Department of Dermatology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Int J Mol Sci. 2020 Oct 11;21(20):7488. doi: 10.3390/ijms21207488.
Psoriasis is an immune cell-mediated inflammatory skin disease. The interleukin (IL)23/IL17 axis plays an important role in the development of psoriasis. The effectiveness of biologic treatments such as tumor necrosis factor (TNF)α inhibitors (infliximab, adalimumab, certolizumab pegol), IL23 inhibitors (ustekinumab, guselkumab, tildrakizumab, risankizumab), and IL17 inhibitors (secukinumab, ixekizumab, brodalumab) have verified these findings. Immune-related cells such as dendritic cells (DCs) and macrophages, in addition to Toll-like receptors and cytokines such as interferon (IFN)α, TNFα, IFNɤ, IL12, IL22, IL23, and IL17, are related to the pathogenesis of psoriasis. Here, we first review new insights regarding the pathogenesis of psoriasis, as it relates to DCs, Langerhans cells, macrophages, the signal transducer and activator of transcription 3 pathway, and aryl hydrocarbon receptor in cutaneous vascular endothelial cells. Based on these findings, we summarize currently available oral treatments and biologics. Furthermore, we describe a new treatment option including Janus kinase inhibitor, tyrosine kinase 2 inhibitor, modulator of sphingosine 1-phosphate receptor 1, and Rho-associated kinase 2 inhibitor.
银屑病是一种免疫细胞介导的炎症性皮肤病。白细胞介素 (IL)23/IL17 轴在银屑病的发展中起着重要作用。肿瘤坏死因子 (TNF)α 抑制剂（英夫利昔单抗、阿达木单抗、certolizumab pegol）、IL23 抑制剂（乌司奴单抗、古塞库单抗、替西单抗、瑞莎珠单抗）和 IL17 抑制剂（司库奇尤单抗、依奇珠单抗、布罗达单抗）等生物治疗的有效性验证了这些发现。免疫相关细胞，如树突状细胞 (DCs)和巨噬细胞，以及 Toll 样受体和细胞因子，如干扰素 (IFN)α、TNFα、IFNɤ、IL12、IL22、IL23 和 IL17，与银屑病的发病机制有关。在这里，我们首先回顾了与 DCs、朗格汉斯细胞、巨噬细胞、信号转导和转录激活因子 3 通路以及皮肤血管内皮细胞中的芳香烃受体有关的银屑病发病机制的新见解。基于这些发现，我们总结了目前可用的口服治疗药物和生物制剂。此外，我们描述了一种新的治疗选择，包括 Janus 激酶抑制剂、酪氨酸激酶 2 抑制剂、鞘氨醇 1-磷酸受体 1 调节剂和 Rho 相关激酶 2 抑制剂。
