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Biomarkers in the pathogenesis, diagnosis, and treatment of psoriasis

机译：牛皮癣的发病机理，诊断和治疗中的生物标志物

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Abstract: Development of psoriasis results from a complex interplay between genetically predisposing factors and environmental triggers that give rise to a self-sustaining pathogenic cycle involving T cells, dendritic cells, connective tissue, and skin epithelium. From 5% to 40% of patients with psoriasis also develop psoriatic arthritis, and increasing evidence indicates an association with other systemic manifestations, including cardiovascular disease and the metabolic syndrome. In psoriatic disease, there is a need for development of biomarkers for assessment of disease severity, for prediction of the outcome of therapeutic interventions, and for distinction between the different clinical variants of the disease. A field of great importance is identification of biomarkers for prediction of development of comorbidities, such as arthritis, cardiovascular disease, and the metabolic syndrome. Genetic determinants of psoriasis and their products not only give an important insight into the pathogenesis of the disease, but may also function as markers of risk for developing cutaneous psoriasis or psoriatic arthritis. So far, there are limited validation data to support the use of candidate biomarkers in clinical practice. Here we review the data from several studies on some of the most promising candidate biomarkers for cutaneous psoriasis and psoriatic arthritis, for the detection of systemic inflammation, and for use as endpoints for therapeutic interventions. Attention is focused on the molecules that take part in the interplay giving rise to psoriasis and on gene products that may represent a link between predisposing genetic factors and the immune and inflammatory processes involved in pathogenesis of the disease. Finally, we provide an overview on how biomarkers can offer insights into the pathogenesis and natural history of psoriasis.
机译：摘要：牛皮癣的发生是由于遗传易感因素与环境触发因素之间复杂的相互作用，导致了涉及T细胞，树突状细胞，结缔组织和皮肤上皮细胞的自我维持的致病周期。从5％到40％的牛皮癣患者也发展为牛皮癣性关节炎，越来越多的证据表明与其他全身表现有关，包括心血管疾病和代谢综合征。在银屑病中，需要开发用于评估疾病严重性，预测治疗干预结果以及区分疾病的不同临床变异的生物标记物。最重要的领域是鉴定用于预测合并症如关节炎，心血管疾病和代谢综合征的生物标志物。牛皮癣及其产品的遗传决定因素不仅对疾病的发病机理具有重要意义，而且还可以作为发展皮肤牛皮癣或牛皮癣关节炎的危险标志。到目前为止，验证数据有限，无法支持在临床实践中使用候选生物标记。在这里，我们回顾了一些针对皮肤银屑病和牛皮癣关节炎，系统性炎症的检测以及用作治疗干预终点的最有希望的候选生物标记物的数项研究的数据。注意力集中在参与引起牛皮癣的相互作用的分子上，以及可能代表易感遗传因素与疾病发病机理中涉及的免疫和炎症过程之间的联系的基因产物。最后，我们概述了生物标记物如何提供有关牛皮癣的发病机理和自然史的见解。

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