Vascular endothelial growth factor‐A as a promising therapeutic target for the management of psoriasis

• Published in: Experimental dermatology Vol. 29; no. 8; pp. 687 - 698
• Main Authors: Luengas‐Martinez, Andrea, Hardman‐Smart, Jonathan, Paus, Ralf, Young, Helen S.
• Format: Journal Article
• Language: English
• Published: Chichester Wiley Subscription Services, Inc 01.08.2020
• Subjects: Angiogenesis; bevacizumab; Dermis; Eye diseases; Immunotherapy; Monoclonal antibodies; Pathogenesis; Patients; personalised medicine; Plaques; Precision medicine; Psoriasis; Remission; Vascular endothelial growth factor; vascular endothelial growth factor‐A
• ISSN: 0906-6705; 1600-0625
• DOI: 10.1111/exd.14151

Vascular endothelial growth factor‐A (VEGF‐A), the main angiogenic mediator, plays a critical role in the pathogenesis of several inflammatory immune‐mediated diseases, including psoriasis. Even though anti‐angiogenic therapies, such as VEGF inhibitors, are licensed for the treatment of various cancers and eye disease, VEGF‐targeting interventions are not part of current psoriasis therapy. In this viewpoint essay, we argue that the existing preclinical research evidence on the role of VEGF‐A in the pathogenesis of psoriasis as well as clinical observations in patients who have experienced psoriasis remission during oncological anti‐VEGF‐A therapy strongly suggests to systematically explore angiogenesis targeting also in the management of psoriasis. We also point out that some psoriasis therapies decrease circulating levels of VEGF‐A and normalise the psoriasis‐associated vascular pathology in the papillary dermis of plaques of psoriasis and that a subset of patients with constitutionally high levels of VEGF‐A may benefit most from the anti‐angiogenic therapy we advocate here. Given that novel, well‐targeted personalised medicine therapies for the development of psoriasis need to be developed, we explore the hypothesis that VEGF‐A and signalling through its receptors constitute a promising target for therapeutic intervention in the future management of psoriasis.