T cell hierarchy in the pathogenesis of psoriasis and associated cardiovascular comorbidities

Fabio Casciano, Paolo D. Pigatto, Paola Secchiero, Roberto Gambari, Eva Reali

Research output: Contribution to journalShort surveypeer-review

Abstract

The key role of T cells in the pathogenesis of cutaneous psoriasis has been well described in the last decade and the knowledge of the relative role of the different subsets of T cells in psoriasis pathogenesis has considerably evolved. Now, it is clear that IL-17A-producing T cells, including Th17/Tc17, have a central role in the pathogenesis of cutaneous psoriasis and therapies blocking the IL-17A pathway show high clinical efficacy. By contrast, the contribution of IFNγ-producing T cells has progressively become less clear because of the lack of efficacy of anti-IFNγ antibodies in clinical studies. In parallel, the role of CD8+ T cells specific for self-antigens has been revived and increasing evidence now indicates that in psoriatic skin the majority CD8+ T cells are present in the form of epidermal tissue-resident memory T cells. In the last years it also emerged the possibility of a contribution of T cell recirculation in the pathogenesis of psoriasis and its systemic manifestations. The aim of this review is to define a hierarchy for the different subsets of T cells in the T cell-mediated inflammatory cascade in psoriatic skin. This analysis will possibly help to distinguish the subsets that initiate the disease, those involved in the establishment of the self-sustaining amplification loop that leads to the cutaneous clinical manifestations and finally the subsets that act as downstream players in established lesions. Specific T cell subpopulations finally will be considered for their possible role in propagating inflammation at distant sites and for representing a link with systemic inflammation and cardiovascular comorbidities.

Original languageEnglish
Article number1390
JournalFrontiers in Immunology
Volume9
Issue numberJUN
DOIs
Publication statusPublished - Jun 19 2018

Keywords

  • Comorbidities
  • Inflammation
  • Psoriasis
  • Psoriatic arthritis
  • Skin
  • TCR repertoire

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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