Genetics of psoriasis and pharmacogenetics of biological drugs.
Psoriasis is a chronic inflammatory disease of the skin. The causes of psoriasis are unknown, although family and twin studies have shown genetic factors to play a key role in its development. The many genes associated with psoriasis and the immune response include TNF α , IL23, and IL12. Advances in knowledge of the pathogenesis of psoriasis have enabled the development of new drugs that target cytokines (e.g., etanercept, adalimumab, and infliximab, which target TNF α , and ustekinumab, which targets the p40 subunit of IL23 and IL12). These drugs have improved the safety and efficacy of treatment in comparison with previous therapies. However, not all patients respond equally to treatment, possibly owing to interindividual genetic variability. In this review, we describe the genes associated with psoriasis and the immune response, the biological drugs used to treat chronic severe plaque psoriasis, new drugs in phase II and III trials, and current knowledge on the implications of pharmacogenomics in predicting response to these treatments.
Servicio de Farmacología Clínica, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid and Instituto de Investigación Sanitaria Princesa (IP), 28006 Madrid, Spain.
Rocío
R
Prieto-Pérez
Teresa
T
Cabaleiro
Esteban
E
Daudén
Dolores
D
Ochoa
Manuel
M
Roman
Francisco
F
Abad-Santos