SPEAKER: The immune system
is like an orchestra
with hundreds of cells
and proteins playing their part.
But when one section starts
to play too loudly,
or another section stops playing
completely,
the whole performance can fall
apart.
That's sort of what happens
with psoriatic disease,
says Dr. Elain Husni,
a rheumatologist at Cleveland
Clinic in Cleveland, Ohio.
ELAINE HUSNI: Your immune system
is overproducing.
It's revved up.
For some reason,
it gets triggered and it starts
thinking that whatever is part
of your body
is actually foreign.
And it starts to attack it.
SPEAKER: Doctors have been
trying to treat
psoriatic diseases for thousands
of years.
For most of that time, progress
was slow going.
When Husni started practicing
20 years ago, she had one drug
to offer her psoriasis
patients, Methotrexate.
It works by slowing the growth
of skin cells, which can divide
so rapidly they build up
into those signature red scaly
patches.
But more recently--
ELAINE HUSNI: So there's been
an explosion of treatment
for many
of these immune-mediated
diseases.
And the reason
for this explosion
is that we have a better
understanding of some
of the drivers of the disease
process.
SPEAKER: In people
with psoriatic disease,
the T-helper lymphocytes,
an important type of white blood
cell, become overactive.
They overproduce certain types
of proteins called cytokines.
It's these excess proteins that
start to attack the skin,
joints, and other organs.
Doctors can intervene with drugs
designed to block parts
of the immune response
and overreaction
before they can wreak havoc
on your body.
These treatments include TNF
inhibitors, IL-17 inhibitors,
JAK/STAT blockades, and IL-23
inhibitors.
Like a good conductor,
these drugs,
along with steroids,
painkillers,
and topical treatments,
can stop the symbols clashing.
On these blockers--
ELAINE HUSNI: The disease
becomes much less.
It's much more tolerable.
And the symptoms, signs
and symptoms are much reduced.
We can't cure it.
Meaning, I can't take it away
completely, but I can certainly
control it so much better.
SPEAKER: New developments
in medical science
could transform
psoriatic disease treatment
again over the next 20 years.
Currently, when a patient goes
to the clinic
with psoriasis symptoms, doctors
have to use trial and error
to figure out which drug is
right for them.
But personalized medicine could
change that.
In the future, doctors may be
able to identify biomarkers
in a patient's sequence DNA
to tell them which treatment
they're most likely to respond
to.
To make this a reality
researchers need more time
and money to continue unraveling
the mysteries
of our immune system.
But they also need more patients
to help by filling out surveys,
volunteering for studies,
and enrolling
in clinical trials.
ELAINE HUSNI: So there's nobody
or nothing that's too small
or too little or unimportant.