I.R.C.C.S Istituto Ortopedico Galeazzi, Department of Dermatology and Venereology, Milan, Italy; University of Milan, Milan, Italy.
I.R.C.C.S Istituto Ortopedico Galeazzi, Laboratory of Translational Immunology, Milan, Italy.
Autoimmun Rev. 2015 Apr;14(4):286-92. doi: 10.1016/j.autrev.2014.11.012. Epub 2014 Nov 28.
According to the current view the histological features of psoriasis arise as a consequence of the interplay between T cells, dendritic cells and keratinocytes giving rise to a self-perpetuating loop that amplifies and sustains inflammation in lesional skin. In particular, myeloid dendritic cell secretion of IL-23 and IL-12 activates IL-17-producing T cells, Th22 and Th1 cells, leading to the production of inflammatory cytokines such as IL-17, IFN-γ, TNF and IL-22. These cytokines mediate effects on keratinocytes thus establishing the inflammatory loop. Unlike psoriasis the immunopathogenic features of psoriatic arthritis are poorly characterized and there is a gap in the knowledge of the pathogenic link between inflammatory T cell responses arising in the skin and the development of joint inflammation. Here we review the knowledge accumulated over the years from the early evidence of autoreactive CD8 T cells that was studied mainly in the years 1990s and 2000s to the recent findings of the role of Th17, Tc17 cells and γδ T cells in psoriatic disease pathogenesis. The review will also focus on common and distinguishing features of T cell responses in psoriatic plaques and in synovial fluid of patients with psoriatic arthritis. The integration of this information could help to distinguish the role played by T cells in the initiation phase of the disease from the role of T cells as downstream effectors sustaining inflammation in psoriatic plaques and potentially leading to disease manifestation in distant joints.
根据目前的观点,银屑病的组织学特征是 T 细胞、树突状细胞和角质形成细胞相互作用的结果,导致一个自我维持的循环,放大和维持病变皮肤的炎症。特别是,髓样树突状细胞分泌的 IL-23 和 IL-12 激活产生 IL-17 的 T 细胞、Th22 和 Th1 细胞,导致炎症细胞因子如 IL-17、IFN-γ、TNF 和 IL-22 的产生。这些细胞因子对角质形成细胞产生影响,从而建立炎症循环。与银屑病不同,银屑病关节炎的免疫发病特征描述得很差,在皮肤中出现的炎症 T 细胞反应与关节炎症发展之间的致病联系的知识存在空白。在这里,我们回顾了多年来积累的知识,从 20 世纪 90 年代和 21 世纪初主要研究的自身反应性 CD8 T 细胞的早期证据,到最近发现 Th17、Tc17 细胞和 γδ T 细胞在银屑病发病机制中的作用。该综述还将重点关注银屑病斑块和银屑病关节炎患者滑液中 T 细胞反应的共同和区别特征。整合这些信息可以帮助区分 T 细胞在疾病起始阶段的作用与 T 细胞作为维持银屑病斑块炎症的下游效应物的作用,并可能导致远处关节疾病表现。
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