Expert opinion on biological therapy · 2026
Identification of plaque psoriasis subgroups based on peripheral blood immune cells subtypes and their relationship with biologic therapy efficacy: a single-center longitudinal cohort study in China.
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Liu Ruizhen, Xie Tingyan, Zhao Juan, Zuo Can, Gao Qian, Kuang Yehong
Аннотация
BACKGROUND: Psoriasis is an immune-mediated inflammatory skin disease with variable biologic therapy response. Current treatment selection lacks reliable predictive biomarkers for personalized decisions.
OBJECTIVES: To identify distinct immunological patient subgroups based on peripheral blood immune cells and evaluate their association with biologic therapy efficacy.
METHODS: This retrospective cohort study included 329 plaque psoriasis patients initiating first-time biologic therapy and 169 healthy controls. Peripheral blood flow cytometry data were analyzed using hierarchical clustering. Kaplan-Meier analysis assessed time to PASI90 achievement among subgroups.
RESULTS: Psoriasis patients showed significantly elevated lymphocyte populations. Three distinct immunological clusters were identified: Cluster 1 (57.8%) with moderate T cells and low NK cells; Cluster 2 (27.7%) with decreased T cells and increased NK cells; and Cluster 3 (14.6%) with increased total lymphocytes. Cluster 1 patients achieved PASI90 significantly faster with both IL-17 and IL-23 inhibitors (p < 0.001).
CONCLUSION: Peripheral blood flow cytometry identified distinct psoriasis immunophenotypes with significant differences in biologic therapy response, offering potential biomarkers for treatment selection and personalized medicine approaches.
OBJECTIVES: To identify distinct immunological patient subgroups based on peripheral blood immune cells and evaluate their association with biologic therapy efficacy.
METHODS: This retrospective cohort study included 329 plaque psoriasis patients initiating first-time biologic therapy and 169 healthy controls. Peripheral blood flow cytometry data were analyzed using hierarchical clustering. Kaplan-Meier analysis assessed time to PASI90 achievement among subgroups.
RESULTS: Psoriasis patients showed significantly elevated lymphocyte populations. Three distinct immunological clusters were identified: Cluster 1 (57.8%) with moderate T cells and low NK cells; Cluster 2 (27.7%) with decreased T cells and increased NK cells; and Cluster 3 (14.6%) with increased total lymphocytes. Cluster 1 patients achieved PASI90 significantly faster with both IL-17 and IL-23 inhibitors (p < 0.001).
CONCLUSION: Peripheral blood flow cytometry identified distinct psoriasis immunophenotypes with significant differences in biologic therapy response, offering potential biomarkers for treatment selection and personalized medicine approaches.