MODERN CONCEPTS OF THE IMMUNOPATHOGENESIS OF PSORIASIS AND THE PROSPECTS OF ANTISENSE THERAPY

Relevance: Psoriasis is a chronic inflammatory disease characterized by its polygenic nature and the leading role of immune mechanisms. It is based on skin and joint damage. Clinically, the disease is characterized by erythematous rashes covered with silver scales. Despite significant progress in elucidating the pathogenesis and the introduction of targeted biological drugs, it has not yet been possible to achieve sustainable, long-term disease control. In this regard, there is a pressing need to develop new therapeutic strategies targeting key links in the pathogenesis. The use of antisense oligonucleotides is considered a promising therapeutic approach.

Objective: To analyze modern concepts of the immunopathogenesis of psoriasis and evaluate the therapeutic potential of antisense oligonucleotides.

Materials and Methods: A literature search was conducted in the PubMed, Scopus, Web of Science, Google Scholar, ScienceDirect, and the Cochrane Library databases. Articles published from 2010 to September 2025 were selected for inclusion. Inclusion criteria comprised articles published in peer-reviewed journals focusing on the immune pathogenesis of psoriasis, the IL-23/IL-17 and IL-36 signaling axes, and the therapeutic potential of antisense oligonucleotides. Only publications with full-text availability and direct relevance to the research topic were considered for inclusion. Exclusion criteria included articles not directly relevant to the research topic, duplicate publications, conference abstracts, letters to the editor, and studies without full-text availability.

Results: Analysis of recent articles in international scientific databases highlights the importance of the IL-23/IL-17 and IL-36 axes in the development of psoriasis. These signaling pathways support chronic inflammation and promote the pathological proliferation of keratinocytes. Moreover, the obtained data indicate that antisense oligonucleotides may represent a promising approach for pathogenetic therapy and can expand the possibilities for targeted treatment of psoriasis.

Conclusions: Psoriasis is a chronic immune-inflammatory disease. In its pathogenesis, the IL-23/IL-17 and IL-36 axes play a key role in the regulation of keratinocyte proliferation, leading to sustained inflammatory mechanisms. Antisense oligonucleotides used in its treatment selectively act on key pathogenic links by suppressing the expression of genes responsible for disease initiation. Although the aforementioned method represents one of the promising approaches for targeted intervention at the molecular level in the disease, there is a need for further in-depth investigation of its efficacy and safety before clinical implementation.

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