101
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Wang L, Tao Y, Deng S, Chu L, Li L. Effectiveness comparisons of traditional Chinese medicine for psoriasis: A Bayesian network meta-analysis. Medicine (Baltimore) 2019; 98:e17055. [PMID: 31490403 PMCID: PMC6739008 DOI: 10.1097/md.0000000000017055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 08/12/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Psoriasis is an immune-mediated polygenic hereditary skin disease quality of the patients' life because of the great trouble it causes to patients. Whereas, there is variability when we regard the selection of traditional Chinese medicine treatments in practice and most choices are made based on personal experience or preference of clinician. This study uses network meta-analysis to compare the effectiveness of different forms of TCM for psoriasis and assesses the evidence with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. METHODS We will search for PubMed, Cochrane Library, AMED, EMbase, WorldSciNet; Nature, Science online and China Journal Full-text Database (CNKI), China Biomedical Literature CD-ROM Database (CBM), and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to April 2019. The quality of the included RCTs will be evaluated by the risk of bias (ROB) tool and the evidence will be evaluated by GRADE. STATA 13.0 and WinBUGS 1.4.3 through the GeMTC package will be used to perform a network meta-analysis to synthesize direct and indirect evidence. RESULTS The results of this network meta-analysis (NMA) will be submitted to a peer-reviewed journal for publication. TRIAL REGISTRATION NUMBER PROSPERO CRD42019137250.
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Affiliation(s)
| | - Yun Tao
- Department of Dermatology, Huabei Petroleum General Hospital
| | - Sheng Deng
- Department of Dermatology, Dongzhimen Hospital Affiliated to Beijing University of Traditional Chinese Medicine
| | - Liyuan Chu
- Department of Dermatology, Dongzhimen Hospital Affiliated to Beijing University of Traditional Chinese Medicine
| | - Linge Li
- Shijiazhuang traditional Chinese Medicine Hospital, China
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102
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Chularojanamontri L, Nimanong S, Wongpraparut C, Silpa-Archa N, Chaiyabutr C, Charoenpipatsin N. How do we treat psoriasis patients with hepatitis C infections in real-world situations? A retrospective analysis of 34 patients. J DERMATOL TREAT 2019; 32:321-327. [PMID: 31418622 DOI: 10.1080/09546634.2019.1657225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND There is still relatively limited data on psoriasis and hepatitis C virus (HCV) infections. OBJECTIVE This study investigated the clinical characteristics and treatment of psoriasis patients with HCV infections in real-world practice. METHODS Medical records of all psoriasis patients with HCV infections who attended the outpatient clinic at Siriraj Hospital over a 10-year period were retrospectively reviewed. RESULTS Of 34 patients, 26 and 8 patients were men and women, respectively with a mean age of 57.0 ± 8.7 (range, 42.2-77.2) years. The median age of psoriasis onset was 42.7 ± 12.7 (range, 8-67.25) years. With a median follow-up period of 13.6 years, cirrhosis and hepatocellular carcinoma were found in 67.6% and 29.4% of the patients, respectively. The interferon used for HCV treatment exacerbated the psoriasis in 20% of those patients. Conventional treatments and anti-tumor necrosis factors (anti-TNFs) were used in strict collaboration with hepatologists. No patients experienced a worsening of their HCV infection. CONCLUSION Despite a limited number of patients, a male predominance and late-onset psoriasis were frequently observed. Although, interferon therapy for HCV can exacerbate psoriasis, it is not contraindicated. All conventional treatments and anti-TNFs can be used, provided that there is strict collaboration with hepatologists.
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Affiliation(s)
- Leena Chularojanamontri
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supot Nimanong
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chanisada Wongpraparut
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Narumol Silpa-Archa
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chayada Chaiyabutr
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Norramon Charoenpipatsin
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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103
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Debureaux P, Masson A, Battistella M, Fontbrune F, Socié G, Bouaziz J, Michonneau D. Chronic graft‐versus‐host disease and inhibition of interleukin‐17: proof of concept in humans. Br J Dermatol 2019; 182:1038-1041. [DOI: 10.1111/bjd.18214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2019] [Indexed: 01/09/2023]
Affiliation(s)
- P.‐E. Debureaux
- Hematology and Transplantation Unit Saint Louis Hospital, APHP Paris France
| | - A. Masson
- Dermatology Unit Saint Louis Hospital, APHP Paris France
- Université de Paris, INSERM U976 Paris France
| | - M. Battistella
- Pathology Department Saint Louis Hospital, APHP Paris France
| | - F. Fontbrune
- Hematology and Transplantation Unit Saint Louis Hospital, APHP Paris France
| | - G. Socié
- Hematology and Transplantation Unit Saint Louis Hospital, APHP Paris France
- Université de Paris, INSERM U976 Paris France
| | - J.D. Bouaziz
- Dermatology Unit Saint Louis Hospital, APHP Paris France
- Université de Paris, INSERM U976 Paris France
| | - D. Michonneau
- Hematology and Transplantation Unit Saint Louis Hospital, APHP Paris France
- Université de Paris, INSERM U976 Paris France
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104
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Silfvast-Kaiser AS, Homan KB, Mansouri B. A narrative review of psoriasis and multiple sclerosis: links and risks. PSORIASIS-TARGETS AND THERAPY 2019; 9:81-90. [PMID: 31687363 PMCID: PMC6709810 DOI: 10.2147/ptt.s186637] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 08/06/2019] [Indexed: 12/20/2022]
Abstract
The association of psoriasis (PsO) with other autoimmune and autoinflammatory diseases has long been a topic of interest. Although previous studies have attempted to clarify the specific relationship between PsO and multiple sclerosis (MS), it remains obscure, with limited and conflicting evidence regarding a link between the two entities. Herein, we review the etiology, pathogenesis, and treatment of each disease and present the available literature to-date regarding a possible relationship between PsO and MS. We conclude that further study is necessary to discern whether there may be a significant relationship between PsO and MS. In the meantime, clinicians may find it appropriate to screen for MS in patients with PsO, allowing for timely referral to a neurologist should it be necessary.
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Affiliation(s)
| | - Katie B Homan
- Department of Dermatology, Baylor Scott and White Medical Center, Temple, TX, USA
| | - Bobbak Mansouri
- Austin Institute for Clinical Research, Pflugerville, TX, USA.,Sanova Dermatology - Pflugerville, Pflugerville, TX, USA.,U.S. Dermatology Partners - Tyler, TX, USA
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105
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Bruin G, Hasselberg A, Koroleva I, Milojevic J, Calonder C, Soon R, Woessner R, Pariser DM, Boutouyrie-Dumont B. Secukinumab Treatment Does Not Alter the Pharmacokinetics of the Cytochrome P450 3A4 Substrate Midazolam in Patients With Moderate to Severe Psoriasis. Clin Pharmacol Ther 2019; 106:1380-1388. [PMID: 31228872 PMCID: PMC6896234 DOI: 10.1002/cpt.1558] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/08/2019] [Indexed: 12/17/2022]
Abstract
This open‐label disease‐drug–drug interaction study assessed whether blockade of the interleukin (IL)‐17A pathway by secukinumab and subsequent downregulation of inflammatory cytokines like IL‐6 or high‐sensitivity C‐reactive protein affects the pharmacokinetics (PKs) of a sensitive probe substrate of the cytochrome P450 3A4 isoform (CYP3A4). The PKs of midazolam, metabolized by CYP3A4, was evaluated before and after 7 and 35 days of treatment initiation of subcutaneous secukinumab at a dose of 300 mg weekly in 24 patients with moderate‐to‐severe psoriasis. Although demonstrating the expected decrease in downstream inflammatory cytokines, secukinumab had no clinically relevant effects on the PKs of midazolam, provided substantial clinical benefit, and was generally well tolerated. In summary, blockade of IL‐17A signaling in patients with moderate‐to‐severe psoriasis does not significantly affect CYP3A4 enzyme activities and, therefore, the use of secukinumab is unlikely to influence the PKs of CYP3A4 substrates.
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Affiliation(s)
- Gerard Bruin
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Anke Hasselberg
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Irina Koroleva
- Novartis Institutes for BioMedical Research, Cambridge, USA.,Current address:, Rubius Therapeutics Inc., Cambridge, Massachusetts, USA
| | - Julie Milojevic
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Rachel Soon
- Novartis Institutes for BioMedical Research, East Hanover, New Jersey, USA
| | - Ralph Woessner
- Novartis Institutes for BioMedical Research, Basel, Switzerland
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106
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Hu S, Yuan S, Chen G, Tu H. Increased incidence of ischaemic heart disease and cerebrovascular disease in psoriasis patients with depression: a nationwide retrospective cohort study. J Eur Acad Dermatol Venereol 2019; 33:1547-1554. [DOI: 10.1111/jdv.15616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 04/01/2019] [Indexed: 12/14/2022]
Affiliation(s)
- S.C.‐S. Hu
- Department of Dermatology Kaohsiung Medical University Hospital Kaohsiung Taiwan
- Department of Dermatology College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
- Department of Medical Research Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan
- Translational Research Center Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan
| | - S.‐S.F. Yuan
- Department of Medical Research Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan
- Translational Research Center Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan
- Graduate Institute of Medicine College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
- Department of Obstetrics and Gynecology Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan
| | - G.‐S. Chen
- Department of Dermatology Kaohsiung Medical University Hospital Kaohsiung Taiwan
- Department of Dermatology College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
| | - H.‐P. Tu
- Department of Public Health and Environmental Medicine School of Medicine College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
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107
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Abstract
PURPOSE OF REVIEW Several chronic inflammatory skin disorders have been linked to metabolic syndrome (MetS) and an increased risk for cardiovascular disease. In this review, we will summarize the recent evidence on the association between psoriasis, hidradenitis suppurativa (HS), and atopic dermatitis (AD) and metabolic syndrome with careful attention to this association among the pediatric population. RECENT FINDINGS Historically, psoriasis has exhibited the most robust association with MetS in the literature. Recent studies show that the prevalence of MetS appears to be higher among patients with HS and can be associated with MetS even in mild disease. A relationship between AD and MetS is still under debate, but research has shown a clear link between pediatric AD and being overweight or obese. SUMMARY There are no current consensus guidelines for metabolic syndrome in the pediatric population, and its clinical implications in children are still unclear. Nevertheless, providers should be aware of the shared underlying inflammatory state and link between several cutaneous disorders and metabolic syndrome. Early diagnosis and proper disease management of these at risk populations has the potential to assist in disease control and mitigate future cardiovascular disease.
