The physiology of psoriatic

Overproductivity of the cells

The psoriasis is a dermatological diseases, when the keratinocytes, the horn-producing cell works too much and cause too big horny layer on the epidermis. In psoriasis the regeneration cycle of the skin cell is upset. During psoriasis the regeneration cycle of the skin cells dysfunctions. These cells develop normally in 21-40 days, come to the surface, while the dead cells continuously roll down. In psoriasis the regeneration of the skin cell causes overproduction. In the main time the new skin cells contact with the dead cells, due to this faulty process the skin gets thick too much.

 
Wrong immun system answer

This occurs because of the disorder of immune cells of the body. The immune system gets mistakenly commands such as attack the healthy skin cells and speed up the growth cycle of skin cells. Instead of the normal-speed peelingof cells, they accumulate and create plaques. Exact root of the cause is still unknown. Researches show that it could be hereditary disease, so the genetic factors are also important in that case, but it is not obligatory to lead to the appearance of symptoms. Other causes can be stress, certain medications and skin injury.

 

 

 The proliferation of the keratinocyte

The skin injurys start immunological processes in the epithelial cells. In this procedure certain white blood cells (activated T cells) play major role. The migration, activation and cytokine production of the T –lymphocytes result the keratinocyte proliferation. In the epidermis you can find CD8 + cytotoxic T (Tc) cells; and CD4 + helper T (Th) cells can be detected in the dermis. In psoriatic skin, the Th1 and Tc1 cells and their production IFN-γ are involved in the activation keratinocytes (skin cells make horny layer).

 

 

The activation of the T-cells

The exact mechanism of activation of lymphocytes, and its place and the nature of the trigger antigen are not known. Some of the results show that it caused by bacterial superantigens what start the activation of the polyclonal T-cell, while others says that the activation of the monoclonal T-lymphocyte, the process could go through specific T-cell receptors. The antigen-presenting cells have the prime duty of the activation of T cells. In prosiasis there are different amount of the Lan gerhans cells and dermal dendritic cells. The researchers found the accumulation of the plazmocitoid dendritic cells. The activated dendritic cells induce the IFN-γ and TNF-α production of the T-cell. The TNF-α enhances the appearance of the adhesion molecules (ICAM-1, VCAM) and induce the formation of a number of cytokines (IL-1, IL-2, IL-4, IL-8, IL-12, IL-18).

 

Immune-mediated inflammatory disease

During the psoriasis mostly all of the innate immune system cells significantly proliferate, like: keratinocytes, mast cells, monocytes, macrophages, granulocytes, natural killer cells, endothelial cells and Langerhans cells. On the basis of recent years immunological and dermatological researches and publications, psoriasis is an immune-mediated inflammatory disorders. The adaptive and the function of innate immune response are abnormally increased. The regulatory mechanisms are insufficiently effective, that could be the main reson of the disease.

 

 

Gyöngyike Beleznay M.D.

 

Dermatologist –Cosmetologist Specialist Doctor, Laser Therapist Private Doctor
Derma-Art ® Private Dermatology Clinic

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