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Migration of polymorphonuclear leukocytes in psoriasis
1Department of Dermatology, University of Nijmegen, The Netherlands.
Abstract:
A characteristic feature of the early and active psoriatic lesion is the intraepidermal penetration of polymorphonuclear leukocytes (PMN) with the formation of intraepidermal micropustules of Kogoj and microabscesses of Munro, localized in the stratum corneum. In pustular psoriasis the accumulation of PMN dominates the clinical picture. During the last decade our insight into the regulation of the migration of PMN has increased. The properties of the circulating blood PMN and the biochemical nature and biological effects of mediators of inflammation have been studied in detail. Several groups have demonstrated that the transdermal and epidermal migration of PMN following challenge with a chemoattractant is slightly diminished in the clinically uninvolved skin and profoundly decreased in the lesional skin of psoriatics, compared to the responsiveness in normal controls. The molecular nature of this process of tachyphylaxis has not yet been established. However, it has been hypothesised that some mediators of inflammation, cytochrome P-450, endothelial cell function, and protease inhibitors might be of relevance in this respect. This report is a review of the literature on transdermal and epidermal migration of PMN in normal and psoriatic skin. The aim of this review is to clarify further the position of the PMN in the pathogenesis of psoriasis and its role as a target for antipsoriatic treatments.
Insights
Polymorphonuclear leukocytes (PMN) migration is impaired in psoriatic skin, impacting psoriasis development. Understanding this neutrophil dysfunction offers new therapeutic targets for psoriasis treatment.
Area of Science:
- Dermatology
- Immunology
- Cell Biology
Background:
- Psoriatic lesions feature intraepidermal polymorphonuclear leukocyte (PMN) infiltration, forming pustules.
- Pustular psoriasis is characterized by significant PMN accumulation.
- Recent research has advanced understanding of PMN migration regulation and inflammatory mediators.
Purpose of the Study:
- To review literature on PMN migration in normal and psoriatic skin.
- To elucidate the role of PMN in psoriasis pathogenesis.
- To explore PMN as a therapeutic target for antipsoriatic treatments.
Main Methods:
- Literature review focusing on transdermal and epidermal PMN migration.
- Analysis of PMN properties, inflammatory mediators, and their effects.
- Comparison of PMN migration in psoriatic versus normal skin.
Main Results:
- PMN migration is diminished in clinically uninvolved psoriatic skin and profoundly decreased in lesional skin.
- The mechanism of this reduced migration (tachyphylaxis) is not fully understood.
- Potential factors include inflammatory mediators, cytochrome P-450, endothelial function, and protease inhibitors.
Conclusions:
- PMN play a critical role in psoriasis pathogenesis.
- The impaired PMN migration in psoriatic skin presents a key area for therapeutic intervention.
- Further research into PMN dysfunction may lead to novel antipsoriatic strategies.