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Review
. 2009 Jun;90(3):232-48.
doi: 10.1111/j.1365-2613.2009.00669.x.

Angiogenesis drives psoriasis pathogenesis

Regina Heidenreich  1 , Martin Röcken, Kamran Ghoreschi
Affiliations
Review

Angiogenesis drives psoriasis pathogenesis

Regina Heidenreich et al. Int J Exp Pathol. 2009 Jun.

Abstract

Psoriasis pathogenesis is closely associated with disease-inducing Th1 and Th17 cells. Yet, several studies suggest that aberrant keratinocyte or endothelial cell signalling significantly contributes to disease manifestation. Histological hallmarks of psoriatic skin include the infiltration of multiple immune cells, keratinocyte proliferation and increased dermal vascularity. Formation of new blood vessels starts with early psoriatic changes and disappears with disease clearance. Several angiogenic mediators like vascular endothelial growth factor, hypoxia-inducible factors, angiopoietins and pro-angiogenic cytokines, such as tumour necrosis factor (TNF), interleukin (IL)-8 and IL-17, are up-regulated in psoriasis development. Contact- and mediator-dependent factors derived from keratinocytes, mast cells and immune cells may contribute to the strong blood vessel formation of psoriasis. New technologies and experimental models provide new insights into the role of angiogenesis in psoriasis pathogenesis. Interestingly, many therapies target not only immune cells, but also protein structures of endothelial cells. Here we summarize the role of pro-angiogenic factors in psoriasis development and discuss angiogenesis as a potential target of novel therapies.

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Figures

Figure 3
Figure 3
Blood vessels in psoriatic lesion. Tortous dermal capillaries stained with anti-CD31 antibody (red).
Figure 2
Figure 2
Psoriasis histology. (a) H&E staining of psoriasis skin. Epidermal thickening with elongated rete ridges. Infiltration of neutrophils in the corneal layer. Lymphocytic infiltrate, few macrophages and mast cells in the dermis. Dilated and elongated capillaries in the papillary dermis. (b) Healthy skin with regular epidermis and orthokeratosis.
Figure 1
Figure 1
Clinical picture of psoriasis. Multiple psoriatic plaques on the back of a patient with chronic psoriasis.
Figure 4
Figure 4
The role of angiogenesis in the pathogenesis of psoriasis. VEGF, vascular endothelial growth factor; IL, interleukin; IFN, interferon; TNF, tumour necrosis factor; TGF, tumour growth factor; MMP, matrix metalloproteinases; bFGF, basic fibroblast growth factor; ECs, endothelial cells; DC, dendritic cells; Th, T-helper cells; N, neutrophils.
See this image and copyright information in PMC

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