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108
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Schön MP. Adaptive and Innate Immunity in Psoriasis and Other Inflammatory Disorders. Front Immunol 2019; 10:1764. [PMID: 31402919 PMCID: PMC6676248 DOI: 10.3389/fimmu.2019.01764] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 07/11/2019] [Indexed: 12/14/2022] Open
Abstract
Over the past three decades, a considerable body of evidence has highlighted T cells as pivotal culprits in the pathogenesis of psoriasis. This includes the association of psoriasis with certain MHC (HLA) alleles, oligoclonal expansion of T cells in some cases, therapeutic response to T cell-directed immunomodulation, the onset of psoriasis following bone marrow transplantation, or induction of psoriasis-like inflammation by T cells in experimental animals. There is accumulating clinical and experimental evidence suggesting that both autoimmune and autoinflammatory mechanisms lie at the core of the disease. Indeed, some studies suggested antigenic functions of structural proteins, and complexes of self-DNA with cathelicidin (LL37) or melanocytic ADAMTSL5 have been proposed more recently as actual auto-antigens in some cases of psoriasis. These findings are accompanied by various immunoregulatory mechanisms, which we increasingly understand and which connect innate and adaptive immunity. Specific adaptive autoimmune responses, together with our current view of psoriasis as a systemic inflammatory disorder, raise the question of whether psoriasis may have connections to autoimmune or autoinflammatory disorders elsewhere in the body. While such associations have been suspected for many years, compelling mechanistic evidence in support of this notion is still scant. This review sets into context the current knowledge about innate and adaptive immunological processes in psoriasis and other autoimmune or autoinflammatory diseases.
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Affiliation(s)
- Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
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109
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McGonagle DG, McInnes IB, Kirkham BW, Sherlock J, Moots R. The role of IL-17A in axial spondyloarthritis and psoriatic arthritis: recent advances and controversies. Ann Rheum Dis 2019; 78:1167-1178. [PMID: 31278139 PMCID: PMC6788885 DOI: 10.1136/annrheumdis-2019-215356] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/17/2019] [Accepted: 06/14/2019] [Indexed: 12/19/2022]
Abstract
Although the pathogenic mechanisms underlying axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) are not fully elucidated, several lines of evidence suggest that immune responses mediated by interleukin 17A (IL-17A) play a pivotal role in both diseases. This is best highlighted by the significant clinical efficacy shown with inhibitors of IL-17A in treating axSpA and PsA. Nevertheless, a number of knowledge gaps exist regarding the role of IL-17A in the pathophysiology of spondyloarthritis in man, including its cellular origin, its precise role in discrete disease processes such enthesitis, bone erosion, and bone formation, and the reasons for the discrepant responses to IL-17A inhibition observed in certain other spondyloarthritis manifestations. In this review, we focus on the latest data from studies investigating the role of IL-17A in ankylosing spondylitis (AS) and PsA that build on existing and emerging scientific knowledge in the field. Key remaining research questions are also highlighted to guide future research.
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Affiliation(s)
- Dennis G McGonagle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton, Leeds Teaching Hospital Trust, Leeds, UK
| | - Iain B McInnes
- Institute of Infection Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Bruce W Kirkham
- Rheumatology Department, Guy's and Saint Thomas' NHS Foundation Trust, London, UK
| | - Jonathan Sherlock
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Robert Moots
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK .,Department of Academic Rheumatology, Aintree University Hospital, Liverpool, UK
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110
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IL-17A inhibition by secukinumab induces early clinical, histopathologic, and molecular resolution of psoriasis. J Allergy Clin Immunol 2019; 144:750-763. [PMID: 31129129 DOI: 10.1016/j.jaci.2019.04.029] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 03/26/2019] [Accepted: 04/18/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Hyperactivity of the IL-23/IL-17 axis is central to plaque psoriasis pathogenesis. Secukinumab, a fully human mAb that selectively inhibits IL-17A, is approved for treatment of psoriasis, psoriatic arthritis, and ankylosing spondylitis. Secukinumab improves the complete spectrum of psoriasis manifestations, with durable clinical responses beyond 5 years of treatment. In the feed-forward model of plaque chronicity, IL-17A has been hypothesized as the key driver of pathogenic gene expression by lesional keratinocytes, but in vivo evidence in human subjects is lacking. METHODS We performed a randomized, double-blind, placebo-controlled study (NCT01537432) of patients receiving secukinumab at the clinically approved dose up to 12 weeks. We then correlated plaque and nonlesional skin transcriptomic profiles with histopathologic and clinical measures of efficacy. RESULTS After 12 weeks of treatment, secukinumab reversed plaque histopathology in the majority of patients and modulated thousands of transcripts. Suppression of the IL-23/IL-17 axis by secukinumab was evident at week 1 and continued through week 12, including reductions in levels of the upstream cytokine IL-23, the drug target IL-17A, and downstream targets, including β-defensin 2. Suppression of the IL-23/IL-17 axis by secukinumab at week 4 was associated with clinical and histologic responses at week 12. Secukinumab did not affect ex vivo T-cell activation, which is consistent with its favorable long-term safety profile. CONCLUSION Our data suggest that IL-17A is the critical node within the multidimensional pathogenic immune circuits that maintain psoriasis plaques and that early reduction of IL-17A-dependent feed-forward transcripts synthesized by hyperplastic keratinocytes favors plaque resolution.
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111
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Kivelevitch D, Amin S, Menter A. Clinical utility of secukinumab in moderate-to-severe scalp psoriasis: evidence to date. Clin Cosmet Investig Dermatol 2019; 12:249-253. [PMID: 31118728 PMCID: PMC6498391 DOI: 10.2147/ccid.s165040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 03/13/2019] [Indexed: 11/23/2022]
Abstract
Psoriasis is an immune-mediated inflammatory dermatosis commonly affecting the scalp and fringes of the face, neck and ears. It may be difficult to treat and the presence of extensive and highly visible lesions may significantly influence psychosocial well-being. Secukinumab, a monoclonal antibody that selectively targets interleukin-17A and has been shown to provide robust and sustained efficacy for whole body psoriasis. In this review, we evaluate the evidence to date of secukinumab in patients with moderate-to-severe scalp psoriasis. A comprehensive Cochrane database and PubMed searches of all available literature in English through September 2018 was performed using the search terms: “psoriasis”, “scalp” and “secukinumab”. Based on current evidence, we conclude that secukinumab is efficacious and well-tolerated treatment for patients with moderate-to-severe scalp psoriasis. Further studies are however warranted.
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Affiliation(s)
| | - Sima Amin
- Texas A&M College of Medicine, Bryan, TX, USA
| | - Alan Menter
- Baylor University Medical Center, Dallas, TX, USA
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112
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Th1, Th17, and Treg Responses are Differently Modulated by TNF-α Inhibitors and Methotrexate in Psoriasis Patients. Sci Rep 2019; 9:7526. [PMID: 31101850 PMCID: PMC6525159 DOI: 10.1038/s41598-019-43899-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 04/18/2019] [Indexed: 11/23/2022] Open
Abstract
Psoriasis is a chronic, recurrent, immune-mediated, hyperproliferative inflammatory skin disease. The role of the adaptive immune system, particularly of Th1 and Th17 lymphocytes, has been regarded as prominent in the immunopathogenesis of psoriasis, as well as decreased Tregs function. Immunobiological drugs were administered in therapeutic pulses and a few studies evaluate their effects on the immune repertoire. The aim of this study was to evaluate the adaptive immune profile of patients with severe psoriasis under immunobiological treatment in two time points. Thirty-two psoriasis patients and 10 control patients were evaluated. In the group of psoriasis patients, 10 patients were on anti-TNF and 14 patients on methotrexate treatment, while 8 individuals were not treated. IL-17, IFN-γ, TNF-α, IL-6, IL-2, and IL-10 were analyzed. CD4 T cell intracellular cytokines were analyzed. It was observed that stimulation could significantly increase the production of IL-17, IFN-γ, TNF-α, and IL-10 only before anti-TNF pulse therapy. The activation of Th1 and Treg cells after stimulation was significantly higher before anti-TNF pulse. Patients on methotrexate or anti-TNF therapy produced significantly lower levels of TNF-α, IL-10, and IL-6. Furthermore, these patients showed a significant decrease in the activated CD4+ T cells. The treatment with immunomodulator or methotrexate modulates the activation of CD4+ T cells, and anti-TNF treatment appears to have a modulating effect on the activation and production of Th1, Th17, and Treg cells.
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113
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Cataldi C, Mari NL, Lozovoy MAB, Martins LMM, Reiche EMV, Maes M, Dichi I, Simão ANC. Proinflammatory and anti-inflammatory cytokine profiles in psoriasis: use as laboratory biomarkers and disease predictors. Inflamm Res 2019; 68:557-567. [PMID: 31062065 DOI: 10.1007/s00011-019-01238-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 04/18/2019] [Accepted: 04/22/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The objectives of this study were to delineate the pro and anti-inflammatory cytokine profiles of psoriasis and cytokine profile models that externally validate the diagnosis. SUBJECTS AND METHODS This study recruited 70 patients with psoriasis and 76 healthy controls. Cytokine profiles were evaluated, including pro-inflammatory M1 (IL-1 + IL-6 + TNF-α), Th1 (IL-2 + IL-12 + IFN-γ), Th17 (IL-6 + IL-17), and immune-inflammatory response system (IRS = M1 + Th1 + Th17) profiles. Moreover, the anti-inflammatory potential included Th2 (IL-4), Th2 + T regulatory (Th2 + Treg, namely IL-4 + IL-10 + TGF-β), anti-inflammatory (Th2 + Treg + adiponectin), and the pro-inflammatory/anti-inflammatory index. RESULTS There was a highly significant association between psoriasis and cytokine levels with an effect size of 0.829 and a particularly strong impact on IL-2 (0.463), IL-12 (0.451), IL-10 (0.532) and adiponectin (0.401). TGF-β and adiponectin were significantly lower while all other cytokines (except IFN-γ) were significantly higher in psoriasis than in controls. In addition, M1, Th1, Th17, Th2 + Treg, and IRS/Anti-inflammatory index were significantly higher in psoriasis patients than in controls. The IRS index, Th2 + Treg, and adiponectin predicted psoriasis with 97.1% sensitivity and 94% specificity. CONCLUSION In conclusion, psoriasis is characterized by increased M1, Th1, Th2 and Th17 profiles together with lowered TGF-β and adiponectin. In addition, we propose a model based on a higher IRS and Th2 + Treg index coupled with lower adiponectin values, which may be used to externally validate the diagnosis of psoriasis. The most important single biomarker of psoriasis is adiponectin. Because the latter may play a role in the modulation of the chronic inflammatory response in psoriasis, adiponectin could be a new drug target to treat psoriasis.
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Affiliation(s)
- Camila Cataldi
- Laboratory of Research in Applied Immunology, University of Londrina, Londrina, PR, Brazil
| | - Naiara Lourenço Mari
- Laboratory of Research in Applied Immunology, University of Londrina, Londrina, PR, Brazil
| | - Marcell Alysson Batisti Lozovoy
- Laboratory of Research in Applied Immunology, Department of Pathology, Clinical Analysis and Toxicology, University of Londrina, Rua Robert Koch, n 60, Londrina, Paraná, 86038-440, Brazil
| | | | - Edna Maria Vissoci Reiche
- Laboratory of Research in Applied Immunology, Department of Pathology, Clinical Analysis and Toxicology, University of Londrina, Rua Robert Koch, n 60, Londrina, Paraná, 86038-440, Brazil
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Isaias Dichi
- Laboratory of Research in Applied Immunology, Department of Internal Medicine, University of Londrina, Londrina, PR, Brazil
| | - Andréa Name Colado Simão
- Laboratory of Research in Applied Immunology, Department of Pathology, Clinical Analysis and Toxicology, University of Londrina, Rua Robert Koch, n 60, Londrina, Paraná, 86038-440, Brazil.
