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Rachael A. Clark, Thomas S. Kupper
Published in Volume 116, Issue 8
J Clin Invest. 2006; 116(8):2084–2087 doi:10.1172/JCI29441
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Figure 1
An emerging model of psoriasis pathogenesis in humans.

Many insults can lead to the activation of dermal dendritic cells, a key initiating step in the development of psoriasis in predisposed individuals. Activated dendritic cells induce the proliferation of autoreactive T cells within the dermis, inducing production of IFN-γ and TNF-α, which in turn induces the production of MCP-1 and other chemotactic cytokines by epidermal cells. These chemotactic agents induce influx of monocytes from the blood, which undergo differentiation into macrophages and myeloid dendritic cells. The studies of Stratis et al. (12) and Wang et al. (20) reported in this issue of the JCI suggest that these dermal macrophages, once activated by T cell or dendritic cell cytokines, then produce large amounts of TNF-α, leading to the skin changes observed in psoriasis. PRR, pathogen-recognition receptor.