The following is a summary of “Integrated proteomics and genomics analysis of paradoxical eczema in psoriasis patients treated with biologics,” published in the November 2023 issue of Allergy & Immunology by Al-Janabi, et al.

Limited research has delved into the immunological and genetic aspects of paradoxical eczema, an adverse event occurring in patients with psoriasis undergoing biologic therapy. For a study, researchers sought to delineate the systemic inflammatory profile of paradoxical eczema using proteomics and investigate potential genetic mediation.

Utilizing the Olink Target 96 Inflammation panel, 256 serum samples from 71 psoriasis patients with paradoxical eczema and 75 control psoriasis patients were analyzed. Differential protein expression and enriched gene sets were identified. Case samples from multiple time points (T1 pre-biologic, T2 post-biologic, and T3 post-paradoxical eczema) were matched 1:1 with control samples. Selected genes contributing to enriched gene sets created polygenic risk scores in an 88-case paradoxical eczema cohort and 3,124 psoriasis controls.

STAMBP expression was lower in cases at T1 than in controls (log-fold change: −0.44; adjusted P = .022). Although no other proteins reached statistical significance at equivalent time points, 11 gene sets, including cytokine and chemokine pathways, were enriched in T2 cases and 10 in T3. Among the 39 proteins contributing to enriched gene sets were associated with the atopic dermatitis serum proteome. A polygenic risk score comprising 38 functional single nucleotide polymorphisms linked to enriched gene sets showed an association with paradoxical eczema (adjusted P = .046).

The systemic inflammatory proteome associated with paradoxical eczema exhibited trends resembling atopic dermatitis at a gene-set level, discernible even before the phenotype’s onset, suggesting a potential genetic basis.

Source: jacionline.org/article/S0091-6749(23)00974-0/fulltext