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IL-17A in Psoriasis and Beyond: Cardiovascular and Metabolic Implications.

  • von Stebut E Department of Dermatology, University of Cologne, Cologne, Germany.
  • Boehncke WH Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland.
  • Ghoreschi K Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
  • Gori T Center of Cardiology-Cardiology I, University Medical Center Mainz, Mainz, Germany.
  • Kaya Z Department of Internal Medicine III, University of Heidelberg, Heidelberg, Germany.
  • Thaci D Institute and Comprehensive Center of Inflammation Medicine, University of Lübeck, Lübeck, Germany.
  • Schäffler A Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany.
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  • 2020-02-04
Published in:
  • Frontiers in immunology. - 2019
IL-17A
cardiovascular
comorbidities
diabetes
psoriasis
Arthritis, Psoriatic
Cardiovascular Diseases
Humans
Interleukin-17
Metabolic Diseases
Th17 Cells
English Interleukin 17A (IL-17A) is one of the currently known six members of the IL-17 cytokine family and is implicated in immune responses to infectious pathogens and in the pathogenesis of inflammatory autoimmune diseases like psoriasis. Psoriatic skin is characterized by high expression of IL-17A and IL-17F, which act on immune and non-immune cell types and strongly contribute to tissue inflammation. In psoriatic lesions, IL-17A, IL-17E, and IL-17F are involved in neutrophil accumulation, followed by the formation of epidermal micro abscesses. IL-17A together with other Th17 cytokines also upregulates the production of several chemokines that are implicated in psoriasis pathogenesis. IL17A-targeting antibodies show an impressive clinical efficacy in patients with psoriasis. Studies have reported an improvement of at least 75% as measured by the psoriasis area and severity index (PASI) in >80% of patients treated with anti-IL-17A therapy. Psoriasis skin manifestations, cardiovascular as well as metabolic disease in psoriasis appear to share pathogenic mechanisms evolving around IL-17A and its proinflammatory role. Thus, anti-IL-17A therapy not only improves skin manifestations of psoriasis, but also cardiovascular inflammation as well as metabolic factors and different domains of psoriatic arthritis (PsA) including peripheral arthritis, enthesitis, dactylitis, and axial involvement. This review summarizes the biological role of IL-17A, before reviewing currently available data on its role in the physiology and pathophysiology of the skin, as well as the cardiovascular and the metabolic system. In conclusion, clinical recommendations for patients with moderate to severe psoriasis based on the current available data are given.
Language
  • English
Open access status
gold
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Persistent URL
https://sonar.ch/global/documents/29291
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