EPIGENETIC REPROGRAMMING IN PSORIASIS AND ITS AYURVEDIC INTERPRETATION IN MANDALA KUSHTA: A REVIEW

Abstract

Psoriasis is a chronic immune-mediated inflammatory skin disorder in which genetic susceptibility and environmental factors interact to influence disease onset, progression, and recurrence. Emerging evidence highlights the significant role of epigenetic mechanisms, including DNA methylation, histone modifications, and microRNA dysregulation, in regulating inflammatory gene expression without altering the DNA sequence. These reversible modifications contribute to abnormal keratinocyte proliferation and persistent activation of pro-inflammatory cytokines such as TNF-α and IL-17.This narrative review explores the role of epigenetic factors in psoriasis and correlates them with the Ayurvedic concept of Mandala Kushta. Relevant biomedical literature on epigenetic alterations in psoriasis was reviewed, alongside classical Ayurvedic texts describing the etiopathogenesis, Dosha-Dushya involvement, recurrence, and environmental influences associated with Mandala Kushta. Current evidence indicates that epigenetic alterations in psoriasis are dynamic and influenced by environmental triggers including diet, stress, infections, and toxins. Similarly, Ayurveda describes Mandala Kushta as a chronic and recurrent disorder resulting from Dosha-Dushya Sammurchana involving Kapha, Pitta, Rakta, Twak, and Mamsa, precipitated by Nidana Sevana, Agnimandya, and Ama formation. The relapsing nature of the disease and the influence of dietary, behavioural, and psychological factors show notable conceptual parallels with epigenetic regulation. Furthermore, Ayurvedic interventions such as Shodhana and Rasayana therapies may exert immunomodulatory, antioxidant, and metabolic effects that could potentially influence epigenetic pathways. Integrating epigenetic insights with Ayurvedic understanding of Mandala Kushta offers a promising framework for translational research, identification of epigenetic biomarkers, and development of personalized, integrative approaches for psoriasis management.