Psoriasis: Pathogenesis, Comorbidities, and Therapy Updated

Abstract

Psoriasis is a chronic inflammatory skin disease characterized by IL-17-dominant abnormal innate and acquired immunity, and the hyperproliferation and aberrant differentiation of epidermal keratinocytes, and comorbid arthritis or cardiometabolic diseases. This Special Issue presented updated information on pathogenesis, comorbidities, and therapy of psoriasis. The pathogenesis of psoriasis may involve the dysfunction of indoleamine 2,3-dioxygenase 2 or of UBA domain containing 1-mediated regulation of CARD14/CARMA2sh. The blood cells of psoriasis patients showed the enhanced oxidative stress/autophagy flux and decreased 20S proteasome activity. Elafin, clusterin, or selenoprotein P may act as biomarkers for psoriasis and comorbid metabolic diseases. The proteomic profile of psoriasis lesions showed the dysfunction of dermal fibroblasts; up-regulation of proinflammatory factors and signal transduction or down-regulation of structural molecules. The skin inflammation in psoriasis may populate certain gut bacteria, such as Staphylococcus aureus and Streptococcus danieliae, which worsen the skin inflammation in turn. The psoriasis-associated pruritus may be caused by immune, nervous, or vascular mechanisms. In addition to current oral treatments and biologics, a new treatment option for psoriasis is now being developed, such as retinoic-acid-receptor-related orphan nuclear receptor γt inhibitors, IL-36 receptor antagonist, or aryl hydrocarbon receptor agonist. Antimicrobial peptides and innate immune cells, involved in the pathogenesis of psoriasis, may be novel therapeutic targets. The pathomechanisms and responses to drugs in collagen diseases are partially shared with and partially different from those in psoriasis. Certain nutrients can exacerbate or regulate the progress of psoriasis. The articles in this Special Issue will encourage attractive approaches to psoriasis by future researchers.

Galectin-3 as a Novel Multifaceted and Not Only Cardiovascular Biomarker in Patients with Psoriasis with Regard to Systemic Treatment—Preliminary Data

“…Psoriasis is a common chronic, autoimmune, and inflammatory disease affecting 2–4% of the global population and an incidence of 60.4 to 140 new cases per 100,000 [ 1 , 2 ]. In recent years the viewpoint on the pathogenesis of psoriasis has evolved significantly at the same time due to continuous enriched research in this field.…”

“…In recent years the viewpoint on the pathogenesis of psoriasis has evolved significantly at the same time due to continuous enriched research in this field. Thus, currently psoriasis is definitely more than skin deep and closely related to numerous cardiometabolic disorders (CMDs), including obesity, diabetes mellitus (DM), dyslipidemia, and hypertension, which make up the metabolic syndrome (MS), as well as non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVD) [ 2 , 3 , 4 ]. It has been widely proven that the higher rate of comorbidities is related to psoriasis severity [ 5 , 6 ].…”

“…Persons with psoriasis have shortened life expectancy of over 5 years mainly due to CVD and increased relative risk of mortality of 1.53 in comparison to 1.12 in the general population [ 7 ]. Psoriatics with severe form present a higher rate of ischemic heart diseases but also have additional absolute risk of 6.2% of a major adverse cardiovascular event (MACE) within 10 years of psoriasis history compared to the healthy population [ 2 , 8 ]. The multidirectional relationship of psoriasis with numerous comorbidities is translated by common genetic or immunological pathways, oxidative stress, as well as systemic metabolically driven inflammation which is important in psoriasis pathogenesis and consequently leads to the development of atherosclerosis, insulin resistance, and CMDs [ 3 , 4 , 5 ].…”

Cognitive Process of Psoriasis and Its Comorbidities: From Epidemiology to Genetics

“…These further increase the difficulty and complexity of treatment for PsO. Understanding and being cognizant of the comorbidities of PsO has shown to be important for its comprehensive diagnosis and treatment (Kanda, 2021). In recent years, numerous epidemiological and genetic studies have focused on the comorbidities of PsO, which has greatly expanded our understanding of PsO and its comorbidities.…”

Haemorrhagic dots as a dermoscopic marker of itch severity in psoriasis

“…The quality of life is commonly reduced in patients with psoriasis not only because of aesthetic issues and troublesome treatment but also because of itch 1,2 . Pruritus occurs in 60–90% of psoriatic patients and may be caused by immune, neurological or vascular mechanisms 3,4 . The therapeutic approach should include itch management adjusted to pruritus severity 1 …”