JULY 2018 VOL 14 NUMBER 2 PSORIASIS REVIEW Included in this Issue 1 Top 5 Research and Clinical Papers IPC’S SEMI-ANNUAL REVIEW OF THE • Clinically resolved psoriatic lesions TOP 5 PAPERS: JULY–DECEMBER 2017 contain psoriasis-specific IL-17- producing αβ T cell clones • Psoriasis and suicidality: A systematic Every 6 months, IPC’s board and councilors recommend and vote on articles that review and meta-analysis make the greatest impact on psoriasis research. The 5 papers that received the • An analysis of IL-36 signature genes most votes for articles published July through December 2017 are reviewed here. and individuals with IL1RL2 knockout Summaries and commentaries were written by this issue’s co-editors, Dr. Colby mutations validates IL-36 as a Evans, Evans Dermatology, Austin, Texas, United States, and Dr. Nancy Podoswa, psoriasis therapeutic target Hospital General Regional No. 1 Dr. Carlos MacGregor Sanchez Navarro, Mexican • Coronary plaque characterization in psoriasis reveals high-risk features Institute of Social Security, Mexico City, Mexico. that improve after treatment in a prospective observational study 1. Residual T-cell clones in both active and resolved • Association between skin and aortic vascular inflammation in patients psoriatic plaques may reinitiate disease if treatment with psoriasis: a case-cohort study stops using Positron Emission Tomography/ Computed Tomography Clinically resolved psoriatic lesions contain psoriasis-specific IL-17-producing 2 A Letter from the President αβ T cell clones. Matos TR, O’Malley JT, Lowry EL, et al. J Clin Invest. 2017 Nov 1;127(11):4031-4041. doi: 10.1172/JCI93396. Epub 2017 Sep 25. 10 A Report from the International Investigative Dermatology (IID) 2018 Meeting Summary T-cell receptor and immunostaining Much has been learned in recent for clonality and cytokine production 15 IP C at the 36th Reunión Anual de years about the local pathogenesis were applied to these specimens. Dermatólogos Latinoamericanos in psoriatic plaques, including the These techniques compared the same (RADLA) development of targeted treatments plaque before and after clearance 20 In other psoriasis news to influence the underlying biology. with treatment and found oligoclonal 22 IPC NEWS This study looked at plaques that were populations of T cells in both. Clonal • Patient care clinically resolved after treatment T cells were most common in the • Research to assess the local T-cell population active plaques but were more • Education and Outreach and presence of Interleukin (IL)-17, a common in the resolved plaques (93% key cytokine in the pathogenesis of reduction from active disease) than • Newsmakers psoriasis. Oligoclonal populations of in normal skin of the same patient. • New IPC councilors T cells were analyzed to try to discern This finding may imply that these and quantify putative pathogenic residual T-cell clones set the stage T-cell clones. Skin samples were for recurrence of disease at the obtained from psoriatic plaques, same site if treatment is stopped. resolved plaques (successfully Further study of these clonal T cells treated with either etanercept or in both active and resolved plaques phototherapy), unaffected skin demonstrated that they produce IL-17 International Psoriasis Council in psoriatic patients, and normal and IL-22, key mediators of psoriasis, 1034 S. Brentwood Blvd., Suite 600 controls undergoing cosmetic and that they have a psoriasis-specific St. Louis, MO 63117 procedures. High-throughput TCR repertoire which was not seen in Tel 972.861.0503 screening of the CDR3 region of the normal skin or other skin diseases. Fax 214.242.3391 www.psoriasiscouncil.org Cont., Page 3 PSORIASIS REVIEW JULY 2018 VOL 14, NUMBER 2 LETTER FROM THE PRESIDENT Dear colleagues, Another newly-launched initiative, IPC’s Psoriasis Master Class program, will help practicing dermatologists increase We are pleased to share the July their understanding of psoriasis and treatment by providing issue of the IPC Psoriasis Review a complete overview of disease pathogenesis, current newsletter with you. We are midway therapies, and treatment considerations. Earlier this year, into 2018 and have been busy we held our first Master Class in Mumbai, India, with 50 these past few months holding dermatologists from around the country participating educational symposia, launching in this 1½-day program. In November, we will be offering new CME activities on our website, another Master Class in Barcelona, Spain, and are planning and convening our psoriasis experts to hold similar classes in the United States and Latin to advance our work to define moderate psoriasis, clarify America in the coming year. You can read more about our our research priorities, and further the development of the