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114
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Macleod T, Ward J, Alase AA, Bridgewood C, Wittmann M, Stonehouse NJ. Antimicrobial Peptide LL-37 Facilitates Intracellular Uptake of RNA Aptamer Apt 21-2 Without Inducing an Inflammatory or Interferon Response. Front Immunol 2019; 10:857. [PMID: 31068939 PMCID: PMC6491520 DOI: 10.3389/fimmu.2019.00857] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 04/02/2019] [Indexed: 11/23/2022] Open
Abstract
RNA aptamers are synthetic single stranded RNA oligonucleotides that function analogously to antibodies. Recently, they have shown promise for use in treating inflammatory skin disease as, unlike antibody-based biologics, they are able to enter the skin following topical administration. However, it is important to understand the inflammatory milieu into which aptamers are delivered, as numerous immune-modulating mediators will be present at abnormal levels. LL-37 is an important immune-modifying protein upregulated in several inflammatory skin conditions, including psoriasis, rosacea and eczema. This inflammatory antimicrobial peptide is known to complex nucleic acids and induce both inflammatory and interferon responses from keratinocytes. Given the attractive notion of using RNA aptamers in topical medication and the prevalence of LL-37 in these inflammatory skin conditions, we examined the effect of LL-37 on the efficacy and safety of the anti-IL-17A RNA aptamer, Apt 21-2. LL-37 was demonstrated to complex with the RNA aptamer by electrophoretic mobility shift and filter binding assays. In contrast to free Apt 21-2, LL-37-complexed Apt 21-2 was observed to efficiently enter both keratinocytes and fibroblasts by confocal microscopy. Despite internalization of LL-37-complexed aptamers, measurement of inflammatory mediators and interferon stimulated genes showed LL-37-complexed Apt 21-2 remained immunologically inert in keratinocytes, fibroblasts, and peripheral blood mononuclear cells including infiltrating dendritic cells and monocytes. The findings of this study suggest RNA aptamers delivered into an inflammatory milieu rich in LL-37 may become complexed and subsequently internalized by surrounding cells in the skin. Whilst the results of this study indicate delivery of RNA aptamers into tissue rich in LL-37 should not cause an unwarranted inflammatory of interferon response, these results have significant implications for the efficacy of aptamers with regards to extracellular vs. intracellular targets that should be taken into consideration when developing treatment strategies utilizing RNA aptamers in inflamed tissue.
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Affiliation(s)
- Tom Macleod
- Institute of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Joseph Ward
- Institute of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Adewonuola A Alase
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Charlie Bridgewood
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Miriam Wittmann
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Medicine and Health, University of Leeds, Leeds, United Kingdom.,National Institute for Health Research, Leeds Biomedical Research Centre, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Nicola J Stonehouse
- Institute of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
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115
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Foulkes AC, Warren RB. Brodalumab in psoriasis: evidence to date and clinical potential. Drugs Context 2019; 8:212570. [PMID: 31024633 PMCID: PMC6474429 DOI: 10.7573/dic.212570] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/22/2019] [Accepted: 01/24/2019] [Indexed: 12/23/2022] Open
Abstract
Brodalumab is a recombinant, fully human monoclonal antibody (IgG2) which binds with high affinity to the interleukin (IL) 17 receptor A (IL17R). Brodalumab is now licensed and approved for the treatment of moderate-to-severe chronic plaque psoriasis in North America and Europe. As the third to market in the class of agents targeting IL-17, we review its place in the expanding armamentarium of cytokine-directed therapies for patients with severe psoriasis. Brodalumab is a highly efficacious therapy for psoriasis, whose mechanism of action is separate from other treatments targeting IL-17. Its use is associated with rapid control of the disease. We suggest that brodalumab is likely to be considered in those patients requiring rapid control of disease, where there is no known history of depression or suicidal ideation.
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Affiliation(s)
- Amy C Foulkes
- The Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester Biomedical Research Centre, Manchester, M6 8HD, UK
| | - Richard B Warren
- The Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester Biomedical Research Centre, Manchester, M6 8HD, UK
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116
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GLP-1 receptor agonist impairs keratinocytes inflammatory signals by activating AMPK. Exp Mol Pathol 2019; 107:124-128. [DOI: 10.1016/j.yexmp.2019.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/21/2018] [Accepted: 01/28/2019] [Indexed: 11/23/2022]
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117
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Wawrzycki B, Pietrzak A, Grywalska E, Krasowska D, Chodorowska G, Roliński J. Interleukin-22 and Its Correlation with Disease Activity in Plaque Psoriasis. Arch Immunol Ther Exp (Warsz) 2019; 67:103-108. [PMID: 30291393 PMCID: PMC6420473 DOI: 10.1007/s00005-018-0527-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 09/17/2018] [Indexed: 02/07/2023]
Abstract
Psoriasis is a chronic debilitating skin disease with an estimated prevalence reaching 2% of the worldwide population. Psoriatic disease is driven by a network of complicated reciprocal interactions among innate and adaptive mechanisms of immune system with structural components of the skin. Interleukin (IL)-22 mediates keratinocyte proliferation and epidermal hyperplasia, inhibits terminal differentiation of keratinocytes, and induces the production of antimicrobial proteins. The aim of this study was the assessment of IL-22 levels and its correlation with disease activity in plaque psoriasis. The study group included 64 patients with mild, moderate and severe psoriasis. Control group was composed of 24 sex- and age-matched healthy volunteers. IL-22 concentration was assessed in supernatants of T-cell cultures as well as in the plasma of study and control group with the use of ELISA method. Statistical analysis showed that concentration of IL-22 in cultures exposed to staphylococcal enterotoxin B was significantly higher than in control samples (p = 0.005) and cultures treated with IL-12 (p = 0.005). Patients with psoriasis presented significantly higher concentrations of IL-22 than healthy individuals (p = 0.0000001). In conclusion, IL-22 may collaborate with other soluble factors and cells together forming inflammatory circuits that otherwise exist as constitutive or inducible pathways in normal skin and become pathologically amplificated in psoriasis. Targeting IL-22 may be promising as a potential therapeutic for plaque psoriasis.
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Affiliation(s)
- Bartłomiej Wawrzycki
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - Aldona Pietrzak
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - Ewelina Grywalska
- Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, Chodzki 4a, 20-093, Lublin, Poland.
| | - Dorota Krasowska
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - Grażyna Chodorowska
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - Jacek Roliński
- Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, Chodzki 4a, 20-093, Lublin, Poland
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118
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Xie ZY, Zhou Y, Deng S, Ding W, Duan XW, Yang LR. Effectiveness comparisons of acupuncture for psoriasis: A Bayesian network meta-analysis protocol. Medicine (Baltimore) 2019; 98:e15356. [PMID: 31027118 PMCID: PMC6831452 DOI: 10.1097/md.0000000000015356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/01/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Psoriasis is an immune-mediated polygenic hereditary skin disease quality of the patients' life because of the great trouble it causes to patients. Whereas there is variability when we regard the selection of acupuncture treatments in practice and most choices are made based on personal experience or preference of clinician. This study uses network meta-analysis to compare the effectiveness of different forms of acupuncture for psoriasis and assesses the evidence with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. METHODS We will search for PubMed, Cochrane Library, AMED, EMbase, WorldSciNet; Nature, Science online and China Journal Full-text Database (CNKI), China Biomedical Literature CD-ROM Database (CBM), and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to April 2019. The quality of the included RCTs will be evaluated by the risk of bias (ROB) tool and the evidence will be evaluated by GRADE. STATA 13.0 and WinBUGS 1.4.3 through the GeMTC package will be used to perform a network meta-analysis to synthesize direct and indirect evidence. RESULTS The results of this network meta-analysis (NMA) will be submitted to a peer-reviewed journal for publication. TRIAL REGISTRATION NUMBER PROSPERO CRD42019123437.
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Affiliation(s)
- Zhi-yin Xie
- Department of Dermatology, Beijing Changping Hospital of Traditional Chinese Medicine, Beijing
| | - Yu Zhou
- Department of Dermatology, Beijing Changping Hospital of Traditional Chinese Medicine, Beijing
| | - Sheng Deng
- Academy of Traditional Chinese Medicine, Chengde Medical University, Hebei
| | - Wei Ding
- Academy of Traditional Chinese Medicine, Chengde Medical University, Hebei
| | - Xing-wu Duan
- Department of Dermatology, Dongzhimen Hospital Affiliated to Beijing University of Traditional Chinese Medicine
| | - Li-rong Yang
- Infirmary of Shahe Campus, Central University of Finance and Economics, Beijing, China
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119
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Plachouri KM, Georgiou S. Challenges in the treatment of psoriasis with biologics: vaccination, history of malignancy, human immunodeficiency virus (HIV) infection, and pediatric psoriasis. Int J Dermatol 2019; 58:1008-1013. [PMID: 30891751 DOI: 10.1111/ijd.14436] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/23/2019] [Accepted: 02/28/2019] [Indexed: 12/25/2022]
Abstract
Biologics are potent immunomodulatory drugs, whose application in the treatment of psoriasis has shown extremely good therapeutic results and a satisfactory safety profile. The administration of these agents in special cases, such as in patients with HIV infection, previous malignancy, unclear vaccination status as well as children, can be challenging. This report is an updated systematic review of the use of biologics in the above-mentioned groups. Articles derived from the databases PubMed, EMBASE, and SCOPUS, and published between 1989 and 2018, were analyzed for this study. The existing evidence is not in all cases sufficient in order to provide adequate insight on the management of these complex situations. The aim of this report is to present a summarized update on the knowledge of this special topic so far and to draw into attention the need to conduct more systematic studies so as to clarify the best therapeutic strategies for these special patient groups when it comes to the use of biologics.
