New Frontiers in Psoriatic Disease Research, Part I: Genetics, Environmental Triggers, Immunology, Pathophysiology, and Precision Medicine

Abstract

Psoriasis is a chronic inflammatory condition characterized by systemic immune dysregulation. Over the past several years, advances in genetics, microbiology, immunology, and mouse models have revealed the complex interplay between the heritable and microenvironmental factors that drive the development of psoriatic inflammation. In the first of this two-part review series, the authors will discuss the newest insights into the pathogenesis of psoriatic disease and highlight how the evolution of these scientific fields has paved the way for a more personalized approach to psoriatic disease treatment.

Figure 1.. The multifactorial pathogenesis of psoriatic disease.

The development of psoriasis and psoriatic arthritis is influenced by a combination of genetic risk loci (red), many of which are involved in regulation of IL-23 receptor signaling and the NF-kB pathway, imbalances in Treg/T17 immunity (blue), as well as changes in the gut and cutaneous microbiome (yellow). Illustration assistance provided by Heather McDonald, BioSerendipity, LLC, Elkridge, MD.