The Role of Vascular Endothelial Growth Factor (VEGF) as A Potential Therapy of Psoriasis Vulgaris: A Literature Review

Abstract

Psoriasis management remains a challenge due to the difficulty of achieving therapeutic targets which are influenced by factors such as varying degrees of psoriasis, lack of therapeutic efficacy, and side effects of therapy. Various efforts are being made to find the best and most effective therapy. Pathogenesis of psoriasis is influenced by T cells, skin vascular disorders also play an important role. Angiogenesis in psoriasis is mediated by vascular endothelial growth factor (VEGF), angiopoietin, tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), and interleukin-17 (IL-17). VEGFA inhibitors still have not received approval in psoriasis therapy, however two case reports of psoriasis patients with 40% and 50% lesion areas experienced significant improvement after bevacizumab administration. The angiogenic factor of VEGF acts as an important biomarker in psoriasis vulgaris and is histopathologically found in keratinocytes. The standard therapy of psoriasis vulgaris has been known to have good efficacies, but both long-term efficacy and treatment failures often occur, patients could not prevent relapse and serious side effects. Therapeutic agents that target VEGF directly including anti-VEGF monoclonal antibodies, VEGF receptor antagonist fusion proteins, receptor tyrosine kinase inhibitors, NVP-BAW2881, and traditional therapeutic agent PSORI-CM02. These therapies are quite promising, though there are various side effects associated with systemic administration of VEGF inhibitors, including proteinuria, hypertension and impaired wound healing. Thus, the development of anti-VEGF as a therapy in the  management of psoriasis requires careful evaluation especially to minimize the toxicity of the treatment.