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Affiliation(s)
| | - Sophia Georgiou
- Dermatology Department, University of Patras, Patras, Greece
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120
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Yan J, Song J, Qiao M, Zhao X, Li R, Jiao J, Sun Q. Long noncoding RNA expression profile and functional analysis in psoriasis. Mol Med Rep 2019; 19:3421-3430. [PMID: 30816535 PMCID: PMC6471922 DOI: 10.3892/mmr.2019.9993] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 11/26/2018] [Indexed: 12/12/2022] Open
Abstract
Long noncoding RNAs (lncRNAs) serve important roles in the biology of autoimmune diseases and immune-associated disorders. To identify lncRNAs specifically associated with psoriasis, the expression of lncRNAs from biopsies obtained from patients with psoriasis were compared with samples obtained from healthy volunteers using a microarray. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was performed to detect the expression of 10 identified dysregulated lncRNAs. Cis- and trans-regulated target genes of lncRNAs were predicted. The results of microarray analysis indicated that 2,194 lncRNAs and 1,725 mRNAs were significantly dysregulated. Gene Ontology and pathway analyses among the dysregulated genes were performed. Co-expression network analysis was also performed to study molecular interactions. Several identified pathways were associated with psoriasis. Among the 2,194 dysregulated lncRNAs, 1,549 of these had cis- or trans-regulated predicted target genes. Among the 1,725 dysregulated mRNAs, 289 of the cis-regulated target genes and 262 of the trans-regulated target genes may be regulated by the differentially expressed lncRNAs; 10 differentially expressed lncRNAs were randomly selected and then validated. Of these lncRNAs, 7 exhibited the same expression profile as determined via microarray analysis, of which 3 lncRNAs were upregulated and 4 lncRNAs were downregulated. To the best of our knowledge, the present study is the first in which a microarray has been used to investigate the expression profile of lncRNAs associated with psoriasis. Additionally, the expression levels of the 10 aforementioned lncRNAs associated with psoriasis were validated in the present study for the first time using RT-qPCR. The findings demonstrated that lncRNAs may contribute to the pathogenesis of psoriasis and suggested their potential diagnostic and therapeutic value. Furthermore, the findings of the present study suggest that the combined actions of several lncRNAs may contribute to the pathogenesis of psoriasis.
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Affiliation(s)
- Jianjun Yan
- Department of Dermatology, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Jie Song
- Department of Medical Insurance, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Meng Qiao
- Department of Dermatology, Shandong Qianfoshan Hospital, Jinan, Shandong 250014, P.R. China
| | - Xintong Zhao
- Department of Dermatology, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Ronghua Li
- Department of Dermatology, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Jian Jiao
- Department of Dermatology, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Qing Sun
- Department of Dermatology, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
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121
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Lynde CW, Beecker J, Dutz J, Flanagan C, Guenther LC, Gulliver W, Papp K, Rahman P, Sholter D, Searles GE. Treating to Target(s) With Interleukin-17 Inhibitors. J Cutan Med Surg 2019; 23:3S-34S. [DOI: 10.1177/1203475418824565] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: The treat-to-target (T2T) strategy has become established in several medical specialties as a key guidance to optimal therapeutic decision making. T2T may be effective in the assessment of the biologic class of agents called interleukin (IL)-17 inhibitors, which are emerging as a safe and effective treatment option for autoimmune inflammatory conditions such as plaque psoriasis, psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Objective: The objective of this article is to use a T2T approach for the evaluation of the effectiveness and safety of IL-17 inhibitors in the management of patients with plaque psoriasis, PsA, and AS. Methods: Following a comprehensive literature search, a full-day meeting was convened to discuss and identify the T2T targets for psoriasis, PsA, and AS. Clinical trial evidence was presented for the approved IL-17 inhibitors—secukinumab, ixekizumab, and brodalumab—to assess whether these data meet T2T safety and efficacy targets. Results: All 3 approved agents were significantly superior to placebo and active controls in the achievement of T2T targets for psoriasis. Secukinumab and ixekizumab were likewise associated with significantly better outcomes than controls in the PsA targets, and secukinumab resulted in significant AS target improvements vs placebo. The IL-17 inhibitors were also associated with low rates of serious adverse events and exacerbations of common comorbid conditions. Conclusion: Phase III trial results support the T2T benefit and safety of IL-17 inhibitors according to their specific indications for the management of patients with plaque psoriasis, PsA, and AS.
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Affiliation(s)
- Charles W. Lynde
- University of Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
- Probity Medical Research, Markham, ON, Canada
| | - Jennifer Beecker
- The Ottawa Hospital, ON, Canada
- The University of Ottawa, ON, Canada
- Probity Medical Research, Ottawa, ON, Canada
| | - Jan Dutz
- University of British Columbia, Vancouver, BC, Canada
- BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | | | | | - Wayne Gulliver
- Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Kim Papp
- Probity Medical Research, Waterloo, ON, Canada
| | - Proton Rahman
- Memorial University of Newfoundland, St. John’s, NL, Canada
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122
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Takeichi T, Kinoshita F, Tanaka H, Fujita S, Kobayashi Y, Nakatochi M, Sugiura K, Akiyama M. The lipoxygenase-hepoxilin pathway is activated in cutaneous plaque lesions of psoriasis. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2018. [DOI: 10.1002/cia2.12039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Takuya Takeichi
- Department of Dermatology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Fumie Kinoshita
- Statistical Analysis Section; Center for Advanced Medicine and Clinical Research; Nagoya University Hospital; Nagoya Japan
| | - Hirotaka Tanaka
- Discovery Research Laboratories II; Ono Pharmaceutical Co., Ltd.; Osaka Japan
| | - Setsuko Fujita
- Discovery Technology Research Laboratories; Ono Pharmaceutical Co., Ltd.; Osaka Japan
| | - Yumiko Kobayashi
- Statistical Analysis Section; Center for Advanced Medicine and Clinical Research; Nagoya University Hospital; Nagoya Japan
| | - Masahiro Nakatochi
- Statistical Analysis Section; Center for Advanced Medicine and Clinical Research; Nagoya University Hospital; Nagoya Japan
| | - Kazumitsu Sugiura
- Department of Dermatology; Fujita Health University School of Medicine; Toyoake Japan
| | - Masashi Akiyama
- Department of Dermatology; Nagoya University Graduate School of Medicine; Nagoya Japan
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123
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Affiliation(s)
| | - So Yeon Paek
- Division of Dermatology, Baylor University Medical Center, Dallas, TX, USA
| | - Alan Menter
- Division of Dermatology, Baylor University Medical Center, Dallas, TX, USA
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124
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Chiricozzi A. Secukinumab in the therapy of psoriasis and psoriatic arthritis: a safe choice in clinical practice. J DERMATOL TREAT 2018; 29:1-2. [DOI: 10.1080/09546634.2018.1557875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Andrea Chiricozzi
- Dermatology Unit, Department of Clinical and Translational Medicine, University of Pisa, Pisa, Italy
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125
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Castela E, Tulic MK, Rozières A, Bourrat E, Nicolas JF, Kanitakis J, Vabres P, Bessis D, Mazereeuw J, Morice-Picard F, Baty D, Berard F, Lacour JP, Passeron T, Chiaverini C. Epidermolysis bullosa simplex generalized severe induces a T helper 17 response and is improved by apremilast treatment. Br J Dermatol 2018; 180:357-364. [PMID: 29932457 DOI: 10.1111/bjd.16897] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Epidermolysis bullosa simplex generalized severe (EBS-gen sev) is a genetic disorder caused by mutation in the KRT5 or KRT14 genes. Although it is usually considered a mechanical disease, recent data argue for additional inflammatory mechanisms. OBJECTIVES To assess the inflammation in the skin of patients with EBS-gen sev. METHODS A first immunohistochemical retrospective study was performed on frozen skin samples from 17 patients with EBS-gen sev. A second multicentre prospective study was conducted on 10 patients with severe EBS-gen sev. Blister fluid and epidermis were processed for immunochemical analysis and quantitative real-time polymerase chain reaction. Cytokine expression was analysed in blister fluid and compared with that in controls. RESULTS Histological analysis showed a constant dermal perivascular CD4+ lymphocyte infiltrate in skin biopsies of both blister (n = 17) and rubbed skin (n = 5), an epidermal infiltration of neutrophils and eosinophils in 70% of cases, and increased immunostaining for CXCL9 and CXCL10 in blistering skin. High levels of T helper 17 cytokines were detected in lesional skin. Three adult patients with EBS-gen sev were treated with apremilast, with a dramatic improvement of skin blistering and good tolerance. CONCLUSIONS Our study demonstrates the importance of inflammation in patients with EBS-gen sev and underlines the key role for T helper 17 cells in its pathogenesis. In addition, this study provides promising new therapeutic approaches for this disabling disorder.
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Affiliation(s)
- E Castela
- Department of Dermatology, CHU de Nice, Hôpital Archet 2, 151 Route de Saint Antoine de Ginestière, 06202 Nice CEDEX 2, France.,INSERM U1111-CIRI851, Université Lyon 1, Lyon, France
| | - M K Tulic
- INSERM U1065, Team 12, C3M, Nice, France
| | - A Rozières
- INSERM U1111-CIRI851, Université Lyon 1, Lyon, France
| | - E Bourrat
- MAGEC, Saint-Louis Hospital, Paris, France
| | - J-F Nicolas
- INSERM U1111-CIRI851, Université Lyon 1, Lyon, France.,Department of Allergology and Clinical Immunology, Hospices Civils de Lyon, Lyon, France
| | - J Kanitakis
- Department of Dermatology , Hospices Civils de Lyon, Lyon, France.,Department of Pathology, Hospices Civils de Lyon, Lyon, France
| | - P Vabres
- Department of Dermatology, CHU de Dijon, Dijon, France
| | - D Bessis
- Department of Dermatology, CHU de Montpellier, Montpellier, France
| | | | | | - D Baty
- Scottish Molecular Genetics Consortium, Ninewells Hospital, Dundee, U.K
| | - F Berard
- Department of Allergology and Clinical Immunology, Hospices Civils de Lyon, Lyon, France
| | - J-P Lacour
- Department of Dermatology, CHU de Nice, Hôpital Archet 2, 151 Route de Saint Antoine de Ginestière, 06202 Nice CEDEX 2, France.,CREBHN, CHU de Nice, Nice, France
| | - T Passeron
- Department of Dermatology, CHU de Nice, Hôpital Archet 2, 151 Route de Saint Antoine de Ginestière, 06202 Nice CEDEX 2, France.,INSERM U1065, Team 12, C3M, Nice, France
| | - C Chiaverini
- Department of Dermatology, CHU de Nice, Hôpital Archet 2, 151 Route de Saint Antoine de Ginestière, 06202 Nice CEDEX 2, France.,CREBHN, CHU de Nice, Nice, France
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126
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Hu S, Lin C, Tu H. Association between psoriasis, psoriatic arthritis and gout: a nationwide population‐based study. J Eur Acad Dermatol Venereol 2018; 33:560-567. [DOI: 10.1111/jdv.15290] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/27/2018] [Indexed: 02/06/2023]
Affiliation(s)
- S.C.‐S. Hu
- Department of Dermatology College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
- Department of Dermatology Kaohsiung Medical University Hospital Kaohsiung Taiwan
- Department of Medical Research Kaohsiung Medical University Hospital Kaohsiung Taiwan
- Translational Research Center Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan
| | - C.‐L. Lin
- Department of Dermatology Kaohsiung Medical University Hospital Kaohsiung Taiwan
- Department of Dermatology Kaohsiung Municipal Hsiao‐Kang Hospital Kaohsiung Taiwan
| | - H.‐P. Tu
- Department of Public Health and Environmental Medicine School of Medicine College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
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127
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De Novo Psoriasis Vulgaris Diagnosed after Nivolumab Treatment for Refractory Hodgkin's Lymphoma, Completely Resolved after Autologous Hematopoietic Stem Cell Transplantation. Case Rep Hematol 2018; 2018:6215958. [PMID: 30410803 PMCID: PMC6206568 DOI: 10.1155/2018/6215958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/09/2018] [Accepted: 09/24/2018] [Indexed: 11/17/2022] Open
Abstract
The programmed cell death protein-1 (PD-1) inhibitor nivolumab has been recently approved as an effective and safe treatment for patients with refractory/relapsed Hodgkin's lymphomas. Dermatological adverse events, mainly skin rash, have been reported in 1–5% of patients. We describe a case of de novo psoriasis vulgaris (PsV), diagnosed after nivolumab treatment for refractory Hodgkin's lymphoma. After administration of 6 cycles, skin lesions appeared in the right tibia, forearms, and dorsum of hands, and biopsy confirmed the diagnosis of PsV. The lesions completely resolved after autologous stem cell transplantation (ASCT) which was performed in the context of the treatment for the primary disease. PsV is an inflammatory skin disease, and it is considered to be mediated through cytotoxic T-cells. PD-1 blockage may lead to expansion of such T-cells, resulting thus in PsV appearance. The early published studies showed that nivolumab represents a safe treatment approach. PsV occurrence has not been reported so far in patients treated with nivolumab for hematological diseases, and it seems that long-term follow-up is necessary to fully clarify the entirety of PD-1 inhibitors' skin adverse events. Additionally, this clinical observation provides an evidence for a potential exploitation of ASCT in refractory and severe forms of PsV.
