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Hartmannsberger B, Scriba S, Guidolin C, Becker J, Mehling K, Doppler K, Sommer C, Rittner HL. Transient immune activation without loss of intraepidermal innervation and associated Schwann cells in patients with complex regional pain syndrome. J Neuroinflammation 2024; 21:23. [PMID: 38233858 PMCID: PMC10792943 DOI: 10.1186/s12974-023-02969-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/22/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Complex regional pain syndrome (CRPS) develops after injury and is characterized by disproportionate pain, oedema, and functional loss. CRPS has clinical signs of neuropathy as well as neurogenic inflammation. Here, we asked whether skin biopsies could be used to differentiate the contribution of these two systems to ultimately guide therapy. To this end, the cutaneous sensory system including nerve fibres and the recently described nociceptive Schwann cells as well as the cutaneous immune system were analysed. METHODS We systematically deep-phenotyped CRPS patients and immunolabelled glabrous skin biopsies from the affected ipsilateral and non-affected contralateral finger of 19 acute (< 12 months) and 6 chronic (> 12 months after trauma) CRPS patients as well as 25 sex- and age-matched healthy controls (HC). Murine foot pads harvested one week after sham or chronic constriction injury were immunolabelled to assess intraepidermal Schwann cells. RESULTS Intraepidermal Schwann cells were detected in human skin of the finger-but their density was much lower compared to mice. Acute and chronic CRPS patients suffered from moderate to severe CRPS symptoms and corresponding pain. Most patients had CRPS type I in the warm category. Their cutaneous neuroglial complex was completely unaffected despite sensory plus signs, e.g. allodynia and hyperalgesia. Cutaneous innate sentinel immune cells, e.g. mast cells and Langerhans cells, infiltrated or proliferated ipsilaterally independently of each other-but only in acute CRPS. No additional adaptive immune cells, e.g. T cells and plasma cells, infiltrated the skin. CONCLUSIONS Diagnostic skin punch biopsies could be used to diagnose individual pathophysiology in a very heterogenous disease like acute CRPS to guide tailored treatment in the future. Since numbers of inflammatory cells and pain did not necessarily correlate, more in-depth analysis of individual patients is necessary.
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Affiliation(s)
- Beate Hartmannsberger
- University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Centre for Interdisciplinary Pain Medicine, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University of Würzburg, Oberdürrbacher Strasse 6, 97080, Würzburg, Germany
| | - Sabrina Scriba
- University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Centre for Interdisciplinary Pain Medicine, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University of Würzburg, Oberdürrbacher Strasse 6, 97080, Würzburg, Germany
| | - Carolina Guidolin
- University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Centre for Interdisciplinary Pain Medicine, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University of Würzburg, Oberdürrbacher Strasse 6, 97080, Würzburg, Germany
| | - Juliane Becker
- University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Centre for Interdisciplinary Pain Medicine, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University of Würzburg, Oberdürrbacher Strasse 6, 97080, Würzburg, Germany
| | - Katharina Mehling
- University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Centre for Interdisciplinary Pain Medicine, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University of Würzburg, Oberdürrbacher Strasse 6, 97080, Würzburg, Germany
| | - Kathrin Doppler
- Department of Neurology, University Hospital Würzburg, 97080, Würzburg, Germany
| | - Claudia Sommer
- Department of Neurology, University Hospital Würzburg, 97080, Würzburg, Germany
| | - Heike L Rittner
- University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Centre for Interdisciplinary Pain Medicine, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University of Würzburg, Oberdürrbacher Strasse 6, 97080, Würzburg, Germany.
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2
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Carmona-Rocha E, Puig L. The biological basis of disease recurrence in psoriasis. Ital J Dermatol Venerol 2023; 158:279-291. [PMID: 37404193 DOI: 10.23736/s2784-8671.23.07583-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Despite the amazing advances produced in our understanding of the pathogenesis of psoriasis, which have led to a therapeutic revolution, our knowledge of the mechanisms of relapse and elicitation of lesions is just starting to unravel. This narrative review tours the different cell types and mechanisms involved in the priming, maintenance, and relapse of psoriasis vulgaris. Our discussion includes dendritic cells, T cells, tissue resident memory cells and mast cells, with a foray into the epigenetic mechanisms of inflammatory memory in keratinocytes. Increasing knowledge is providing a glimpse of a potential therapeutic window of opportunity in psoriasis, providing long term remission and eventual modification of the natural history of the disease.
