Transcriptomic Analysis Identifies Dual Th17/Type 2 Immune Signature in Taiwanese Patients With Psoriasis
A transcriptomic analysis of Taiwanese patients with chronic plaque psoriasis identified a distinct dual Th17/type 2 immune endotype accompanied by marked IL-36 activation, highlighting potential opportunities for population-specific therapeutic strategies.
Although the IL-23/Th17 axis is recognized as a central driver of psoriasis, molecular heterogeneity across different ethnic populations has not been well characterized. Investigators analyzed lesional and nonlesional skin biopsies from 11 patients with chronic plaque psoriasis and compared them with normal skin samples from 9 healthy controls using bulk RNA sequencing. Serum cytokine levels were subsequently validated in 50 patients with psoriasis and 9 healthy controls.
The analysis identified 4694 differentially expressed genes between lesional psoriasis skin and normal skin. Consistent with established disease biology, investigators confirmed robust activation of the Th17 pathway, including increased expression of IL-17A, IL-17C, and IL-23A. However, the study also identified an unexpected type 2 inflammatory component. According to the authors, “a profound dual immune dysregulation was identified,” characterized by significant upregulation of type 2 markers, including IL-4R, CCL17, and thymic stromal lymphopoietin.
Among cytokine pathways, IL-36 signaling demonstrated the strongest activation. The investigators reported that “the IL-36 family was the most highly activated cytokine axis,” with IL-36G exhibiting the greatest increase in expression.Genes involved in epidermal barrier function, including KRT77 and GJB4, were significantly downregulated, suggesting impaired barrier integrity.
Correlation analyses also identified potential biomarkers of disease severity. IL-36RN and the combined expression of AREG and CDSN demonstrated strong correlations with Psoriasis Area and Severity Index scores.The authors acknowledged that the findings are limited by the relatively small sample size and focus on a single ethnic population and emphasized that the transcriptomic data demonstrate associations rather than causality.
Reference
Chen CH, Lee MS, Chang WY, et al. Uncovering a dual th17/type 2 transcriptomic endotype in psoriasis. J Am Acad Dermatol. Published online July 2, 2026. doi:10.1016/j.jaad.2026.06.131
