Cutaneous adipose tissue carries a strong inflammatory signature in patients with psoriasis.

Clinical Snapshot

Key Findings

• P Value: Not specified in abstract

• Effect Size: Marked improvement in inflammatory signatures with secukinumab treatment

• Primary Outcome: 2132 differentially expressed transcripts in psoriatic CAT compared to healthy controls

• Nnt Or Sensitivity: Greater than 2-fold higher number of differentially expressed genes in obese vs non-obese psoriatic CAT

• Confidence Interval: Not reported in abstract

Clinical Application

Secukinumab is established therapy; CAT biopsy techniques are specialised but feasible in research/tertiary settings Secukinumab is PBS-listed for psoriasis in Australia; findings support systemic inflammation concept relevant to Australian dermatology and rheumatology practice Adult patients with psoriasis, particularly those with concurrent obesity

Abstract

This study provides a comprehensive evaluation of the cutaneous adipose tissue (CAT) transcriptome in patients with psoriasis and investigates the effects of IL-17 blockade on CAT inflammation through a randomized placebo-controlled trial using secukinumab (ObePso-S study, ClinicalTrials.gov NCT03055494). RNA sequencing analysis of CAT biopsies from 82 patients with psoriasis revealed 2132 differentially expressed transcripts compared with healthy controls. Notably, significant gene dysregulation was observed in both lesional skin (LS)-CAT and non-lesional (NL)-CAT, including activation of IL-17-driven pathways, antimicrobial peptide-related, and neutrophil degranulation signatures. Stratification by obesity demonstrated that obese psoriatic CAT exhibited a more than 2-fold higher number of differentially expressed genes than non-obese counterparts, suggesting a synergistic interaction between psoriasis and obesity in driving CAT inflammation. Treatment with secukinumab markedly improved inflammatory signatures in psoriatic CAT, with greater improvements observed in obese patients. These findings reveal a pronounced and partially IL-17-dependent inflammatory phenotype in psoriatic CAT, challenge the conventional concept of psoriasis as a solely superficial skin disease, and highlight CAT as an important contributor to systemic inflammation in psoriasis.

References

1. 1.Shishido-Takahashi, N., Garcet, S., Cueto, I., Hur, H. B., Muscianisi, E., Steadman, J., Blauvelt, A., & Krueger, J. G. (2026). Cutaneous adipose tissue carries a strong inflammatory signature in patients with psoriasis. JCI Insight. https://doi.org/10.1172/jci.insight.194171