Targeted therapy for psoriasis: Pathogenetic aspects and effectiveness

The main issues of etiopathogenesis and approaches to the treatment of psoriasis are presented in this article. The most modern current data on the pathogenetic component of psoriasis are reflected. The possibilities of therapeutic measures using targeted therapy have been determined. Psoriasis is a chronic immune-mediated inflammatory disease primarily affecting the skin. The prevalence of psoriasis is 0.4–4%, occurs mainly in adults aged 20 to 60 years, and there is no significant gender difference. Currently, the leading etiopathogenetic role in psoriasis is determined by hereditary immune disorders. Many immune cells involved in the inflammatory process contribute to the pathogenesis and development of psoriasis. The most important in this aspect are Th17, which contribute to the formation of increased amounts of interleukins (IL) 17, which are important in maintaining chronic inflammation associated with the induction and pronounced synergistic effect of other proinflammatory cytokines. Taking into account the available data, it should be noted that IL-17 (mainly IL-17A and IL-17F) are the key cytokines of the pathogenetic component of psoriasis, and human epidermal keratinocytes are the dominant population of skin cells expressing receptors for IL-17. The IL-17 pathway has also been suggested to modulate inflammatory responses linking comorbid systemic diseases to psoriasis. The latest priority research into the etiopathogenesis of psoriasis was the trigger for the creation of a group of fundamentally new genetically engineered biological drugs (GEBPs), and understanding the key role of IL-17 formed the basis for the development of drugs with a targeted effect on this target. The use of a fundamentally new targeted drug – the interleukin IL-17A blocker – netakimab in patients with psoriasis is important and significant in terms of treating cases that are torpid to therapy with cytostatics and phototherapy and achieving prolongation of clinical remission.