Department of Dermatology, Asahikawa Medical University Hospital, Asahikawa, Japan.
International Medical Support Center, Asahikawa Medical University Hospital, Asahikawa, Japan.
J Dermatol. 2021 Jun;48(6):761-777. doi: 10.1111/1346-8138.15727. Epub 2021 Jan 6.
Psoriasis is a multifactorial recalcitrant inflammatory skin disease characterized by bothersome scaly reddish plaques especially on frequently chafed body parts, such as the extensor sites of the extremities and scalp. Nonetheless, through recent advance in molecular-targeted therapies including biologics and small-molecule inhibitors, even the severest symptoms of psoriasis and its comorbidities, such as psoriatic arthritis, can be excellently treated. The superb clinical effects lead to not only remarkable alleviation of symptoms but also a deep understanding of patients' impaired "quality of life" caused by this disease. Along with the development of novel treatment options targeting various specific molecules, such as proinflammatory cytokines and signal transduction-associated molecules, clinicians have thoroughly understood the molecular mechanism of psoriasis, and discovered that the IL-23/IL-17 axis mainly depending on Th17 cell function is a crucial pathogenesis of this disease. Accumulation of knowledge about the working mechanism and clinical effect of molecular-targeted therapies is indispensable for clinicians to establish a more refined therapeutic strategy for treating psoriasis.
银屑病是一种多因素导致的难治性炎症性皮肤病,其特征为红斑上附有鳞屑,且红斑通常出现在频繁摩擦的身体部位,如四肢伸侧和头皮。尽管如此,近年来通过分子靶向治疗(包括生物制剂和小分子抑制剂),即使是最严重的银屑病症状及其合并症(如银屑病关节炎)也能得到很好的治疗。这些出色的临床疗效不仅显著缓解了症状,还使人们深入了解了这种疾病对患者“生活质量”的损害。随着针对各种特定分子(如促炎细胞因子和信号转导相关分子)的新型治疗选择的发展,临床医生已经彻底了解了银屑病的分子机制,并发现主要依赖于 Th17 细胞功能的 IL-23/IL-17 轴是该疾病的关键发病机制。对分子靶向治疗的作用机制和临床效果的了解对于临床医生制定更精细的银屑病治疗策略是不可或缺的。