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Pathogenesis-oriented therapy of psoriasis using biologics.

Wolf-Henning Boehncke1,2, Nicolò Costantino Brembilla1

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Summary

Psoriasis is an immune-mediated disease. Biologics targeting interleukin-23 and interleukin-17A offer effective and safe treatment, advancing personalized medicine for psoriasis management.

Keywords:
BiologicsTH17-lymphocytescomorbiditypersonalized medicinepsoriasisregulatory T-lymphocytestherapytissue-resident memory T-cells

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Area of Science:

  • Immunology
  • Dermatology
  • Pharmacology

Background:

  • Psoriasis is an immune-mediated inflammatory disease.
  • The central pathogenic axis involves interleukin-23 (IL-23), T helper 17 (TH17) lymphocytes, and interleukin-17A (IL-17A).
  • Conventional systemic therapies have limitations in efficacy and safety.

Approach:

  • Review of current literature since 2018 on psoriasis pathogenesis and biologic therapies.
  • Assessment of the role of innate and adaptive immune system elements in psoriasis.
  • Correlation of biologic drug effects with the physiological and pathophysiological roles of their targets.

Key Points:

  • Biologics targeting the IL-23/TH17/IL-17A axis are highly effective and safe for psoriasis.
  • These targeted therapies offer improved outcomes compared to conventional treatments.
  • Biologics' impact on comorbidities is crucial for therapeutic decisions.

Conclusions:

  • Targeting the IL-23/TH17/IL-17A axis represents a significant advancement in psoriasis treatment.
  • The efficacy of biologics on comorbidities moves psoriasis management towards personalized medicine.
  • Future research should continue to explore targeted therapies for improved patient outcomes.