Circulating Th1, Th17 Cells and Related Cytokines: A Study in Psoriasis Patients in Bangladesh

Introduction: Psoriasis is an autoimmune chronic inflammatory skin disease.Recent discovery of IL-23/Th17 axis focuses that alteration of cytokine mediated T cell populations are the main driver of disease severity and disease progression.The study aimed to evaluate role of Th1, Th17 cells and serum level of TNF-α, IL-17 and IL-23 in psoriasis.Materials and methods: This was a prospective type of cross sectional study.A total of 35 psoriasis patients and 35 healthy controls were enrolled.Disease severity was assessed by Psoriasis Area and Severity Index (PASI) scoring.Peripheral blood mononuclear cells were separated by Ficoll-Hypaque density centrifugation and circulating Th1 and Th17 cells were quantified by flow cytometric immuno-phenotyping.Serum TNF-α, IL-17 and IL-23 level of study subjects were measured by ELISA.Results: We observed frequency of both CD4+IFNϒ+/Th1 (P=0.001) and CD4+IL17+/Th17 (P=<0.001) cells increased significantly in psoriatic patients when comparing with healthy controls.Th17 cells were increased with disease progression.We also observed higher concentration of serum TNF-α (P=0.002),IL-17(P=0.002)and IL-23 (P=<0.001) in psoriasis patients.Frequencies of Th1 and Th17 cells and serum TNFα level were correlated with disease duration, whilst serum IL-17 level were correlated with disease severity.We didn't find any correlation of IL-23 with severity and disease duration.Conclusion: Predominance of Th17 and Th1 cells along with elevated serum cytokines, is suggestive that IL-23/Th17 axis is activated in psoriasis.By evaluating these soluble biomarkers clinician can plan appropriate treatment for psoriasis patients and further disease progression can be halted accordingly.