1. Date of download: 7/9/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Clinical and Immunologic Assessment of Patients With Psoriasis in a Randomized, Double-blind, Placebo-Controlled Trial Using Recombinant Human Interleukin 10 Arch Dermatol. 2002;138(10):1341-1346. doi:10.1001/archderm.138.10.1341 Patient disposition. rhIL-10 indicates recombinant human interleukin 10; FDA, US Food and Drug Administration. Figure Legend:

2. Date of download: 7/9/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Clinical and Immunologic Assessment of Patients With Psoriasis in a Randomized, Double-blind, Placebo-Controlled Trial Using Recombinant Human Interleukin 10 Arch Dermatol. 2002;138(10):1341-1346. doi:10.1001/archderm.138.10.1341 Recombinant human interleukin 10 (rhIL-10) leads to transient clinical improvement. Representative clinical photographs of an rhIL- 10–treated patient showing significant improvement at week 6 (Psoriasis Area Severity Index [PASI] score = 6.6) compared with baseline (PASI score = 31.8) and disease flare at week 12 (PASI score = 19.1). Figure Legend:

3. Date of download: 7/9/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Clinical and Immunologic Assessment of Patients With Psoriasis in a Randomized, Double-blind, Placebo-Controlled Trial Using Recombinant Human Interleukin 10 Arch Dermatol. 2002;138(10):1341-1346. doi:10.1001/archderm.138.10.1341 Recombinant human interleukin 10 (rhIL-10) leads to decreases in platelet counts, hemoglobin levels, and cholesterol levels and increases in serum IgE levels. Absolute mean values ± SEMs for either rhIL-10–treated (closed diamonds or closed bars) or placebo-treated (open circles or open bars) patients during the study are shown. To convert cholesterol to millimoles per liter, multiply by 0.0259. Figure Legend:

4. Date of download: 7/9/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Clinical and Immunologic Assessment of Patients With Psoriasis in a Randomized, Double-blind, Placebo-Controlled Trial Using Recombinant Human Interleukin 10 Arch Dermatol. 2002;138(10):1341-1346. doi:10.1001/archderm.138.10.1341 Recombinant human interleukin 10 (rhIL-10) leads to decreased production of type 1 and proinflammatory cytokines by peripheral blood CD4 + T cells and monocytes. Peripheral blood mononuclear cells were collected at 0 (baseline), 6, and 12 weeks in the study, frozen, thawed, and restimulated with 4-α-phorbol 12-myristate 13-acetate and ionomycin. Intracellular cytokine production was quantified using monoclonal antibody staining and flow cytometry. A, Representative dot plots from a single patient receiving rhIL-10 showing decreased interferon γ (IFN-γ) and increased IL-4 production by CD4 + T cells throughout 12 weeks. B, Mean IFN-γ/IL-4 production ratio in CD4 + T cells throughout 12 weeks, using the ratio at week 0 (baseline) as 100% (left panel). Mean percentage of CD4 + T cells or monocytes producing tumor necrosis factor α (TNF-α) throughout 12 weeks, using the percentage of cells at week 0 (baseline) as 100%. T cells and monocytes were identified and gated based on CD4 expression and forward scatter–side scatter profile. Closed diamonds indicate rhIL-10–treated patients; open diamonds, placebo-treated patients; asterisk, P<.05; and dagger, P<.005. Figure Legend: