Future Perspectives in the Treatment of Psoriasis

Abstract

All available antipsoriatic therapies are of symptomatic character. Treatments established so far are limited in their use due to side effects or lack of efficacy resulting in poor quality of life for affected people. Development of new therapeutic approaches would not only broaden our armamentarium against psoriasis, but could also increase our understanding of the pathogenesis of this disease. In brief, 2 main targets represent attractive candidates, either the keratinocyte itself or the immune system. Promising therapeutic strategies include: (1) the search for new psoriasis susceptibility genes and their resulting phenotypes; (2) the interference with certain parts of cell signaling pathways that are involved in inflammatory processes; (3) the inhibition or elimination of activated T lymphocytes, e.g. by blocking of costimulatory signals or by deviation of a pathogenic immune response into a nonpathogenic one; (4) the blockade of proinflammatory cytokines; (5) the inhibition of leukocyte extravasation or trafficking; (6) the inhibition of angiogenesis. Some of these strategies are in phase 2 trials, others have already reached phase 3 status and are close to being approved by medicine agencies, and some are still visions of the future. This book chapter will give an overview of these new treatment strategies.

An update on psoriasis and metabolic syndrome: A meta-analysis of observational studies

“…Psoriasis patients also experience a decreased quality of life as a result of this disease [5]. The pathogenesis of psoriasis is currently under active investigation, with studies aiming to identify genetic susceptibility loci for psoriasis in order to detect novel targets for systemic therapy [6–9]. While the exact pathogenesis of psoriasis is not fully understood, basic and translational investigations have led to a renewed understanding of Th-17 and Th-1 pathways involved in the development of psoriasis [10].…”

Psoriatic Skin Models: A Need for the Pharmaceutical Industry

“…It affects about 2 % of the world population (Baker et al, 2008, Wippel-Slupetzky & Stingl, 2009. Previous studies have demonstrated that psoriasis prevalence varies as a result of two factors: (1) geographical localization and (2) ethnic group.…”

Perspectivas futuras no tratamento da psoríase: novidades em terapêutica biológica.

“…A patogénese da psoríase tem sido matéria de debate, nomeadamente, se a doença se inicia como um distúrbio primário dos queratinócitos ou como consequência de uma resposta imunológica alterada contra um, ainda não identificado, antigénio 10 . Hoje em dia, a primeira teoria tem sido abandonada, aceitando a maioria dos autores que se trata de uma doença imuno-mediada.…”

“…A formação do complexo receptor das IL/JAK leva à fosforilação das STAT, proteínas citoplasmáticas latentes, envolvidas na transmissão de sinais extracelulares ao núcleo. As proteínas STAT fosforiladas são então translocadas para o núcleo onde iniciam a transcrição de mais citocinas inflamatórias 4,10,25…”