Actualización en terapia biológica para psoriasis y artritis psoriática (parte II): agentes biológicos (inhibidores IL-23)

Abstract

Psoriasis is a chronic, inflammatory skin disease, associated with cardiovascular comorbidities, metabolic syndrome, neoplasia, psychiatric impairment and arthritis (among others), which affect patients' quality of life, as well as their life expectancy. Even though it is a multifactorial process of unknown causes, its relationship to class 1 HLA alleles and their polymorphisms has been described. Its physiopathology involves a dysregulation of the systemic inflammatory response, mediated by T Helper lymphocytes, dermal cells, cytokines and interleukins, and their interactions with keratinocytes and sinovial cells. This triggers a differentiation of lymphocytes towards a Th 17 phenotype, which activates inflammatory processes mediated mainly by interleukin 17 (IL-17), with the subsequent proliferation of keratinocytes and inflammatory and angiogenic mediators, resulting in the typical cutaneous and osteoarticular clinical features. Biological agents are recombinat proteins produced in different cell lines aimed at interrupting inflammatory pathways in psoriasis and psoriatic arthritis, specifically, immune or genetic mediators involved in the progression of these diseases, ultimately targeting the IL-23/IL-17 axis. The following article includes the most recent clinical trials regarding the use of biological agents, in particular, IL-23 inhibitors in the treatment of psoriasis and psoriatic arthritis.