Matwiejuk Mateusz, Kulczyńska-Przybik Agnieszka, Myśliwiec Hanna, Chabowski Adrian, Mroczko Barbara, Flisiak Iwona
Department of Dermatology and Venereology, Medical University of Bialystok, 15-540 Bialystok, Poland.
Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland.
Int J Mol Sci. 2025 Jul 4;26(13):6475. doi: 10.3390/ijms26136475.
Psoriasis is a chronic, immune-mediated inflammatory skin disease with complex genetic, environmental, and immunological determinants. Beyond the skin, it affects multiple systems, including the joints and cardiovascular system. A hallmark of psoriasis is an overactivation of the innate and adaptive immune responses, leading to dysregulated cytokine signaling, altered keratinocyte function, and aberrant expression of structural and regulatory proteins. In recent years, growing attention has been given to the skin as a neuro-immuno-endocrine organ, with evidence showing the role of stress-related neuropeptides, UVB-induced immune modulation, and vitamin D signaling in the disease pathogenesis. This review highlights emerging evidence on key multifunctional proteins-elafin, chemerin, and NAMPT (visfatin)-that exert both pro- and anti-inflammatory actions. Although still underexplored, these molecules appear to contribute significantly to the psoriatic microenvironment by modulating inflammation, immunity, and skin barrier function. Their dual roles suggest complex interactions within the cutaneous immune-neuroendocrine network, positioning them as potential biomarkers or therapeutic targets in psoriasis. By integrating insights into classical and emerging mediators, this review aims to provide a comprehensive perspective on the evolving landscape of psoriasis pathophysiology.
银屑病是一种慢性、免疫介导的炎症性皮肤病，具有复杂的遗传、环境和免疫决定因素。除皮肤外，它还影响多个系统，包括关节和心血管系统。银屑病的一个标志是先天性和适应性免疫反应的过度激活，导致细胞因子信号失调、角质形成细胞功能改变以及结构和调节蛋白的异常表达。近年来，皮肤作为神经免疫内分泌器官受到越来越多的关注，有证据表明应激相关神经肽、紫外线B诱导的免疫调节以及维生素D信号在该疾病发病机制中的作用。本综述重点介绍了关键多功能蛋白——弹性蛋白、chemerin和烟酰胺磷酸核糖转移酶（内脂素）——的新证据，这些蛋白具有促炎和抗炎作用。尽管仍未得到充分研究，但这些分子似乎通过调节炎症、免疫和皮肤屏障功能，对银屑病微环境有显著贡献。它们的双重作用表明皮肤免疫神经内分泌网络内存在复杂的相互作用，使其成为银屑病潜在的生物标志物或治疗靶点。通过整合对经典和新出现介质的见解，本综述旨在提供一个关于银屑病病理生理学不断演变的全面观点。
