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Annales de Dermatologie et de Vénéréologie
Volume 139, n° S2
pages 68-72 (avril 2012)
Doi : 10.1016/S0151-9638(12)70113-8
Physiopathologie du psoriasis
Pathogenesis of psoriasis
 

D. Jullien
Université de Lyon, Lyon, F-69003, France; Université Lyon 1, faculté de médecine Lyon EST, France; Hospices Civils de Lyon, Service de Dermatologie, Hôpital Edouard Herriot, Lyon, F-69437, France 

Résumé

Le psoriasis est une maladie polymorphe. La grande diversité des facteurs de susceptibilité génétique, des mécanismes immunologiques et des facteurs déclenchants qui se combinent pour aboutir au développement des lésions contribue largement à ce poly morphisme. Il est illusoire de vouloir chercher la source de la maladie dans un dérèglement exclusif du système immunitaire ou dans une altération primitive isolée des cellules cutanées épithéliales ou stromales. C’est plus vraisemblablement des combinaisons de différentes anomalies de ces deux compartiments qui, chez un individu, donnent naissance au phénotype psoriasique. Ainsi, si les lymphocytes T sont essentiels au développement des plaques, si le rôle de l’immunité innée y est de mieux en mieux reconnu et si de nombreux gènes de susceptibilité de la maladie sont en lien avec l’immunité, il existe d’autres facteurs de susceptibilité non immunologiques tels que des anomalies primitives des kératinocytes; des modèles murins de psoriasis sont ainsi basés sur des modifications ciblées des kératinocytes. Cet article fait un point actuel sur la physiopathologie de la maladie.

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Summary

Psoriasis is a polymorphous disease. The multiple ways to combine susceptibility genes, immunological mechanisms and modifying factors which interact toward the development of the lesions contribute widely to this polymorphism. It is elusive to look for the source of the disease in an exclusive disorder of the immune system or in an isolated primitive change of the epithelial or stromal skin cells. It is more likely that various combinations of selective abnormalities of these two compartments give raise to the psoriatic phenotype. Indeed, if in on hand T-cells are essential in the development of psoriatic plaques, the role of innate immunity in this process is better recognized, and numerous psoriasis susceptibility genes are linked to immunity, on the other hand some susceptibility factors related to primitive abnormalities of keratinocytes and some of the most recent murine models of psoriasis are based on modifications targeted to the keratinocytes. This article makes a current point on the physiopathology of the disease.

The full text of this article is available in PDF format.

Mots clés : Psoriasis, Génétique, Immunologie, Physiopathologie

Keywords : Psoriasis, Genetics, Immunology, Physiopathology




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