Master Class in India on page 23. Global Psoriasis Atlas project. As these two endeavors illustrate, IPC’s educational In addition to our continued efforts on these projects, I am programs and activities are playing important roles in pleased to highlight an initiative we launched earlier this enhancing the skills of dermatologists and other health year, the IPC International Fellowship Program. Available care professionals worldwide. They provide opportunities to early-career dermatologists-in-training or junior faculty for practitioners to deepen their expertise and to carry who want to improve their abilities to care for patients our work forward into their universities, clinics, and with psoriasis and develop effective leadership skills, this communities. program aims to foster the next generation of psoriasis leaders. While participating in this yearlong program, As a global network of psoriasis experts, thought leaders, selected fellows are paired with IPC board members or and professionals committed to enhancing care, the IPC is councilors to gain real-world experience in clinical practice uniquely equipped to affect how psoriasis is understood and laboratory research. Additionally, IPC fellows will and treated throughout the world. By continually advancing participate in an international dermatology congress during and sharing our knowledge about this disease through our the year and will be invited to join IPC activities and attend core areas of education and research, we will be able to our annual Think Tank meeting. build expertise in the medical community and influence better patient outcomes. For this first-year program, we received a number of applications from highly qualified candidates from around We look forward to expanding these important efforts the world, ultimately selecting 3 young professionals from and hope you will continue to engage with us as we strive Chile, China, and the Czech Republic. Next year, we hope toward our vision of a world free of psoriasis. to expand the program to include 5 fellows. See page 21 to learn more about this year’s fellows. With best wishes, This new initiative is an example of IPC’s ongoing efforts to grow global expertise and leadership in the field of psoriasis. By leveraging the deep knowledge of IPC’s network of councilors through education programs, Alexa Boer Kimball, MD, MPH events, and other endeavors, we will increase our ability to President, International Psoriasis Council influence the care and treatment of people with psoriasis around the world. 2 Advancing Knowledge | Enhancing Care PSORIASIS REVIEW JULY 2018 VOL 14, NUMBER 2 IPC’S SEMI-ANNUAL REVIEW OF THE TOP 5 PAPERS: JULY-DECEMBER 2017 Cont. from Page 1 COMMENTARY Our understanding of the cellular cascade if triggered or if treatment is withdrawn. and cytokine activity in active psoriatic plaques has Even in clinically resolved lesions, these clonal T cells grown tremendously in the last 20 years. Furthering continue to produce IL-17, indicating that they have not that understanding will require studies such as this been destroyed or deactivated but simply suppressed that look at the immunologic tableau during or after by the successful treatment. As the authors point out, treatment and in recurrence. This study establishes better understanding of these persistent clonal T-cell that populations of long-lived clonal T cells exist in populations could potentially lead to treatments that can active psoriatic plaques but also in resolved plaques and kill or inactivate these populations, possibly leading to therefore may stand ready to reinitiate the inflammatory longer-term control of psoriasis. – Dr. Colby Evans For additional copies of the IPC Psoriasis Review newsletter, or to learn more about IPC, please visit www.psoriasiscouncil.org. IPC BOARD OF DIRECTORS Asia Jörg Prinz Catherine Smith Charles W. Lynde Kristian Reich Richard Warren Richard Langley Officers China Xuejun Zhang Robert Sabat Helen Young Yves Poulin Alexa B. Kimball, President, Wolfram Sterry Ronald Vender United States Min Zheng Latin America Diamant Thaçi United States Jonathan Barker, Vice India Argentina Ireland April Armstrong President/President-Elect, Murlidhar Rajagopalan Edgardo Chouela Brian Kirby Andrew Blauvelt United Kingdom Cristina Echeverría Japan Caitríona Ryan Anne Bowcock Craig L. Leonardi, Treasurer, Matías Maskin United States Akimichi Morita Kristina Callis Duffin Masamoto Murakami Italy Bruce Strober, Secretary, Giampiero Girolomoni Brazil Clay Cockerell Hidemi Nakagawa Gladys Aires-Martins United States Paolo Gisondi Kevin Cooper Yukari Okubo André Vicente Esteves de Christy Langan, Chief Luigi Naldi Kelly M. Cordoro Tadashi Terui Carvalho Executive Officer, United Carlo Pincelli JT Elder States Malaysia