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Affiliation(s)
- Elena Carmona-Rocha
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lluís Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain -
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3
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Chimbetete T, Choshi P, Pedretti S, Porter M, Roberts R, Lehloenya R, Peter J. Skin infiltrating T-cell profile of drug reaction with eosinophilia and systemic symptoms (DRESS) reactions among HIV-infected patients. Front Med (Lausanne) 2023; 10:1118527. [PMID: 37215719 PMCID: PMC10196146 DOI: 10.3389/fmed.2023.1118527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/17/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Drug Reaction with Eosinophilia Systemic Symptoms (DRESS) is more common in persons living with HIV (PLHIV), and first-line anti-TB drugs (FLTDs) and cotrimoxazole are the commonest offending drugs. Limited data is available on the skin infiltrating T-cell profile among DRESS patients with systemic CD4 T-cell depletion associated with HIV. Materials and methods HIV cases with validated DRESS phenotypes (possible, probable, or definite) and confirmed reactions to either one or multiple FLTDs and/or cotrimoxazole were chosen (n = 14). These cases were matched against controls of HIV-negative patients who developed DRESS (n = 5). Immunohistochemistry assays were carried out with the following antibodies: CD3, CD4, CD8, CD45RO and FoxP3. Positive cells were normalized to the number of CD3+ cells present. Results Skin infiltrating T-cells were mainly found in the dermis. Dermal and epidermal CD4+ T-cells (and CD4+/CD8+ ratios) were lower in HIV-positive vs. negative DRESS; p < 0.001 and p = 0.004, respectively; without correlation to whole blood CD4 cell counts. In contrast, no difference in dermal CD4+FoxP3+ T-cells was found in HIV-positive vs. negative DRESS, median (IQR) CD4+FoxP3+ T-cells: [10 (0-30) cells/mm2 vs. 4 (3-8) cells/mm2, p = 0.325]. HIV-positive DRESS patients reacting to more than one drug had no difference in CD8+ T-cell infiltrates, but higher epidermal and dermal CD4+FoxP3+ T-cell infiltrates compared to single drug reactors. Conclusion DRESS, irrespective of HIV status, was associated with an increased skin infiltration of CD8+ T-cells, while CD4+ T-cells were lower in HIV-positive DRESS compared to HIV-negative DRESS skin. While inter-individual variation was high, the frequency of dermal CD4+FoxP3+ T-cells was higher in HIV-positive DRESS cases reacting to more than one drug. Further research is warranted to understand the clinical impact of these changes.
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Affiliation(s)
- Tafadzwa Chimbetete
- Division of Allergy and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Phuti Choshi
- Division of Allergy and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Sarah Pedretti
- Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - Mireille Porter
- Division of Allergy and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Riyaadh Roberts
- Division of Anatomical Pathology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Rannakoe Lehloenya
- Division of Dermatology, Department of Medicine, University of Cape Town, Cape Town, South Africa
- Combined Drug Allergy Clinic, Groote Schuur Hospital, Cape Town, South Africa
| | - Jonathan Peter
- Division of Allergy and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa
- Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa
- Combined Drug Allergy Clinic, Groote Schuur Hospital, Cape Town, South Africa
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4
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Monnot GC, Wegrecki M, Cheng TY, Chen YL, Sallee BN, Chakravarthy R, Karantza IM, Tin SY, Khaleel AE, Monga I, Uwakwe LN, Tillman A, Cheng B, Youssef S, Ng SW, Shahine A, Garcia-Vilas JA, Uhlemann AC, Bordone LA, Han A, Rohde CH, Ogg G, Moody DB, Rossjohn J, de Jong A. Staphylococcal phosphatidylglycerol antigens activate human T cells via CD1a. Nat Immunol 2023; 24:110-122. [PMID: 36550321 PMCID: PMC10389259 DOI: 10.1038/s41590-022-01375-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 10/31/2022] [Indexed: 12/24/2022]
Abstract
Expressed on epidermal Langerhans cells, CD1a presents a range of self-lipid antigens found within the skin; however, the extent to which CD1a presents microbial ligands from bacteria colonizing the skin is unclear. Here we identified CD1a-dependent T cell responses to phosphatidylglycerol (PG), a ubiquitous bacterial membrane phospholipid, as well as to lysylPG, a modified PG, present in several Gram-positive bacteria and highly abundant in Staphylococcus aureus. The crystal structure of the CD1a-PG complex showed that the acyl chains were buried within the A'- and F'-pockets of CD1a, while the phosphoglycerol headgroup remained solvent exposed in the F'-portal and was available for T cell receptor contact. Using lysylPG and PG-loaded CD1a tetramers, we identified T cells in peripheral blood and in skin that respond to these lipids in a dose-dependent manner. Tetramer+CD4+ T cell lines secreted type 2 helper T cell cytokines in response to phosphatidylglycerols as well as to co-cultures of CD1a+ dendritic cells and Staphylococcus bacteria. The expansion in patients with atopic dermatitis of CD4+ CD1a-(lysyl)PG tetramer+ T cells suggests a response to lipids made by bacteria associated with atopic dermatitis and provides a link supporting involvement of PG-based lipid-activated T cells in atopic dermatitis pathogenesis.
