Prieto-Pérez Rocío, Cabaleiro Teresa, Daudén Esteban, Ochoa Dolores, Roman Manuel, Abad-Santos Francisco
Servicio de Farmacología Clínica, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid and Instituto de Investigación Sanitaria Princesa (IP), 28006 Madrid, Spain.
Autoimmune Dis. 2013;2013:613086. doi: 10.1155/2013/613086. Epub 2013 Aug 28.
Psoriasis is a chronic inflammatory disease of the skin. The causes of psoriasis are unknown, although family and twin studies have shown genetic factors to play a key role in its development. The many genes associated with psoriasis and the immune response include TNF α , IL23, and IL12. Advances in knowledge of the pathogenesis of psoriasis have enabled the development of new drugs that target cytokines (e.g., etanercept, adalimumab, and infliximab, which target TNF α , and ustekinumab, which targets the p40 subunit of IL23 and IL12). These drugs have improved the safety and efficacy of treatment in comparison with previous therapies. However, not all patients respond equally to treatment, possibly owing to interindividual genetic variability. In this review, we describe the genes associated with psoriasis and the immune response, the biological drugs used to treat chronic severe plaque psoriasis, new drugs in phase II and III trials, and current knowledge on the implications of pharmacogenomics in predicting response to these treatments.
银屑病是一种慢性皮肤炎症性疾病。尽管家族和双胞胎研究表明遗传因素在其发病过程中起关键作用，但银屑病的病因尚不清楚。与银屑病和免疫反应相关的众多基因包括肿瘤坏死因子α（TNFα）、白细胞介素23（IL23）和白细胞介素12（IL12）。银屑病发病机制知识的进展促使了针对细胞因子的新药的研发（例如，靶向TNFα的依那西普、阿达木单抗和英夫利昔单抗，以及靶向IL23和IL12的p40亚基的乌司奴单抗）。与先前的疗法相比，这些药物提高了治疗的安全性和有效性。然而，并非所有患者对治疗的反应都相同，这可能是由于个体间的基因变异性所致。在本综述中，我们描述了与银屑病和免疫反应相关的基因、用于治疗慢性重度斑块状银屑病的生物药物、处于II期和III期试验的新药，以及目前关于药物基因组学在预测这些治疗反应中的意义的知识。
