Skin-infiltrating, interleukin-22–producing T cells differentiate pediatric psoriasis from adult psoriasis

Pediatric psoriasis: Evolving perspectives

“…Psoriasis in general is thought to be driven by type 17 T helper (Th17)/interleukin (IL)‐23 pathway activation with a positive inflammatory feedback loop due to the persistent release of pro‐inflammatory cytokines, particularly TNF‐α, IL‐23, and IL‐17A. Although large‐scale studies have yet to be published about the composition of the inflammatory infiltrate in the skin of children with psoriasis, early work in this area has revealed differences in the inflammatory composition of psoriatic plaques in children and adults …”

“…In 2015, ustekinumab was approved in Europe for use in adolescents (aged ≥12) and adalimumab for use in children (aged ≥4 years) and adolescents with psoriasis who have had an inadequate response to or are inappropriate candidates for topical therapy and phototherapies. Little has been published about the use of anti‐IL‐17 agents in children, although recent findings suggest it may play an important role in therapy for children …”

“…Psoriasis in general is thought to be driven by type 17 T helper (Th17)/interleukin (IL)-23 pathway activation with a positive inflammatory feedback loop due to the persistent release of pro-inflammatory cytokines, particularly TNF-a, IL-23, and IL-17A. Although large-scalestudies have yet to be published about the composition of the inflammatory infiltrate in the skin of children with psoriasis, early work in this area has revealed differences in the inflammatory composition of psoriatic plaques in children and adults 57. In the last 3 decades, the development of several highly effective biologic drugs has revolutionized the treatment of moderate to severe plaque psoriasis, reflecting our increased understanding of its pathogenesis, including the central importance of IL-23 and IL-17.…”

Childhood psoriasis

“…Compared to adult psoriatic patients, pediatric patients displayed a different profile of expression of cytokines produced by CD4 and CD8 cells in the diseased tissue (significant increase in IL-22 and much lower increase in IL-17 levels). Unlike in adult patients, no increase in regulatory T cells was observed in children [48] (Table 2). …”

“…naniu z dorosłymi pacjentami. W przeciwieństwie do dorosłych u dzieci nie wystąpił wzrost liczby limfocytów T regulatorowych [48] (tab. 2).…”