Developing Genomic-based Assays with Genetic Assessment

Psoriasis is a chronic, immune mediated polygenic inflammatory skin disease, that results in the appearance of red, scaly plaques occurring most commonly on the elbows, knees, scalp, and lower back of patients. The condition greatly affects the patients wellness to the extent that it could be life-ruining and stigmatizing. Psoriasis is now understood to be a disorder of the immune system where white blood cells become overactive and produce excess amounts of cytokines, such as tumor necrosis factor, interleukin-2, and interferon-gamma. These factors in turn trigger inflammation in the skin and other organs. Psoriasis, now considered a systemic disease, is associated with psychological, metabolic, arthritic, and cardiovascular comorbidities.

Psoriasis cases vary according to age and geographic region, and are more frequently reported in countries distant from the equator. The prevalence of psoriasis in the Indonesian population is estimated at 0.3% (95% CI: 0.06-1.65%).

Currently, the best treatment for psoriasis in Indonesia is Methotrexate (MTX), an immunosuppressant. This medication exhibits interindividual variability in treatment outcomes, and poor clinical response is reported in up to 30% of patients, variability inside effects, including hepatotoxicity, has also been reported and in severe cases it may lead to untimely treatment cessation. It is believed that genetic factors play critical roles in the observed variability in treatment outcomes and side effects.

The current project is aimed at developing genomic-based assays that enable the identification of with poor response of methotrexate treatment as well as methotrexate hepatotoxicity in psoriasis patients. Genetic assessment of these SNPs enables early treatment of psoriasis, which can improve the clinical outcome of longer periods of treatment-free remission, limited spread of lesions to new locations, and potentially complete resolution of psoriatic disease.

Vision

The project’s goal is to develop an easy to implement assay for the characterisation of genes associated with poor response of MTX treatment and MTX hepatotoxicity to improve the outcome of psoriasis patients. The long term aim is the application of personalized pharmacotherapy based on gene polymorphisms for a more efficient, compatible and cost-effective treatment of patients.

Disease Target

Psoriasis

Outcome

• Development genomics test panel for psoriasis
• Collaboration projects with international stakeholders to provide genomics-based services, not only for psoriasis, but also aging, beauty and wellness