{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T05:52:29Z","timestamp":1769579549083,"version":"3.49.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:00:00Z","timestamp":1618444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The interleukin (IL)\u201023\/T\u2010helper (Th)17 axis is considered central to the pathogenesis of psoriasis, with IL\u201036\u03b3 considered a marker for histological differential diagnosis. However, expression data regarding key cytokines in the pathogenesis of psoriasis, as well as data on the effects of IL\u201023 inhibition on downstream cytokines in human psoriatic skin, are limited. We investigated the expression profile of key cytokines and the effect of ustekinumab (UST) on cytokine expression in human psoriatic tissue. Tumor necrosis factor (TNF)\u2010\u03b1, IL\u201023, IL\u201017A, and IL\u201022 were highly expressed in the epidermis, dermal papillae, and upper dermis in patients with psoriasis compared with controls; IL\u201036\u03b3 was strongly expressed in the upper epidermis. Compared with the untreated group, expression intensity and area of IL\u201023 were significantly decreased in the UST group; expression areas of TNF\u2010\u03b1, IL\u201017A, IL\u201022, and IL\u201036\u03b3 did not differ. This study identified the distribution and quantitative expression levels of key cytokines in psoriatic lesions and demonstrated that only IL\u201023 was downregulated without blocking downstream effector cytokines in recalcitrant psoriatic lesions during UST treatment. Our results suggest that, although IL\u201023 is inhibited, the persistent expression of IL\u201017 through an alternative pathway maintains the vicious cycle of the TNF\u2010\u03b1\/IL\u201023\/IL\u201017 axis with IL\u201036\u03b3, inducing refractory psoriatic lesions in patients with well\u2010controlled psoriasis.<\/jats:p>","DOI":"10.1111\/1346-8138.15822","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T20:29:23Z","timestamp":1618604963000},"page":"876-882","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Persistent expression of interleukin\u201017 and downstream effector cytokines in recalcitrant psoriatic lesions after ustekinumab treatment"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2223-1606","authenticated-orcid":false,"given":"Bo Ri","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Dermatology Seoul 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