Like most cells in our body, the cells that comprise our skin undergo a timely division allowing for skin renewal. However, such a seemingly smooth process can have its pitfalls leading to skin disorders. One such disorder is psoriasis. Psoriasis is a chronic inflammatory condition that occurs when skin cells begin to divide rapidly leading to large red plaques on the skin surface. Current therapy options include the prescription drug Humira, which often poses the risk of developing serious side effects including heart and liver problems. Light therapy is seen as a safer alternative to prescription drugs but can be quite costly as a single treatment can cost upwards of several hundred to even several thousand dollars. Therefore, safer and more economical treatment options are needed to treat psoriasis.
An international team of researchers led by Dr. Sauzanne Khalilieh, a clinical pharmacologist at Merck & Co., have developed a better therapeutic option for controlling psoriasis. The team developed an antibody known as tildrakizumab that binds to a protein known as interleukin-23 (IL-23), which is part of the immune system and is a key molecule in the skin inflammatory response. Individuals with psoriasis have high levels of IL-23 (as well as another IL-23 partner protein, IL-12) within their skin cells, which can help explain the cause behind the inflammatory condition.
To determine if the antibody would be useful in suppressing the inflammatory effects of psoriasis, they conducted a randomized phase I clinical trial on 65 individuals that exhibited moderate plaque psoriasis. The 65 individuals underwent dosing with either a placebo or varying doses of the antibody on the first day of treatment, followed by additional doses after about two months. A final third dose of treatment was given approximately three months later. After each dosing (placebo or antibody), the progression of plaque reduction was closely monitored. The investigators scheduled routine check-ups at approximately 6.5 months or one-year after beginning their initial course of treatment. Patients that were placed on the antibody therapy exhibited a remarkable 75% reduction in their skin plaques. Furthermore, the researchers took skin biopsy samples from patients before beginning treatment and during the course of treatment to track potential changes within the skin’s substructure. It was revealed that patients suffering from psoriasis had an altered skin substructure that was partially restored upon administering the antibody. In addition, the biopsy analysis also showed that the antibody treatment considerably reduced skin lesions, a common occurrence in psoriatic patients. The researchers report some minimal as well as major side effects amongst the 65 individuals that underwent the initial round of therapy.
A larger study needs to be conducted before this antibody-based treatment becomes a commercially available option. Nevertheless, this research represents a major advance in combating a chronic skin disorder that in the past could only be treated with drugs with adverse side effects or costly light therapy.
This study was published on March 09th, 2015 in the journal Nature.
Photo courtesy of www.pixabay.com
