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Review
. 2021 Jan 7:11:596086.
doi: 10.3389/fimmu.2020.596086. eCollection 2020.

The IL-17/IL-23 Axis and Its Genetic Contribution to Psoriatic Arthritis

Matteo Vecellio  1   2 , Vivien Xanath Hake  2 , Connor Davidson  1 , Maria Cristina Carena  3 , B Paul Wordsworth  1 , Carlo Selmi  2
Affiliations
Review

The IL-17/IL-23 Axis and Its Genetic Contribution to Psoriatic Arthritis

Matteo Vecellio et al. Front Immunol. .

Abstract

Psoriatic arthritis (PsA) is a chronic inflammatory disease belonging to the family of spondyloarthropathies (SpA). PsA commonly aggravates psoriasis of the skin and frequently manifests as an oligoarthritis with axial skeletal involvement and extraarticular manifestations including dactylitis, enthesitis, and uveitis. The weight of genetic predisposition to psoriasis and PsA is illustrated by the concordance rates in monozygotic twins which clearly demonstrate that genomics is insufficient to induce the clinical phenotype. The association of PsA with several single nucleotide polymorphisms (SNPs) at the IL23R locus and the involvement of Th17 cells in the immunopathogenesis of PsA clearly put the IL-23/IL-17 axis in the spotlight. The IL-23 and IL-17 cytokines have a pivotal role in the chronic inflammation of the synovium in PsA and are also prominent in the skin lesions of those with PsA. In this review, we focus on the genetic association of the IL-23/IL-17 axis with PsA and the contribution of these master cytokines in the pathophysiology of the disease, highlighting the main cell types incriminated in PsA and their specific role in the peripheral blood, lesional skin and joints of patients. We then provide an overview of the approved biologic drugs targeting the IL-23/IL-17 axis and discuss the advantages of genetic stratification to enhance personalized therapies in PsA.

Keywords: IL17; IL23; SNPs (single nucleotide polymorphisms); genetics; psoriatic arthritis; therapy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Genetics studies allowed the identification of the IL-23/IL-17 axis having a crucial functional role in PsA pathogenesis. Genetics lead to the development of biological drugs targeting the IL-23/IL-17 axis in PsA. Red arrow indicates the target of different biologics.
See this image and copyright information in PMC

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