[The immunological mechanisms of psoriasis].

Abstract

The occurrence of ANA in eluates of lymphocytes and polymorphonuclear leucocytes obtained in five untreated psoriasis patients could be demonstrated by means of the indirect immunofloruescence technique. These antibodies appear to be mainly directed against the nuclei of the basal cell layer, however, ANA directed against the nuclei of epidermal and dermal cells have also been encountered. The immunological mechanisms in psoriasis may therefore be looked upon as the result of an alteration in the structure of nucleic acid or nuclear protein of the basal layer cells. Finally psoriasis may be the result of an interplay of various exogenous factors and a special genetical make-up leading to the release of certain nuclear proteins initiating a delayed type immune response at the onset and an Arthus type reaction located in the upper layers of the epidermis at a later stage of the disease, and as a secundary phenomenon the derailment of keratinization. Moreover a slightly decreased mean percentage of circulating lymphocytes forming rosettes with sheep erythrocytes have been found in the patients studied. This slight decrease suggests a diminution of the T-lymphocyte control facilitating the antibody production by B-lymphocytes. The course of events in psoriasis is a self perpetuating inflammatory process.