Genetic factors are involved not only in the overall risk of suffering
psoriasis, but also in their clinical characteristics and eventually in
drug outcome.
Biological therapies have dramatically improved the prognosis of
Psoriasis. However, these treatments are very expensive and patients often exhibit a heterogeneous response that could be partially attributed to their genetic background. Thus, the research for
genetic markers in psoriatic patients that could predict a poor response to
biological therapies is an important issue. Our aim was to evaluate the effect of
DNA variants at the "TNFα pathway" that could affect the risk of developing
Psoriasis or the response to
biological therapies among these patients. The genetic association study included a total of 518 Psoriatic patients and 480 healthy controls. Ninety of these patients received
biological treatment and based on the change in the PASI score after 24 weeks were classified as good (PASI score ≥75%), intermediate (PASI 50-75), and non-responders (PASI <50). Next generation sequencing (NGS) with
semiconductor-array technology was used to identify the
nucleotide variants in the TNF α, TNFRSF1A and TNFRSF1B, and we only found three missense
amino acid changes, all in TNFRSF1B. Interestingly, we found a significantly higher frequency of rs1061622 G carriers among CW6-positive patients (p = 0.004; OR = 1.69, 95% CI = 1.18-2.41). Allele G (p.196R) carriers were significantly more frequent in the non-responder group (56%) (p = 0.05). In conclusion, we report a significant association between the TNFRSF1B p.M196R variant and the risk for
psoriasis and the response to treatment with anti-TNF or anti-
Il-12/Il-23. The genotyping of this polymorphism could help to optimize the treatment by identifying patients with a likely poor response to
biological drugs.