Pathophysiology and new targets for drug development

Psoriasis pathophysiology is an extremely complex web of events. Our current paradigm describes a complex interplay between T cells, dendritic cells, neutrophils, mast cells, fibroblasts, nerve cells, the vascular endothelium and keratinocytes, with inflammation maintained through a continuous cycle of activation of inflammatory cells and keratinocyte hyperproliferation mediated via cytokines, chemokines and growth factors. The genetic associations found through genome-wide association studies have served as a guide to the central pathogenic pathways operating in this fascinating disease and this will be central in the development of future therapeutic targets and eventual cure.