Small molecules under development for psoriasis: on the road to the individualized therapies
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REVIEW
Small molecules under development for psoriasis: on the road to the individualized therapies Cervantes‑Durán Claudia1 · Velázquez‑Hernández María‑Elena2 · Valentín‑Escalera Josué3 · Bartolomé‑Camacho María‑Carmen4 · Rodríguez‑Orozco Alain‑Raimundo5 · García‑Pérez Martha‑Estrella3 Received: 25 November 2019 / Accepted: 26 February 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Psoriasis is an incurable cutaneous illness characterized by the presence of well-delimited reddish plaques and silvery-white dry scales. So far, there is a limited understanding of its pathogenesis, though recent discoveries on the immunological, genetic and molecular aspects of this disease have significantly contributed to the identification of new targets and the development of novel drugs. Despite these advances, many patients are still dissatisfied, so to improve patient satisfaction, reliability, and clinical outcomes, the individualization of the treatments for this disease becomes a necessity. This review summarizes recent findings related to psoriasis pathogenesis and describes new small molecules and targets recently identified as promising for treatments. Additionally, the current status, challenges and the future directions for achieving individualized therapy for this disease and the need for more collaborative studies are discussed. The individualization of treatments for psoriasis, rather than a goal, is analyzed as a process where a dynamic integration between the needs and characteristics of the patients, the pharmacological progress, and the clinical decisions takes place. Keywords Psoriasis · Targets · Therapy · Individualized medicine · Pathogenesis · Small molecules
Key points New targets have been linked with psoriasis pathogenesis Several small molecules are under development for psoriasis, although their place in the antipsoriatic treatment schemes has not been established Individualization of psoriasis treatments requires a holistic and dynamic integration among patient’s needs, available therapeutic options, and clinical decisions * García‑Pérez Martha‑Estrella [email protected] 1
Escuela Nacional de Estudios Superiores Campus Morelia, Universidad Nacional Autónoma de México, Morelia, Michoacán, Mexico
2
Clínica de Enfermedades Crónicas y Procedimientos Especiales, Morelia, Michoacán, Mexico
3
Instituto de Investigaciones Químico‑Biológicas, Universidad Michoacana de San Nicolás de Hidalgo, Edif B‑1, Ciudad Universitaria, Francisco J. Mújica, s/n, 58030 Morelia, Michoacán, Mexico
Introduction Psoriasis is an incurable dermatological illness characterized by the presence of well-delimited reddish plaques and silvery-white dry scales. Worldwide prevalence ranges from 0.51 to 11.43% in adults and from 0 to 1.37% for children [1], so it is a common disease. Psoriasis onset can be triggered by injury, drugs, and infections [2]. So far, there is an incomplete understanding of its pathogenesis, but most accepted concepts indicate that it is driven by a complex
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