Psoriasis: immunopathogenesis and evolving immunomodulators and systemic therapies; U.S. experiences

Abstract

Given the role of the inflammatory immune responses in the pathogenesis of psoriasis, the goal of modern medicine and pharmacotherapy lies in the design and use of specific targets in cell-mediated immune reactions and the modulation of the expression of various inflammatory cytokines. The clinical evidence of efficacy of some of these new biological immunomodulatory agents from several U.S.-based research studies and clinical experiences is convincing.

In Vivo and In Vitro Models of Psoriasis

“…Treatments A broad spectrum of anti-psoriatic treatments, both topical and systemic, is available for the management of psoriasis (Fitzpatrick and Wolff, 2008). However, it is often resistant to treatment or, else, frequently relapses upon cessation of medication after partial or acceptable clearance is obtained (Kormeili, et al, 2004). The severity of the disease usually determines the therapeutic approach.…”

“…Approximately, 70 to 80% of all patients with psoriasis can be treated adequately with topical therapy (Schon and Boehncke, 2005). For others, phototherapy and systemic treatments are effective; however, the duration of a treatment is restricted because of the cumulative toxicity potential of an individual therapy (Kormeili, et al, 2004). For example, some treatments may increase the risk of cancer (phototherapy) while others can induce disorders in the liver (methotrexate) (Dubertret, 2004).…”

Psoriatic Skin Models: A Need for the Pharmaceutical Industry

“…Previous studies have demonstrated that psoriasis prevalence varies as a result of two factors: (1) geographical localization and (2) ethnic group. Firstly, psoriasis shows a significant geographical variability with the lowest incidence seen at the equator and increasing frequency towards the poles (Kormeili et al, 2004, Lowes et al, 2007 (Fig. 2).…”

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“…Psoriasis is a common autoimmune inflammatory skin disease that affects about 2-3% of the US population and over 125 million patient's worldwide [26][27][28] . It is characterized by T-cell mediated hyper proliferation of keratinocytes and inflammatory processes based on complex genetic background 26,27 .…”