Цитокиновый профиль и предикторы эффективности генно-инженерной биологической терапии при псориазе и псориатическом артрите: обзор литературы

Псориаз и псориатический артрит (ПсА) рассматриваются как гетерогенные иммуновоспалительные заболевания с выраженным системным компонентом, формирование которых обусловлено сложным взаимодействием врожденного и адаптивного иммунитета. Центральную роль в патогенезе псориатической болезни играет ось IL-23/Th17/IL-17, однако все большее значение придается внеосевым медиаторам воспаления, включая IL-6, IL-8, IL-22, IL-33 и IL-35, отражающим тканевую специфичность и иммунную гетерогенность заболевания. Внедрение ингибиторов ФНО-α и IL-17A существенно улучшило кожные и суставные исходы, однако вариабельность клинического ответа и вторичная потеря эффективности остаются актуальной проблемой. Анализ данных клинических и иммунологических исследований свидетельствует о неоднородности динамики сывороточных цитокинов на фоне биологической терапии и необходимости поиска надежных предикторов ответа. Перспективным направлением является комплексная оценка цитокинового профиля и доступных гематологических маркеров системного воспаления, включая нейтрофильно-лимфоцитарное соотношение (NLR), как инструментов мониторинга и персонализации терапии.

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