जर्नल ऑफ़ क्लिनिकल एंड एक्सपेरिमेंटल डर्मेटोलॉजी रिसर्च
खुला एक्सेस

अमूर्त

Paradoxical Responses in Biologic Therapy for Psoriasis: Unraveling Mechanisms and Optimizing Treatment Strategies

Jingyan Kong, Minghui Zhao, Xiaoyu Ma, Fan Yang, Hongxiao Gao

This review article comprehensively investigates the paradoxical reactions provoked by biologics in the treatment of psoriasis, examining the role of chemokines, inflammatory mediators, oxidative stress responses, as well as genetic and environmental factors. Biologics, whilst offering significant relief to psoriasis symptoms, can in some cases exacerbate the condition through the induction of other chemokines and inflammatory mediators, or by disrupting intracellular antioxidant mechanisms. Additionally, the presence of gene polymorphisms in psoriasis patients may influence the sensitivity to biologics, with specific polymorphisms in the HLA-Cw6, IL23R, and IL12B genes possibly impacting the reactivity to TNF-α and IL-23 inhibitors. Environmental factors, such as infections, lifestyle, and psychological stress, can also affect the occurrence of paradoxical reactions, with smoking, alcohol consumption, and infections potentially impacting the efficacy and safety of biologics. This review underscores the importance of a holistic understanding of the role of these factors in paradoxical reactions for optimizing psoriasis treatment plans.