Evolution of biologic therapies for the treatment of psoriasis.
Over the past three decades, laboratory and clinical research findings have shown that T cells are the primary mediators of psoriasis pathogenesis and that psoriasis can be treated by eliminating these T cells or interfering with their activation or activity. Based on these observations, many new biologic therapies to treat psoriasis are now in development. These agents, developed primarily through recombinant DNA techniques, are designed to target T cells and the immunologic cascade associated with their activation. Four basic strategic approaches that focus on the steps involved in the immunopathology of psoriasis are: 1) elimination of the pathogenic T cells; 2) inhibition of T-cell activation, proliferation, and migration; 3) immune deviation to down-regulate the type 1 (TH1) response predominant in psoriasis; and 4) blockade of cytokine production. The goal of these new therapies is to improve the treatment of psoriasis, particularly moderate to severe disease, with agents that are well tolerated and safe for long-term use.
Gordon
Kenneth B
KB
Department of Medicine, Division of Dermatology, Loyola University, Stritch School of Medicine, Maywood, IL 60153, USA. kgordon@lumc.edu
McCormick
Thomas S
TS
D001691:Biological Therapy / Q000592:standards* / Q000639:trends; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005544:Forecasting; D006801:Humans; D007167:Immunotherapy / Q000592:standards / Q000639:trends; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D011379:Prognosis; D011565:Psoriasis / Q000175:diagnosis* / Q000188:drug therapy* / Q000276:immunology; D018570:Risk Assessment; D012720:Severity of Illness Index; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D016896:Treatment Outcome
D016572:Cyclosporine; D008727:Methotrexate