Псориаз – сложные механизмы патогенеза и коморбидности: все ли нам известно?

Псориаз – это хроническое неинфекционное иммуноопосредованное заболевание кожи, которое представляет собой важную проблему для современной медицины. В мире более 60 млн человек страдают псориазом. Это заболевание ухудшает качество жизни пациентов, может привести к развитию депрессии, социальной изоляции и инвалидизации пациентов. Несмотря на многолетнюю историю изучения псориаза, продолжаются научные исследования, открывающие новые механизмы патогенеза. Псориаз связан с генетическими нарушениями и с триггерными (пусковыми) факторами внешней и внутренней среды. Заболевание является сложным и многофакторным. Различные иммунозависимые клетки, цитокины, интерлейкины принимают участие в патогенезе псориаза. Опубликованы многочисленные научные работы, посвященные патологическим изменениям микробиоты кожи и кишечника у пациентов с псориазом. Ось «кишечник – кожа» – это новая концепция взаимодействия между кожными заболеваниями и микробиомом через воспалительные медиаторы, метаболиты и кишечный барьер. Исследователями было показано, что нарушения баланса микробиома кишечника ассоциированы с аутоиммунными состояниями, такими как ревматоидный артрит, системная красная волчанка, рассеянный склероз, псориаз. Представляют интерес эксперименты на лабораторных животных, например изучение мышиных моделей развития псориаза. Важную роль играет сопутствующая коморбидная патология, особенно метаболические заболевания. Ряд авторов изучили взаимосвязь псориаза с метаболическим синдромом, сахарным диабетом 2-го типа, неалкогольной жировой болезнью печени, ожирением, артериальной гипертонией, хронической болезнью почек. Несмотря на многочисленные исследования, проблема псориаза актуальна до сих пор, и не потеряет актуальности в будущем. В данном описательном обзоре литературы рассмотрены современные изученные механизмы этиологии и патогенеза, влияние кожной и кишечной микрофлоры, а также коморбидности на течение псориаза.

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