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Psoriasis is not an autoimmune disease?

Lionel Fry1, Barbara S Baker, Anne V Powles

  • 1Department of Medicine, Imperial College, London, UK.

Experimental Dermatology
|October 29, 2014
PubMed
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Psoriasis may not be an autoimmune disease but rather an abnormal immune response to skin bacteria, influenced by genetics. This challenges the traditional autoimmune model, highlighting the role of innate immunity and microbial interactions.

Keywords:
autoimmunitymicrobiomepsoriasis

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Area of Science:

  • Immunology
  • Dermatology
  • Microbiology

Background:

  • The classification of psoriasis as an autoimmune disease is based on molecular mimicry between streptococcal and keratin proteins.
  • However, only CD8 T lymphocytes, not CD4 T cells crucial for psoriasis initiation, respond to these homologous peptides.
  • Recent research indicates the involvement of the innate immune system and skin bacterial microbiota in psoriasis.

Purpose of the Study:

  • To question the autoimmune disease model of psoriasis.
  • To explore the role of skin microbiota and innate immunity in psoriasis pathogenesis.
  • To investigate the genetic links between psoriasis, Crohn's disease, and periodontitis.

Main Methods:

  • Analysis of T lymphocyte responses to homologous peptides.
  • Investigation of skin bacterial microbiota composition in psoriatic lesions and normal skin.
  • Review of genetic susceptibility loci associated with innate immunity.

Main Results:

  • Peripheral blood CD8 T lymphocytes, not CD4 T cells, respond to homologous peptides.
  • Firmicutes and Streptococcus are common in both normal and psoriatic skin microbiota.
  • Genetic findings predominantly link psoriasis susceptibility loci to innate immunity.
  • Shared innate immunity gene mutations exist between psoriasis and Crohn's disease patients.

Conclusions:

  • Psoriasis initiation may stem from an abnormal immune response to skin bacteria, driven by genetic factors.
  • The findings challenge the established autoimmune model, suggesting a dysbiosis-related mechanism.
  • Further research into innate immunity and microbial interactions is warranted for understanding psoriasis.