ABSTRACT
This chapter focuses on the role of the Interleukin (IL)-23/Th17 inflammatory pathway in psoriasis pathogenesis and on the specific targeting of IL-12/IL-23 by ustekinumab. Ustekinumab is a monoclonal antibody directed against p40 and thus will inhibit action of IL-23 and IL-12. A. Cooper and colleagues showed that ustekinumab therapy rapidly decreased expression of a variety of proinflammatory cytokine genes in lesional psoriatic skin, including p19, p40, and IL-17A. A variety of controlled studies, cases series, and case reports support the use of ustekinumab in other forms of psoriasis. Ustekinumab Dosing should be emphasized that dosing for ustekinumab is infrequent and thus very convenient for patients with a chronic disease such as psoriasis. Regarding the potential for ustekinumab-treated patients to develop malignancies, five-year studies show no significant signals. Most scientists involved in studying psoriasis pathogenesis believe that ustekinumab principally acts through IL-23 inhibition.
