Кишечника: пути патогенеза и вопросы выбора генно-инженерных препаратов

Psoriasis and inflammatory bowel disease (IBD) 
are multifactorial chronic immuno-inflamma-
tory potentially disabling disorders with similar 
genetic factors and immunological pathways, 
in particular, genetic polymorphisms of IL-23R, 
which determines the signal IL-12/23-mediated 
pathway of immunopathogenesis. The emer-
gence of genetically engineered biological 
agents has changed the prognosis for both pso-
riasis and IBD. The intersection of the therapeutic 
spectrum in psoriasis and IBD is a very important 
point when choosing the management strategy 
for these patients. Infliximab and adalimumab 
are effective in the treatment of psoriasis, pso-
riatic arthritis, Crohn's disease, ulcerative colitis 
(evidence level 1A). Ustekinumab demonstrates 
effectiveness in the treatment of psoriasis, pso-
riatic arthritis (evidence level 1A) and Crohn's 
disease (evidence level 1B). Etanercept and 
secukinumab have been shown to be effective 
against psoriasis, psoriatic arthritis (evidence 
level 1A) and ineffective and even associated 
with exacerbation risk in Crohn's disease and 
ulcerative colitis. Inhibition of regulatory cyto-
kines IL-12/23 also has a number of advantages 
compared to the blockade of effector cytokines 
(TNF-α, IL-17) due to potentially long-term and 
stable treatment results and less frequent ad-
ministration.
Key words: biologic therapy, IL-12, IL-23, immu-
notherapy, inflammatory bowel diseases, Crohn's 
disease, psoriasis, psoriatic arthritis, monoclonal 
antibody, ustekinumab
For citation: Kruglova LS, Lvov AN, Kagramanova AV, 
Knyazev OV. Psoriasis and inflammatory bowel 
diseases: pathogenetic pathways and the choice 
of biologic therapy (a literature review). Almanac 
of Clinical Medicine. 2019;47(6):568–78. doi: 
10.18786/2072-0505-2019-47-062.
Received 6 August 2019; revised 1 November 2019; 
accepted 5 November 2019; published online 
13 November 2019
1
Central State Medical Academy of the Presidential 
Administration of the Russian Federation; 19/1A 
Marshala Timoshenko ul., Moscow, 121359, Russian 
Federation
2
Moscow Scientific and Practical Center of 
Dermatovenereology and Cosmetology; 
17 Leninskiy prospekt, Moscow, 119071, Russian 
Federation
3
Loginov Moscow Clinical Scientific Center, Moscow 
Healthcare Department; 86 Shosse Entuziastov, 
Moscow, 111123, Russian Federation

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