Recombinantly engineered human proteins: transforming the treatment of psoriasis.
Psoriasis is a chronic, inflammatory disease with lesions that produce considerable physical discomfort and often lead to substantial disruption in patients' daily activities. The use of currently available, nonspecific, systemic immunosuppressive therapies for patients with moderate to severe psoriasis is limited by an inability to maintain disease remission safely. Advances in recombinant DNA technology paralleled with increased understanding of the immunopathology of psoriasis have led to the development of numerous biologic agents for the treatment of this disease. These new biologic therapies target specific steps in psoriasis pathology, including direct effects on T cells, T cell activation, T cell migration, and cellular production and secretion of cytokines. By selectively targeting the activities of T cells that are directly involved in psoriasis pathogenesis, these novel agents offer improved safety profiles and enhanced efficacy. In this article, the mechanisms of T cell pathogenicity that guided the development of these new biologic therapies are reviewed along with clinical data on the progress of these agents.
Gottlieb
Alice B
AB
Clinical Research Center, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick 08901, USA. gottliab@umdnj.edu
Bos
Jan D
JD
D000077944:Alefacept; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D016207:Cytokines / Q000037:antagonists & inhibitors; D000077561:Daclizumab; D004167:Diphtheria Toxin / Q000627:therapeutic use; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D007167:Immunotherapy; D000069285:Infliximab; D007376:Interleukin-2 / Q000627:therapeutic use; D008213:Lymphocyte Activation; D018448:Models, Immunological; D015202:Protein Engineering; D011565:Psoriasis / Q000188:drug therapy* / Q000276:immunology / Q000628:therapy; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000235:genetics / Q000627:therapeutic use*; D013601:T-Lymphocytes / Q000276:immunology
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D016207:Cytokines; D004167:Diphtheria Toxin; D007074:Immunoglobulin G; D007376:Interleukin-2; C079851:OKT4A monoclonal antibody; D018124:Receptors, Tumor Necrosis Factor; D011993:Recombinant Fusion Proteins; D011994:Recombinant Proteins; C078456:denileukin diftitox; D000069285:Infliximab; D000077561:Daclizumab; D000077944:Alefacept; D000068800:Etanercept; C437823:galiximab