GLP-1 Receptor Agonists, Obesity And Psoriasis

I have previously discussed the not too uncommon association between obesity and psoriasis, a chronic, autoimmune disease that causes red, scaly patches to appear on the skin, and affects 2-3% of the population in Western countries.

Hogan and colleagues, St Vincent’s University Hospital, University College Dublin, Ireland, in a paper just published in Diabetologia, now report improvement of psoriasis in three obese patients with type 2 diabetes several weeks after the initiation of therapy with the glucagon-like peptide-1 (GLP-1) receptor (GLP-1R) agonists exenatide and liraglutide.

Regular readers may recall that GLP-1 receptor agonists were recently introduced for the treatment of diabetes and are currently under investigation for the treatment of obesity.

In addition to the clinical improvement, with reduced itching and/or a reduction in Psoriasis Area and Severity Index (PASI) scores, they also provide evidence that GLP-1 receptor agonist treatment had immunological effects in that it increased the number of natural killer T (NKT) cells in the circulation and reduced the number of invariant NKT cells in the psoriatic plaques.

In an accompanying commentary, Drucker and Rosen from the University of Toronto, point out that apart from the ‘classical’ metabolic effects of GLP-1 (e.g. on the secretion of insulin and glucagon), GLP-1 receptors are also found in numerous immune cell subpopulations, including thymoyctes, splenocytes, bone marrow-derived cells, and regulatory T cells.

It is therefore biologically ‘plausible’ that administration of GLP-1 analogues could have anti-inflammatory effects on psoriasis (and perhaps other inflammatory abnormalities).

Obviously, a few cases do not yet make an indication, but they certainly suggest that this hypothesis may well be worthy of further study.

I certainly wonder, if any of my readers have experienced similar improvements in inflammatory conditions like psoriasis with the use of GLP-1 analogues.

Edmonton, Alberta

Hogan AE, Tobin AM, Ahern T, Corrigan MA, Gaoatswe G, Jackson R, O’Reilly V, Lynch L, Doherty DG, Moynagh PN, Kirby B, O’Connell J, & O’Shea D (2011). Glucagon-like peptide-1 (GLP-1) and the regulation of human invariant natural killer T cells: lessons from obesity, diabetes and psoriasis. Diabetologia PMID: 21744074

Drucker DJ, & Rosen CF (2011). Glucagon-like peptide-1 (GLP-1) receptor agonists, obesity and psoriasis: diabetes meets dermatology. Diabetologia PMID: 21892687