Zhu Ying, Zhou Yong, Ma Xiaonan, Duan Zhenduo, Xu Hong, Li Yuanyuan, Kong Yunfan, Yang Lei, Xin Xiaofei
Department of Pharmaceutics, China Pharmaceutical University, Nanjing 210009, China.
National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, 1037 Luoyu Road, Wuhan 430074, China.
Pharmaceutics. 2025 Feb 20;17(3):283. doi: 10.3390/pharmaceutics17030283.
Psoriasis is a chronic inflammatory disease with a complex pathogenesis, influenced by various factors involving environment, genes, and immunity. The main symptoms of psoriasis include erythema, scales, itching, etc. At present, therapeutic drugs for psoriasis are continually evolving towards enhancing treatment efficacy and reducing side effects. Firstly, the pathogenesis and characteristics of psoriasis were summarized. Then, the types and benefits of topical therapy were introduced, such as the aspects of avoiding systemic toxic effects, first pass effect, and gastrointestinal reactions with accelerating the onset time of the drugs and improving its efficacy, and were compared to systemic drugs. In the case of methotrexate, cyclosporin A, Janus kinase (JAK) inhibitors, and phosphodiesterase-4 (PDE-4) inhibitors, this review had a further discussion on the improvement and translation of these molecules from systemic therapy to topical therapy in clinical practice. To further augment the limitation of skin permeability, nanotechnology and novel topical drug delivery system including nanomedicines, hydrogels, ionic liquids, and microneedles were elaborated for psoriasis management. Also, exploration of topical targeting pathogenic genes through small interfering RNA (siRNA) using nanoparticles and ionic liquids (ILs) is of great significance for long-term treatment in psoriasis. Taken together, the development of numerous topical delivery platforms is expected to achieve enhanced penetration, and precise and efficient delivery of small molecule and RNA interference (RNAi) therapeutics in psoriasis with clinical translation prospects.
银屑病是一种发病机制复杂的慢性炎症性疾病，受环境、基因和免疫等多种因素影响。银屑病的主要症状包括红斑、鳞屑、瘙痒等。目前，银屑病治疗药物不断朝着提高治疗效果和减少副作用的方向发展。首先，总结了银屑病的发病机制和特点。然后，介绍了局部治疗的类型和优势，如避免全身毒性作用、首过效应和胃肠道反应，同时加快药物起效时间并提高疗效，并与全身用药进行了比较。对于甲氨蝶呤、环孢素A、 Janus激酶（JAK）抑制剂和磷酸二酯酶-4（PDE-4）抑制剂，本综述进一步探讨了这些分子在临床实践中从全身治疗向局部治疗的改进和转化。为进一步克服皮肤通透性的限制，阐述了纳米技术和新型局部给药系统，包括纳米药物、水凝胶、离子液体和微针在银屑病治疗中的应用。此外，利用纳米颗粒和离子液体（ILs）通过小干扰RNA（siRNA）局部靶向致病基因对银屑病的长期治疗具有重要意义。综上所述，众多局部给药平台的发展有望实现小分子和RNA干扰（RNAi）治疗药物在银屑病中的增强渗透、精准高效递送，并具有临床转化前景。
