Historically, agents used to treat psoriasis were discovered by experimentation or by accident. In contrast, current novel therapeutic agents are designed from a better understanding of the immune processes involved in psoriasis and by the specific targeting of molecular mediators. Examples can be seen in the use of biologics which target T cells and TNF inhibitors.
It has been suggested that cannabis might treat psoriasis, due to the anti-inflammatory properties of its cannabinoids, and the regulatory effects of THC on the immune system. The adverse effects of cannabis might be overcome by use of more specific cannabinoid receptor medications, to inhibit keratinocyte proliferation.
Future innovation should see the creation of additional drugs that refine the targeting of immune-mediators further.
Research into antisense oligonucleotides carries the potential to provide novel therapeutic strategies for treating psoriasis.
ABT-874 is a human anti-IL-12 monoclonal antibody being developed by Abbott Laboratories in conjunction with Cambridge Antibody Technology for the treatment of multiple autoimmune diseases including psoriasis. Phase II trials have been completed and showed promising results. Abbott was planning to initiate Phase III trials in 2007.
In 2004, Tas and Avci demonstrated cyclopamine’s clinical potential for the treatment of psoriasis and basal cell carcinoma in two preliminary proof of concept studies. By treating 31 psoriatic lesions in 7 patients, these authors asserted
that topical cyclopamine was more effective in the clinical and histological clearance of guttate and plaque psoriasis than the topical steroid clobetasol-17 propionate. Furthermore, they demonstrated that concurrent application of cylopamine and clobetasol-17 propionate accelerated regression and clearance of selected lesions greater than cyclopamine alone with clearance times as early as 48 hours.They assert that cyclopamine inhibits the abnormal proliferation of epithelial cells, induces terminal differentiation, and is associated with the decreased presence of inflammatory cells, including CD41 lymphocytes.
On August 27, 2006, scientists led by Jeung-Hoon Lee created in the laboratory synthetic lipids called pseudoceramides which are involved in skin cell growth and could be used in treating skin diseases such as atopic dermatitis, a form of eczema characterized by red, flaky and very itchy skin; psoriasis, and glucocorticoid-induced epidermal atrophy, in which the skin shrinks due to skin cell loss.
On November 17, 2008, scientists led by Yin-Ku Lin of Chang Gung Memorial Hospital and Chang Gung University in Taoyuan, Taiwan, told Reuters by telephone that Indigo naturalis (Qing Dai), a dark blue plant used in traditional Chinese medicine, appears to be effective in treating psoriasis. In the latest issue of Archives of Dermatology, they wrote, "The indigo naturalis ointment-treated lesions showed an 81 percent improvement, the (non-medicated) ointment-treated lesions showed a 26 percent improvement."
Talarozole amplifies the effects of retinoic acid by inhibiting its metabolism, it is undergoing clinical trials.
Further Reading
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