Treatment Class May Worsen Fungal Infections in Patients With Psoriasis

Therapeutic blockage of the pro-inflammatory cytokine interleukin-17A could exacerbate fungal infections in patients with several autoimmune diseases such as psoriasis and psoriatic arthritis, according to a review article published online in the journal Giornale Italiano di Dermatologia e Venereologia. 

The paper focused on Candida infections in patients with psoriasis and psoriatic arthritis treated with interleukin-17 (IL-17) inhibitors. The review included a study of new anti-IL biologics including secukinumab, ixekizumab, and bromalizumab as well as pivotal trials of bimekizumab. 

“IL-17 activates signaling through the IL-17 receptor,” researchers wrote, “which induces other proinflammatory cytokines, antimicrobial peptides, and neutrophil chemokines that are important for antifungal activity.” 

While excessive IL-17 can also cause unwanted inflammatory effects, IL-17 deficits reduce control against some infections, researchers explained.  

“Therefore,” they advised, “a better understanding of IL-17-mediated immunity to Candida is necessary for the development of autoimmune therapeutics that maintain antifungal immunity.”

—Jolynn Tumolo 

Reference: 

Rodríguez-Cerdeira C, González-Cespón JL, Martínez-Herrera E, et al. Candida infections in patients with psoriasis and psoriatic arthritis treated with interleukin-17 inhibitors and their practical management [published online ahead of print, 2020 Oct 7]. G Ital Dermatol Venereol. 2020;10.23736/S0392-0488.20.06580-3. doi:10.23736/S0392-0488.20.06580-3