Role of TLR7 in the immunopathogenesis of psoriasis and psoriatic arthritis

Abstract

BACKGROUND: Toll-like receptor 7 (TLR7) plays a significant role in the development of inflammation in psoriasis. However, there are very few data on the role of different polymorphic markers of the TLR7 gene in psoriasis and psoriatic arthritis.

AIM: Study of the role of polymorphic marker rs179009 of TLR7 gene in patients with severe psoriasis.

MATERIALS AND METHODS: The study was conducted during the period of 2016–2024. The analysis of innate immunity indicators in the study group was performed by obtaining RNA in peripheral venous blood and polymorphisms of the gene recognizing marker rs179009 of the TLR7 receptor were investigated by polymerase chain reaction with TaqMan probes. To assess the area and severity of psoriatic lesions of the skin process, we used a standardised method of assessment — determination of the PASI index.

RESULTS: The main group consisted of 168 patients (100%) with psoriasis. Of these, 45 (26.8%) were women and 123 men (73.2%). The average age of the patients was 54.0±14.0 years. The mean duration of psoriasis course was 11.8±0.6 years. The mean psoriasis area and severity index (PASI) value was 17.7±7.2. When analyzing the genotypes of polymorphic marker rs179009 in the TLR7 gene in patients with psoriasis of different severity, it was revealed that heterozygote CT was significantly more frequent in patients with mild psoriasis, and homozygote CC and homozygote TT were registered at PASI >10 (p <0.05). The C allele of the studied marker was significantly more frequent in patients with late psoriasis debut and late development of psoriatic arthritis (p <0.01). In contrast, the T allele was significantly more frequent in patients with early debut of psoriasis and psoriatic arthritis (p <0.01). When analyzing the genotypes of polymorphic marker rs179009 in the TLR7 gene, the occurrence of homozygous CC and TT genotypes was also found to have statistically significant differences. The CC genotype was more frequently registered in patients with late onset of psoriasis and late onset of arthritis (p <0.05). In contrast, the TT genotype was significantly more frequently registered in patients with the debut of skin and joint process before 40 years of age (p <0.05).

CONCLUSION: In our study it was found that homozygous carriage of CC and TT genotypes of polymorphic marker rs179009 in the TLR7 gene predisposes to a more severe course of the skin process in psoriasis. Also, the presence in the patient of allele C or homozygote CC of marker rs179009 in the TLR7 gene is a predictor of late onset of the skin process and the development of arthritis. While the presence of the T allele or TT homozygote statistically significantly predisposes to early onset of psoriasis and early onset of joint symptoms with the development of psoriatic arthritis.

Keywords

psoriasis / psoriatic arthritis / toll-like receptors / polymorphic marker rs179009 of the TLR7 gene

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