Updated Genetic Background of Generalized Pustular Psoriasis As an Autoinflammatory Keratinization Disease

Overview

Journal J Dermatol

Specialty Dermatology

Date 2024 Dec 19

PMID 39698752

Authors

Masashi Akiyama

Affiliations

Soon will be listed here.

Abstract

Generalized pustular psoriasis (GPP) is a severe autoinflammatory keratinization disease (AiKD) characterized by acute flares of widespread sterile pustules and high fever. GPP is potentially life-threatening. Recently clarified genetic predisposing factors for GPP suggest that the excessive activation of innate immune pathways in the skin, including of interleukin (IL)-1 and IL-36 signaling, plays a significant role in the GPP pathogenesis. IL36RN, CARD14, AP1S3, MPO, SERPINA3, BTN3A3, and MEFV have been identified as GPP-related genes. The pathogenesis of GPP provoked by variants in these seven genes is tightly associated with the excessive activation of innate immune pathways and the resulting autoinflammation in the skin. Various biologics, including inhibitors for the tumor necrosis factor, IL-17, and IL-23 pathways, are used as treatments for GPP. The new understanding of the genetic background of GPP, mentioned above, indicates that the genetic predisposing factors are predominantly related to the excessive activation of innate immunity and autoinflammation. In this context, inhibitors of inflammatory signaling, including of the IL-1 and IL-36 pathways, have been used in clinical practice and investigated as potential future therapies.

Citing Articles

Updated genetic background of generalized pustular psoriasis as an autoinflammatory keratinization disease.

Akiyama M J Dermatol. 2024; 52(3):400-407.

PMID: 39698752 PMC: 11883853. DOI: 10.1111/1346-8138.17585.

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