Psoriasis Pathogenesis and Treatment

Overview

Journal Int J Mol Sci

Publisher MDPI

Specialties Biochemistry
Chemistry
Molecular Biology

Date 2019 Mar 27

PMID 30909615

Citations 623

Authors

Adriana Rendon

Knut Schakel

Affiliations

Soon will be listed here.

Abstract

Research on psoriasis pathogenesis has largely increased knowledge on skin biology in general. In the past 15 years, breakthroughs in the understanding of the pathogenesis of psoriasis have been translated into targeted and highly effective therapies providing fundamental insights into the pathogenesis of chronic inflammatory diseases with a dominant IL-23/Th17 axis. This review discusses the mechanisms involved in the initiation and development of the disease, as well as the therapeutic options that have arisen from the dissection of the inflammatory psoriatic pathways. Our discussion begins by addressing the inflammatory pathways and key cell types initiating and perpetuating psoriatic inflammation. Next, we describe the role of genetics, associated epigenetic mechanisms, and the interaction of the skin flora in the pathophysiology of psoriasis. Finally, we include a comprehensive review of well-established widely available therapies and novel targeted drugs.

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References

McMillin B, Maddern B, Graham W . A role for tonsillectomy in the treatment of psoriasis?. Ear Nose Throat J. 1999; 78(3):155-8. View

Rapp S, Feldman S, Exum M, Fleischer Jr A, Reboussin D . Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol. 1999; 41(3 Pt 1):401-7. DOI: 10.1016/s0190-9622(99)70112-x. View

Mallon E, Bunce M, Savoie H, Rowe A, Newson R, Gotch F . HLA-C and guttate psoriasis. Br J Dermatol. 2000; 143(6):1177-82. DOI: 10.1046/j.1365-2133.2000.03885.x. View

Ho V, Griffiths C, Berth-Jones J, Papp K, Vanaclocha F, Dauden E . Intermittent short courses of cyclosporine microemulsion for the long-term management of psoriasis: a 2-year cohort study. J Am Acad Dermatol. 2001; 44(4):643-51. DOI: 10.1067/mjd.2001.112400. View

Christophers E . Psoriasis--epidemiology and clinical spectrum. Clin Exp Dermatol. 2001; 26(4):314-20. DOI: 10.1046/j.1365-2230.2001.00832.x. View

Davidson A, Diamond B . Autoimmune diseases. N Engl J Med. 2001; 345(5):340-50. DOI: 10.1056/NEJM200108023450506. View

Parham C, Chirica M, Timans J, Vaisberg E, Travis M, Cheung J . A receptor for the heterodimeric cytokine IL-23 is composed of IL-12Rbeta1 and a novel cytokine receptor subunit, IL-23R. J Immunol. 2002; 168(11):5699-708. DOI: 10.4049/jimmunol.168.11.5699. View

Gollnick H, Altmeyer P, Kaufmann R, Ring J, Christophers E, Pavel S . Topical calcipotriol plus oral fumaric acid is more effective and faster acting than oral fumaric acid monotherapy in the treatment of severe chronic plaque psoriasis vulgaris. Dermatology. 2002; 205(1):46-53. DOI: 10.1159/000063148. View

Gudjonsson J, Karason A, Antonsdottir A, Runarsdottir E, Hauksson V, Upmanyu R . Psoriasis patients who are homozygous for the HLA-Cw*0602 allele have a 2.5-fold increased risk of developing psoriasis compared with Cw6 heterozygotes. Br J Dermatol. 2003; 148(2):233-5. DOI: 10.1046/j.1365-2133.2003.05115.x. View

10.

Salomon J, Szepietowski J, Proniewicz A . Psoriatic nails: a prospective clinical study. J Cutan Med Surg. 2003; 7(4):317-21. DOI: 10.1007/s10227-002-0143-0. View

11.

Carboni I, de Felice C, De Simoni I, Soda R, Chimenti S . Fumaric acid esters in the treatment of psoriasis: an Italian experience. J Dermatolog Treat. 2004; 15(1):23-6. DOI: 10.1080/09546630310019346. View

12.

Johnston A, Gudjonsson J, Sigmundsdottir H, Love T, Valdimarsson H . Peripheral blood T cell responses to keratin peptides that share sequences with streptococcal M proteins are largely restricted to skin-homing CD8(+) T cells. Clin Exp Immunol. 2004; 138(1):83-93. PMC: 1809187. DOI: 10.1111/j.1365-2249.2004.00600.x. View

13.

Sagoo G, Cork M, Patel R, Tazi-Ahnini R . Genome-wide studies of psoriasis susceptibility loci: a review. J Dermatol Sci. 2004; 35(3):171-9. DOI: 10.1016/j.jdermsci.2004.02.009. View

14.

Allen M, Ameen H, Veal C, Evans J, Ramrakha-Jones V, Marsland A . The major psoriasis susceptibility locus PSORS1 is not a risk factor for late-onset psoriasis. J Invest Dermatol. 2005; 124(1):103-6. DOI: 10.1111/j.0022-202X.2004.23511.x. View

15.

Hwu W, Yang C, Fann C, Chen C, Tsai T, Chien Y . Mapping of psoriasis to 17q terminus. J Med Genet. 2005; 42(2):152-8. PMC: 1736001. DOI: 10.1136/jmg.2004.018564. View

16.

Sonkoly E, Bata-Csorgo Z, Pivarcsi A, Polyanka H, Kenderessy-Szabo A, Molnar G . Identification and characterization of a novel, psoriasis susceptibility-related noncoding RNA gene, PRINS. J Biol Chem. 2005; 280(25):24159-67. DOI: 10.1074/jbc.M501704200. View

17.

Lizzul P, Aphale A, Malaviya R, Sun Y, Masud S, Dombrovskiy V . Differential expression of phosphorylated NF-kappaB/RelA in normal and psoriatic epidermis and downregulation of NF-kappaB in response to treatment with etanercept. J Invest Dermatol. 2005; 124(6):1275-83. DOI: 10.1111/j.0022-202X.2005.23735.x. View

18.

Nestle F, Conrad C, Tun-Kyi A, Homey B, Gombert M, Boyman O . Plasmacytoid predendritic cells initiate psoriasis through interferon-alpha production. J Exp Med. 2005; 202(1):135-43. PMC: 2212894. DOI: 10.1084/jem.20050500. View

19.

Bowcock A, Krueger J . Getting under the skin: the immunogenetics of psoriasis. Nat Rev Immunol. 2005; 5(9):699-711. DOI: 10.1038/nri1689. View

20.

Nair R, Stuart P, Nistor I, Hiremagalore R, Chia N, Jenisch S . Sequence and haplotype analysis supports HLA-C as the psoriasis susceptibility 1 gene. Am J Hum Genet. 2006; 78(5):827-851. PMC: 1474031. DOI: 10.1086/503821. View