Analysis of molecular and clinical parameters of 4-year adalimumab therapy in psoriatic patients

Introduction
Through interaction with receptors TNFR1 and TNFR2, TNF-a activates a signal path, which exacerbates an inflammatory process, constituting an inseparable element of psoriasis.

Aim
To evaluate changes in the expression of TNF-a, TNFR1, TNFR2 during the 4-year-long adalimumab therapy in psoriatic patients, searching for the correlation between molecular and clinical markers. In addition, the role of miRNAs was analysed.

Material and methods
Whole blood and serum samples of psoriatic patients treated with adalimumab constituted material for the study. Changes in the expression of TNF-a and its receptors were evaluated with the use of the RTqPCR method and MALDI ToF mass spectroscopy, PASI, BSA, DAS28 indexes were used for the clinical analysis of the patients, while the role of miRNA molecules was determined basing on microrna.org database

Results
Different TNF-a expression patterns were determined in patients with observed resistance to the medicine. We found that there is a correlation between the molecular markers of an inflammatory process and the clinical indexes. The bioinformatic analysis indicates the potential role of miRNAs in the regulation of expression of the analysed genes. Changes in the profile of TNF-a during adalimumab therapy are significantly determined by the individual variability and susceptibility to the biological medicine or its loss.

Conclusions
TNF-a seems to be a useful marker to evaluate the efficacy of therapy and occurring resistance to the medicine. A complex mechanism for the regulation of the analysed gene expression was underlined, which involved the potential role of miRNAs.