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128
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Munera-Campos M, Ballesca F, Richarz N, Ferrandiz C, Carrascosa JM. Paradoxical eczematous reaction to ixekizumab. J Eur Acad Dermatol Venereol 2018; 33:e40-e42. [PMID: 29953678 DOI: 10.1111/jdv.15156] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- M Munera-Campos
- Dermatology Department, Germans Trias i Pujol University Hospital, Badalona, Barcelona, Spain
| | - F Ballesca
- Dermatology Department, Germans Trias i Pujol University Hospital, Badalona, Barcelona, Spain
| | - N Richarz
- Dermatology Department, Germans Trias i Pujol University Hospital, Badalona, Barcelona, Spain
| | - C Ferrandiz
- Dermatology Department, Germans Trias i Pujol University Hospital, Badalona, Barcelona, Spain
| | - J M Carrascosa
- Dermatology Department, Germans Trias i Pujol University Hospital, Badalona, Barcelona, Spain
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129
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Pradhan M, Alexander A, Singh MR, Singh D, Saraf S, Saraf S, Ajazuddin. Understanding the prospective of nano-formulations towards the treatment of psoriasis. Biomed Pharmacother 2018; 107:447-463. [PMID: 30103117 DOI: 10.1016/j.biopha.2018.07.156] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 07/28/2018] [Accepted: 07/31/2018] [Indexed: 12/14/2022] Open
Abstract
Psoriasis is a consistently recurring, inflammatory, autoimmune disorder of the skin, affecting about 2-5% of the world population. Abundant therapeutic agents are accessible for the treatment of psoriasis. Nevertheless, none of them are entirely secure and effective to treat the disease without compromising patient compliance. Furthermore, already existing drugs are supposed to restrain the ailment and alleviate the sign and symptoms with no complete cure. However, they focus on restraining the disease and alleviating the symptoms without providing an absolute cure. Therefore there remains a vital challenge, to explore a new drug moiety or delivery system which could safely and effectively manage psoriasis without compromising patient compliance. Furthermore, conventional formulations offer reduced benefit/risk ratio of anti-psoriatic drugs, which limits the use of existing conventional formulations. Novel formulations based on nanocarriers are a promising prospect to overcome the limitation of conventional formulations by offering a reduction in dose, dosing frequency, dose-dependent, side effects with enhanced efficacy. Presently nano-formulations have gained widespread application for effective and safe treatment of psoriasis. The present review primarily focuses on conventional therapeutic strategy and recent advances in lipid-based, polymer-based and metallic nano-formulations of a variety of anti-psoriatic drugs. The practicability of various nanocarrier systems including liposomes, nanostructured lipid carriers, ethosomes, solid lipid nanoparticles, nanocapsules, micelles, dendrimers, gold nanoparticles and silver nanoparticles have been discussed in detail. The review also traces related patents to exemplify the role of various nanoparticles in psoriasis treatment. In a nutshell, nano-formulations remain established as a promising modality for treating psoriasis treatment as they propose better penetration, targeted delivery, enhanced safety, and efficacy.
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Affiliation(s)
- Madhulika Pradhan
- Rungta College of Pharmaceutical Sciences and Research, Kohka, Kurud Road, Bhilai, Chhattisgarh, 490024, India
| | - Amit Alexander
- Rungta College of Pharmaceutical Sciences and Research, Kohka, Kurud Road, Bhilai, Chhattisgarh, 490024, India
| | - Manju Rawat Singh
- University Institute of Pharmacy, Pt. Ravishankar Shukla University, Raipur, Chhattisgarh, 4920110, India
| | - Deependra Singh
- University Institute of Pharmacy, Pt. Ravishankar Shukla University, Raipur, Chhattisgarh, 4920110, India
| | - Swarnlata Saraf
- University Institute of Pharmacy, Pt. Ravishankar Shukla University, Raipur, Chhattisgarh, 4920110, India
| | - Shailendra Saraf
- University Institute of Pharmacy, Pt. Ravishankar Shukla University, Raipur, Chhattisgarh, 4920110, India; Durg University, Govt. Vasudev Vaman Patankar Girls' P.G. College Campus, Raipur Naka, Durg, Chhattisgarh, 491001, India
| | - Ajazuddin
- Rungta College of Pharmaceutical Sciences and Research, Kohka, Kurud Road, Bhilai, Chhattisgarh, 490024, India.
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130
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Brembilla NC, Senra L, Boehncke WH. The IL-17 Family of Cytokines in Psoriasis: IL-17A and Beyond. Front Immunol 2018; 9:1682. [PMID: 30127781 PMCID: PMC6088173 DOI: 10.3389/fimmu.2018.01682] [Citation(s) in RCA: 286] [Impact Index Per Article: 47.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/09/2018] [Indexed: 12/14/2022] Open
Abstract
Psoriasis is a frequent chronic inflammatory skin disease, nowadays considered a major global health problem. Several new drugs, targeting the IL-23/IL-17A pathway, have been recently licensed or are in clinical development. These therapies represent a major improvement of the way in which psoriasis is managed, since they show an unprecedented efficacy on skin symptoms of psoriasis. This has been made possible, thanks to an increasingly more accurate pathogenic view of psoriasis. Today, the belief that Th17 cells mediate psoriasis is moving to the concept of psoriasis as an IL-17A-driven disease. New questions arise at the horizon, given that IL-17A is part of a newly described family of cytokines, which has five distinct homologous: IL-17B, IL-17C, IL-17D, IL-17E, also known as IL-25 and IL-17F. IL-17 family cytokines elicit similar effects in target cells, but simultaneously trigger different and sometimes opposite functions in a tissue-specific manner. This is complicated by the fact that IL-17 cytokines show a high capacity of synergisms with other inflammatory stimuli. In this review, we will summarize the current knowledge around the cytokines belonging to the IL-17 family in relation to skin inflammation in general and psoriasis in particular, and discuss possible clinical implications. A comprehensive understanding of the different roles played by the IL-17 cytokines is crucial to appreciate current and developing therapies and to allow an effective pathogenesis- and mechanisms-driven drug design.
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Affiliation(s)
| | - Luisa Senra
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Wolf-Henning Boehncke
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
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131
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Ergen EN, Yusuf N. Inhibition of interleukin-12 and/or interleukin-23 for the treatment of psoriasis: What is the evidence for an effect on malignancy? Exp Dermatol 2018; 27:737-747. [PMID: 29704872 PMCID: PMC6023723 DOI: 10.1111/exd.13676] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2018] [Indexed: 12/25/2022]
Abstract
Immune cells and cytokines play an important role in the pathogenesis of psoriasis. Interleukin-12 (IL-12) and IL-23 promote cellular responses mediated by T cells, which contribute to an inflammatory loop responsible for the induction and maintenance of psoriatic plaques. Antibodies that inhibit IL-12/23 or IL-23 are key treatment options for patients with psoriasis. IL-12 and IL-23 also play a key role in immune responses to infections and tumors. A growing body of information from clinical trials, cohort studies, postmarketing reports, genetic studies and animal models provides insights into the potential biological relationships between IL-12/23 inhibition and malignancies. We summarize this information in tables and provide some context for the interpretation of these data with the goal of informing dermatologists who are using IL-12/23 or IL-23 inhibitors to treat patients with psoriasis.
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Affiliation(s)
- Elizabeth N. Ergen
- Department of DermatologyUniversity of Alabama at BirminghamBirminghamALUSA
| | - Nabiha Yusuf
- Department of DermatologyUniversity of Alabama at BirminghamBirminghamALUSA
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132
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Giuseppe P, Nicola P, Valentina C, Elena C, Salvatrice C, Rosario G, Rita BM. A Case of Moderate Hidradenitis Suppurativa and Psoriasis Treated with Secukinumab. Ann Dermatol 2018; 30:462-464. [PMID: 30065588 PMCID: PMC6029963 DOI: 10.5021/ad.2018.30.4.462] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/22/2017] [Accepted: 09/07/2017] [Indexed: 11/24/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a disorder of the apocrine gland causing a chronic, recurrent and painful inflammation. It is a disabilitating condition and, though many therapeutic options are available, the response is often ineffective in most cases and patients can present many recurrences with physical and psychological sequelae. Recent data had shown increased interleukin (IL)-17 serum levels in patients with HS. Psoriasis is a chronic immune-mediated inflammatory disorder and new evidences have shown the role of Th17 cells in its pathogenesis and the therapeutic efficacy of anti-IL-17 antibodies. We present a case of a patient suffering from psoriasis and HS successfully treated with anti-IL-17 antibodies for both conditions. This is the first case report of HS treated with secukinumab.
