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. 2010 Apr-Jun;55(2):161–170. doi: 10.4103/0019-5154.62754

Figure 1.

Figure 1

Biologics in psoriasis and their possible mechanisms. TNF- α secreted by antigen-presenting cells; Th-1 cells and keratinocytes can be neutralized by the anti-TNF biologics infliximab, etanercept, adalimumab, and golimumab. Adalimumab and golimumab are fully human antibodies directed against TNF-α. Infliximab was developed from a mouse anti-TNF antibody that was then partially humanized. Etanercept is a molecullarly engineered molecule formed by linking the TNF-α receptor to the Fc portion of an antibody. Ustekinumab and ABT-874 are directed against the p40 subunit of IL-12 and IL-23. IL-12 is needed for differentiation of naive cells into Th-1 cells and IL-23 is needed for the maintenance of IL-17-secreting Th17 cells. IFN-α secreted by Th-1 cells and IL-17 and IL-22 secreted by Th-17 cells activate keratinocytes, which in turn proliferate and secrete IL-12 and TNF-α.