Ustekinumab improves psoriasis without altering T cell cytokine production, differentiation, and T cell receptor repertoire diversity

PLoS One. 2012;7(12):e51819. doi: 10.1371/journal.pone.0051819. Epub 2012 Dec 14.

Abstract

Ustekinumab is a fully human IgG1κ monoclonal antibody targeting interleukin (IL)-12/23 p40 subunit. The role of IL-12/23-mediated pathway in the mechanism of various inflammatory disorders especially psoriasis has been well recognized. Recently the long-term efficacy and safety of ustekinumab in patients with moderate-to-severe psoriasis has been evaluated in phase 2/3 clinical trials, and the results showed no significant risk for serious adverse effects, infections, or malignancies. Ustekinumab inhibits the function of the IL-12/23 p40 subunit, and therefore it is believed that inhibition of IL-12 p40 pathway decreases IFN-γ production. The major concern for the use of ustekinumab is the possibility of increased immunosuppression due to low IFN-γ production. However, the effects of ustekinumab on CD4(+) T cell function have not been fully investigated so far. In this study, we explored changes in cytokine production by memory CD4(+) T cells as well as in the differentiation of naïve T cells to helper T cell (Th) 1, Th2, or Th17 cells in psoriasis patients treated with ustekinumab. The effect of the treatment on T cell receptor repertoire diversity was also evaluated. The results showed that ustekinumab improves clinical manifestation in patients with psoriasis without affecting cytokine production in memory T cells, T cell maturation, or T cell receptor repertoire diversity. Although the number of patients is limited, the present study suggests that T cell immune response remains unaffected in psoriasis patients treated with ustekinumab.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal, Humanized / immunology
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • CD4-Positive T-Lymphocytes / drug effects
  • CD4-Positive T-Lymphocytes / immunology*
  • CD4-Positive T-Lymphocytes / metabolism
  • Case-Control Studies
  • Cell Differentiation / drug effects
  • Cell Differentiation / immunology
  • Cells, Cultured
  • Cytokines / biosynthesis*
  • Cytokines / immunology
  • Cytokines / metabolism
  • Humans
  • Immunity, Cellular / drug effects
  • Immunity, Cellular / immunology
  • Psoriasis / blood
  • Psoriasis / drug therapy*
  • Psoriasis / immunology*
  • Receptors, Antigen, T-Cell / immunology
  • Receptors, Antigen, T-Cell / metabolism*
  • T-Lymphocytes, Helper-Inducer / drug effects
  • T-Lymphocytes, Helper-Inducer / immunology
  • T-Lymphocytes, Helper-Inducer / metabolism
  • Ustekinumab

Substances

  • Antibodies, Monoclonal, Humanized
  • Cytokines
  • Receptors, Antigen, T-Cell
  • Ustekinumab

Grants and funding

K. Yamanaka (23591643) and H. Mizutani (24591647) receive grants for scientific research from the Ministry of Education, Culture, Sports, Science and Technology, Japan. Other authors do not receive any financial support. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.