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Affiliation(s)
- Gwennaëlle C Monnot
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Marcin Wegrecki
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Tan-Yun Cheng
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yi-Ling Chen
- Medical Research Council Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Brigitte N Sallee
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Reka Chakravarthy
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Ioanna Maria Karantza
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Shin Yi Tin
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Alexandra E Khaleel
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Isha Monga
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Laura N Uwakwe
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Alice Tillman
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
- Microbiome and Pathogen Genomics Core, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Bin Cheng
- Department of Biostatistics, Columbia University Irving Medical Center, New York, NY, USA
| | - Soundos Youssef
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Soo Weei Ng
- Medical Research Council Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Adam Shahine
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Javier A Garcia-Vilas
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Anne-Catrin Uhlemann
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
- Microbiome and Pathogen Genomics Core, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Lindsey A Bordone
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Arnold Han
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Christine H Rohde
- Department of Surgery, Columbia University Irving Medical Center, New York, NY, USA
| | - Graham Ogg
- Medical Research Council Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - D Branch Moody
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jamie Rossjohn
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
- Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Annemieke de Jong
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA.
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5
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Leyva-Castillo JM, Sun L, Wu SY, Rockowitz S, Sliz P, Geha R. Single-cell transcriptome profile of mouse skin undergoing antigen-driven allergic inflammation recapitulates findings in atopic dermatitis skin lesions. J Allergy Clin Immunol 2022; 150:373-384. [PMID: 35300986 PMCID: PMC9378429 DOI: 10.1016/j.jaci.2022.03.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 02/05/2022] [Accepted: 03/03/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Allergic skin inflammation elicited in mice by epicutaneous (EC) sensitization with antigen shares characteristics with human atopic dermatitis (AD). OBJECTIVE We characterized gene expression by single cells in mouse skin undergoing antigen-driven allergic inflammation and compared the results with findings in AD skin lesions. METHODS Mice were EC sensitized by application of ovalbumin (OVA) or saline to tape-stripped skin. Single-cell RNA sequencing was performed on skin cells 12 days later. Flow cytometry analysis was performed to validate results. RESULTS Sequencing identified 7 nonhematopoietic and 6 hematopoietic cell subsets in EC-sensitized mouse skin. OVA sensitization resulted in the expansion in the skin of T cells, dendritic cells, macrophages, mast cells/basophils, fibroblasts, and myocytes cell clusters, and in upregulation of TH2 cytokine gene expression in CD4+ T cells and mast cells/basophils. Genes differentially expressed in OVA-sensitized skin included genes important for inflammation in dendritic cells and macrophages, collagen deposition, and leukocyte migration in fibroblasts, chemotaxis in endothelial cells and skin barrier integrity, and differentiation in KCs-findings that recapitulate those in AD skin lesions. Unexpectedly, mast cells/basophils, rather than T cells, were the major source of Il4 and ll13 in OVA-sensitized mouse skin. In addition, our results suggest novel pathways in fibroblast and endothelial cells that may contribute to allergic skin inflammation. CONCLUSION The gene expression profile of single cells in mouse skin undergoing antigen-driven shares many features with that in AD skin lesions and unveils novel pathways that may be involved in allergic skin inflammation.
