Drug Discovery Lab, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER)-Ahmedabad, Gujarat, India.
Int J Dermatol. 2018 Nov;57(11):1387-1402. doi: 10.1111/ijd.14047. Epub 2018 Jun 19.
Skin is the most visible and vulnerable organ of the integumentary system. Psoriasis is a chronic inflammatory skin disorder with an equal prevalence rate in males and females globally. Psoriasis is seen today beyond a cosmetic turmoil as it significantly impacts the socioeconomic life of the patients. Patients with severe psoriasis report feeling denounced and isolated. Despite detailed understanding of the molecular mechanisms and pathogenesis of psoriasis, issues like the autoimmune cause of inflammation and role of external, genetic, cutaneous, and systemic factors on initiation, progression, and treatment of psoriasis are still ambiguous. The present review summarizes immunogenic pathophysiology of psoriasis with a cascade of events from stimuli-based release of self-nucleotides to the hyperproliferation of keratinocytes leading to psoriasis. The review emphasizes challenges and hurdles toward the efficient treatment of psoriasis. The review also provides a detailed understanding of conventional and novel treatment strategies including drug delivery approaches and patented technologies for therapeutic and preventive approaches leading to improved outcome for psoriasis patients. The review summarizes a brief insight on biologics and gene therapy that has resulted in a paradigm shift in the treatment strategies for psoriasis management.
皮肤是人体最明显和最脆弱的器官，是人体表皮系统的一部分。银屑病是一种慢性炎症性皮肤疾病，在全球范围内男性和女性的患病率相同。如今，银屑病不仅是一种美容问题，还严重影响着患者的社会经济生活。严重银屑病患者会感到被排斥和孤立。尽管人们对银屑病的分子机制和发病机制有了详细的了解，但炎症的自身免疫原因以及外部、遗传、皮肤和全身因素在银屑病的发生、发展和治疗中的作用等问题仍然不清楚。本文综述了银屑病的免疫发病机制，包括从基于刺激的自身核苷酸释放到导致银屑病的角质形成细胞过度增殖的级联事件。本文强调了银屑病有效治疗面临的挑战和障碍。本文还详细介绍了传统和新型治疗策略，包括药物输送方法和专利技术，用于治疗和预防，从而改善银屑病患者的治疗效果。本文总结了生物制剂和基因治疗的简要进展，这导致了银屑病治疗策略的范式转变。
