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PHARMACOGENOMIC INSIGHTS INTO PSORIASIS TREATMENT: IMPACT OF TNF-α GENE POLYMORPHISMS ON ETANERCEPT RESPONSE AND SERUM TNF-α IN IRAQI PATIENTS WITH MODERATE TO SEVERE PSORIASIS
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Psoriasis is a chronic inflammatory condition that requires effective treatment. Genetic variability, particularly in the Tumour Necrosis Factor-alpha (TNF-α) gene, may influence patients’ response to biological therapies such as etanercept. This study evaluated the association of four TNF-α gene polymorphisms (rs361525 G/A, rs673 G/A, rs1800629 G/A, and rs1800750 G/A) with serum TNF-α levels and response to etanercept in Iraqi patients with psoriasis. A retrospective study was conducted on 80 patients with moderate-to-severe psoriasis who received etanercept for at least six months. Patients were categorised as responders (≥ 75% PASI reduction) or non-responders (≤ 50% PASI reduction). Genotyping was performed using PCR and Sanger sequencing. A significant association was observed between the rs673 G/A polymorphism and etanercept response: the GA genotype was predominantly present in responders and showed a negative association with non-response (phi = -0.318, p = 0.007), whereas the GG genotype demonstrated a positive association (phi = 0.411, p = 0.0007). Non-responders had significantly higher post-treatment serum TNF-α levels compared with responders. These findings suggest that the rs673 G/A polymorphism and TNF-α levels may be associated with etanercept response. However, larger studies are needed to validate these associations before clinical implementation.

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Publication Date
Mon Dec 29 2025
Journal Name
Journal Of Advances In Medical And Biomedical Research
Genetic Insights Into Psoriasis Therapy: A Review of Polymorphisms in the Genes of Both TNF-α and the TNF Signaling Pathway on the Response to Anti-TNF-α
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Tumor necrosis factor-alpha (TNF-α) inhibitors are widely used as first-line treatments for moderate to severe plaque psoriasis, yet clinical responses vary considerably among patients despite their overall safety and efficacy. Genetic factors that influence the effectiveness of biologic therapies may contribute to this variability. This review, conducted between May and ...

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Publication Date
Tue Oct 28 2025
Journal Name
Pharmacia
Association of IL-1β gene promoter polymorphisms and serum levels with etanercept response in Iraqi patients with moderate to severe psoriasis
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Psoriasis, a chronic inflammatory dermatological condition, exhibits heterogeneous responses to anti-TNF therapies such as etanercept (ETN), underscoring the need for predictive biomarkers. This study investigated the association of interleukin-1 beta (IL-1β) gene promoter polymorphisms (rs1143623 C/G, rs752338864 C/G, and rs1143627 C/T) with ETN efficacy in 80 Iraqi patients with moderate to severe plaque psoriasis. Patients were categorized according to treatment response: responders achieved ≥ 75% reduction in the Psoriasis Area and Severity Index (PASI), whereas non-responders demonstrated ≤ 50% reduction. Post-treatment serum IL-1β levels were significantly higher in non-responders (50.35 ± 15.81 pg/mL) compared to respo

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Publication Date
Wed Mar 18 2020
Journal Name
Baghdad Science Journal
Incidence of Toxoplasmosis in Psoriasis Patients and Possible Correlation with Tumor Necrosis Factor-α
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            Toxoplasma gondii is an opportunistic parasite in immune-compromised persons. The prevalence of toxoplasmosis in psoriasis patients is investigated. In addition, the treatment effect on psoriasis patients infected with toxoplasmosis through evaluating Tumor Necrosis Factor-α (TNF-α) cytokine levels is studied. Blood samples were collected from 130 individuals who involved 60 control samples and 70 samples with psoriasis. They attended Medical City Hospital in Baghdad province from October 2017 - February 2018. Then, the anti- T. gondii antibodies (IgM and IgG) and TNF- α in the sera were determined via the enzyme linked immune-sorbent assay. The highe

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Publication Date
Sun Oct 31 2021
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn: 2789-3219 )
Evaluation of EOS Gene Expression and IL-6 Serum Levels in Iraqi Patients with Psoriasis
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Background: EOS (encoded by the IKZF4 gene) is a member of the zinc finger transcription factor IKaros family, and plays a critical role in Treg suppressor functions, and maintaining Treg stability. IL-6 is a soluble mediator with a pleiotropic effect on inflammation, immune response, and hematopoiesis. Aim: To estimate serum IL-6 level and EOS gene expression in Iraqi patients with psoriasis. Method: Twenty-two patients with psoriasis (8 females, 14 males) with age ranged 18-72 years, were recruited from Baghdad Teaching Hospital, Dermatology Clinic, Baghdad, and 24 healthy donors. The serum levels of IL-6 by ELISA and the gene expression of IKZF4 (EOS gene) by RT-qPCR technique. Results: The results showed a non-significant diffe

