Overactive Immune System or Over-sensitive Skin?
from Kurt

Ed: I wrote last month to let you know about my Soriatane experience [Soriatane Treatment a Bust].  Now I'm halfway into my second month of Enbrel injections.  What a surprise!  I'm now about 90% cleared with no areas of redness left — only smooth if still slightly discolored skin.  I wore shorts for the first time in 2 years and didn't get even one of "those looks" from anyone.  Put me down as an Enbrel believer.  Knock on wood that things continue this way.  I had this same euphoric feeling after my first PUVA clearing. 

Anyway I have a thought for you.

I saw your comment on wondering why Enbrel only works sometimes.  From a layman’s point of view, I see two ways that psoriasis can happen.  One is that an overactive immune system attacks the skin (an organ).  The skin responds by reproducing when a certain threshold of this attack is achieved.  Suppressing the immune system keeps the "attack" below the threshold. 

From the other point of view what happens is the threshold switch that causes skin reproduction in the skin organ somehow gets lowered or "broken."  Then no amount of immune system lowering will help.  In this case the only option left is to raise or fix the resistance threshold of the skin.  Have you seen or heard anything on this thought?

Thanks for all your help and comfort.

I wish you well. –Kurt

*****

Ed’s Response:  Good to learn you're deriving some benefit from Enbrel.  Your two-sided coin theory about P / skin & immune system is interesting. 

If I understand you correctly, you're suggesting that INSTEAD OF an over-active immune system, some flakers may have an OVER-SENSITIVE skin response to a normal immune system.  The only criticism of that notion I can think of is a statement I read saying that an "abnormal amount of a certain kind of T-cell is detected in P lesions."  (Of course, I'm paraphrasing.  This research derived from studies of cyclosporine unrelated to P.) 

If the skin was OVER REACTING to a normal immune cell presence, that flip side of your theory would be supported.  If, on the other hand — and I don't know if this is true or not — there is ALWAYS an exceptional amount of immune cells present in P lesions, your flip side would not be supported. 

Anyway, your theory sure would be useful in setting my mind at ease regarding my lack of fortune with Enbrel.  It would be blessedly simple for me to conclude my skin was OVER REACTING to a normal immune response, so Enbrel, which is a very selective immune cell suppressing agent, really couldn't be expected to help me.

If the mystery resolves in favor of your theory, you can be sure I'll let you know!  Thanks again, -Ed

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