The biological basis of disease recurrence in psoriasis : a historical perspective and current models
Puig Sanz, Lluís (Institut d'Investigació Biomèdica Sant Pau)
Costanzo, Antonio (Humanitas University)
Muñoz-Elías, Ernesto J. (Janssen Research & Development)
Jazra, Maria (Medical Affairs)
Wegner, Sven (Janssen-Cilag GmbH)
Paul, Carle (Hôpital Larrey)
Conrad, Curdin (University Hospital CHUV)
Universitat Autònoma de Barcelona

Fecha:	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 T-cell 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.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	British journal of dermatology, Vol. 186 Núm. 5 (may 2022) , p. 773-781, ISSN 1365-2133

DOI: 10.1111/bjd.20963
PMID: 34939663

9 p, 1.1 MB

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