银屑病是一种遗传和环境共同作用诱发的、免疫介导的慢性炎症性皮肤病。环磷酸腺苷(cAMP)/蛋白激酶A(PKA)通路与银屑病的发病机制密切相关,而磷酸二酯酶4是可以专一水解cAMP的酶,因此磷酸二酯酶4成为银屑病治疗的期望小分子靶点。磷酸二酯酶4抑制剂类药物通过竞争性阻断磷酸二酯酶4对cAMP的降解作用,使T辅助细胞1(Th1)、Th2和Th17的免疫反应减弱来发挥治疗作用。磷酸二酯酶4抑制剂如阿普司特、罗氟司特、克立硼罗、Hemay005、奥利司特、MK-0873、tanimilast、DRM02在治疗银屑病及其共病方面有巨大的潜力。就磷酸二酯酶4抑制剂治疗银屑病的作用机制、疗效、安全性进行了总结。

Psoriasis is an immune-mediated chronic inflammatory skin disease induced by a combination of genetics and the environment. cAMP/PKA pathway is closely related to the pathogenesis of psoriasis, and phosphodiesterase 4 is an enzyme that can specifically hydrolyze cAMP, so phosphodiesterase 4 becomes desired small molecule targets for psoriasis therapy. Phosphodiesterase 4 inhibitor drugs play a therapeutic role by competitively blocking the degradation of cAMP by phosphodiesterase 4, then weakening the immune response of Th1, Th2, and Th-17. Phosphodiesterase 4 inhibitor drugs, such as apremilast, roflumilast, criborrol, Hemay005, orlistat, MK-0873, tanimilast, and DRM02 have great potential in the treatment of psoriasis and its comorbidities. This article summarizes the mechanism of action, efficacy, and safety of phosphodiesterase 4 inhibitor drugs in treatment of psoriasis.

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