Treatment targeted to cell surface epitopes.

Expression of a variety of surface epitopes is a characteristic feature of immune cells. Receptors and adhesion molecules are the most predominant ones. It is also characteristic that epitope expression is modulated during cellular activation. In inflammatory skin diseases these structures can be used to define not only the type of cell but also their activity status. The availability of monoclonal antibodies and fusion proteins enabled to target cellular surface epitopes in order to modulate the cellular function as a principle of treatment. In psoriasis receptor-targeted therapy has been developed and tested in a considerable number of clinical trials. However, these approaches revealed that not all the strategies are equally effective. In this review the development of receptor-targeted treatment for skin disorders, mainly psoriasis, is described. Clinical as well as experimental data obtained with the various compounds employed are discussed with regard to clinical efficacy, safety and tolerability.