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Affiliation(s)
- Pistone Giuseppe
- Section of Dermatology, Department of Biomedicine, Internal Medicine and Specialties (Di.Bi.MIS), University of Palermo, Palermo, Italy
| | - Pardo Nicola
- Section of Dermatology, Department of Biomedicine, Internal Medicine and Specialties (Di.Bi.MIS), University of Palermo, Palermo, Italy
| | - Caputo Valentina
- Section of Dermatology, Department of Biomedicine, Internal Medicine and Specialties (Di.Bi.MIS), University of Palermo, Palermo, Italy
| | - Castelli Elena
- Section of Dermatology, Department of Biomedicine, Internal Medicine and Specialties (Di.Bi.MIS), University of Palermo, Palermo, Italy
| | - Curiale Salvatrice
- Section of Dermatology, Department of Biomedicine, Internal Medicine and Specialties (Di.Bi.MIS), University of Palermo, Palermo, Italy
| | - Gurreri Rosario
- Section of Dermatology, Department of Biomedicine, Internal Medicine and Specialties (Di.Bi.MIS), University of Palermo, Palermo, Italy
| | - Bongiorno Maria Rita
- Section of Dermatology, Department of Biomedicine, Internal Medicine and Specialties (Di.Bi.MIS), University of Palermo, Palermo, Italy
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133
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Schön MP, Erpenbeck L. The Interleukin-23/Interleukin-17 Axis Links Adaptive and Innate Immunity in Psoriasis. Front Immunol 2018; 9:1323. [PMID: 29963046 PMCID: PMC6013559 DOI: 10.3389/fimmu.2018.01323] [Citation(s) in RCA: 144] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 05/28/2018] [Indexed: 12/15/2022] Open
Abstract
Research into the pathophysiology of psoriasis has shed light onto many fascinating immunological interactions and underlying genetic constellations. Most prominent among these is the crosstalk between components of the innate and the adaptive immune system and the crucial role of interleukins (IL)-23 and -17 within this network. While it is clear that IL-23 drives and maintains the differentiation of Th17 lymphocytes, many aspects of the regulation of IL-23 and IL-17 are not quite as straightforward and have been unraveled only recently. For example, we know now that Th17 cells are not the only source of IL-17 but that cells of the innate immune system also produce considerable amounts of this central effector cytokine. In addition, there is IL-23-independent production of IL-17. Besides other innate immune cells, neutrophilic granulocytes prominently contribute to IL-17-related immune regulations in psoriasis, and it appears that they employ several mechanisms including the formation of neutrophil extracellular traps. Here, we strive to put the central role of the IL-23/IL-17 axis into perspective within the crosstalk between components of the innate and the adaptive immune system. Our aim is to better understand the complex immune regulation in psoriasis, a disorder that has become a model disease for chronic inflammation.
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Affiliation(s)
- Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.,Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, University of Osnabrück, Osnabrück, Germany
| | - Luise Erpenbeck
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
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134
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Wang XY, Chen XY, Li J, Zhang HY, Liu J, Sun LD. MiR-200a expression in CD4+ T cells correlates with the expression of Th17/Treg cells and relevant cytokines in psoriasis vulgaris: A case control study. Biomed Pharmacother 2018; 93:1158-1164. [PMID: 28738533 DOI: 10.1016/j.biopha.2017.06.055] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 06/12/2017] [Accepted: 06/19/2017] [Indexed: 01/21/2023] Open
Abstract
The main aim of this study is to investigate the underlying relationship shared between microRNA-200a (miR-200a) and its link to concentrations of Th17 and Treg cells, mRNA expressions of their specific transcription factors retinoic acid-related orphan receptor γt (RORγt) and head box protein 3 (FOXP3) and relevant cytokines in patients with psoriasis vulgaris (PV). A total of 189 patients previously diagnosed with PV were selected as the experimental group, whilst 109 healthy individuals as the control group. According to the psoriasis area and severity index (PASI), subjects in the experimental group were assigned into the severe group (95 cases) and the moderate group (94 cases). CD4+ T and Th17/Treg cells were extracted. MiR-200a expression and RORγt and FoxP3 mRNA expressions were detected by qRT-PCR. Concentrations of Th17 and Treg cells were measured via flow cytometry. ELISA was conducted for serum IL-17, IL-23 and TGF-β levels. Correlation analysis was completed in accordance with the Pearson method. Compared with the moderate group, higher miR-200a expression, RORγt mRNA expression, percentage of Th17, Th17/Treg ratio and levels of IL-17 and IL-23 exhibited in the severe group, whilst FoxP3 mRNA expression and, percentage of Treg as well as TGF-β were lower. A same trend displayed when comparing the moderate group to the control group. We found that miR-200a expression, percentage of Th17, Th17/Treg ratio, IL-17 and IL-23 levels and RORγt mRNA expression are positively correlated with PASI grade, while the percentage of Treg, TGF-β level and FoxP3 mRNA expression are negatively correlated with PASI grade. The results also displayed that the percentage of Th17, Th17/Treg ratio, IL-17 and IL-23 levels and RORγt mRNA expression are positively correlated with miR-200a expression, while the percentage seen in Treg and TGF-βand FoxP3 mRNA expression are negatively correlated with miR-200a expression. Our results provided a strong evidence that up-regulation of microRNA-200a in CD4+ T cells may induce immune dysfunction through Th17/Treg cells and relevant cytokines in PV patients.
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Affiliation(s)
- Xiao-Yan Wang
- Department of Dermatology, Qingdao Municipal Hospital, Qingdao 266011, PR China
| | - Xing-Yu Chen
- Department of Dermatology, Qingdao Municipal Hospital, Qingdao 266011, PR China
| | - Jun Li
- Department of Dermatology, Qingdao Municipal Hospital, Qingdao University, Qingdao 266011, PR China
| | - Hong-Ying Zhang
- Department of Dermatology, Qingdao Municipal Hospital, Qingdao 266011, PR China.
| | - Juan Liu
- Department of Dermatology, Zhujiang Hospital of Southern Medical University, Guangzhou 510280, PR China
| | - Le-Dong Sun
- Department of Dermatology, Zhujiang Hospital of Southern Medical University, Guangzhou 510280, PR China
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135
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Fleming P. Ixekizumab and psoriasis: an important entry into the therapeutic landscape. Br J Dermatol 2018; 178:585-586. [DOI: 10.1111/bjd.16263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- P. Fleming
- Division of Dermatology; University of Toronto; Sunnybrook Health Sciences Centre (M1-722), 2075 Bayview Avenue Toronto ON Canada M4N 3M5
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136
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Ma L, Xue H, Qi R, Wang Y, Yuan L. Effect of γ-secretase inhibitor on Th17 cell differentiation and function of mouse psoriasis-like skin inflammation. J Transl Med 2018. [PMID: 29523162 PMCID: PMC5845192 DOI: 10.1186/s12967-018-1442-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background Th17 cells and its effective cytokine IL-17A play an important role in the pathogenesis of abnormal immune responses in psoriasis. Notch1 signaling has been implicated in Th17 cell differentiation and function. In this study, our aim was to evaluate the possible inhibitory effect of Notch1 signaling inhibitor, γ-secretase inhibitor DAPT, on psoriatic Th17 cell differentiation and function in a mouse model of psoriasis-like skin inflammation. Methods Mouse psoriasis-like skin inflammation model was established by topical 5% imiquimod (IMQ) application, and experimental mice were divided into control group, IMQ-treated group and IM + DAPT-treated group. DAPT and the equivalent amount of Dimethyl sulfoxide was intraperitoneally injected in IMQ + DAPT-treated group and the other two experimental groups respectively. Skin tissues of the three experimental groups were acquired and stained with haematoxylin and eosin (HE). Splenic single-cells and serum were collected to detect the percentage of Th17 cells, the mRNA expression levels of Notch1 and its target gene Hes-1, Th17-specific transcription factor RORγt and its effective cytokines IL-17A, as well as IL-17A serum concentration. In addition, splenic CD4+ T cells from IMQ-treated mice were isolated and treated by DAPT to further measure the inhibitory effect of DAPT on the Th17 cell differentiation and IL-17A secretion in vitro. Results DAPT treatment alleviated the severity of IMQ-induced mouse psoriasis-like skin inflammation and decreased the scores of erythema, scaling and thickening. HE stain reveals obviously reduced epidermal hyperplasia and dermal inflammatory cells infiltration in IMQ + DAPT-treated mice. The increased expression of splenic Th17 cell percentage, along with Notch1, Hes-1, RORγt and IL-17A mRNA and IL-17A serum concentration in IMQ-treated mice were significantly decreased when experimental mice were treated by IMQ and DAPT combinedly. Data obtained from in vitro study in IMQ-treated mice also demonstrated that blocking Notch1 signaling by DAPT can result in a dose-dependent decrease of Th17 cell proportion, mRNA expression of Notch1, Hes-1, RORγt and IL-17A as well as IL-17A secretion in splenic CD4+ T cells. Conclusion These data suggest that Notch1 inhibition by DAPT can effectively alleviate the severity of mouse psoriasis-like skin inflammation by regulating the differentiation and function of Th17 cells, indicating that DAPT might be a potential therapeutic candidate for the treatment of psoriatic inflammation.
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Affiliation(s)
- Lei Ma
- Department of Dermatology, Binzhou Medical University Hospital, 661 Second Huanghe Road, Binzhou, 256603, China.
| | - Haibo Xue
- Department of Endocrinology and Metabolism, Binzhou Medical University Hospital, 661 Second Huanghe Road, Binzhou, 256603, China.
| | - Ruiqun Qi
- Department of Dermatology, The First Affiliated Hospital of China Medical University, 155 North Nanjing Road, Shenyang, 110001, China
| | - Yanqin Wang
- Department of Dermatology, Binzhou Medical University Hospital, 661 Second Huanghe Road, Binzhou, 256603, China
| | - Libing Yuan
- Department of Endocrinology and Metabolism, Binzhou Medical University Hospital, 661 Second Huanghe Road, Binzhou, 256603, China
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137
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Gooderham MJ, Papp KA, Lynde CW. Shifting the focus - the primary role of IL-23 in psoriasis and other inflammatory disorders. J Eur Acad Dermatol Venereol 2018; 32:1111-1119. [PMID: 29438576 PMCID: PMC6033004 DOI: 10.1111/jdv.14868] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 01/29/2018] [Indexed: 12/12/2022]
Abstract
Insights into the pathophysiology of autoimmune inflammatory diseases including psoriasis have advanced considerably in recent years, and in parallel, so too have the available treatment options. Current clinical paradigms for the treatment of psoriasis have evolved to include targeted biologic therapies, starting with tumour necrosis factor‐alpha (TNF‐α) inhibitors and later, agents targeting interleukin (IL)‐12/23 and IL‐17. The most recent evidence suggests that IL‐23 might be an even more potent target for the effective treatment of psoriasis and other autoimmune inflammatory disorders. This review will describe recent developments leading to the current understanding of the key role of IL‐23 as a ‘master regulator’ of autoimmune inflammation and the clinical evidence for agents that specifically target this modulator in the context of treating psoriasis, spondyloarthropathy and inflammatory bowel disease.
