T-cell-targeted biologicals for psoriasis.
Psoriasis is now accepted as a T-cell-mediated disease and that targeting of T cell function and/or trafficking is a logical approach to therapy. As a consequence of recombinant DNA technologies biologic therapies are synthesisable in sufficient quantities for clinical use. The original proof of concept for T-cell-targeted therapies in psoriasis came with the demonstration that anti-CD4 monoclonal antibodies were effective. Progress is such that two T-cell-directed biologicals - alefacept and efalizumab - have recently been approved in the U.S.A. for the treatment of psoriasis. In addition to providing new therapies the T-cell-targeted biologicals with their selective approach can be used as sophisticated tools to dissect out and help our understanding of key pathomechanisms in psoriasis; the non - efficacy of anti - E-selectin is a case in point. It is likely that the most appropriate place for T-cell-directed biologicals in the management of chronic plaque psoriasis will be for maintenance, rather than induction, of remission. This is a reflection of mode of action and relative safety for long-term administration.
Griffiths
Christopher E M
CE
The Dermatology Centre, Hope Hospital, University of Manchester, Manchester, UK. christopher.griffiths@man.ac.uk
D000077944:Alefacept; D000911:Antibodies, Monoclonal / Q000235:genetics / Q000494:pharmacology / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D001685:Biological Factors / Q000235:genetics / Q000494:pharmacology / Q000627:therapeutic use*; D004274:DNA, Recombinant / Q000494:pharmacology / Q000627:therapeutic use; D016503:Drug Delivery Systems / Q000379:methods*; D006801:Humans; D011565:Psoriasis / Q000188:drug therapy* / Q000378:metabolism; D011993:Recombinant Fusion Proteins / Q000235:genetics / Q000494:pharmacology / Q000627:therapeutic use; D013601:T-Lymphocytes / Q000187:drug effects* / Q000378:metabolism
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001685:Biological Factors; D004274:DNA, Recombinant; D011993:Recombinant Fusion Proteins; D000077944:Alefacept; C472181:efalizumab