Current and potential immune therapies and vaccines in the management of psoriasis.
Psoriasis is a chronic, immune skin disease associated with significant morbidity. Development of psoriasis is influenced by numerous genes, one allele is HLA-CW*0602. Other genes and single nucleotide polymorphisms affect immunologic pathways and antimicrobial peptide synthesis. Dendritic cells initiate psoriasis by activating T-cells toward a Th1 and Th17 response, with increased cytokines including TNF-α, IL-6, -12, -17, -22, and -23. IL-22 appears to promote keratinocyte dedifferentiation and increased antimicrobial peptide synthesis while TNF-α and IL-17 induce leukocyte localization within the psoriatic plaque. These recent insights identifying key cytokine pathways have led to the development of inhibitors with significant efficacy in the treatment of psoriasis. While a strategy for vaccine modulation of the immune response in psoriasis is in progress, with new technology they may provide a cost-effective long-term treatment that may induce tolerance or targeted self-inhibition for patients with autoimmune disorders, such as psoriasis.
Division of Dermatology; Department of Internal Medicine; Ohio State University Wexner Medical Center; Columbus, OH USA.
Benjamin H
BH
Kaffenberger
Division of Dermatology; Department of Internal Medicine; Ohio State University Wexner Medical Center; Columbus, OH USA.
Grace L
GL
Lee
Division of Dermatology; Department of Internal Medicine; Ohio State University Wexner Medical Center; Columbus, OH USA.
Kelly
K
Tyler
Division of Dermatology; Department of Internal Medicine; Ohio State University Wexner Medical Center; Columbus, OH USA.
Derek V
DV
Chan
Division of Rheumatology; Department of Internal Medicine; Ohio State University Wexner Medical Center; Columbus, OH USA.
Wael
W
Jarjour
Department of Medical Virology, Immunology, and Molecular Genetics; Ohio State University Wexner Medical Center; Columbus, OH USA.
Maria E
ME
Ariza
Department of Medical Virology, Immunology, and Molecular Genetics; Ohio State University Wexner Medical Center; Columbus, OH USA.
Marshall V
MV
Williams
Division of Dermatology; Department of Internal Medicine; Ohio State University Wexner Medical Center; Columbus, OH USA.
Henry K
HK
Wong
D049109:Cell Proliferation; D016207:Cytokines / Q000378:metabolism; D003713:Dendritic Cells / Q000276:immunology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods*; D015603:Keratinocytes / Q000502:physiology; D011565:Psoriasis / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D013601:T-Lymphocytes / Q000276:immunology
D016207:Cytokines; D007155:Immunologic Factors
IL-17; IL-22; IL-23; TNF-α; biologic therapies; cytokine inhibitors; immunotherapy; interleukins; psoriasis; vaccines