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Psoriasis therapy: current and future perspectives
( Knut Schakel ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2
Psoriasis affects a large number of people world wide and is characterized as a chronic, immune-mediated inflammatory skin disease associated with complex genetic susceptibility. Recent studies including those from our laboratory show that the pathologic features observed in psoriasis arise as a result of innate and adaptive immune activation. An important finding was that particularly dermal dendritic cells expressing the marker molecule 6-sulfo Lac NAc (slan) are a rich source of pro-inflammatory factors such as tumor necrosis factor (TNF)-α and interleukin-12 and -23, thereby, stimulating T helper 17 responses and the activation of neutrophils. This increased understanding of the cellular- and cytokine network in psoriasis during the past years paved the way for the rational development of novel treatment strategies and drugs targeting a plethora of specific immune mechanisms. Introduction of these drugs into the clinic in many cases validated and extended the existing pathogenetic concept of psoriasis. This rapid development of knowledge - bench to bedside to bench - proved to be particularly fruitful in psoriasis. Currently in clinical trials for psoriasis treatment are biologics like anti-interleukin-17, anti-interleukin-17 receptor-, anti-interleukin-12/23- and anti-interleukin-22 agents, as well as small molecules targeting Janus kinases, phosphodiesterase 4 and adenosine receptors among others. Although we still can not cure psoriasis, the translational medicine approach has much increased the quality of live of our patients and will consistently change our view on this chronic skin disease.