Available evidence indicates that other clinical subtypes of psoriasis exist on a spectrum between these two clinical phenotypes. Highlights: Plaque psoriasis exhibits both autoimmune and autoinflammatory immune responses.
Book Title: Psoriasis: a Mixed Autoimmune and Autoinflammatory Disease
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Published on 2017 by
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Book is About: Psoriasis
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Graphical abstract: Immunologically psoriasis is characterized by a mixture of both autoimmune and autoinflammatory immune responses. The balance between the two dictates the clinical presentation of psoriasis with chronic plaque psoriasis having prominent adaptive/autoimmune responses while pustular psoriasis is dominated by autoinflammatory immune responses. Available evidence indicates that other clinical subtypes of psoriasis exist on a spectrum between these two clinical phenotypes. Highlights: Plaque psoriasis exhibits both autoimmune and autoinflammatory immune responses. The autoinflammatory loop in psoriasis is driven by IL-36 cytokine responses. Neutrophils and keratinocytes promote autoinflammatory responses in psoriasis. Psoriasis subtypes have variable balance of autoimmune and autoinflammatory responses. Abstract : In recent years marked progress has been made in our understanding of the critical biologic and immunologic pathways involved in psoriasis. Genetic studies have demonstrated that susceptibility to psoriasis involves components of both the adaptive and innate immune system and not surprisingly activation of both of these arms of the immune system is found in psoriatic skin. While adaptive immune responses predominate in chronic plaque psoriasis, innate and autoinflammatory responses dominate in pustular forms of psoriasis, with other clinical subtypes extending on a spectrum between plaque and pustular psoriasis. This makes psoriasis a unique disease where both autoimmune and autoinflammatory responses co-exist, with the balance between the two being critical in shaping its clinical presentation.
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