The value of genotyping patients for the presence of HLA-C in the personalized treatment of psoriasis

Introduction: Some cases of psoriasis still unfortunately do not respond, do not respond adequately or lose response to biotechnological therapies available to help control psoriasis. The common solution is to switch to other biological drugs, with a corresponding increase in pharmaceutical costs. Genetic polymorphisms have also recently been shown to influence the response of psoriasis patients to biological drugs.Areas covered: The PubMed databases were searched for articles regarding HLA-C and response to biological therapies. Additional publications were collected from references identified in articles and related citations in PubMed.Expert opinion: The clinical response to a specific biological drug may be correlated with genetic variations. Since genetic variations lead to different molecular pathways, identifying genetic markers in psoriasis patients that can predict a response to biologics is of fundamental importance. In this sense, recent evidences published in literature, suggest that HLA-C*06:02 typifies a molecularly different subtype of psoriasis whose maintenance and amplification are strongly controlled by IL12/23 signaling and therefore more responsive to the selective blockade of this signaling pathway, and it is not yet possible to exclude that this allele also influences the response to the most recent anti-IL-17 drugs.