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Affiliation(s)
- M J Gooderham
- SKiN Centre for Dermatology, Probity Medical Research, Queen's University, Peterborough, ON, Canada
| | - K A Papp
- K Papp Clinical Research and Probity Medical Research, Waterloo, ON, Canada
| | - C W Lynde
- Lynde Dermatology, Probity Medical Research, Markham, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
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138
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Ma K, Yang L, Shen R, Kong B, Chen W, Liang J, Tang G, Zhang B. Th17 cells regulate the production of CXCL1 in breast cancer. Int Immunopharmacol 2018; 56:320-329. [PMID: 29438938 DOI: 10.1016/j.intimp.2018.01.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/05/2018] [Accepted: 01/17/2018] [Indexed: 12/22/2022]
Abstract
Recently, the link between inflammation and cancer has been targeted for the prevention or treatment of malignant tumours. We aimed to investigate the relationship between Th17 cells and CXCL1 in breast cancer and the biological effects of CXCL1 on breast cancer. In vivo, the Th17 cell frequency in the peripheral blood was determined by flow cytometry. Secretion of IL-17 and CXCL1 in the blood serum was determined by enzyme-linked immunosorbent assay (ELISA). Expression of IL-17A and CXCL1 mRNA was determined by qRT-PCR. In vitro, the effects of Th17/CXCL1 during breast cancer were assessed in the human breast cancer cell lines MCF-7 and MDA-MB-231. Cell proliferation was measured using the CCK8 assay. Cell invasion and migration ability were assessed using a transwell cell invasion and wound- healing assay. In vivo, Th17 cells and CXCL1 were increased in breast cancer patients. Moreover, their changes were correlated in breast cancer cells. Th17 cells upregulate the production of CXCL1 during breast cancer progression. CXCL1, which is produced by breast cancer cells, can promote cancer growth and development, and may also point to a specific histogenetic pathway.
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Affiliation(s)
- Kai Ma
- Department of Immunology, Medical College of Qingdao University, Qingdao, China
| | - Lihua Yang
- Department of Immunology, Medical College of Qingdao University, Qingdao, China
| | - Ruowu Shen
- Department of Anatomy, Medical College of Qingdao University, Qingdao, China
| | - Bin Kong
- Department of Breast Centre, the Affiliated Hospital of Qingdao University Medical College, Qingdao, China
| | - Wenting Chen
- Department of Immunology, Medical College of Qingdao University, Qingdao, China
| | - Jie Liang
- Institute for Immunology, Ruprecht-Karls-university, Heidelberg 69120, Germany
| | - Guoqing Tang
- Department of Immunology, Medical College of Qingdao University, Qingdao, China
| | - Bei Zhang
- Department of Immunology, Medical College of Qingdao University, Qingdao, China.
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139
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Martini S, Pozzi G, Carubbi C, Masselli E, Galli D, Di Nuzzo S, Banchini A, Gobbi G, Vitale M, Mirandola P. PKCε promotes human Th17 differentiation: Implications in the pathophysiology of psoriasis. Eur J Immunol 2018; 48:644-654. [DOI: 10.1002/eji.201747102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 12/01/2017] [Accepted: 12/15/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Silvia Martini
- Department of Medicine & Surgery (DiMeC); University of Parma; Parma IT
- CoreLab; Azienda Ospedaliero-Universitaria di Parma; Parma IT
| | - Giulia Pozzi
- Department of Medicine & Surgery (DiMeC); University of Parma; Parma IT
| | - Cecilia Carubbi
- Department of Medicine & Surgery (DiMeC); University of Parma; Parma IT
- CoreLab; Azienda Ospedaliero-Universitaria di Parma; Parma IT
| | - Elena Masselli
- Department of Medicine & Surgery (DiMeC); University of Parma; Parma IT
| | - Daniela Galli
- Department of Medicine & Surgery (DiMeC); University of Parma; Parma IT
| | - Sergio Di Nuzzo
- Department of Medicine & Surgery (DiMeC); University of Parma; Parma IT
| | - Antonio Banchini
- Department of Medicine & Surgery (DiMeC); University of Parma; Parma IT
| | - Giuliana Gobbi
- Department of Medicine & Surgery (DiMeC); University of Parma; Parma IT
- CoreLab; Azienda Ospedaliero-Universitaria di Parma; Parma IT
| | - Marco Vitale
- Department of Medicine & Surgery (DiMeC); University of Parma; Parma IT
- CoreLab; Azienda Ospedaliero-Universitaria di Parma; Parma IT
| | - Prisco Mirandola
- Department of Medicine & Surgery (DiMeC); University of Parma; Parma IT
- CoreLab; Azienda Ospedaliero-Universitaria di Parma; Parma IT
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140
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Sawyer L, Fotheringham I, Wright E, Yasmeen N, Gibbons C, Holmen Møller A. The comparative efficacy of brodalumab in patients with moderate-to-severe psoriasis: a systematic literature review and network meta-analysis. J DERMATOL TREAT 2018; 29:557-568. [PMID: 29323542 DOI: 10.1080/09546634.2018.1427205] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE To evaluate the relative efficacy of brodalumab compared with approved biologic therapies and apremilast for moderate-to-severe psoriasis. METHODS We searched MEDLINE, Embase, and Cochrane for randomized controlled trials reporting induction phase responses. The primary analysis examined the proportion of patients achieving Psoriasis Area Severity Index (PASI) 50, 75, 90, or 100 responses using a random-effects Bayesian multinomial likelihood model with probit link, with and without adjustment for variation in study-level placebo responses. RESULTS A total of 54 studies were included. Based on PASI 100 response, the most efficacious therapies were brodalumab 210 mg every two weeks (Q2W) and ixekizumab. Brodalumab 210 mg Q2W was significantly more efficacious than adalimumab, apremilast, brodalumab 140 mg Q2W, etanercept, infliximab, secukinumab, and ustekinumab. Results were consistent for PASI 50, 75, and 90 outcomes and all sensitivity analyses. CONCLUSIONS Our findings are consistent with pivotal trials which indicate that high levels of complete clearance can be achieved with brodalumab. Based on existing evidence, induction-phase efficacy of brodalumab is similar to ixekizumab and superior to other approved therapies, including anti-TNFs, apremilast, secukinumab, and ustekinumab.
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141
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Troyanova-Slavkova S, Eickenscheidt L, Dumann K, Kowalzick L. [Initially undetected de novo psoriasis triggered by nivolumab for metastatic base of the tongue carcinoma]. Hautarzt 2018; 69:674-680. [PMID: 29330579 DOI: 10.1007/s00105-017-4109-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Nivolumab is a monoclonal antibody that binds to the PD-1 receptor on T cells and inhibits the interaction with the PD-L1 and PD-L2 ligands on cancer cells. Thus, nivolumab has immunostimulatory properties. The known side effects of this therapy include fatigue, skin rash, dysfunction of the thyroid gland and colitis, which are explained by the immunoregulatory mechanisms of the drug. Here we report on the case of a 58-year-old man with metastatic base of tongue carcinoma who developed de novo psoriasis triggered by nivolumab. The patient was treated for months with the diagnosis of a generalized mycosis. This case highlights the importance of vigilance for unexpected cutaneous side effects during immune stimulating therapy with checkpoint inhibitors.
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Affiliation(s)
- S Troyanova-Slavkova
- Klinik für Hautkrankheiten und Allergologie, HELIOS Vogtland-Klinikum Plauen GmbH, Postfach 100153, 08505, Plauen, Deutschland
| | - L Eickenscheidt
- Klinik für Hautkrankheiten und Allergologie, HELIOS Vogtland-Klinikum Plauen GmbH, Postfach 100153, 08505, Plauen, Deutschland
| | - K Dumann
- Dermatohistopathologie, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Leipzig, Deutschland
| | - L Kowalzick
- Klinik für Hautkrankheiten und Allergologie, HELIOS Vogtland-Klinikum Plauen GmbH, Postfach 100153, 08505, Plauen, Deutschland.
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142
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Chen H, Liu H, Lu C, Wang M, Li X, Zhao H, Yan Y, Yu W, Han L, Dai Z. PSORI-CM02 Formula Increases CD4+ Foxp3+ Regulatory T Cell Frequency and Ameliorates Imiquimod-Induced Psoriasis in Mice. Front Immunol 2018; 8:1767. [PMID: 29358932 PMCID: PMC5766646 DOI: 10.3389/fimmu.2017.01767] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 11/27/2017] [Indexed: 12/24/2022] Open
Abstract
Psoriasis is an autoimmune and inflammatory disease, which is estimated to affect 2–3% of the population in the world. PSORI-CM02 is an empirical formula of Chinese medicine optimized from Yin Xie Ling, which is widely used to treat psoriasis in China for decades. However, its antipsoriatic mechanisms are still not well understood. Here, we explored the therapeutic effects of PSORI-CM02 on psoriasis and its mechanisms of action in imiquimod-induced psoriasis-like mouse models and human HaCaT cells. In experiments in vitro, PSORI-CM02 significantly inhibited HaCaT cell proliferation in dose-dependent and time-dependent manners. Furthermore, it hindered the progression of HaCaT cell cycle and arrested HaCaT cells at G1 phase. On the other hand, our in vivo studies demonstrated that PSORI-CM02 dramatically reduced psoriasis area and severity index scores and lesion temperature in imiquimod-induced psoriatic mice. The antioxidative activities of glutathione, catalase, and superoxide dismutase were increased while oxidative activity of malonaldehyde was markedly decreased after treatments with PSORI-CM02. PSORI-CM02 also suppressed the mRNA expression of proinflammatory cytokines, including TNF-α, IL-6, and IL-17, and lowered their protein levels in the serum as well. In addition, PSORI-CM02 could reduce the expression of IKKα and NF-κB in psoriatic skin tissue. It also upregulated the proportion of CD4+ Foxp3+ regulatory T cells (Tregs) in both lymph nodes and spleens and promoted CD4+ CD25+ Treg proliferation in vitro. Taken together, our research demonstrated that PSORI-CM02 inhibited HaCaT cell proliferation by arresting them at G1 phase and alleviated systemic inflammation and psoriasis in mice via altering the oxidative/anti-oxidative status, tipping the balance between Th17 responsiveness and CD4+ Foxp3+ Treg generation, and suppressing the expression of proinflammatory cytokines as well as NF-κB signaling.
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Affiliation(s)
- Haiming Chen
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Postdoctoral Programme, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Huazhen Liu
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Chuanjian Lu
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, China
| | - Maojie Wang
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Xiong Li
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Hui Zhao
- Key Laboratory for Regenerative Medicine, Ministry of Education, Faculty of Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Kunming Institute of Zoology Chinese Academy of Sciences-The Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research of Common Diseases, Hong Kong, China
| | - Yuhong Yan
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Wanling Yu
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Ling Han
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, China
| | - Zhenhua Dai
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
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143
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Severe Psoriasis Flare After Anti-Programmed Death Ligand 1 (PD-L1) Therapy for Metastatic Non-Small Cell Lung Cancer (NSCLC). J Immunother 2018; 39:202-4. [PMID: 27163740 DOI: 10.1097/cji.0000000000000121] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Immunomodulatory agents that target PD-1 and its ligand (PD-L1) are being increasingly used in the management of lung cancer. Potential immune-related adverse events include dermatological complications which mostly are of low grade severity. The use of immune checkpoint inhibitors may lead to the exacerbation of autoimmune conditions. We report a case of a documented psoriasis flare with anti-PD-1 treatment for lung cancer.
