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The Yin and Yang of opposing vectors: an explanation for side effects of biologics

Presented By
Prof. Curdin Conrad, Lausanne University Hospital, Switzerland

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Conference
PFGC 2021
Although classical and paradoxical psoriasis have a similar phenotype, their pathogenesis is completely different. A Yin-Yang effect between 2 opposing vectors seems to be a general principle in immunology. Thus, selective targeting of inflammatory pathways may displace inflammatory balance and cause dermatological side effects. Psoriasis is a Th1 and/or Th17 cell-mediated autoimmune disease affecting the skin of genetically predisposed individuals. It has been 15 years since a key innate immune pathway was uncovered for triggering psoriasis [1]. In the early (acute) phase, plasmacytoid dendritic cells (pDCs) accumulate in the skin of psoriasis patients and become activated, for example by mechanical stimulation of the skin to produce interferon (IFN)α. Through the production of IFNα, pDCs drive the activation and expansion of autoimmune T cells in pre-psoriatic skin, leading to the development of psoriasis. In contrast, IFNα does not play a role in the ch...


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