Effective Therapeutical Modulation of the Inflammation in Patients with Psoriasis Using Guselkumab Targeting the Specific Subunit p19 IL-23 of the Regulatory Axis of IL-23/Th17

Authors: J. Krejsek
Authors‘ workplace: Ústav klinické imunologie a alergologie, LF UK a FN Hradec Králové, přednosta prof. RNDr. Jan Krejsek, CSc.
Published in: Čes-slov Derm, 93, 2018, No. 6, p. 244-249


The special role in the pathogenesis of psoriasis is given to keratinocytes which are releasing damage associated molecular patterns (DAMP) as a consequence of the exposure to the various noxious stimuli. The identification of DAMP by PRR receptor is followed by the both local and systemic release of proinflammatory cytokines. Some DAMP pattern, so called alarmins, are processed in dendritic cells and are presented as antigenic fragments in optimal cytokine and costimulatory microenvironment to T cells. The abnormal functional polarisation of proliferating T cells in to Th17, Th1, and Th22 subsets is the consequence of this presentation. The critical role into the polarisation to the Th1 and Th17 subsets is given to IL-12 and IL-23 cytokines which share in their unique dimeric structures the common subunit p40. IL-23 is irreplaceable for the whole activity of Th17 subset. This concept is evidenced by the excellent results of several clinical studies in which the neutralisation of p19 subunit specific for IL-23 by guselkumab is substantially alleviating clinical activity of psoriasis. The clinical efficacy and excellent safety profil of guselkumab is superior to other biologicals used in the treatment of psoriasis.


psoriasis – pathogenesis – IL – IL – IL – p – biological therapy – guselkumab


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