Could a topical transform your DNA?

| Melissa Leavitt

If you have psoriasis, you’re probably no stranger to moisturizer.

But what if your moisturizer could do more than soothe your plaques? What if it had a special ingredient that could drill deep inside your skin to actually stop your psoriasis?

One day it might.

Dr. Amy Paller, a dermatologist and researcher at Northwestern University in Chicago, is working to develop that special ingredient. It’s a tiny substance that, when added to a gel or ointment and applied to the skin, may prevent one of the major immune system responses that leads to psoriasis.

Topicals 2.0

If she’s successful, it could revolutionize treatment for the vast majority of psoriasis patients—up to 80 percent, Paller said—who rely on topicals.

According to Paller, it’s a revolution that’s long overdue.

“What do we have now for that 80-plus percent? The same topical steroids that we had more than 30 years ago when I was in training,” she said.

Recent years have seen groundbreaking advances in our understanding of what causes psoriasis. Many of those advances have been translated into life-changing systemic therapies such as biologic drugs.

But, Paller said strides in biologics “have done nothing for the vast majority of individuals with psoriasis.”

Her topical would target the same immune pathway as some of the most cutting-edge biologics. It’s known as the IL-17 pathway, and it’s where the inflammatory cascade of psoriasis begins.

But it would take a different route to get there—and a very different vehicle.

Instead of using a large antibody that has to be injected, Paller is targeting IL-17, a pro-inflammatory protein, using gene regulation.

“Every protein starts off as a DNA code,” Paller explained. The material she’s created disrupts that code by binding to genetic material inside the cell. “It stops it cold from turning into a protein.”

Early clinical trial results

Working with her colleague Dr. Chad Mirkin at Northwestern, Paller put the formula into something called spherical nucleic acids. When dropped into a gel or ointment base, their spherical shape allows the formula to enter the skin, she said.

Paller’s team has already created a similar topical that blocks a different protein, called tumor necrosis factor-alpha (TNF-alpha), that’s involved in psoriasis. Clinical trials testing this therapy have already begun. Like IL-17, TNF-alpha drives the inflammatory response behind the disease.

According to a report appearing in August 2016 in the magazine Science, Mirkin discussed his research with spherical nucleic acids and the trials testing the formula to block TNF-alpha at the American Chemical Society meeting that month.

In the report, Mirkin said that, although there is still a long way to go before the formula could be used as a treatment, initial results suggest that spherical nucleic acids are safe and could one day become an effective therapy.

NPF supporters keep the project alive

Paller received the 2016 Ostrow Graff Family Discovery Grant from the National Psoriasis Foundation to further her research blocking IL-17. With her NPF funding, Paller now has the resources she needs to bring her treatment targeting IL-17—the protein that gets the whole inflammatory ball rolling—closer to the clinical trial phase.

Without her Discovery Grant, she said the project may have languished in the lab.

“More than ever, people have been having trouble getting grants to do research, particularly research that might have some risks,” she said. “We did not have any other funding for this.”

Photo of Dr. Paller courtesy of Northwestern University.


Driving discovery, creating community

For more than 50 years, we’ve been driving efforts to cure psoriatic disease and improve the lives of those affected. But there’s still plenty to do! Learn how you can help our advocacy team shape the laws and policies that affect people with psoriasis and psoriatic arthritis – in your state and across the country. Help us raise funds to support research by joining Team NPF, where you can walk, run, cycle, play bingo or create your own fundraising event. If you or someone you love needs free, personalized support for living a healthier life with psoriatic disease, contact our Patient Navigation Center. And keep the National Psoriasis Foundation going strong by making a donation today. Together, we will find a cure.

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