Lessons from Psoriasis: What Can We Apply to Alopecia Areata?
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This document summarizes key findings and lessons from research on psoriasis that can help inform the understanding of alopecia areata. It outlines the main cells and mediators involved in the pathogenesis of psoriasis such as Th1, Th17, and Th22 cells. It also summarizes clinical trials that demonstrated the efficacy of biologics targeting cytokines such as TNF-α, IL-12/IL-23, IL-17, and IL-23 for treating psoriasis. The document aims to draw parallels between the pathogenesis of psoriasis and alopecia areata to help identify new potential treatment targets and strategies for alopecia areata.
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Lessons from Psoriasis: What Can We Apply to Alopecia Areata?
- 1. Lessons from Psoriasis-What Can We Apply to Alopecia Areata? Mark Lebwohl, MD ProfessorAnd Chairman Kimberly and Eric J. Waldman Department of Dermatology Icahn School of Medicine at Mount Sinai
- 2. IL-17A IL-17F IL-17R IL-12 Antimicrobial peptides IL-1β IL-6 TNF-α S100 CXCL8 CXCL9 CXCL10 CXCL11 CCL20 Activation Natural killer T cell Keratinocyt e Myeloid dendritic cell Plasmacytoid dendritic cell Macrophage IL-1β IL-6 TNF-αTNF-α INF-γ INF-γ Th1 cell Th17 cell TNF-α INF-γ Keratinocyt e TNF- α Adaptive immunity Innate immunity Innate immunity IL-20 Adapted from: Nestle F, et al, NEJM 2009; 501. Pathogenesis of Psoriasis Th22 cell IL-22 IL-20 IL-23
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- 11. Adapted from Nestle FO, et al. N Engl J Med. 2009;361:496-509. Ixekizumab, Secukinumab, Bimekizumab IL-17A IIL-17F IL-23 IL-12 Antimicrobial peptides IL-1β IL-6 TNF-α S100 CXCL8 CXCL9 CXCL10 CXCL11 CCL20 Activation Natural killer T cell Keratinocyte Myeloid dendritic cell Plasmacytoid dendritic cell Macrophage IL-1β IL-6 TNF-αTNF-α INF-γ INF-α Th1 cell Th17 cell TNF-α INF-γ Keratinocyte TNF-α Adaptive immunity Innate immunityInnate immunity IL-20 Th22 cell IL-22 IL-20 Secukinumab Ixekizumab Key Cells and Mediators in Psoriasis
- 12. IL-17A IL-17F IL-17R IL-12 Antimicrobial peptides IL-1β IL-6 TNF-α S100 CXCL8 CXCL9 CXCL10 CXCL11 CCL20 Activation Natural killer T cell Keratinocyte Myeloid dendritic cell Plasmacytoid dendritic cell Macrophage IL-1β IL-6 TNF-αTNF-α INF-γ INF-γ Th1 cell Th17 cell TNF-α INF-γ Keratinocyte TNF-α Adaptive immunity Innate immunityInnate immunity IL-20 Adapted from: Nestle F, et al, NEJM 2009; 501. Mechanism of Brodalumab Th22 cell IL-22 IL-20 IL-23
- 13. IL-17A IL-17F IL-17R IL-12 Antimicrobial peptides IL-1β IL-6 TNF-α S100 CXCL8 CXCL9 CXCL10 CXCL11 CCL20 Activation Natural killer T cell Keratinocyte Myeloid dendritic cell Plasmacytoid dendritic cell Macrophage IL-1β IL-6 TNF-αTNF-α INF-γ INF-γ Th1 cell Th17 cell TNF-α INF-γ Keratinocyte TNF-α Adaptive immunity Innate immunityInnate immunity IL-20 Adapted from: Nestle F, et al, NEJM 2009; 501. Mechanism of Guselkumab, Risankizumab, Mirikizumab Th22 cell IL-22 IL-20 IL-23
- 14. Secukinumab in plaque psoriasis--results of two phase 3 trials. Langley RG, Elewski BE, Lebwohl M, Reich K, Griffiths CE, Papp K, Puig L, Nakagawa H, Spelman L, Sigurgeirsson B, Rivas E, Tsai TF, Wasel N, Tyring S, Salko T, Hampele I, Notter M, Karpov A, Helou S, Papavassilis C; ERASURE Study Group; FIXTURE Study Group. N Engl J Med. 2014 Jul 24;371(4):326-38.
- 15. Comparison of ixekizumab with etanercept or placebo in moderate-to-severe psoriasis (UNCOVER-2 and UNCOVER-3): results from two phase 3 randomised trials. Griffiths CE, Reich K, Lebwohl M, van de Kerkhof P, Paul C, Menter A, Cameron GS, Erickson J, Zhang L, Secrest RJ, Ball S, Braun DK, Osuntokun OO, Heffernan MP, Nickoloff BJ, Papp K; UNCOVER-2 and UNCOVER-3 investigators. Lancet. 2015;386(9993):541-51.
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- 18. Confidential TSLP Gittler JK…and Guttman-Yassky E. J Allergy Clin Immunol Sep 2012
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