Psoriasis: Insights and Understanding

Overview

• Psoriasis affects over 6 million Americans.
• Historically considered a skin disease, it is now recognized as a serious condition impacting quality of life and emotional well-being.

Causes and Nature

• Exact cause unknown; multifactorial with environmental and genetic factors.
• Immune dysregulation is a suspected contributor, causing inflammation and excessive keratinocyte production.
• Psoriatic plaques form due to this dysregulation.

Immune System Involvement

• T Lymphocytes and Cytokines:

  • T cells become activated through multi-step interactions with other cells.
  • Antigen-presenting cells (e.g., dendritic cells) activate T cells in the presence of antigens.
  • Dendritic cells present antigens to naive T cells in lymph nodes.
  • This process transforms naive T cells into memory T cells, which "remember" antigens.

• Inflammatory Process:

  • Memory T cells migrate through the bloodstream to inflamed skin.
  • Involves adhesion molecules, such as ICAM-1.
  • Cytokines like TNF-alpha and interferon-gamma are secreted, leading to keratinocyte plaques.
  • Interleukins 12 and 23 from dendritic cells activate T cells, perpetuating inflammation.

Current Understanding and Research

• Improved understanding of immunopathogenesis.
• Exact triggers and mechanisms remain unclear.
• No cure currently available.

Future Directions

• Further research on the inflammatory nature may aid in prevention and treatment strategies.