Recent landscape in psoriasis

The unexpectedly high efficacy of cyclosporine in treating psoriasis was first observed in a patient with rheumatoid arthritis, 1 prompting physicians and scientists to hypothesize that T-cells play a central role in the disease's pathogenesis.Cyclosporine was subsequently approved for psoriasis vulgaris, demonstrating remarkable efficacy. 2This breakthrough spurred the development of T-cell-targeted therapies, including biologics, utilizing various modern approaches.The first biologic to target T-cell function was the anti-CD2 antibody alefacept.Alefacept inhibits memory effector T-cell activation by blocking the interaction between the adhesion molecule CD2 on T-cells and LFA-3 on antigenpresenting cells (APCs).Clinical trials demonstrated a PASI 50 rate of approximately 40% at the primary endpoint (12 weeks), compared to a placebo response of about 15%. 3 Another target, CTLA4, is a T-cell surface molecule that interacts with the co-stimulatory molecule CD80/86 on APCs, a critical step for T-cell activation.Blocking this interaction with CTLA4-Ig (abatacept) proved effective for rheumatoid arthritis and psoriatic arthritis 4 but showed minimal impact on the skin symptoms of psoriasis. 5CD11a, aRecent landscape in psoriasis