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Focus on psoriasis, focus on genetic susceptibility of psoriasis -- the 10th World psoriasis day

Source:Institute of Dermatology, Anhui Medical University    Date:2016/08/19    Browse:2569 second

        Psoriasis is a chronic, recurrent and inflammatory disease with genetic tendency, which can involve multiple systems. From the patient's point of view, psoriasis seriously affects the image and quality of life, and is compared with chronic cancer that cannot be cured. At present, the number of psoriasis patients in the world has reached 125 million, while the number of psoriasis patients in China is about 8 million.

        In July 2004, representatives of psoriasis patients and non psoriasis patients from all over the world formed the psoriasis Steering Committee. At the same time, it was proposed by the international psoriasis Association (IFPA), and the meeting unanimously agreed to designate October 29 of each year as "world psoriasis day". At present, the world psoriasis day has been paid attention to by all regions of the world, and has been officially recognized by some countries. World psoriasis day is a development project that helps to raise awareness of psoriasis and eliminate some misunderstandings and fallacies about psoriasis; encourages health care providers to give psoriasis patients better access to appropriate treatment methods; provides patients and the public with relevant information and knowledge; and provides a platform for patients to express their feelings. The theme of this year's world psoriasis day on October 29 is "hope, action, change".

        As people pay more and more attention to psoriasis, many related groups and associations have been established gradually. The National Psoriasis gene association (NPF), established in 1968, is the largest organization in the world to serve patients with psoriasis and psoriatic arthritis. By providing information and services to help patients control their condition, and to provide support for research to discover ways to treat psoriasis. More than 2.1 million people are provided with professional health education and publicity activities every year, and more than 11.2 million US dollars have been invested in research grants and scholarships for psoriasis.

Psoriasis is caused by environmental and genetic factors. Infection, immune dysfunction, metabolic disorder, endocrine dysfunction, mental factors, smoking, drinking, obesity and trauma are all the predisposing factors of psoriasis. Nowadays, the urban environment is deteriorating directly, and the air quality is getting worse and worse, which is also an important inducement for psoriasis.

        Genetic epidemiological survey showed that psoriasis has a genetic tendency, and the risk of psoriasis in the first and second degree relatives of patients is far higher than that of the general population. With the continuous progress of genetic research, there are 74 known psoriasis susceptibility genes at home and abroad, involving T cell receptor, antigen processing and presentation, TNF - α / NF κ B, IL-23, IL-17, JAK / STAT signaling and other signaling pathways. In recent years, Dermatology Research Institute of Anhui Medical University has found 38 psoriasis susceptibility genes, including HLA-C, TNFAIP3, NFKB1, IL12B, IL23R, etc., accounting for 51.35% of the total number of psoriasis susceptibility genes. Direct sequencing of HLA region revealed 8 independent signals. These studies have preliminarily completed the construction of psoriasis susceptibility gene map of Han population and found silver The genetic differences among different races of scurf have promoted the understanding of genetic basis and pathogenesis of psoriasis.

        The newly discovered susceptibility genes play an important role in promoting psoriasis risk prediction, drug efficacy and side effects evaluation, and clinical diagnosis and treatment. Among them, the human leukocyte antigen (HLA) region is closely related to the maintenance of human immunity. The gene mutation in this region is the most important genetic factor in the pathogenesis of psoriasis and can be used as an important marker for the risk prediction of psoriasis. New biological agents are mostly related to the susceptibility genes found. For example, inflixidan, adalimumab and etanercept act on TNF - α in vivo. TNF - α activity plays an important role in the pathogenesis of psoriasis and has a significant impact on the symptoms of psoriasis. Eutekimab is a monoclonal antibody against P40, the common subunit of IL-12 and IL-23. It plays a therapeutic role by blocking the binding of these two inflammatory mediators with receptors on the surface of T lymphocytes. Secukinumab and other three different IL-17 antagonists are currently in clinical evaluation of psoriasis. Genetic studies also contribute to the selection of psoriasis drugs and the prediction of adverse effects. The results showed that patients with HLA-Cw6 genotype had better efficacy than those without HLA-Cw6 genotype. The genetic variation of ABCC1, adora2a and slc19a1 genes was associated with the toxicity of methotrexate in psoriasis.

        With the development of medicine, precision medicine has been widely concerned. Based on the knowledge system obtained from the large sample study, and based on the biomedical, especially various omics data, it carries out personalized precise prevention, accurate diagnosis and precise treatment programs according to the specificity of individual patients in various aspects such as genotype, phenotype, environment and lifestyle. In recent years, Chinese researchers have gradually established the susceptibility gene map of the Han population, and formed systematic genotypic research data. At the same time, combined with the phenotypic and environmental factors of genetic epidemiological investigation, it will promote the development of specific new drugs in Chinese population, greatly promote the process of accurate treatment of psoriasis, and further improve and optimize the clinical diagnosis and treatment level of psoriasis.


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