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Vol. 103. Issue S2.
Actualización del uso de ustekinumab: un ava nce en el tratamiento de la psoriasis
Pages 7-15 (October 2012)
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Vol. 103. Issue S2.
Actualización del uso de ustekinumab: un ava nce en el tratamiento de la psoriasis
Pages 7-15 (October 2012)
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Mecanismo de acción de ustekinumab y su relevancia en la patogénesis de la psoriasis. Impacto en el sistema inmune
Mechanism of Action of Ustekinumab and its Relevance in the Pathogenesisof Psoriasis. Impact on the Immune System
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J.M. Carrascosa
Corresponding author
jmcarrascosac@hotmail.com

Autor para correspondencia.
Servei de Dermatologia. Hospital Universitari Germans Trias i Pujol. Universitat Autònoma de Barcelona. Badalona.Barcelona. España
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Resumen

La psoriasis es un proceso inflamatorio crónico en el que participan de forma conjunta la inmunidad innata y la adquirida. Los queratinocitos serán la primera diana a través de la liberación de péptidos antimicrobianos tales como la catelicidina LL37, que a través de la formación de agregados con el ADN del individuo permite la activación de diversas poblaciones de células dendríticas. En este modelo, algunas poblaciones linfocitarias no descritas previamente en la psoriasis, como las células dendríticas mieloides CD11+ y los linfocitos Th17, desempeñan un papel fundamental en la patogenia de las lesiones. Asimismo, la vía de las interleucinas 12/23, que permite la diferenciación y proliferación clonal de las subpoblaciones linfocitarias Th1 y Th17, implicadas de forma prioritaria en la génesis de la placa psoriásica, representa un punto clave no sólo como nexo entre la inmunidad innata y la adquirida, sino también como diana terapéutica, demostrada ya en la práctica clínica por ustekinumab.

Palabras clave:
Ustekinumab
Th17
IL-12/23
Psoriasis
Abstract

Psoriasis is a chronic inflammatory disorder mediated by elements of both the innate and the adaptive immune system. The first cells involved in the inflammatory response are keratinocytes. These release antimicrobial peptides, such as cathelicidin LL37, which subsequently form complexes with self DNA, enabling the activation of different dendritic cell populations. It is now considered that lymphocyte subsets that have only recently been implicated in psoriasis, such as CD11+ dendritic cells and TH17 cells, play a key role in the pathogenesis of psoriatic lesions. The interleukin 12/23 pathway enables the differentiation and clonal expansion of TH1 and TH17 cells, 2 types of helper T cells that have an essential role in the formation of psoriatic plaques. This pathway not only acts as a bridge between the innate and adaptive immune system, but is also an important therapeutic target, as has been demonstrated clinically with ustekinumab.

Keywords:
Ustekinumab: TH17
IL-12/23
Psoriasis
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