Ion Ana, Dorobanțu Alexandra Maria, Popa Liliana Gabriela, Mihai Mara Mădălina, Orzan Olguța Anca
Department of Dermatology, 'Elias' Emergency University Hospital, 011461 Bucharest, Romania.
'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Biology (Basel). 2022 May 25;11(6):808. doi: 10.3390/biology11060808.
Psoriasis is a chronic multisystem inflammatory disease associated with a plethora of comorbidities including metabolic syndrome, cardiovascular disease, hypertension, diabetes, hyperlipidemia, obesity, anxiety, depression, chronic kidney disease, and malignancy. Advancement in unveiling new key elements in the pathophysiology of psoriasis led to significant progress in the development of biologic agents which target different signaling pathways and cytokines involved in the inflammatory cascade responsible for the clinical manifestations found in psoriasis. Currently available novel therapeutic options for moderate-severe psoriasis include tumor necrosis factor alpha inhibitors, inhibitors of the interleukin 17, and inhibitors of the interleukin 23. Nevertheless, concerns have been raised with respect to the possible risks associated with the use of biologic therapy requiring close collaboration between dermatologists and physicians of different specialties. Our aim was to perform an in-depth literature review and discuss the potential risks associated with biologic therapy in patients with psoriasis and concurrent diseases with a focus on the influence of novel therapeutic agents on liver function in the context of hepatopathies, particularly viral hepatitis. A multidisciplinary teamwork and periodic evaluation of psoriasis patients under biologic therapy is highly encouraged to obtain an accurate management for each case.
银屑病是一种慢性多系统炎症性疾病，与多种合并症相关，包括代谢综合征、心血管疾病、高血压、糖尿病、高脂血症、肥胖症、焦虑症、抑郁症、慢性肾脏病和恶性肿瘤。在揭示银屑病病理生理学新关键要素方面的进展，促使靶向参与导致银屑病临床表现的炎症级联反应的不同信号通路和细胞因子的生物制剂研发取得了重大进展。目前用于中重度银屑病的新型治疗选择包括肿瘤坏死因子α抑制剂、白细胞介素17抑制剂和白细胞介素23抑制剂。然而，人们对生物治疗可能存在的风险表示担忧，这需要皮肤科医生与不同专科医生密切合作。我们的目的是进行深入的文献综述，并讨论银屑病患者及并发疾病接受生物治疗的潜在风险，重点关注新型治疗药物在肝病（尤其是病毒性肝炎）背景下对肝功能的影响。强烈鼓励多学科团队合作，并对接受生物治疗的银屑病患者进行定期评估，以便对每个病例进行准确管理。
