Department of Dermatology and Venereology Policlinico Umberto I of Rome, University of Rome Sapienza, Rome, Italy.
J Dermatol. 2012 Sep;39(9):752-60. doi: 10.1111/j.1346-8138.2012.01606.x. Epub 2012 Jun 14.
Psoriasis is a common, inflammatory, chronic, relapsing skin disease. New insight about the etiology of this disease shows the important role played by the epidermal barrier function, its integrity and pathogen responses in combination with microbial environmental factors. A pivotal role in the management of this balance is played by NLR genes, also known as NBD-LRR or CATERPILLER, that encode important mediators of innate immunity and provide the first line of defense against pathogens. The polymorphism of these genes is implicated in the pathogenesis of several immunological diseases and might be of importance in the pathogenesis of barrier organ disorders. Crohn's disease is considered archetypal of these kinds of disorders; similarities between Crohn's disease and psoriasis and their similar pathogenetic mechanisms may support the concept of psoriasis as a barrier organ disorder and common genetic ground lying behind these illnesses. Considering psoriasis as a "barrier organ disease" is not only a mere mental exercise; this consideration may, in fact, open new prospects in the treatment of these disorders just by preventing alterations of microbial flora or regulating the response of the host to infective diseases.
银屑病是一种常见的炎症性、慢性、复发性皮肤病。对这种疾病病因的新认识表明，表皮屏障功能、其完整性和病原体反应与微生物环境因素的结合起着重要作用。NLR 基因（也称为 NBD-LRR 或 CATERPILLER）在这种平衡的管理中起着关键作用，这些基因编码先天免疫的重要介质，并为病原体提供第一道防线。这些基因的多态性与几种免疫性疾病的发病机制有关，可能在屏障器官疾病的发病机制中起重要作用。克罗恩病被认为是这类疾病的典型代表；克罗恩病和银屑病之间的相似性及其相似的发病机制可能支持将银屑病视为一种屏障器官疾病的概念，以及这些疾病背后的共同遗传基础。将银屑病视为“屏障器官疾病”不仅是一种纯粹的思维练习；事实上，通过防止微生物菌群的改变或调节宿主对传染病的反应，这种考虑可能为这些疾病的治疗开辟新的前景。
