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首页> 外文期刊>BMJ: British medical journal >Immunomodulatory drugs for psoriasis
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Immunomodulatory drugs for psoriasis

机译：免疫调节药物牛皮癣

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With a prevalence of 2-3%, psoriasis is among the most common skin diseases. Clinical hallmarks comprise erythematous plaques covered by silvery scaling and a chronic recurrent course. Psoriasis is now considered an autoimmune disease in which antigen presentation to cutaneous T helper cells triggers secretion of cytokines, causing proliferation of keratinocytes and expression of adhesion molecules on endothelial cells. These attract additional effector T cells from the circulation, which are then activated in an antigen specific manner, leading to secretion of more cytokines and perpetuation of the process. Although topical treatments are sufficient for many patients, about 20% need additional systemic drugs. All of these bear a considerable potential for serious side effects, such as hepatotoxicity and nephrotoxicity (methotrexate, cyclosporine), teratogenicity (oral retinoids), and cancer (PUVA, which is psoralen and long wave ultraviolet radiation; cyclosporine), which limits their long term use. The limitations of treatments on the one hand and a growing understanding of the pathogenesis of psoriasis on the other have stimulated much interest in the field of immunomodulation for the management of this chronic disease.
机译：流行的2 - 3%,牛皮癣是最常见的皮肤疾病。包括红斑的斑块被银色的覆盖缩放和慢性复发性课程。现在被认为是一种自身免疫性疾病的皮肤的辅助T细胞抗原表达触发细胞因子的分泌,导致角化细胞扩散和表达在内皮细胞粘附分子。吸引更多的效应T细胞在一个循环,然后激活抗原特异性的方式导致的分泌细胞因子及延续的过程。虽然局部治疗是足够了许多病人,20%需要额外的系统性药物。严重的副作用,如肝毒性和肾毒性(甲氨蝶呤、环孢霉素),致畸性(口服类维生素a),和癌症(PUVA补骨脂素和长波紫外辐射;限制了他们的长期使用。治疗一方面和增长对银屑病的发病机制的理解另一个激发了浓厚的兴趣免疫调节领域的管理这种慢性疾病。

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