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Affiliation(s)
- Juan Manuel Leyva-Castillo
- Division of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA.,Corresponding authors: Juan-Manuel Leyva-Castillo, PhD. Boston Children’s Hospital, Division of Immunology, One Blackfan Circle, Boston, Massachusetts 02115, USA. Phone: 617-919-2465, Fax: 617-730-0528, Raif S. Geha, MD. Boston Children’s Hospital, Division of Immunology, One Blackfan Circle, Boston, Massachusetts 02115, USA. Phone: 617-919-2482, Fax: 617-730-0528,
| | - Liang Sun
- The Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, USA
| | - Shih-Ying Wu
- The Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, USA
| | - Shira Rockowitz
- The Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, USA
| | - Piotr Sliz
- The Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, USA.,Division of Molecular Medicine, Boston Children’s Hospital, Boston, USA
| | - Raif Geha
- Division of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA.,Corresponding authors: Juan-Manuel Leyva-Castillo, PhD. Boston Children’s Hospital, Division of Immunology, One Blackfan Circle, Boston, Massachusetts 02115, USA. Phone: 617-919-2465, Fax: 617-730-0528, Raif S. Geha, MD. Boston Children’s Hospital, Division of Immunology, One Blackfan Circle, Boston, Massachusetts 02115, USA. Phone: 617-919-2482, Fax: 617-730-0528,
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6
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Puig L, Costanzo A, Muñoz‐Elías EJ, Jazra M, Wegner S, Paul C, Conrad C. The biological basis of disease recurrence in psoriasis: a historical perspective and current models. Br J Dermatol 2021; 186:773-781. [PMID: 34939663 PMCID: PMC9374062 DOI: 10.1111/bjd.20963] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 11/23/2021] [Accepted: 12/17/2021] [Indexed: 11/29/2022]
Abstract
A key challenge in psoriasis therapy is the tendency for lesions to recur in previously affected anatomical locations after treatment discontinuation following lesion resolution. Available evidence supports the concept of a localized immunological ‘memory’ that persists in resolved skin after complete disappearance of visible inflammation, as well as the role of a specific subpopulation of T cells characterized by the dermotropic CCR4+ phenotype and forming a local memory. Increasing knowledge of the interleukin (IL)‐23/T helper 17 (Th17) cell pathway in psoriasis immunopathology is pointing away from the historical classification of psoriasis as primarily a Th1‐type disease. Research undertaken from the 1990s to the mid‐2000s provided evidence for the existence of a large population of CD8+ and CD4+ tissue‐resident memory T cells in resolved skin, which can initiate and perpetuate immune responses of psoriasis in the absence of T‐cell recruitment from the blood. Dendritic cells (DCs) are antigen‐presenting cells that contribute to psoriasis pathology via the secretion of IL‐23, the upstream regulator of Th17 cells, while plasmacytoid DCs are involved via IL‐36 signalling and type I interferon activation. Overall, the evidence discussed in this review indicates that IL‐23‐driven/IL‐17‐producing T cells play a critical role in psoriasis pathology and recurrence, making these cytokines logical therapeutic targets. The review also explains the clinical efficacy of IL‐17 and IL‐23 receptor blockers in the treatment of psoriasis.
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Affiliation(s)
- Lluís Puig
- Department of Dermatology Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Antonio Costanzo
- Unit of Dermatology IRCCS Humanitas Research Hospital Rozzano Milan Italy
- Department of Biomedical Sciences Humanitas University Pieve Emanuele Milan Italy
| | - Ernesto J. Muñoz‐Elías
- Department of Immunology ‐ Translational Biology, Biomarkers & Early Development Janssen Research & Development La Jolla CA/Spring House PA USA
| | | | - Sven Wegner
- Medical Affairs, Janssen‐Cilag GmbH Neuss Germany
| | - Carle Paul
- Department of Dermatology Hôpital Larrey, CHU Toulouse Toulouse France
| | - Curdin Conrad
- Department of Dermatology University Hospital CHUV Lausanne Switzerland
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7
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Gadsbøll ASØ, Jee MH, Ahlström MG, Dyring-Andersen B, Woetmann A, Ødum N, Johansen JD, Geisler C, Bonefeld CM. Epidermal T cell subsets-Effect of age and antigen exposure in humans and mice. Contact Dermatitis 2021; 84:375-384. [PMID: 33576047 DOI: 10.1111/cod.13806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Epidermal T cells play a central role in immune surveillance and in inflammatory skin diseases. Major differences in the epidermal T cell composition are found between adult humans and antigen-inexperienced laboratory mice. Whether this is due to inborn species differences, to different environmental exposures, or a combination of the two is a matter of debate. OBJECTIVES To investigate the role of age and exposure to antigens on epidermal T cell subsets in human and mouse skin. METHODS We isolated T cells from the epidermis from 19 infants and 26 adults, and determined the frequency of CD4+ and CD8+ αβ T cells and γδ T cells by flow cytometry. In addition, we determined the epidermal T cell composition in antigen-inexperienced and antigen-experienced mice. RESULTS We found that humans are born with very few epidermal T cells. The number increases and the composition changes with age. In antigen-inexperienced mice, the epidermal T cell composition is unaffected by age, but it is dramatically affected by antigen exposure. CONCLUSION Taken together, we show that antigen exposure, as opposed to age, is the major factor determining the composition of epidermal T cells, suggesting that the skin of antigen-experienced mice better reflects the immunological conditions in human skin.
