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Revista Cubana de Hematología, Inmunología y Hemoterapia
versão impressa ISSN 0864-0289
Resumo
ALFONSO-VALDES, María Elena. Immunopathogenesis of psoriasis. Impact on clinical manifestations and its treatment. Rev Cubana Hematol Inmunol Hemoter [online]. 2012, vol.28, n.4, pp. 357-373. ISSN 0864-0289.
Psoriasis is a T cell-mediated chronic inflammatory disease of the skin. It affects genetically predisposed individuals and presents several subtypes. It is characterized by the presence of well-defined erythematous, scaly, irregular border plaque or lesions, affecting mainly the elbows, knees, scalp, and trunk. The HLA-Cw6 allele of major histocompatibility system is related to the presence and severity of this disease. From the physiopathogenic viewpoint, psoriasis is a Th1-type immune disease in which the axle IL-23/Th17 is fundamental. Th17 cells produce proinflammatory cytokines (IL-17A, IL-17F, IL-22 and IL-26) which activate keratinocytes and cause hyperproliferation and increased production of proinflammatory cytokines and antimicrobial peptides. The latter, in turn, recruit and activate other immune cells of swollen skin. There is thus an amplification of the inflammatory response that leads to clinical manifestations of this disease. The treatment of psoriasis includes topical antiinflammatory agents, phototherapy and systemic immunosuppressive biological agents, including those which are fusion proteins, inhibitors of alpha tumor factor necrosis, and interleukin inhibitors 12 and 23.
Palavras-chave : psoriasis; immunopathogenesis; T cells; IFNa; plasmacytoid dendritic cells; Th17 cells; IL-23/Th17 axis.