Fournier Christa, Tisman Glenn
Dermatol Online J. 2010 Feb 15;16(2):17.
Psoriasis is a disease characterized by epidermal hyperproliferation that results in the formation of lesional plaques covered by scale. Psoriasis is thought to be angiogenesis dependent. Clear cell renal cell carcinoma is a hypervascularized solid tumor associated with loss of function of the von Hippel-Lindau (VHL) tumor suppressor gene and increased Raf-1 activity. A 68-year-old man who suffered from recalcitrant psoriasis for over 50 years was treated with sorafenib for metastatic clear cell renal carcinoma. One month later, his psoriasis, previously 8 x 6 cm on the mid posterior thorax, completely resolved. Sorafenib works by inhibiting several receptor tyrosine kinases (RTKs), such as vascular endothelial growth factor (VEGFR) and platelet-derived growth factor receptor (PDGFR)). It also inhibits intracellular Raf kinase (Raf-1), which targets the ubiquitous mitogen-activated protein kinase (MAPK) intracellular signal transduction pathway. We suggest that this patient's remission of psoriasis could be related to the inhibition/modulation of VEGF, PDGFR, Raf-1, and MAPK.
银屑病是一种以表皮过度增殖为特征的疾病，可导致形成覆盖有鳞屑的皮损斑块。银屑病被认为依赖血管生成。透明细胞肾细胞癌是一种血管高度丰富的实体瘤，与冯·希佩尔-林道（VHL）肿瘤抑制基因功能丧失及Raf-1活性增加有关。一名患有顽固性银屑病50多年的68岁男性因转移性透明细胞肾细胞癌接受索拉非尼治疗。1个月后，其先前位于胸后中部大小为8×6 cm的银屑病完全消退。索拉非尼通过抑制多种受体酪氨酸激酶（RTK）发挥作用，如血管内皮生长因子（VEGFR）和血小板衍生生长因子受体（PDGFR）。它还抑制细胞内Raf激酶（Raf-1），后者作用于普遍存在的丝裂原活化蛋白激酶（MAPK）细胞内信号转导通路。我们认为该患者银屑病的缓解可能与VEGF、PDGFR、Raf-1和MAPK的抑制/调节有关。
