Track: Clinical Studies

Topic: Other

Abstract:

Background: Psoriasis, a chronic skin disorder characterized by papulosquamous lesions, often exhibits relapse, particularly in previously healed areas, termed "molecular scarring." This phenomenon suggests complex interactions involving keratinocytes, immune cells like tissue-resident memory T cells (TRMs), cytokines, and epigenetic modifications, contributing to pattern-specific recurrence.

Method: This study delves into the immunopathogenesis of psoriasis, focusing on TRMs, the balance between regulatory T cells (Tregs) and Th17 cells, and the impact of treatments on disease recurrence. It assesses TRM marker expression and the efficacy of therapies like anti-IL-17 agents and phototherapy in altering disease progression. The genomic characteristics of treated lesions post-treatment and the duration of clinical remission associated with different therapeutic approaches are also explored.

Result: Data highlighted the pivotal role of TRMs in psoriasis relapse, with environmental triggers reactivating these cells and inducing inflammatory cytokine production. Treatments targeting IL-17 lead to a rapid decrease in TRM markers, especially in the dermis, with varying durations of disease remission depending on the therapeutic approach. Additionally, the genomic profile of treated lesions does not fully normalize, with treatment type influencing gene expression variations, potentially impacting molecular scar size and relapse duration.

Conclusion: Psoriasis relapse correlates with TRM presence and molecular scarring, influenced by treatment modalities. Targeting TRMs and adjusting therapies could prolong clinical remission and mitigate disease progression. Future research should elucidate psoriasis relapse mechanisms further, developing targeted treatments to normalize healed skin's genomic profile, enhancing patient outcomes and disease management.

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Mona Homayouni, MD