Pathogenesis of Plaque Psoriasis

Mark G. Lebwohl, MD, and Alice B. Gottlieb, MD, PhD, discuss pathogenesis of plaque psoriasis and new emerging targets.

Mark G. Lebwohl, MD: Hi, I’m Dr Mark Lebwohl, and welcome to the Dermatology Times® DermView IL [interleukin]-17 Inhibitors for the Treatment of Plaque Psoriasis. I’m dean for clinical therapeutics at the Mount Sinai School of Medicine in New York; now called the Icahn School of Medicine in New York. Joining me today is Dr Alice Gottlieb, clinical professor and medical director of the Department of Dermatology at the Icahn School of Medicine at Mount Sinai-Union Square. In this video series, we’re going to review the pathogenesis of psoriasis as well as discussing impact of IL-17 inhibitors on psoriasis. Let’s get started. Our understanding of the pathogenesis of plaque psoriasis has evolved significantly over the years. How has this led to the development and use of more targeted and effective therapies, Alice?

Alice B. Gottlieb, MD, PhD: The discovery of the efficacy of tumor necrosis factor [TNF] blockers in psoriasis and for that matter in psoriatic arthritis, revolutionized the treatment of both diseases. Then it became evidence that both IL-17 and interleukin 23 play a key role in the pathogenesis of psoriasis and especially IL-17 in psoriatic arthritis. With this realization, there was realization of possibly greater efficacy, at least in the skin and even potentially increased safety, which has produced an advance even further than the introduction of TNF blockers for psoriasis and psoriatic arthritis.

Mark G. Lebwohl, MD: Yes. I’m going to interrupt because there is too much modesty going on here. Alice Gottlieb was responsible for identifying TNFs role in psoriasis. She was the first to publish a double-blind placebo-controlled trial showing that infliximab was dramatically effective in the treatment of psoriasis. That changed the world because until then, the treatments that we had, primarily cyclosporine methotrexate, were profoundly immunosuppressive, they had a ton of side effects and we now had the ability to target 1 molecule TNF alpha, and thus get rid of psoriasis. That was a major breakthrough for which you are responsible, Alice.

Alice B. Gottlieb, MD, PhD: Thank you.

Transcript edited for clarity

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