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Publication Date
Wed Sep 27 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Genetic Polymorphism in TNF-α Promoter Region: Its Association with Severity and Susceptibility to Rheumatoid Arthritis in Iraqi Patients with Active Disease
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Objectives: To study the prevalence of rs1799964 (-1031 T/C) and rs361525 (- 238 G/A) SNPs and their effect on the disease activity, severity, and cytokines production in newly diagnosed Iraqi rheumatoid arthritis patients. Patients and Methods: sixty-three patients were diagnosed by a specialist physician while attending the rheumatology unit and twenty control participated. The inflammatory markers were measured and PCR amplification and sequencing were performed to demonstrate TNF-α SNPs. Results: Regarding (-1031 C/T) SNP, the TT genotype and allele C were significantly present in the controls, and the CT genotype was distributed significantly in the patients. The TT genotype was mostly distributed in the mild-moder

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Publication Date
Wed Feb 28 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
The Effects of -806 T/C and -857 T/C Single Nucleotide Polymorphisms in the TNF-α Gene on Rheumatoid Arthritis Severity and Inflammatory Markers
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Background: Polymorphisms in the TNF-α gene affect the development and progression of rheumatoid arthritis. Objective: To investigate the associations between (-806 T/C) and (-857 T/C) SNPs with rheumatoid arthritis severity and susceptibility in a sample of Iraqi patients. Methods: A case-control study was conducted in Baghdad, Iraq. Twenty healthy controls and 63 patients confirmed to be newly diagnosed with rheumatoid arthritis were included. Those are divided into two groups (patients and controls), and the patients were further subdivided into severe and mild-moderate groups. Samples from those participants were analyzed for clinical and inflammatory parameter measurements. Genotyping by the Sanger method was performed to stu

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Publication Date
Fri Dec 23 2022
Journal Name
F1000research
Association between polymorphisms within the gene coding for tumor necrosis factor (TNF)-alpha with outcomes of treatment in a sample of Iraqi patients with ankylosing spondylitis taking etanercept: an observational study
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Background:Ankylosing spondylitis (AS) is a progressive, chronic inflammatory illness with an unclear etiology that explicitly targets the vertebral column, peripheral joints, and extraarticular tissues. The purpose of this research was to investigate if the existence of single nucleotide polymorphisms (SNPs) in the promoter region of the tumor necrosis factor-alpha (TNF-α) gene at positions -1031T/C (rs199964), -857C/T (rs1799724) and -806C/T (rs4248158) in a sample of Iraqi AS patients could influence the patients' outcomes with etanercept.

Methods:Sixty patients with established AS receiving only etanercept were selected to enroll in this study, with a mean age of 40.75±8.6

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Publication Date
Wed Feb 24 2021
Journal Name
Iraqi Journal Of Agricultural Sciences
THE ROLE OF IFN- γ AND TNF- α IN EXPERIMENTAL MASTITIS
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This study was design to characterize the immune response in experimentally Pseudomonas aeruginosa mastitis mice treated probiotic bifidocin and cazacin of Bifidobacterium spp. and Lactobacillus casei. We quantified the level of the IFN-γ and TNF-α cytokines in blood by ELISA technique. IFN-γ level was significantly higher in infected group compared to control (340.21 ± 41.61, 8.45 ± 0.83 pg/ml, respectively). While the level of IFN-γ was significantly higher in mastitis mice than bifidocin and cazacin treated mice. Also, TNF-α level showed a significant increase in mastitis mice compared to controls (320.11±40.33, 8.45±0.83pg/ml, respectively). Among mastitis and bifidocin (9 and 18 mg/ml), cazacin (11 and 22 mg/ml) treate

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Publication Date
Fri Dec 20 2024
Journal Name
Iraqi Journal Of Pharmaceutical Sciences
Genetic Polymorphisms at TNF-Alpha Receptors Associated some Autoimmune Diseases and Response of Anti-TNF Biologics: Review
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Some genetic factors are not only involved in some autoimmune diseases but also interfere with their treatment, Such as Crohn's disease (CD), Rheumatoid Arthritis (RA), ankylosing spondylitis (AS), and psoriasis (PS). Tumor Necrosis Factor (TNF) is a most important pro-inflammatory cytokine, which has been recognized as a main factor that participates in the pathogenesis and development of autoimmune disorders. Therefore, TNF could be a prospective target for treating these disorders, and many anti-TNF were developed to treat these disorders. Although the high efficacy of many anti-TNF biologic medications, the Patients' clinical responses to the autoimmune treatment showed significant heterogeneity. Two types of TNF receptor (TNFR); 1 an

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Publication Date
Sat Dec 24 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of TNF-Alpha Gene Polymorphisms At -376 G/A, -806 C/T, and -1031 T/C on The Likelihood of Becoming a Non-Responder to Etanercept in A Sample of Iraqi Rheumatoid Arthritis Patients
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Tumor necrosis factor-alpha (TNF-α) antagonists’ therapy are expensive and has a non-responsive rate between 30% to 40% in rheumatoid arthritis patients. Genetic variation plays a vital role in the responsiveness to this type of therapy.The aim of this study is to investigate if the presence of genetic polymorphism in the TNF-α gene promoter region at locations -376 G/A (rs1800750), -806 C/T (rs4248158), and -1031 T/C (rs1799964) affects rheumatoid arthritis patient's tendency to be a non-responder to etanercept.

Eighty RA patients on etanercept (ETN) for at least six months were recruited from the Rheumatology Unit at Baghdad Teaching Hospital. Based on The European League Against Rheumatism response (EULAR) criteria, patient

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