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Affiliation(s)
- Anne-Sofie Østergaard Gadsbøll
- The LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mia Hamilton Jee
- The LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - Malin Glindvad Ahlström
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - Beatrice Dyring-Andersen
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Hellerup, Denmark
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anders Woetmann
- The LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Ødum
- The LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jeanne Duus Johansen
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - Carsten Geisler
- The LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Menné Bonefeld
- The LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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8
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Otake S, Otsubaki T, Uesato N, Ueda Y, Murayama T, Hayashi M. Topical Application of BMS-509744, a Selective Inhibitor of Interleukin-2-Inducible T Cell Kinase, Ameliorates Imiquimod-Induced Skin Inflammation in Mice. Biol Pharm Bull 2021; 44:528-534. [PMID: 33473072 DOI: 10.1248/bpb.b20-00850] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Psoriasis is an immune disorder-related inflammatory skin disease. Recent studies have suggested a contribution of T cell activation in the pathogenesis of psoriasis. Interleukin-2 (IL-2)-inducible T cell kinase (ITK) regulates T cell activation, including proliferation, and cytokine production. In this study, we investigated the effect of the topically administered selective ITK inhibitor BMS-509744 on imiquimod (IMQ)-induced psoriasis-like skin inflammation in mice. Topically administered BMS-509744 ameliorated IMQ-induced psoriasis-like skin inflammation as shown by decreased skin lesions, epidermal thickening, and cell infiltration into the dermis. These suppressive effects occurred with lower numbers of cluster of differentiation antigen-3+ (CD3+) T cells and T helper subset 17 (Th17)-related cytokine expression in IMQ-treated skin. IMQ-induced upregulation of proinflammatory cytokine expression was also inhibited by topical application of BMS-509744 in IMQ-treated skin. Our report showed for the first time that topical application of BMS-509744 ameliorated psoriasis-like skin inflammation in mice, which is likely mediated by the inhibition of T cell activation in the skin lesions.
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Affiliation(s)
- Sho Otake
- Central Pharmaceutical Research Institute, Japan Tobacco Inc.,Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, Chiba University
| | - Tomoko Otsubaki
- Central Pharmaceutical Research Institute, Japan Tobacco Inc
| | - Naofumi Uesato
- Central Pharmaceutical Research Institute, Japan Tobacco Inc
| | - Yoshifumi Ueda
- Central Pharmaceutical Research Institute, Japan Tobacco Inc
| | - Toshihiko Murayama
- Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, Chiba University
| | - Mikio Hayashi
- Central Pharmaceutical Research Institute, Japan Tobacco Inc
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9
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A novel humanized mouse model to study the function of human cutaneous memory T cells in vivo in human skin. Sci Rep 2020; 10:11164. [PMID: 32636404 PMCID: PMC7341892 DOI: 10.1038/s41598-020-67430-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 06/01/2020] [Indexed: 12/31/2022] Open
Abstract
Human skin contains a population of memory T cells that supports tissue homeostasis and provides protective immunity. The study of human memory T cells is often restricted to in vitro studies and to human PBMC serving as primary cell source. Because the tissue environment impacts the phenotype and function of memory T cells, it is crucial to study these cells within their tissue. Here we utilized immunodeficient NOD-scid IL2rγnull (NSG) mice that carried in vivo-generated engineered human skin (ES). ES was generated from human keratinocytes and fibroblasts and was initially devoid of skin-resident immune cells. Upon adoptive transfer of human PBMC, this reductionist system allowed us to study human T cell recruitment from a circulating pool of T cells into non-inflamed human skin in vivo. Circulating human memory T cells preferentially infiltrated ES and showed diverse functional profiles of T cells found in fresh human skin. The chemokine and cytokine microenvironment of ES closely resembled that of non-inflamed human skin. Upon entering the ES T cells assumed a resident memory T cell-like phenotype in the absence of infection, and a proportion of these cutaneous T cells can be locally activated upon injection of monocyte derived dendritic cells (moDCs) that presented Candida albicans. Interestingly, we found that CD69+ memory T cells produced higher levels of effector cytokines in response to Candida albicans, compared to CD69- T cells. Overall, this model has broad utility in many areas of human skin immunology research, including the study of immune-mediated skin diseases.
