Inflammatory Biomarkers for Assessing Treatment Response in Psoriasis: A Narrative Review

Abstract

Psoriasis vulgaris is a chronic immune-mediated inflammatory disease in which treatment response is assessed using clinical indices such as the Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI), despite their limited ability to capture systemic inflammation and underlying immunological activity. This narrative review aims to summarize current evidence on inflammatory biomarkers for monitoring treatment response and to evaluate their potential clinical utility. A structured, non-systematic literature search was performed in April–May 2026 across PubMed, Cochrane Library, Scopus, and ClinicalTrials.gov, focusing primarily on literature published during the preceding 10 years, with selected earlier studies being retained when directly relevant. Emerging data indicate that multiple biomarker domains may reflect therapeutic outcomes, including cytokines and chemokines, acute-phase proteins, complete-blood-count (CBC)-derived inflammatory indices, genetic markers, micro(mi)RNAs, metabolomic and lipidomic profiles, and tissue-based markers. These biomarkers may serve as severity-associated, baseline-predictive, pharmacodynamic, or prognostic markers, and these roles should not be interpreted interchangeably. Nevertheless, discrepancies between biomarker dynamics and clinical improvement occur, reflecting the partial dissociation between local and systemic inflammation, disease heterogeneity, and differences in response kinetics. Although inflammatory biomarkers provide a biologically grounded framework for assessing treatment response, their clinical implementation remains limited. Further large-scale, standardized studies are required to validate candidate markers and support the development of integrated, multi-omics approaches for personalized management.