Lipeng Tang,1– 3,* Huichang Bi,4,* Kangguang Lin,5,* Yisi Chen,3,* Haiyan Xian,3,* Yuan Li,6,7,* Hesong Xie,8,* Guangjuan Zheng,1– 3,9,* Peng Wang,4 Yonggen Chen,10 Biying Yang,11 Yaqian Tan,12 Qi Song,13 Maojie Wang,14 Guanzhuo Li,3 Jiameng Chang,3 Yuanjun Guan,15 Kwok-Fai So,16 Chuanjian Lu10 

1State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 2Guangdong-Hong Kong-Macau Joint Laboratory on Chinese Medicine and Immune Disease Research, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 3Department of Pharmacology of Traditional Chinese Medicine, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 4NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening & Guangdong-Hongkong-Macao Joint Laboratory for New Drug Screening, Southern Medical University, Guangzhou, People’s Republic of China; 5Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, People’s Republic of China; 6Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 7Oujiang Laboratory (Zhejiang Laboratory for Regenerative Medicine, Vision and Brain Health), Institute of Mental Health and Drug Discovery of Wenzhou Medical University, Wenzhou, People’s Republic of China; 8Biology Resource Center, Guangzhou National Laboratory, Guangzhou, People’s Republic of China; 9Department of Pathology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 10Department of Dermatology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 11Department of Neurology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 12Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China; 13Department of Pharmacy, Guangzhou Institute of Cancer Research of The Affiliated Cancer Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China; 14Department of Rheumatology Clinical and Basic Research, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 15Core Facilities for Medical Science, Zhongshan School of Medicine of Sun Yat-Sen University, Guangzhou, People’s Republic of China; 16Ministry of Education Joint International Research Laboratory of CNS Regeneration, Jinan University, Guangzhou, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Kwok-Fai So, Ministry of Education Joint International Research Laboratory of CNS Regeneration, Jinan University, 601# Huangpu Avenue West, Guangzhou, 510632, People’s Republic of China, Email hrmaskf@hku.hk Chuanjian Lu, The Second Clinical College of Guangzhou University of Chinese Medicine, 111# Dade Road, Guangzhou, 510000, People’s Republic of China, Tel +86-20-81887233, Fax +86-20-81887233, Email lcj@gzucm.edu.cn

Abstract: Psoriasis, a common chronic inflammatory skin disease affecting approximately 2– 3% of the global population, frequently co-occurs with depression. This highly prevalent comorbidity significantly impairs patients’ quality of life. Despite the substantial physical and mental health burden imposed by psoriatic depression, the underlying pathophysiological mechanisms connecting psoriasis and depression remain poorly understood. In this review, we explored several pathological processes that may contribute to psoriasis-associated depression, including immune cells dysregulations, hormones imbalances, hypothalamic-pituitary-adrenal (HPA) axis dysfunctions, neuropeptides expression abnormalities, and gut dysbiosis. The primary purpose of this review was to present a comprehensive overview of the pathogenic mechanisms linking psoriasis and depression. These insights may guide trans-disciplinary interventions aimed at both skin and mood symptoms.

Keywords: psoriasis, depression, Th17 cell, HPA axis, neuropeptides, gut microbiota