院士讲学周课件银屑病免疫治疗

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1、Mukden Medical School (1891),Manchuria Medical University (1911),China Medical University (1931),in Psoriasis,Immunopathogenesis,Biologic Therapeutics,&,Psoriasis is a T cell-mediated disease (a historical perspective),Previously, hyperproliferation and abnormal differentiation of KCs were assumed t

2、o be the primary defects. Prior therapeutics including retinoids, PUVA, UVB, and MTX, all of which have side effects.,Later, it was found that mononuclear cell infiltration appears before epidermal changes. Studies with mAbs showed accumulations of CD4+ and CD8+ T cells. Accordingly it was suggested

3、 that psoriasis might be a chronic skin inflammation as a result of persistent stimulation of T cells by immunogen of epidermal origin.,Several evidences about the role of activated cellular immunity: (1) PUVA depletes T cells; (2) cyclosporine and tacrolimus are effective; (3) flare of symptoms dur

4、ing perturbation of the immune system or interferon treatment; (4) new lesions are induced by injection of IFN into nonlesional skin of the patient.,Subsequent studies demonstrated the predominance of activated Tc1 in the epidermis, activated TH1 in the dermis, the presence of mature LCs, and the ex

5、pression of CD31, CD34 and PNAd on endothelial cells, in the psoriatic lesions.,From J G Krueger, 2002,Most direct evidence was the results of DAB389 IL-2(a fusion protein composed of human IL-2 sequence and a fragment of diphtheria toxin) on the treatment of psoriasis.,New biologic therapeutics for

6、 psoriasis,Abs(chimeric, humanized, human sequence) fusion proteins recombinant cytokines,Designed to target specific immune-activation steps with least global immune suppression, blocking the cell surface molecules and the cytokines participating in the inflammatory process.,From J G Krueger, 2002,

7、Targeting primary stimulation Targeting costimulation Targeting T cell proliferative signals Immune deviation Blockade of effector cytokines,Strategies for Immunobiologic Therapy of Psoriasis,Therapeutic Agents Targeting Primary Stimulation,Therapeutic Agents Targeting Costimulation,Therapeutic Agen

8、ts Targeting T cell Proliferative Signals,Therapeutic Agents Blocking Effector Cytokines,Before Treatment,After Treatment,Publications About 600 papers published in journals, such as : J Immunol J Invest Dermatol Archiv Dermatol Br J Dermatol Acta Derm Venereol Dermatol Surg J Am Acad Dermatol J Cutaneous Pathol J Appl Cosmetol Clin Exp Dermatol Connect Tissue Res Int J Dermatol Transplantation Dis Markers J Dermatol Int Arch Alle Appl Immunol Tissue Antigens Australasian J Dermatol J Dermatol Science Develop Genetics Chin Med J *Chinese J Dermatol,

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