medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-348medsovet-8538Research ArticleЗАБОЛЕВАНИЯ КОЖИDERMAL DISEASESГенно-инженерная терапия псориаза: больше, чем просто очищение кожиBiological gene therapy for psoriasis: more than just skin clearancehttps://orcid.org/0000-0001-5723-6573ЖуковаО. В.ZhukovaО. V.

Жукова Ольга Валентиновна, д.м.н., профессор, заведующая кафедрой дерматовенерологии и аллергологии с курсом иммунологии Медицинского института, Российский университет дружбы народов имени Патриса Лумумбы; главный врач, Московский научно-практический центр дерматовенерологии и косметологии

117198, Москва, ул. Миклухо-Маклая, д. 6,

119071, Москва, Ленинский проспект, д. 17

Olga V. Zhukova, Dr. Sci. (Med.), Professor, Head of the Department of Dermatovenereology and Allergology with the course of Immunology, Institute of Medicine, Peoples’ Friendship University of Russia named after Patrice Lumumba; Chief Medical Officer, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology

6, Miklukho-Maklai St., Moscow, 117198, 

17, Leninskiy Ave., Moscow, 119071

klinderma@inbox.ruhttps://orcid.org/0000-0002-2793-8862АртемьеваС. И.ArtemyevaS. I.

Артемьева Софья Иосифовна, научный сотрудник отдела клинической дерматовенерологии и косметологии, врач-дерматовенеролог

119071, Москва, Ленинский проспект, д. 17

Sofya I. Artemyeva, Researcher and Dermatovenerologist

17, Leninskiy Ave., Moscow, 119071

sofya.chern@gmail.comРоссийский университет дружбы народов имени Патриса Лумумбы; Московский научно-практический центр дерматовенерологии и косметологииРоссияPeoples’ Friendship University of Russia named after Patrice Lumumba; Moscow Scientific and Practical Center of Dermatovenereology and CosmetologyRussian FederationМосковский научно-практический центр дерматовенерологии и косметологииРоссияMoscow Scientific and Practical Center of Dermatovenereology and CosmetologyRussian Federation20241409202401493100Copyright © Жукова О.В., Артемьева С.И., 20242024Жукова О.В., Артемьева С.И.Zhukova О.V., Artemyeva S.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8538

Псориаз признан системным воспалительным заболеванием, значительно влияющим на все основные аспекты здоровья пациентов, что требует своевременного комплексного подхода к лечению. Данный подход должен улучшать общее благополучие пациентов и учитывать психосоциальные аспекты их жизни. Особое внимание в современных исследованиях уделяется псориатическому артриту (ПсА), поражающему до 30% пациентов с псориазом. Возрастает интерес к возможности остановки прогрессирования псориатического процесса и предотвращения манифеста ПсА. Недавние исследования показали, что своевременное лечение с помощью генно-инженерных биологических препаратов (ГИБП) может остановить прогрессирование болезни и предотвратить развитие инвалидизирующих осложнений. В статье обсуждаются ключевые клинические и иммунологические маркеры, которые могут предсказать развитие ПсА, что открывает пути для более ранней и целенаправленной терапии. Особое внимание уделяется роли препарата гуселькумаб, моноклонального антитела, направленного на ингибирование интерлейкина-23, в предотвращении развития ПсА у пациентов с высоким риском. Клинические наблюдения за тремя пациентами с псориазом, получавшими лечение гуселькумабом, показали не только достижение полного очищения кожи (PASI 0), но и положительные изменения по всем основным параметрам тяжести псориаза, стойкую ремиссию кожного процесса и положительную динамику проявлений псориатической ониходистрофии, считающейся на сегодняшний день основным предиктором ПсА. Данные результаты свидетельствуют о подавлении системного воспаления и контроле риска прогрессирования заболевания. Общее значительное улучшение состояния пациентов, вместе с ключевым показателем эффективности терапии – улучшением качества жизни подчеркивают важность и эффективность своевременной инициации целенаправленной терапии у пациентов с псориазом при наличии определенных отягощающих факторов.

Psoriasis is recognized as a systemic inflammatory disease, significantly affecting all major aspects of patients’ health, requiring a timely comprehensive approach to treatment. This approach should improve the overall well-being of patients and consider the psychosocial aspects of their lives. Special attention in modern research is given to psoriatic arthritis (PsA), which affects up to 30% of patients with psoriasis. There is growing interest in the possibility of stopping the progression of the psoriatic process and preventing the manifestation of PsA. Recent studies have shown that timely treatment with genetically engineered biological agents (biologics) can halt disease progression and prevent the development of disabling complications. The article discusses key clinical and immunological markers that can predict the development of PsA, opening pathways for earlier and targeted therapy. Special attention is given to the role of guselkumab, a monoclonal antibody targeting interleukin-23, in preventing the development of PsA in high-risk patients. Clinical observations of three patients with psoriasis treated with guselkumab showed not only complete skin clearance (PASI 0) but also positive changes in all major parameters of psoriasis severity, sustained remission of the skin process, and positive dynamics of manifestations of psoriatic onychodystrophy, which is currently considered the main predictor of PsA. These results indicate suppression of systemic inflammation and control of disease progression risk. The significant overall improvement in patient condition, along with the key indicator of therapy effectiveness – improved quality of life emphasizes the importance and efficacy of timely initiation of targeted therapy in patients with psoriasis with certain aggravating factors. 

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The authors declare that there are no conflicts of interest present.