Achieving durable psoriasis remission with nucleic acid therapeutics

Psoriasis is a chronic immune-mediated inflammatory disorder characterized by immune imbalance and keratinocyte hyperproliferation. Highly effective immunomodulators, with well-established safety profiles, have substantially transformed disease management, achieving durable remission in many patients and reshaping current therapeutic paradigms. However, several unmet clinical needs have driven increasing interest in next-generation nucleic-acid-based therapies, including siRNA, miRNA and therapeutic oligonucleotides, which enable precise and modular gene-level modulation. In this review, their therapeutic potential is summarized and key challenges - such as immunogenicity, off-target effects, delivery barriers and manufacturing scalability - are critically examined. Recent advances in biomaterials that facilitate safer and more-durable gene modulation are further summarized; and potential opportunities for future personalized strategies that complement existing biologic therapies are discussed.