Anti-tumor necrosis factor drug responses and skin-blood DNA methylation age: Relationships in moderate-to-severe psoriasis

Jamaji C. Nwanaji-Enwerem, Ugoji Nwanaji-Enwerem, Andrea A. Baccarelli, Ramone F. Williams, Elena Colicino

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Studies have examined the utility of DNA methylation as a biomarker of psoriasis treatment responses, but investigations of treatment responses with Skin-Blood DNA methylation age (SkinBloodAge)—a methylation-based measure of health designed using skin tissues—are lacking. Using a HumanMethylation450 BeadChip blood DNA methylation data set from 70 white patients who presented with moderate-to-severe plaque psoriasis and were treated with anti-tumor necrosis factor (TNF) agents in Madrid, Spain, we examined the cross-sectional relationships of SkinBloodAge with anti-TNF treatment responses. Partial responders had a 7.2-year higher mean SkinBloodAge than excellent responders (P =.03). In linear regression models adjusted for chronological age, sex and anti-TNF agents - on average - partial responders had a 2.65-year higher SkinBloodAge than excellent responders (95%CI: 0.44, 4.86, P =.02). This relationship was attenuated in a sensitivity analysis adjusting for white blood cells including known T-cell mediators of psoriasis pathophysiology (β = 1.91-years, 95%CI: −0.50, 4.32, P =.12). Overall, our study suggests that partial responders to anti-TNF therapy have higher SkinBloodAges when compared to excellent responders. Although these findings still need to be confirmed more broadly, they further suggest that SkinBloodAge may be a useful treatment response biomarker that can be incorporated with other blood tests before anti-TNF therapy initiation in moderate-to-severe psoriasis patients.

Original languageEnglish
Pages (from-to)1197-1203
Number of pages7
JournalExperimental Dermatology
Issue number8
StatePublished - Aug 2021


  • DNA methylation age
  • ageing
  • anti-TNF
  • biomarkers
  • epigenetic age
  • epigenetic clock
  • psoriasis
  • skinblood clock


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