Advances in treating psoriasis

Abstract

Psoriasis is a T helper (Th)17/Th1-mediated autoimmune disease affecting the skin and joints. So far, distinct traditional oral compounds and modern biologics have been approved in most countries for the treatment of patients with moderate to severe psoriasis or psoriatic arthritis. Yet, the anti-psoriatic therapeutic spectrum is to be extended by a number of novel targeted therapies including biologics and modern oral compounds. The next set of anti-psoriatic biologics targets mainly Th17-associated cytokines such as IL-17 or IL-23. In contrast, modern oral anti-psoriatics, such as dimethyl fumarate (DMF), apremilast or Janus kinase (JAK) inhibitors interfere with intracellular proteins and affect signaling pathways. Here we summarize the current systemic therapies for psoriasis and their immunological mechanism. The recent advances in psoriasis therapy will help treat our patients efficiently and complete our understanding of disease pathogenesis.

Regulation of dimethyl-fumarate toxicity by proteasome inhibitors

“…3 More recently, DMF has been approved in The United States for the treatment of multiple sclerosis (Tecfidera). 4 The drug has immunomodulatory actions, e.g.…”

The role of IL-4 in psoriasis

“…Likewise modern antipsoriatic small molecules interfere with IL-23 cytokine production or signaling [14]. An alternative approach is a treatment that modulates the immune response from a Th17 phenotype toward a less inflammatory Th2 phenotype without causing risks of severe immunosuppression.…”

A Critical Evaluation of Dead Sea Therapy in the Management of Psoriasis

“…While the basic pathological condition in psoriasis is increased skin cell proliferation, the inflammatory changes in blood vessels further worsen the condition [1]. Apart from its therapeutic effect the DS is also effective because of its unique environment mainly its high temperature and low humidity [3].…”