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Review
. 2024 Jul;154(1):42-50.
doi: 10.1016/j.jaci.2024.05.008. Epub 2024 May 17.

Inflammatory memory in psoriasis: From remission to recurrence

Luc Francis  1 , Francesca Capon  2 , Catherine H Smith  1 , Muzlifah Haniffa  3 , Satveer K Mahil  4
Affiliations
Free article
Review

Inflammatory memory in psoriasis: From remission to recurrence

Luc Francis et al. J Allergy Clin Immunol. 2024 Jul.
Free article

Abstract

The routine use of targeted systemic immunomodulatory therapies has transformed outcomes for people with severe psoriasis, with skin clearance (clinical remission) rates up to 60% at 1 year of biologic treatment. However, psoriasis may recur following drug withdrawal, and as a result, patients tend to continue receiving costly treatment indefinitely. Here, we review research into the "inflammatory memory" in resolved psoriasis skin and the potential mechanisms leading to psoriasis recurrence following drug withdrawal. Research has implicated immune cells such as tissue resident memory T cells, Langerhans cells, and dermal dendritic cells, and there is growing interest in keratinocytes and fibroblasts. A better understanding of the interactions between these cell populations, enabled by single cell technologies, will help to elucidate the events underpinning the shift from remission to recurrence. This may inform the development of personalized strategies for sustaining remission while reducing long-term drug burden.

Keywords: Inflammatory memory; epigenetics; psoriasis; recurrence; remission; single cell technology; tissue resident memory T cell.

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Conflict of interest statement

Disclosure statement Supported by the Psoriasis Association (PhD studentship ST2/21 [to L.F.] and grant BSTOP50/5 [to C.H.S.]), the National Institute for Health and Care Research (NIHR Advanced Fellowship NIHR302258 [to S.K.M.] and NIHR Senior Investigator Award [to C.H.S.]), and the Wellcome Trust (senior research fellowship [to M.H.]). Disclosure of potential conflict of interest: C. H. Smith reports departmental research funding as an investigator in the European Union’s Innovative Medicines Initiative consortia involving multiple industry partners (see biomap-imi.eu and hippocrates-imi.eu for details). F. Capon has received grant support and consultancy fees from Boehringer Ingelheim. S. K. Mahil reports departmental income from AbbVie, Almirall, Eli Lilly, Janssen, Leo, Novartis, Pfizer, Sanofi, and UCB, outside the submitted work. The rest of the authors declare no relevant conflicts of interest.