Tung-Lin Lee1, Tsen-Fang Tsai2. 1. Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan. 2. Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan S. Rd., Taipei, 100, Taiwan. tftsai@yahoo.com.
Abstract
PURPOSE: Psoriasis is an inflammatory disease characterized by skin thickening with silvery white desquamation due to dysregulated inflammatory pathways and elevated levels of inflammatory cytokines. Biologic agents targeting these inflammatory cytokines have brought about significant improvement in clearing psoriatic lesions in patients with moderate-to-severe psoriasis. Moreover, biologics exert both beneficial and detrimental effects on comorbidities in psoriasis, which include increased risk of cardiovascular events, metabolic syndrome, among other conditions. However, non-immune functions of cytokines targeted by biologics, and, hence, the potential risks and benefits of biologics for psoriasis to different organs/systems and comorbidities, have not been well elucidated. RESULTS: This review summarizes current understanding of the pathogenesis of psoriasis-related comorbidities and emerging discoveries of roles of cytokines targeted in psoriasis treatment, including tumor necrosis factor α and interleukins 12, 23, and 17, aiming to complete the safety profile of each biologics and provide therapeutic implications on psoriasis-related comorbidities, and on diseases involving other organs or systems.
PURPOSE: Psoriasis is an inflammatory disease characterized by skin thickening with silvery white desquamation due to dysregulated inflammatory pathways and elevated levels of inflammatory cytokines. Biologic agents targeting these inflammatory cytokines have brought about significant improvement in clearing psoriatic lesions in patients with moderate-to-severe psoriasis. Moreover, biologics exert both beneficial and detrimental effects on comorbidities in psoriasis, which include increased risk of cardiovascular events, metabolic syndrome, among other conditions. However, non-immune functions of cytokines targeted by biologics, and, hence, the potential risks and benefits of biologics for psoriasis to different organs/systems and comorbidities, have not been well elucidated. RESULTS: This review summarizes current understanding of the pathogenesis of psoriasis-related comorbidities and emerging discoveries of roles of cytokines targeted in psoriasis treatment, including tumor necrosis factor α and interleukins 12, 23, and 17, aiming to complete the safety profile of each biologics and provide therapeutic implications on psoriasis-related comorbidities, and on diseases involving other organs or systems.
Authors: S K Mahil; M C Ezejimofor; L S Exton; L Manounah; A D Burden; L C Coates; M de Brito; A McGuire; R Murphy; C M Owen; R Parslew; R T Woolf; Z Z N Yiu; O A Uthman; M F Mohd Mustapa; C H Smith Journal: Br J Dermatol Date: 2020-08-09 Impact factor: 9.302
Authors: Christopher E M Griffiths; April W Armstrong; Johann E Gudjonsson; Jonathan N W N Barker Journal: Lancet Date: 2021-04-03 Impact factor: 79.321
Authors: C H Smith; Z Z N Yiu; T Bale; A D Burden; L C Coates; W Edwards; E MacMahon; S K Mahil; A McGuire; R Murphy; C Nelson-Piercy; C M Owen; R Parslew; O A Uthman; R T Woolf; L Manounah; M C Ezejimofor; L S Exton; M F Mohd Mustapa Journal: Br J Dermatol Date: 2020-07-21 Impact factor: 9.302