critical role in the pathogenesis of psoriasis and is upregulated in psoriasis skin lesions. In clinical practice, anti-IL-23Ap19 antibodies are highly effective against psoriasis. IL-39 (p19/ Epstein-Barr virus-induced (EBI) 3), a newly discovered cytokine in 2015, shares the p19 subunit with IL-23. Anti-IL-23Ap19 antibodies may bind to IL-39; also, the cytokine may contribute to the pathogenesis of psoriasis. To investigate IL23Ap19- and/or EBI3-including cytokines in psoriatic keratinocytes, we analyzed IL-23Ap19 and EBI3 expressions in psoriasis skin lesions, using immunohistochemistry and normal human epidermal keratinocytes (NHEKs) stimulated with inflammatory cytokines, using quantitative real-time polymerase chain reaction (RT-PCR), enzyme-linked immunosorbent assay (ELISA), and liquid chromatography-electrospray tandem mass spectrometry (LC-Ms/Ms). Immunohistochemical analysis showed that IL-23Ap19 and EBI3 expressions were upregulated in the psoriasis skin lesions. In vitro, these expressions were synergistically induced by the triple combination of tumor necrosis factor (TNF)-α, IL-17A, and interferon (IFN)-γ, and suppressed by dexamethasone, vitamin D3, and acitretin. In ELISA and LC-Ms/Ms analyses, keratinocyte-derived IL-23Ap19 and EBI3, but not heterodimeric forms, were detected with humanized anti-IL-23Ap19 monoclonal antibodies, tildrakizumab, and anti-EBI3 antibodies, respectively. Psoriatic keratinocytes may express IL-23Ap19 and EBI3 proteins in a monomer or homopolymer, such as homodimer or homotrimer.
Highlights
Psoriasis is a chronic inflammatory skin disease characterized by epidermal thickening and neutrophil and T-cell infiltration [1]
The Expression of IL-23Ap19 and EBI3 Is Upregulated in Psoriatic Keratinocytes
We focused on p19- and/or EBI3-including cytokines produced by psoriatic keratinocytes
Summary
Psoriasis is a chronic inflammatory skin disease characterized by epidermal thickening and neutrophil and T-cell infiltration [1]. It is clinically characterized by well-dermacated, scaly erythematous plaques that typically develop on the scalp, elbows, knees, and buttocks [2]. In addition to IL-23, the IL-12 cytokine family includes IL-12 (p35/p40), IL-27 (p28/EBI3), IL-35 (p35/EBI3), and IL-39 (p19/EBI3). Anti-IL-23Ap19 antibodies (risankizumab, tildrakizumab, guselkumab) are already known to be clinically effective against moderateto-severe psoriasis [17,18,19]. Some groups reported that collateral targeting of IL-12 by anti-IL-12/23p40 antibodies is counterproductive in the therapy of psoriasis [21]
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