The biological basis of disease recurrence in psoriasis: a historical perspective and current models
Por:
Puig, L, Costanzo, A, Munoz-Elias, EJ, Jazra, M, Wegner, S, Paul, CF, Conrad, C
Publicada:
1 may 2022
Resumen:
A key challenge in psoriasis therapy is the tendency for lesions to recur in previously affected anatomical locations after treatment discontinuation following lesion resolution. Available evidence supports the concept of a localized immunological 'memory' that persists in resolved skin after complete disappearance of visible inflammation, as well as the role of a specific subpopulation of T cells characterized by the dermotropic CCR4(+) phenotype and forming a local memory. Increasing knowledge of the interleukin (IL)-23/T helper 17 (Th17) cell pathway in psoriasis immunopathology is pointing away from the historical classification of psoriasis as primarily a Th1-type disease. Research undertaken from the 1990s to the mid-2000s provided evidence for the existence of a large population of CD8(+) and CD4(+) tissue-resident memory T cells in resolved skin, which can initiate and perpetuate immune responses of psoriasis in the absence of Tcell recruitment from the blood. Dendritic cells (DCs) are antigen-presenting cells that contribute to psoriasis pathology via the secretion of IL-23, the upstream regulator of Th17 cells, while plasmacytoid DCs are involved via IL-36 signalling and type I interferon activation. Overall, the evidence discussed in this review indicates that IL-23-driven/IL-17-producing T cells play a critical role in psoriasis pathology and recurrence, making these cytokines logical therapeutic targets. The review also explains the clinical efficacy of IL-17 and IL-23 receptor blockers in the treatment of psoriasis.
Filiaciones:
Puig, L:
Hosp Santa Creu & Sant Pau, Dept Dermatol, Barcelona, Spain
Costanzo, A:
IRCCS Humanitas Res Hosp, Unit Dermatol, Milan, Italy
Humanitas Univ, Dept Biomed Sci, Milan, Italy
Munoz-Elias, EJ:
Janssen Res & Dev, Dept Immunol Translat Biol Biomarkers & Early Dev, CA Spring House, La Jolla, PA USA
Jazra, M:
Janssen Cilag, Med Affairs, Paris, France
Wegner, S:
Janssen Cilag GmbH, Med Affairs, Neuss, Germany
Paul, CF:
CHU Toulouse, Hop Larrey, Dept Dermatol, Toulouse, France
Conrad, C:
Univ Hosp CHUV, Dept Dermatol, Lausanne, Switzerland
Green Published, Green
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