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TL1A Expression in Psoriatic Skin

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01744327
Recruitment Status : Unknown
Verified May 2013 by Bo Bang, MD, Ph.D, Bispebjerg Hospital.
Recruitment status was:  Active, not recruiting
First Posted : December 6, 2012
Last Update Posted : May 29, 2013
University of Copenhagen
Information provided by (Responsible Party):
Bo Bang, MD, Ph.D, Bispebjerg Hospital

Brief Summary:
TL1A is a newly discovered signal molecule that may be crucially involved in the maintenance of chronic inflammatory disorders. TL1A has also been demonstrated in psoriatic skin but the importance of TL1A in psoriasis is still unknown. Understanding inflammatory signal molecules in psoriasis is important because the development of new drugs directed against relevant signal molecules (e.g. TNF-α and IL12/23) has proved to be a very efficacious treatment principle. However, despite the dramatic progress in therapeutic options during the last decade, there is still a fraction of patients that are insufficiently treated with the currently available therapies. TL1A has been claimed to be the next important target for development of biologics in the field of chronic inflammation.

Condition or disease

Detailed Description:

Psoriasis is a common autoimmune disease; affecting approximately 2 % of the western population. Among these 15% are estimated to have severe disease that requires systemic therapy with e.g. methotrexate, cyclosporine or acitretin that are all drugs associated with high frequencies of side-effects. In contrast to this the recent development of the biologic drugs has provided very efficacious and in general well-tolerated new therapeutics. But even with these newer drugs treatment-failures exist and for this group new treatments are needed TNF-like ligand 1A (TL1A) is a novel member of the TNF family of cytokines. Increasing evidence suggests that in addition to TNF-alfa and IFN-gamma psoriasis is also an IL-23 and IL-17 dependent disease so TH1 and TH17 T cells are suggested to be important in driving the disease. Therefore TL1A, which through binding to DR3 influences TH1 and TH17 T cell differentiation, could be an important cytokine in the early inflammatory process in psoriasis. Recently expression of TL1A in psoriatic skin lesions has been demonstrated but the importance of this remains to be investigated.

TL1A exists in both a membrane bound- and a soluble form and is secreted from antigen presenting cells (APCs) such as monocytes, dendritic cells and macrophages in response to stimulation with immune complexes, bacteria or cytokines (TNF-alfa and IL-1beta). Membrane bound TL1A has also been described in T cells. Recently, a new isoform of soluble TL1A (TL1A(V84-L251)) was discovered with functional differences to TL1A(L72-L251. It's unknown whether this isoform is present in psoriatic skin.

Research on TL1A has focused on autoimmune diseases where immune complexes are formed, e.g. rheumatoid arthritis. However, studies have suggested that early pathogenesis in psoriasis could dependent on formation of large complexes between bacterial DNA and the anti-microbial peptide LL-37 which induce cytokine secretion from APC. Cytokines that could lead to TL1A excretion. Whether TL1A can be secreted in this way is unknown.

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Study Type : Observational
Estimated Enrollment : 20 participants
Observational Model: Case-Control
Time Perspective: Prospective
Official Title: An Exploratory Study Investigating TL1A Expression in Psoriatic Skin and Serum and Monocytes Capacity to Produce TL1A
Study Start Date : December 2012
Estimated Primary Completion Date : December 2013

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Psoriasis

Chronic Plaque type psoriasis
Patients with plaque type psoriasis

Primary Outcome Measures :
  1. Expression of TL1A in psoriatic skin [ Time Frame: 3 months ]
    Staining intensity of TL1A by IHC in involved psoriatic skin compared to uninvolved and skin from normal controls

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
Plaque type psoriasis

Inclusion Criteria:

  • Plaque type psoriasis
  • at least 6 month history of psoriasis

Exclusion Criteria:

  • systemic anti-psoriatic medication
  • topical anti-psoriatic medication (wash-out period 2 weeks)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01744327

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Department of dermatology D40 , Bispebjerg Hospital
Copenhagen, Denmark, 2400 NV
Sponsors and Collaborators
Bispebjerg Hospital
University of Copenhagen
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Responsible Party: Bo Bang, MD, Ph.D, Chief Physician, Associate Professor, Bispebjerg Hospital Identifier: NCT01744327    
Other Study ID Numbers: 331536
First Posted: December 6, 2012    Key Record Dates
Last Update Posted: May 29, 2013
Last Verified: May 2013
Additional relevant MeSH terms:
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Skin Diseases, Papulosquamous
Skin Diseases