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144
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Woo YR, Cho DH, Park HJ. Molecular Mechanisms and Management of a Cutaneous Inflammatory Disorder: Psoriasis. Int J Mol Sci 2017; 18:ijms18122684. [PMID: 29232931 PMCID: PMC5751286 DOI: 10.3390/ijms18122684] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/07/2017] [Accepted: 12/07/2017] [Indexed: 12/11/2022] Open
Abstract
Psoriasis is a complex chronic inflammatory cutaneous disorder. To date, robust molecular mechanisms of psoriasis have been reported. Among diverse aberrant immunopathogenetic mechanisms, the current model emphasizes the role of Th1 and the IL-23/Th17 axis, skin-resident immune cells and major signal transduction pathways involved in psoriasis. The multiple genetic risk loci for psoriasis have been rapidly revealed with the advent of a novel technology. Moreover, identifying epigenetic modifications could bridge the gap between genetic and environmental risk factors in psoriasis. This review will provide a better understanding of the pathogenesis of psoriasis by unraveling the complicated interplay among immunological abnormalities, genetic risk foci, epigenetic modification and environmental factors of psoriasis. With advances in molecular biology, diverse new targets are under investigation to manage psoriasis. The recent advances in treatment modalities for psoriasis based on targeted molecules are also discussed.
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Affiliation(s)
- Yu Ri Woo
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea.
| | - Dae Ho Cho
- Department of Life Science, Sookmyung Women's University, Seoul 04310, Korea.
| | - Hyun Jeong Park
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea.
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145
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Oliveira ALDB, Monteiro VVS, Navegantes-Lima KC, Reis JF, Gomes RDS, Rodrigues DVS, Gaspar SLDF, Monteiro MC. Resveratrol Role in Autoimmune Disease-A Mini-Review. Nutrients 2017; 9:nu9121306. [PMID: 29194364 PMCID: PMC5748756 DOI: 10.3390/nu9121306] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 09/20/2017] [Accepted: 10/20/2017] [Indexed: 02/07/2023] Open
Abstract
Autoimmune diseases are still considered to be pressing concerns due the fact that they are leaders in death and disability causes worldwide. Resveratrol is a polyphenol derived from a variety of foods and beverages, including red grapes and red wine. Anti-inflammatory, antioxidant, and antiaging properties of resveratrol have been reported, and in some animal and human studies this compound reduced and ameliorated the progression of autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, psoriasis, inflammatory bowel disease, and type 1 diabetes mellitus. Thus, this review aims to summarize and critically analyze the role of resveratrol in the modulation of several organ-specific or systemic autoimmune diseases.
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Affiliation(s)
- Ana Lígia de Brito Oliveira
- Pharmaceutical Science Post-Graduation Program, Neuroscience and Cellular Biology Post Graduation Program, Faculty of Pharmacy, Federal University of Pará, Avenue Augusto Correa SN, Guamá, Pará 66075-110, Brazil.
| | - Valter Vinicius Silva Monteiro
- School of Pharmacy, Health Science Institute, Federal University of Pará/UFPA, Avenue Augusto Correa SN, Guamá, Pará 66075-110, Brazil.
| | - Kely Campos Navegantes-Lima
- Pharmaceutical Science Post-Graduation Program, Neuroscience and Cellular Biology Post Graduation Program, Faculty of Pharmacy, Federal University of Pará, Avenue Augusto Correa SN, Guamá, Pará 66075-110, Brazil.
| | - Jordano Ferreira Reis
- School of Pharmacy, Health Science Institute, Federal University of Pará/UFPA, Avenue Augusto Correa SN, Guamá, Pará 66075-110, Brazil.
| | - Rafaelli de Souza Gomes
- Pharmaceutical Science Post-Graduation Program, Neuroscience and Cellular Biology Post Graduation Program, Faculty of Pharmacy, Federal University of Pará, Avenue Augusto Correa SN, Guamá, Pará 66075-110, Brazil.
| | - Dávila Valentina Silva Rodrigues
- School of Pharmacy, Health Science Institute, Federal University of Pará/UFPA, Avenue Augusto Correa SN, Guamá, Pará 66075-110, Brazil.
| | - Silvia Letícia de França Gaspar
- School of Pharmacy, Health Science Institute, Federal University of Pará/UFPA, Avenue Augusto Correa SN, Guamá, Pará 66075-110, Brazil.
| | - Marta Chagas Monteiro
- Pharmaceutical Science Post-Graduation Program, Neuroscience and Cellular Biology Post Graduation Program, Faculty of Pharmacy, Federal University of Pará, Avenue Augusto Correa SN, Guamá, Pará 66075-110, Brazil.
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146
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Early Recognition and Treatment Heralds Optimal Outcomes: the Benefits of Combined Rheumatology–Dermatology Clinics and Integrative Care of Psoriasis and Psoriatic Arthritis Patients. Curr Rheumatol Rep 2017; 20:1. [DOI: 10.1007/s11926-017-0706-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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147
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Frieder J, Kivelevitch D, Menter A. Secukinumab: a review of the anti-IL-17A biologic for the treatment of psoriasis. Ther Adv Chronic Dis 2017; 9:5-21. [PMID: 29344327 DOI: 10.1177/2040622317738910] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 09/28/2017] [Indexed: 12/12/2022] Open
Abstract
Psoriasis is a systemic inflammatory disease associated with numerous comorbidities and a profound impact on patients' quality of life. While its complex immune pathogenesis is still not fully delineated, current evidence supports a fundamental role of the T-helper-17 (TH-17) pathway and its related interleukin-17 (IL-17) cytokine. Thus, new antipsoriatic therapies have been developed to block this key cytokine and its downstream effects. Secukinumab is a fully humanized, monoclonal anti-IL-17A antibody, and the first in its class to be approved by the US Food and Drug Administration for the treatment of moderate to severe plaque psoriasis. It has also been approved for the treatment of active psoriatic arthritis and ankylosing spondylitis. Its clinical efficacy in plaque psoriasis has been well demonstrated in numerous phase II and III clinical trials. In addition, it has shown superiority in clinical trials to current biologic agents including etanercept and ustekinumab, with a safe adverse event profile. In correlation with excellent skin improvements, secukinumab is also associated with significant improvements in health-related quality of life measures. Thus, secukinumab offers the potential for equal, or improved, therapeutic effects compared with other biologics, and is a valuable addition to our current antipsoriatic armamentarium.
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Affiliation(s)
- Jillian Frieder
- Baylor Scott and White- Division of Dermatology, Dallas, TX, USA
| | | | - Alan Menter
- Baylor Scott and White- Division of Dermatology, 3900 Junius Street, Suite 125, Dallas, TX 75246, USA
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148
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Maarouf M, Clark AK, Lee DE, Shi VY. Targeted treatments for hidradenitis suppurativa: a review of the current literature and ongoing clinical trials. J DERMATOL TREAT 2017; 29:441-449. [DOI: 10.1080/09546634.2017.1395806] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Melody Maarouf
- College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Ashley K. Clark
- School of Medicine, University of California, Davis, Sacramento, CA, USA
| | - Dylan E. Lee
- School of Medicine, Creighton University, Omaha, NE, USA
| | - Vivian Y. Shi
- Department of Medicine, Division of Dermatology, University of Arizona, Tucson, AZ, USA
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149
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Wang EA, Suzuki E, Maverakis E, Adamopoulos IE. Targeting IL-17 in psoriatic arthritis. Eur J Rheumatol 2017; 4:272-277. [PMID: 29308283 DOI: 10.5152/eurjrheum.2017.17037] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 08/23/2017] [Indexed: 12/14/2022] Open
Abstract
Psoriatic arthritis (PsA) is a chronic and progressive inflammatory arthritis intimately associated with psoriasis, and can be an impairing disease that leads to reduced quality of life and significant morbidity. Treatment often requires TNF antagonists, yet many patients with PsA are not responsive to the standard anti-TNF therapies. The interleukin-17 (IL-17)/IL-17 receptor (IL-17R) family has recently been implicated in the pathogenesis of PsA and psoriasis. Much enthusiasm has been generated for the development of biologics that target the IL-17 signaling pathway directly or indirectly, many of which have produced striking results in the setting of psoriasis and PsA. Herein, we review the role of IL-17 and the IL-17 receptor (IL-17R) in the pathogenesis of PsA, as well as the clinical evidence for IL-17 and IL-17R targeted therapeutics.
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Affiliation(s)
| | - Erika Suzuki
- Department of Internal Medicine, Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis, CA, USA
| | | | - Iannis E Adamopoulos
- Department of Internal Medicine, Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis, CA, USA.,Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children Northern California, CA, USA
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150
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Malik K, Ungar B, Garcet S, Dutt R, Dickstein D, Zheng X, Xu H, Estrada YD, Suárez-Fariñas M, Shemer A, Krueger JG, Guttman-Yassky E. Dust mite induces multiple polar T cell axes in human skin. Clin Exp Allergy 2017; 47:1648-1660. [DOI: 10.1111/cea.13040] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/11/2017] [Accepted: 08/18/2017] [Indexed: 12/18/2022]
Affiliation(s)
- K. Malik
- Department of Dermatology; Icahn School of Medicine at Mount Sinai; New York NY USA
- Laboratory for Investigative Dermatology; The Rockefeller University; New York NY USA
| | - B. Ungar
- Department of Dermatology; Icahn School of Medicine at Mount Sinai; New York NY USA
- Laboratory for Investigative Dermatology; The Rockefeller University; New York NY USA
| | - S. Garcet
- Laboratory for Investigative Dermatology; The Rockefeller University; New York NY USA
| | - R. Dutt
- Department of Dermatology; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - D. Dickstein
- Department of Dermatology; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - X. Zheng
- Laboratory for Investigative Dermatology; The Rockefeller University; New York NY USA
| | - H. Xu
- Department of Dermatology; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - Y. D. Estrada
- Department of Dermatology; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - M. Suárez-Fariñas
- Laboratory for Investigative Dermatology; The Rockefeller University; New York NY USA
- Department of Population Health Science and Policy; Icahn School of Medicine at Mount Sinai; New York NY USA
- Department of Genetics and Genomics Science; Icahn School of Medicine at Mount Sinai; New York NY USA
- Icahn Institute for Genomics and Multiscale Biology; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - A. Shemer
- The Department of Dermatology; Tel-Hashomer; Tel-Aviv Israel
| | - J. G. Krueger
- Laboratory for Investigative Dermatology; The Rockefeller University; New York NY USA
| | - E. Guttman-Yassky
- Department of Dermatology; Icahn School of Medicine at Mount Sinai; New York NY USA
- Laboratory for Investigative Dermatology; The Rockefeller University; New York NY USA
- Department of Genetics and Genomics Science; Icahn School of Medicine at Mount Sinai; New York NY USA
- The Immunology Institute; Icahn School of Medicine at Mount Sinai; New York NY USA
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