New aspects of psoriasis pathogenesis: metabolomic profiling in dermatology

Psoriasis is a common chronic inflammatory skin disease. In recent years, there has been an increase in the morbidity of psoriasis and in the number of severe, atypical, disabling, resistant to administered therapy forms of the disease. The disease significantly impairs quality of life, reduces the work productivity and social activity of patients, which determines not only medical but also social significance of the problem. An effective approach to treat psoriasis based only on the clinical picture of the disease does not yet exist. This is largely due to insufficient knowledge of pathogenesis, in particular its molecular mechanism, which makes it difficult to discover new therapeutic entities. Specific features of psoriasis, including its relationship with metabolic concomitant diseases, confirm the importance of metabolomic profiling for studying pathogenesis and approaches to the disease treatment. More accurate and non-invasive diagnostic tools are needed considering that the diagnosis is based on clinical data and morphological evaluation of skin lesions, as well as more seldom on invasive methods (histological examination). Currently, there are also no precise methods to assess the disease activity. The aim of many studies of psoriasis based on metabolomic profiling is an attempt to deepen and broaden the understanding of pathogenesis and pathophysiology of psoriasis from a new perspective. The ability of a metabolomic profiling to reflect the state of a biological system using its end products (metabolites) may indicate what’s actually going on in the patient’s body. In addition, metabolomic profiling will allow to reveal the treatment mechanism, providing an evidence base for broad clinical application as well as monitoring response to the treatment.