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10
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Ghafouri-Fard S, Eghtedarian R, Taheri M, Rakhshan A. The eminent roles of ncRNAs in the pathogenesis of psoriasis. Noncoding RNA Res 2020; 5:99-108. [PMID: 32695942 PMCID: PMC7355384 DOI: 10.1016/j.ncrna.2020.06.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 06/28/2020] [Accepted: 06/28/2020] [Indexed: 12/11/2022] Open
Abstract
Psoriasis is a chronic immune-related disorder in which both genetic and environmental parameters are involved. Recent studies have demonstrated dysregulation of long non-coding RNAs (lncRNAs) and microRNAs (miRNAs) in the peripheral blood or skin lesions of patients with psoriasis. While a number of lncRNAs such as MEG3, AL162231.4 and NONHSAT044111 have been down-regulated in the course of psoriasis, others including PRINS, MIR31HG, RP6‐65G23.1, MSX2P1, SLC6A14-1:1, NR_003062 have been up-regulated. Moreover, expressions of several miRNAs have been dysregulated in this disorder. Among dysregulated miRNAs are miR-126, miR-143, miR-19a and miR-155 whose diagnostic roles in the psoriasis have also been assessed. Dysregulated non-coding RNAs in this disorder participate in the regulation of chemokine signaling pathway and immune response, control of epidermal development and skin barrier as well as modulation of function of certain subsets of T cells. Besides, these transcripts possibly regulate activity of NF-κΒ, mTOR, MAPK and JAK-STAT signaling pathways. Besides, expression levels of circRNAs have been decreased in the psoriasis lesions. Massive alterations in the levels of lncRNAs and miRNAs in the psoriasis lesions or peripheral blood of affected individuals show participation of these transcripts in the pathogenesis of this disorder.
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Affiliation(s)
- Soudeh Ghafouri-Fard
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reyhane Eghtedarian
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Taheri
- Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Rakhshan
- Department of Pathology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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11
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Li B, He S, Liu R, Huang L, Liu G, Wang R, Yang Z, Liu X, Leng Y, Liu D, Ye C, Li Y, Chen Y, Yin H, Fang W. Total glucosides of paeony attenuates animal psoriasis induced inflammatory response through inhibiting STAT1 and STAT3 phosphorylation. JOURNAL OF ETHNOPHARMACOLOGY 2019; 243:112121. [PMID: 31356966 DOI: 10.1016/j.jep.2019.112121] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 07/19/2019] [Accepted: 07/25/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Psoriasis is an immune system meditated disease, especially T cells. It disturbed many people around the world and hard to therapy. Paeonia lactiflora Pall has been used as a medicine in china for thousands of years. Recent studies found that the main component of Paeonia lactiflora Pall can alleviates the immune response in many diseases. In this study, we researched the effects and possible mechanisms of total glucosides of paeony (TGP) on animal psoriasis. AIM OF THE STUDY To study the therapeutic effects and mechanisms of TGP in 5% propranolol cream-induced psoriasis in guinea pigs and Imiquimod (IMQ) cream-induced psoriasis in mice. MATERIALS AND METHODS The effect of TGP was evaluated using a psoriasis-like model of guinea pigs and mice. Ear thickness was accessed, and pathology injury was observed by H&E staining. The levels of serum IL-1β, IL-6, IL-12, IL-17, IL-23, TNF-α, and IFN-γ, skin IL-17A, IL-22 and orphan nuclear receptor (RORγt) mRNA expression, proliferating cell nuclear antigen (PCNA), total or phosphorylated signal transducers and activators of transcription (STAT1, STAT3) were determined by enzyme linked immunosorbent assays (ELISAs), real time PCR, immunohistochemical staining, and western blotting, respectively. RESULTS Compared with model group, TGP treatment decreased the ear thickness, improved pathology of psoriasis, alleviated IMQ-induced keratinocyte proliferation, reduced the inflammatory cytokine, and downregulated IL-17A, IL-22, and RORγt mRNA in mice. Further study indicated that TGP inhibited STAT1 and STAT3 phosphorylation in lesion skins of psoriasis-like mice. CONCLUSIONS TGP alleviates the symptoms of psoriasis-like guinea pigs and mice, and the possible mechanism may relate to inhibit T helper 17 (TH17) cell differentiation and keratinocytes proliferation by inhibiting STAT1 and STAT3 phosphorylation.
