Assessing Disease-Modifying Effects of IL-23 Inhibition by Guselkumab on T-Cell Profile Shifts

Anti-IL-23 antibody therapies result in improvements to the underlying immunopathology of psoriasis. However, the dynamics of the immune profile after the administration of anti-IL-23 biologics, along with their association with treatment response, remain unclear investigation. We focused on guselkumab, an anti-IL-23p19 antibody, and performed a comprehensive analysis of immune cells, serum inflammatory molecules, and transcriptomics of CD4+ T cells, aiming to identify disease-modifying drug effects in psoriasis. A total of 24 biologic-naive patients were enrolled. Peripheral and skin lesional blood samples were collected at baseline and after treatment with guselkumab. We conducted FACS analysis of regulatory T cells (Tregs), resident memory T cells (TRMs), and dendritic cells, measured serum cytokine and chemokine levels, and examined gene expression changes using RNA-seq data for peripheral CD4+ T cells. RNA-seq of 1.0×10⁵ CD4 cells from peripheral blood before and at 4 and 12 weeks after Guselkumab administration.