Unfortunately, there has not been as much progress in a disease scoring system as there has been in development of drugs to treat the disease itself 3, 4, 5, 6, 7. It has a high global prevalence (approximately 125 million 2) and life-long nature, with disease manifestations above and below the skin surface. Psoriasis is a chronic inflammatory skin disease mediated by a dysregulated immune system characterized by red, thickened skin and an angiogenic tissue response to stress, injury, and infection 1, 2. Therefore, measurement of serum IL-19 provides clinicians with an objective disease-activity assessment tool for psoriasis and atopic dermatitis patients. In atopic dermatitis, IL-19 was significantly elevated, correlated with EASI scores, and decreased with skin improvement.
We also measured IL-19 in baricitinib-treated atopic dermatitis patients. Many patients with limited skin disease, including genital psoriasis and psoriatic arthritis patients, also had increased IL-19, which was reduced to normal levels upon ixekizumab treatment, correlating with PASI improvement. In baricitinib- and etanercept-treated psoriasis patients, IL-19 decreases also correlated with improvement. IL-19 increased upon ixekizumab withdraw, prior to relapse, and decreased following re-treatment.
Not only was IL-19 increased in psoriasis and correlated to PASI, but ixekizumab administration led to rapid, sustained IL-19 decreases to normal levels, with decreases at 2-weeks correlating with PASI improvement at 16-weeks. Our novel interleukin-19 (IL-19) immunoassay was initially tested to determine concentrations of IL-19 serum levels, then correlated with the psoriasis activity and severity index (PASI) in psoriasis, and the eczema area and severity index (EASI) in atopic dermatitis. Because development of reliable biomarkers in psoriasis and atopic dermatitis has lagged behind therapeutic progress, we created a blood-based test to fill the void in objective methods available for dermatological assessments.
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