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Affiliation(s)
- Binbin Li
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, PR China
| | - Shucheng He
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, PR China
| | - Rui Liu
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, PR China
| | - Liangliang Huang
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, PR China
| | - Ge Liu
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, PR China
| | - Ruixuan Wang
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, PR China
| | - Zhuoyue Yang
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, PR China
| | - Xinyi Liu
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, PR China
| | - Ye Leng
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, PR China
| | - Dan Liu
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, PR China
| | - Chengyu Ye
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, PR China
| | - Yunman Li
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, PR China.
| | - Yongjian Chen
- Ningbo Liwah Pharmaceutical Co, Ningbo, 315174, PR China
| | - Hong Yin
- Ningbo Liwah Pharmaceutical Co, Ningbo, 315174, PR China
| | - Weirong Fang
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, PR China.
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12
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Le ST, Merleev AA, Luxardi G, Shimoda M, Adamopoulos IE, Tsoi LC, Wang JZ, Alexanian C, Raychaudhuri SP, Hwang ST, Gudjonsson J, Marusina AI, Maverakis E. 2D Visualization of the Psoriasis Transcriptome Fails to Support the Existence of Dual-Secreting IL-17A/IL-22 Th17 T Cells. Front Immunol 2019; 10:589. [PMID: 31019502 PMCID: PMC6458264 DOI: 10.3389/fimmu.2019.00589] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 03/05/2019] [Indexed: 12/15/2022] Open
Abstract
The present paradigm of psoriasis pathogenesis revolves around the IL-23/IL-17A axis. Dual-secreting Th17 T cells presumably are the predominant sources of the psoriasis phenotype-driving cytokines, IL-17A and IL-22. We thus conducted a meta-analysis of independently acquired RNA-seq psoriasis datasets to explore the relationship between the expression of IL17A and IL22. This analysis failed to support the existence of dual secreting IL-17A/IL-22 Th17 cells as a major source of these cytokines. However, variable relationships amongst the expression of psoriasis susceptibility genes and of IL17A, IL22, and IL23A were identified. Additionally, to shed light on gene expression relationships in psoriasis, we applied a machine learning nonlinear dimensionality reduction strategy (t-SNE) to display the entire psoriasis transcriptome as a 2-dimensonal image. This analysis revealed a variety of gene clusters, relevant to psoriasis pathophysiology but failed to support a relationship between IL17A and IL22. These results support existing theories on alternative sources of IL-17A and IL-22 in psoriasis such as a Th22 cells and non-T cell populations.
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Affiliation(s)
- Stephanie T. Le
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
| | - Alexander A. Merleev
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
| | - Guillaume Luxardi
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
| | - Michiko Shimoda
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
| | - Iannis E. Adamopoulos
- Division of Rheumatology, Allergy and Clinical Immunology, Department of Internal Medicine, University of California, Davis, Sacramento, CA, United States
| | - Lam C. Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, United States
| | - Jenny Z. Wang
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
- Albert Einstein College of Medicine, Bronx, NY, United States
| | - Claire Alexanian
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
- Georgetown University School of Medicine, Washington, DC, United States
| | - Siba P. Raychaudhuri
- Division of Rheumatology, Allergy and Clinical Immunology, Department of Internal Medicine, University of California, Davis, Sacramento, CA, United States
- Department of Veterans Affairs, VA Sacramento Medical Center, Northern California Health Care System, Mather, CA, United States
| | - Samuel T. Hwang
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
| | - Johann Gudjonsson
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Alina I. Marusina
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
| | - Emanual Maverakis
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
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13
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Wang Y, Edelmayer R, Wetter J, Salte K, Gauvin D, Leys L, Paulsboe S, Su Z, Weinberg I, Namovic M, Gauld SB, Honore P, Scott VE, McGaraughty S. Monocytes/Macrophages play a pathogenic role in IL-23 mediated psoriasis-like skin inflammation. Sci Rep 2019; 9:5310. [PMID: 30926837 PMCID: PMC6441056 DOI: 10.1038/s41598-019-41655-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 03/14/2019] [Indexed: 02/08/2023] Open
Abstract
Psoriasis is an immune-mediated inflammatory skin disease that affects millions worldwide. Studying immune cells involved in psoriasis pathogenesis is essential to identify effective and safe therapeutics for the disease. Using human psoriasis skin, activated macrophages were observed in both lesional and non-lesional skin, but were elevated in lesional skin. Activation of the IL-23/IL-17 pathway is integral to the development of psoriasis. To further characterize the monocyte/macrophage (Mon/Mac) population when the IL-23 pathway is activated, a murine model of intradermal injection of IL-23 was used. Flow cytometry revealed that Mon/Mac cells were the dominant immune population, particularly late in the model, highlighted by strong presence of Ly6ChiMHC IIhi cells. The Mon/Mac cells were also shown to have high expression for TNFα but not IL-17A. Prophylactic dosing of a CSF-1R inhibitor to deplete Mon/Mac cells significantly reduced several inflammatory mediators from the skin tissue suggesting a pathogenic role for Mon/Mac. Treatment dosing of the inhibitor produced a less robust effect. Mon/Mac cells were also differentiated by levels of Ki67 and TNFα expression. These data point to an important contribution of Mon/Mac cells in IL-23 related skin inflammation and suggest that these cells are a significant player in the underlying pathophysiology of psoriasis.
