Is There A Genetic Link To Psoriasis?

Psoriasis is an autoimmune disorder that affects the skin. It is characterized by the appearance of red and itchy scales, inflammation, dry skin, and redness. It typically affects the knees, scalp, hands, feet, and elbows. Psoriasis causes the body to start producing new skin cells at a rapid pace, which leads to the overproduction of new skin cells under the surface of the existing skin cells. These new cells migrate to the surface and start forcing out the existing skin cells. This is what causes inflammation, scales, and itching associated with psoriasis. While the exact cause of psoriasis is unknown, genetics is believed to play a significant role in determining who develops psoriasis and who does not. So, is there a genetic link to psoriasis, and if so, what is this all about? Let’s find out.

Overview of Psoriasis

Psoriasis is an autoimmune condition that affects the skin. It is marked by inflammation, redness, and the appearance of itchy scales. It is estimated that in 2013, around 7.4 million people in the United States were affected by psoriasis.(1,2) This chronic condition causes the immune system of the body to start producing skin cells at a rapid pace, which creates a buildup of cells on the surface of the skin. The immune cells present in your bloodstream begin mistakenly recognizing these newly produced skin cells as harmful invaders and start attacking them. This is what increases the production of the new skin cells underneath the surface of the skin. This leads to scaling and inflammation.(3,4) These psoriatic scales are mostly silver-white and develop in thick, red patches. During a flare-up of psoriasis, these patches tend to bleed and crack.(5)

The exact cause of psoriasis is unknown, but genetics is believed to play a role in the development of this condition. Read on to find out more about whether there is a genetic link to psoriasis.

Genetics and Psoriasis

The National Psoriasis Foundation (NPF) suggests that the autoimmune disorder of psoriasis tends to develop between the ages of 15 to 35 years.(6) However, there is no evidence to show that psoriasis only develops between these ages. It can occur at any age. In fact, nearly 20,000 children under the age of 10 years get diagnosed with psoriasis each year. Additionally, almost 40 percent of people with this condition start developing symptoms of psoriasis before they turn 15.(7)

Psoriasis has also been found to affect people who have no family history of the disorder. Nevertheless, having a family member with psoriasis will significantly increase the risk of developing the condition.(8)

  • If both the parents have psoriasis, then your risk of developing psoriasis is 50 percent.
  • If only one of the parents has psoriasis, then you have ten percent of developing the disorder.
  • It has been found that around one-third of people with psoriasis have a relative with the disorder.

Scientists who have been exploring the genetic basis of psoriasis typically begin their research by assuming that the disorder is caused by an issue in the immune system. Research carried out on skin affected by psoriasis has found that many immune cells start producing inflammatory compounds known as cytokines.(9) At the same time, skin affected by psoriasis is also known to contain several gene mutations known as alleles.(10)

When research began on psoriasis and its genetic link, researchers believed that there was only one allele that was responsible for passing the disease genetically through families. However, it was later discovered that the allele, known as HLA-Cw6, was alone incapable of causing a person to develop psoriasis.(11) Recent studies, though, have found that more research is still needed to gain more insight into the exact relationship between psoriasis and HLA-Cw6.(12)

Researchers have been able to identify around 25 different regions in the human genome (or genetic material) that are believed to be associated with psoriasis with the use of more advanced gene mapping technologies.(13) Due to this, genetic studies can now give us an idea about a person’s risk of developing psoriasis.

Since psoriasis develops as a result of immune responses and the interaction with your skin, this means that it is challenging to find out the exact cause and effect. These new genetic findings have provided us with valuable observations, but the precise cause of why some people develop psoriasis and others don’t is still not clearly understood. Similarly, the exact manner by which the disease gets passed from a parent to a child is also not completely understood.

Other Contributing Factors of Psoriasis

Apart from genetics, there are many other contributing factors that can cause psoriasis. Environmental factors and lifestyle factors are also responsible for triggering an outbreak of psoriasis or even contribute to the development of the condition.

