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Abstract：
Psoriasis is a chronic inflammatory disease that sometimes necessitates therapeutic intervention with biologics. Autoantibody production during treatment with tumor necrosis factor (TNF) inhibitors is a recognized phenomenon, however, the production of autoantibodies associated with antiphospholipid syndrome (APS) has not been comprehensively evaluated in patients with psoriasis. This study was conducted to assess the prevalence of APS-associated autoantibodies in patients with psoriasis treated with different biologics and to investigate the potential associations between autoantibody production and clinical or serological parameters. Patients with psoriasis undergoing biologics treatments were enrolled in this study, and were categorized based on the type of biologics administered, TNF, interleukin (IL)-17, or IL-23 inhibitors. Clinical and serological data were collected and analyzed in conjunction with data on APS autoantibodies. TNF inhibitors were associated with a higher frequency of APS autoantibodies compared to IL-17 and IL-23 inhibitors. Notably, the presence of APS autoantibodies correlated with concurrent arthritis and higher disease severity at treatment initiation in patients treated with TNF inhibitors. Elevated Psoriasis Area and Severity Index scores and anti-nuclear antibody titers higher than × 320 were predictors of APS autoantibody production. Despite the higher autoantibody rates, clinical symptoms of APS were absent in these patients. This study provides the first comprehensive evidence of an increased frequency of APS autoantibodies associated with TNF inhibitor treatment in patients with psoriasis. The observed association between APS autoantibody positivity and TNF inhibitor treatment or clinical parameters suggests a potential immunomodulatory interplay between autoimmunity and inflammation in the pathogenesis of psoriasis.
摘要：
牛皮癣是一种慢性炎症性疾病，有时需要生物制剂的治疗干预。在使用肿瘤坏死因子（TNF）抑制剂治疗期间产生自身抗体是一种公认的现象，然而,在银屑病患者中,与抗磷脂综合征(APS)相关的自身抗体的产生尚未得到全面评估.这项研究是为了评估接受不同生物制剂治疗的银屑病患者中APS相关自身抗体的患病率，并研究自身抗体产生与临床或血清学参数之间的潜在关联。接受生物制剂治疗的银屑病患者参加了这项研究，并根据所管理的生物制品的类型进行分类，TNF,白介素（IL）-17或IL-23抑制剂。收集临床和血清学数据，并结合APS自身抗体数据进行分析。与IL-17和IL-23抑制剂相比，TNF抑制剂与较高频率的APS自身抗体相关。值得注意的是,在接受TNF抑制剂治疗的患者中,APS自身抗体的存在与并发关节炎和开始治疗时更高的疾病严重程度相关.银屑病面积和严重程度指数评分升高以及抗核抗体滴度高于×320是APS自身抗体产生的预测因子。尽管自身抗体率较高，这些患者没有APS的临床症状.这项研究提供了第一个全面的证据，表明银屑病患者中与TNF抑制剂治疗相关的APS自身抗体频率增加。观察到的APS自身抗体阳性与TNF抑制剂治疗或临床参数之间的关联表明，在牛皮癣的发病机理中，自身免疫与炎症之间存在潜在的免疫调节相互作用。
