Inflammatory bowel disease and psoriasis: modernizing the multidisciplinary approach
C R H Hedin1,2, E Sonkoly1,3, M Eberhardson1,4
1From the, Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden.
Journal of Internal Medicine
|May 4, 2021
Summary
Psoriasis and inflammatory bowel disease (IBD) are immune-mediated conditions sharing genetic and environmental factors. While treatments targeting specific cytokines show promise, disease heterogeneity necessitates advanced molecular diagnostics for personalized therapies.
Area of Science:
- Immunology
- Gastroenterology
- Dermatology
Background:
- Psoriasis and inflammatory bowel disease (IBD) are prevalent immune-mediated disorders affecting barrier organs.
- Prevalence varies globally, with higher rates in industrialized nations and linked to lifestyle factors.
- Both conditions involve complex genetic, epigenetic, and environmental interactions, including microbiota influences.
Purpose of the Study:
- To explore the shared and distinct pathogenetic mechanisms of psoriasis and IBD.
- To highlight the role of epigenetics and microbiota in disease development.
- To discuss therapeutic implications and unmet needs arising from disease heterogeneity.
Main Methods:
- Review of current literature on psoriasis and IBD pathogenesis.
- Analysis of genetic, epigenetic, and microbiota data.
- Comparison of therapeutic strategies and outcomes.
Main Results:
- Significant overlap exists in immune pathways and genetic susceptibility between psoriasis and IBD.
- Epigenetic modifications (DNA methylation, histone modifications, noncoding RNAs) are crucial in gene-environment interactions.
- Therapeutic efficacy differs, with IL-23/IL-17 inhibitors superior in psoriasis, while IL-17 may be less beneficial in IBD compared to anti-TNFs.
Conclusions:
- Psoriasis and IBD share commonalities but possess distinct features influencing treatment selection.
- Disease heterogeneity underscores the need for precise phenotyping and molecular diagnostics.
- Advancements in understanding pathogenesis are driving the development of targeted therapies, yet unmet needs persist.
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