Psoriasis: from basic and clinical research to the development of new treatments

Abstract

Psoriasis is an incurable cutaneous disease of inflammatory nature, characterized by erythematous plaques. It is estimated to affect 2 to 3 % of the world population; it is less common in equatorial than in Nordic regions.1 In Mexico there are few epidemiological studies on the disease, and thus the real magnitude of the problem remains unknown. At a symposium celebrated in 2009 in Dallas, Texas, the prevalence in Mexico was estimated to be 2.9 %,2 which would be equivalent to more than 3 million affected Mexicans. The incidence of death directly related to psoriasis is low, but its physical and psychological manifestations make it incapacitating, comparable to cancer, diabetes and depression.3 Current anti-psoriatic treatments are essentially directed to the management of symptoms and include phototherapy, as well as topical and systemic medications aimed at:4 – Inhibiting keratinocyte hyperproliferation (vitamin D analogues). – Normalizing keratinocyte differentiation process (vitamin D analogues, retinoids). – Decreasing immunocyte recruitment and activation (cyclosporine A, biotechnological medications). – Neutralizing pro-inflammatory cytokines (biotechnological medications). However, their long-term use is limited by efficacy loss, toxicity and elevated costs. As a consequence, from 31 to 70 % of patients with psoriasis are highly dissatisfied.5 The pharmaceutical industry is increasingly interested in the development of new treatments. In recent years, the term “translational medicine” has been born, which refers to a new paradigm based on the need to integrate scientific knowledge that is generated from basic research to the development of treatments with clinical impact (bench-to-bedside). It is a bidirectional concept, where the new findings derived Abstract