Environmental factors that may contribute to the onset of psoriasis or trigger a flare-up include:(14)

  • Cold and dry weather
  • Stress
  • Withdrawal from medications such as corticosteroids
  • Medications such as beta-blockers, antimalarial drugs, and lithium
  • Infections such as strep throat and HIV

Sometimes, trauma or injury to the skin can also end up becoming the site of a psoriasis flare-up. People with psoriasis are also more likely to be at a higher risk of developing certain diseases, such as:

Excessive alcohol consumption and smoking are also known to increase the likelihood of developing psoriasis or trigger a flare-up.

Conclusion

Even though extensive research has shown that there is a firm link between genetics and psoriasis, but the exact reason how this happens is still unknown. If you have a family history of psoriasis, then it increases your risk of developing the condition as well. While gene therapy is not yet available as a treatment for psoriasis, but new research into the genetic cause of the disorder is promising. Many recent discoveries hold tremendous promise that some form of gene therapy will be developed in the near future to help people who are living with psoriasis. However, more research is still needed to understand the exact methodology of how psoriasis is inherited.

References:

  1. Rachakonda, T.D., Schupp, C.W. and Armstrong, A.W., 2014. Psoriasis prevalence among adults in the United States. Journal of the American Academy of Dermatology, 70(3), pp.512-516.
  2. Rachakonda, T.D., Schupp, C.W. and Armstrong, A.W., 2014. Psoriasis prevalence among adults in the United States. Journal of the American Academy of Dermatology, 70(3), pp.512-516.
  3. Psoriasis.org. 2020. Scalp Psoriasis. [online] Available at: <https://www.psoriasis.org/scalp/> [Accessed 17 August 2020].
  4. Cdc.gov. 2020. Psoriasis | CDC. [online] Available at: <https://www.cdc.gov/psoriasis/index.htm> [Accessed 16 August 2020].
  5. Mdedge.com. 2020. Debunking Psoriasis Myths: Remove Psoriasis Scales Gently. [online] Available at: <https://www.mdedge.com/dermatology/article/178767/psoriasis/debunking-psoriasis-myths-remove-psoriasis-scales-gently> [Accessed 17 August 2020].
  6. Psoriasis.org. 2020. National Psoriasis Foundation. [online] Available at: <https://www.psoriasis.org/for-parents/> [Accessed 17 August 2020]. Relvas, M. and Torres, T., 2017. Pediatric psoriasis. American Journal of Clinical Dermatology, 18(6), pp.797-811.
  7. Raychaudhuri, S.P. and Gross, J., 2000. A comparative study of pediatric onset psoriasis with adult onset psoriasis. Pediatric dermatology, 17(3), pp.174-178.
  8. Gupta, R., Debbaneh, M.G. and Liao, W., 2014. Genetic epidemiology of psoriasis. Current dermatology reports, 3(1), pp.61-78.
  9. Jordan, C.T., Cao, L., Roberson, E.D., Pierson, K.C., Yang, C.F., Joyce, C.E., Ryan, C., Duan, S., Helms, C.A., Liu, Y. and Chen, Y., 2012. PSORS2 is due to mutations in CARD14. The American Journal of Human Genetics, 90(5), pp.784-795.
  10. Roberson, E.D. and Bowcock, A.M., 2010. Psoriasis genetics: breaking the barrier. Trends in Genetics, 26(9), pp.415-423.
  11. Chen, L. and Tsai, T.F., 2018. HLA‐Cw6 and psoriasis. British Journal of Dermatology, 178(4), pp.854-862.
  12. Psoriasis.org. 2020. Psoriasis Causes And Triggers. [online] Available at: <https://www.psoriasis.org/research/genes-and-psoriatic-disease> [Accessed 17 August 2020].
  13. Zeng, J., Luo, S., Huang, Y. and Lu, Q., 2017. Critical role of environmental factors in the pathogenesis of psoriasis. The Journal of dermatology, 44(8), pp.863-872.

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