Inflammation induces dermal Vγ4+ γδT17 memory-like cells that travel to distant skin and accelerate secondary IL-17-driven responses

Bone remodeling in psoriasis and psoriatic arthritis: an update

PURPOSE OF REVIEW

This article reviews and outlines recent advances in the field of bone remodeling in psoriatic disease and identify avenues for further research.

RECENT FINDINGS

High-resolution imaging revealed that new bone formation, observed in psoriatic arthritis (PsA) is centered at enthesial sites in contrast to hand osteoarthritis, and new bone formation is also present in psoriasis patients without arthritis. Accumulating evidence strongly suggests that the IL-23/IL-17 pathway is directly involved in altered bone phenotypes in PsA. Apart from Th17 and Th22 cells, CD8IL-17 T cells, γδT cells, and type 3 innate lymphoid cells also secrete IL-17 and IL-22. Further studies will be needed to clarify the role of these cells in bone remodeling in the context of psoriatic disease. Recent research also strengthened the earlier viewpoint that mechanical stress can serve as a trigger for joint inflammation and arthritis development. Recent findings suggest that inflammation beginning in the skin may become more generalized and involve musculoskeletal structures. Other reports suggest that gut microbiota might have a role in joint inflammatory responses and bone remodeling in psoriatic disease. Successful application of omics approaches and advance imaging studies also revealed many novel aspects of psoriatic diseases and joint-related pathologies which will likely help pinpoint causal genes, pathways, and novel biomarkers in the near future.

SUMMARY

Imaging studies have provided new insights into new bone formation phenotypes in PsA. The IL-23/IL-17 pathway is of central importance in psoriatic bone remodeling where, apart from CD4 T helper cells, other IL-17 and IL-22-secreting innate and adaptive cells may also be involved. Insights from study of the microbiome and from omics technologies will set the stage for new advances in our understanding of bone disorders in psoriatic diseases.

Dermal IL-17-producing γδ T cells establish long-lived memory in the skin

Conventional αβ T cells have the ability to form a long-lasting resident memory T-cell (TRM ) population in nonlymphoid tissues after encountering foreign antigen. Conversely, the concept of 'innate memory', where the ability of nonadaptive branches of the immune system to deliver a rapid, strengthened immune response upon reinfection or rechallenge, is just emerging. Using the αβ T-cell-independent Aldara psoriasis mouse model in combination with genetic fate-mapping and reporter systems, we identified a subset of γδ T cells in mice that is capable of establishing a long-lived memory population in the skin. IL-17A/F-producing Vγ4(+) Vδ4(+) T cells populate and persist in the dermis for long periods of time after initial stimulation with Aldara. Experienced Vγ4(+) Vδ4(+) cells show enhanced effector functions and mediate an exacerbated secondary inflammatory response. In addition to identifying a unique feature of γδ T cells during inflammation, our results have direct relevance to the human disease as this quasi-innate memory provides a mechanistic insight into relapses and chronification of psoriasis.

γδ T cells come to stay: Innate skin memory in the Aldara model

The term immunological memory has long been a trademark restricted to adaptive lymphocytes such as memory B cells and plasma cells as well as memory CD8(+) αβ T cells. In recent years, innate lymphocytes such as NK cells have also been shown to adapt to their environment by antigen-specific expansion and selective survival. However, whether γδ T cells mount comparable memory responses to pathogenic stimuli is less well understood. In this issue of European Journal of Immunology, Hartwig et al. [Eur. J. Immunol. 2015. 45: 3022-3033] identify a subset of IL-17-producing γδ T cells that are capable of establishing long-lived memory in the skin of mice exposed to imiquimod in the Aldara psoriasis model. These γδ T cells uniformly express a Vγ4(+) Vδ4(+) TCR. They produce IL-17A/F and persist in the dermis for long periods of time, also at untreated distal sites. Upon secondary challenge, experienced Vγ4(+) Vδ4(+) cells show enhanced effector functions and mediate exacerbated secondary inflammation. These findings showcase innate γδ T-cell memory that uses a single conserved public TCR combination. Furthermore, they provide mechanistic insight to the observed psoriatic relapses in patients in response to topical treatment with imiquimod.