广泛性脓疱型银屑病(3GPP)是一种罕见且严重的银屑病亚型,显著影响患者的生活质量。直到最近,没有具体的治疗方式,和治疗符合治疗斑块状银屑病的指南,包括常规治疗,如类维生素A,甲氨蝶呤,甚至生物制品,虽然在某些情况下有效,可能与明显的副作用有关,需要更有效和安全的选择。广泛性脓疱型银屑病的病理生理学是复杂的,尚未完全了解,但与斑块状银屑病的发病机制有一定的重叠。在3GPP中,先天免疫系统似乎发挥了更重要的作用,与白细胞介素(IL)-36途径从根本上参与。Spesolimab和imsidolimab,最近开发的两种治疗剂,通过结合IL-36受体(IL-36R)靶向IL-36炎症途径。这两种生物制剂已经在1期和2期临床试验中进行了评估,并在安全性和有效性方面显示出了可喜的结果。IL-36受体抑制剂显示出巨大的疗效和良好的安全性,展示了它们成为领先治疗选择的潜力。这篇综述旨在探索和总结当前科学文献中关于最近开发的如何治疗3GPP的方法。
Generalized Pustular Psoriasis (GPP) is a rare and severe subtype of psoriasis that significantly impacts patients\' quality of life. Until recently, no specific treatment modalities were available, and treatment for GPP followed the guidelines for the treatment of plaque psoriasis, consisting of conventional treatments, such as retinoids, methotrexate, and even biologics, which although effective in some cases, may be associated with significant side effects, necessitating more effective and safe options. The pathophysiology of Generalized Pustular Psoriasis is complex and not fully understood, but there is some overlap with the pathogenesis of Plaque Psoriasis. In GPP, the innate immune system seems to play a more significant role, with the interleukin (IL)-36 pathway being fundamentally involved. Spesolimab and
imsidolimab, two recently developed therapeutic agents, target the IL-36 inflammatory pathway by binding to the IL-36 receptor (IL-36R). Both biologics have already been evaluated in phase 1 and 2 clinical trials and have shown promising results in terms of safety and efficacy. IL-36 receptor inhibitors demonstrated great efficacy and good safety profile in the management of patients with GPP, demonstrating their potential to emerge as a leading treatment option. This review aims to explore and summarize the current scientific literature on the most recently developed treatments for GPP.