Discovery of the IL-23/IL-17 signaling pathway and the treatment of psoriasis

JE Hawkes, BY Yan, TC Chan… - The Journal of …, 2018 - journals.aai.org
JE Hawkes, BY Yan, TC Chan, JG Krueger
The Journal of Immunology, 2018journals.aai.org
Psoriasis vulgaris is a common, heterogeneous, chronic inflammatory skin disease
characterized by thickened, red, scaly plaques and systemic inflammation. Psoriasis is also
associated with multiple comorbid conditions, such as joint destruction, cardiovascular
disease, stroke, hypertension, metabolic syndrome, and chronic kidney disease. The
discovery of IL-17–producing T cells in a mouse model of autoimmunity transformed our
understanding of inflammation driven by T lymphocytes and associations with human …
Abstract
Psoriasis vulgaris is a common, heterogeneous, chronic inflammatory skin disease characterized by thickened, red, scaly plaques and systemic inflammation. Psoriasis is also associated with multiple comorbid conditions, such as joint destruction, cardiovascular disease, stroke, hypertension, metabolic syndrome, and chronic kidney disease. The discovery of IL-17–producing T cells in a mouse model of autoimmunity transformed our understanding of inflammation driven by T lymphocytes and associations with human inflammatory diseases, such as psoriasis. Under the regulation of IL-23, T cells that produce high levels of IL-17 create a self-amplifying, feed-forward inflammatory response in keratinocytes that drives the development of thickened skin lesions infiltrated with a mixture of inflammatory cell populations. Recently, the Food and Drug Administration approved multiple highly effective psoriasis therapies that disrupt IL-17 (secukinumab, ixekizumab, and brodalumab) and IL-23 (guselkumab and tildrakizumab) signaling in the skin, thus leading to a major paradigm shift in the way that psoriatic disease is managed.
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