Psoriasis and atopic dermatitis (AD) are diseases of distinct T-cell “polar” subsets and can both be treated by specific cytokine antagonists or more broad immunosuppressive drugs, according to a recent review. The diseases are similar in that epidermal keratinocytes respond to T-cell derived cytokines by altering growth and differentiation responses, accounting for major parts of the overall disease phenotype. Today, ∼90% of psoriasis patients have extremely controlled disease by targeting the IL-23/Th17 T-cell axis with IL-23 or IL-17-targeting antibodies. The question that remains is whether targeting a single cytokine axis in AD, for example, Th2 axis, will lead to disease suppression in the majority of patients and across all subtypes, including those with higher IL-17 expression, or whether it is necessary to personalize therapies and target multiple T-cell axes to attain similar disease improvement to psoriasis.
Guttman-Yassky E, Krueger JG. Atopic dermatitis and psoriasis: Two different immune diseases or one spectrum? [Published online ahead of print September 1, 2017]. Curr Opin Immunol. doi:10.1016/j.coi.2017.08.008.