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Assessment of tumor necrosis factor alpha and interleukinـ10 in obese psoriatic patients before and after using apremilast
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Background Psoriasis is one of the most prevalent chronic inflammatory skin conditions; its prevalence ranges from 1 to 3%. Tumor necrosis factor-alpha (TNF-α), a cytokine that enhances inflammation, is overexpressed in synovium and skin plaques in psoriasis. TNF-α plays a critical role in the pathogenesis of psoriasis. IL-10 is the most crucial cytokine for reducing excessive immune responses and decreasing pro-inflammatory reactions in all autoimmune disorders.   Objective To evaluate the effect of Apremilast on ILـ10, TNFـα, and BMI in obese psoriatic patients.   Methods Thirty patients included in this investigative study to measure the concentrations of TNFـα, ILـ10 and BMI, before and after receiving Apremilast. TNFـα and ILـ10 were examined by ELISA technique.   Results The present work found that the concentration of TNF-α before receiving Apremilast was 286.80 pg/ml, and after six months from baseline, it was reduced to 131.08 pg/ml (P<0.01). Also, IL-10 before using Apremilast was 69.28 pg/ml, and after six months of treatment it increased to 112.57 ±7.89, which was statistically significant (P<0.01). There were no statistically significant differences in BMI (P>0.05).   Conclusion Apremilast significantly reduced the inflammatory cytokine TNF-α and increased the anti-inflammatory cytokine IL-10, leading to improvement in psoriasis lesions. It also reduced Body Mass Index in obese psoriatic patients.  

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