Psoriasis Clinical Trial
Official title:
miRNAs and mRNAs in Psoriasis During Treatment With Biological Drugs.
PURPOSE - The purpose of this study is to identify and determine miRNA expression and their
targets before and during biological treatment of psoriatic patients.
HYPOTHESIS - Changes in the expression of specific miRNAs play an important role for the
cytokine expression profile seen in lesional psoriatic skin. miRNAs may therefore serve as a
potential target for future anti-psoriatic treatment as well as possible predictors of
biological treatment response.
PERSPECTIVES - The results from this novel research project will increase the investigators
understanding of the underlying mechanisms leading to psoriasis. Furthermore it is possible
that predictors of treatment response can be identified. Identification of biomarkers
predicting treatment outcome will individualize patient care, reduce number of treatment
failures and thereby have a tremendous socio-economic impact and increase the patients
quality of life.
BACKGROUND: Psoriasis is a chronic inflammatory skin disease affecting 2-3% of the
population worldwide and having tremendously impact on the patients' quality of life.
Progress has been made in the understanding of the cellular immunology and biology of
psoriasis, but the ultimate cause for psoriasis is still unknown.
miRNA are ~22 nt noncoding RNAs that modulate gene expression at the post-transcriptional
level. miRNAs have regulatory roles in development, differentiation, growth control and
apoptosis.
AIM OF PROJECT: To identify psoriasis specific miRNA. To investigate the differences in
miRNA expression and their targets between lesional and non-lesional psoriatic skin. To
investigate changes in the miRNA expression during biological treatment.
METHODS: Patients included are adults (> 18 years) with psoriasis vulgaris who are going to
be treated with biological drugs independent of this project (according to national
guidelines). A signed informed consent will be obtained before patients are included in the
project.
Patients are not allowed to have received local treatment 2 weeks before inclusion or having
had any systemic treatment including UVB 6 weeks before inclusion. 4 mm punch-biopsies from
lesional and non-lesional psoriatic skin will be obtained using a local anaesthetic
containing 1% Lidocaine at day 0 and up to four times after treatment at the following days
4, 14, 28 or 84. Before and during treatment patients will be monitored with a clinical
score including PASI, BSA and PGA. Clinical evaluation will be conducted by a trained
dermatologist at day 0 and day 84. That allows us to compare clinical changes to findings
obtained during this study.
miRNA and mRNA expression will be analysis with quantitativePCR, protein level with ELISA
and cell proliferation will be measure by a standard cell proliferation assay. miRNA
microarray are commercially available and will be used to identify miRNA of interest.
NOVELTY: Changes in the expression of miRNA in psoriasis and miRNA regulation during
treatment of psoriasis have only been sparsely studied. The results from this research
project will therefore increase our understanding of the underlying mechanisms leading to
psoriasis and may generate important new tools for individualised treatment of psoriasis.
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Observational Model: Case-Only, Time Perspective: Prospective
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