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Affiliation(s)
- Yibing Wang
- Dermatology, AbbVie Inc., 1 North Waukegan Rd., North Chicago, IL, 60064, USA.
| | - Rebecca Edelmayer
- Dermatology, AbbVie Inc., 1 North Waukegan Rd., North Chicago, IL, 60064, USA
| | - Joe Wetter
- Dermatology, AbbVie Inc., 1 North Waukegan Rd., North Chicago, IL, 60064, USA
| | - Katherine Salte
- Dermatology, AbbVie Inc., 1 North Waukegan Rd., North Chicago, IL, 60064, USA
| | - Donna Gauvin
- Dermatology, AbbVie Inc., 1 North Waukegan Rd., North Chicago, IL, 60064, USA
| | - Laura Leys
- Dermatology, AbbVie Inc., 1 North Waukegan Rd., North Chicago, IL, 60064, USA
| | - Stephanie Paulsboe
- Dermatology, AbbVie Inc., 1 North Waukegan Rd., North Chicago, IL, 60064, USA
| | - Zhi Su
- Dermatology, AbbVie Inc., 1 North Waukegan Rd., North Chicago, IL, 60064, USA
| | - Isaac Weinberg
- Dermatology, AbbVie Inc., 1 North Waukegan Rd., North Chicago, IL, 60064, USA
| | - Marian Namovic
- Dermatology, AbbVie Inc., 1 North Waukegan Rd., North Chicago, IL, 60064, USA
| | - Stephen B Gauld
- Dermatology, AbbVie Inc., 1 North Waukegan Rd., North Chicago, IL, 60064, USA
| | - Prisca Honore
- Dermatology, AbbVie Inc., 1 North Waukegan Rd., North Chicago, IL, 60064, USA
| | - Victoria E Scott
- Dermatology, AbbVie Inc., 1 North Waukegan Rd., North Chicago, IL, 60064, USA
| | - Steve McGaraughty
- Dermatology, AbbVie Inc., 1 North Waukegan Rd., North Chicago, IL, 60064, USA
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14
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Calautti E, Avalle L, Poli V. Psoriasis: A STAT3-Centric View. Int J Mol Sci 2018; 19:ijms19010171. [PMID: 29316631 PMCID: PMC5796120 DOI: 10.3390/ijms19010171] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/22/2017] [Accepted: 01/04/2018] [Indexed: 12/24/2022] Open
Abstract
Signal Transducer and Activator of Transcription (STAT)3 has recently emerged as a key player in the development and pathogenesis of psoriasis and psoriatic-like inflammatory conditions. Indeed, STAT3 hyperactivation has been reported in virtually every cell type involved in disease initiation and maintenance, and this factor mediates the signal of most cytokines that are involved in disease pathogenesis, including the central Interleukin (IL)-23/IL-17/IL-22 axis. Despite the recent availability of effective biological agents (monoclonal antibodies) against IL-17 and IL-23, which have radically changed the current standard of disease management, the possibility of targeting either STAT3 itself or, even better, the family of upstream activators Janus kinases (JAK1, 2, 3, and TYK2) offers additional therapeutic options. Due to the oral/topical administration modality of these small molecule drugs, their lower cost, and the reduced risk of eliciting adverse immune responses, these compounds are being actively scrutinized in clinical settings. Here, we summarize the main pathological features of psoriatic conditions that provide the rationale for targeting the JAK/STAT3 axis in disease treatment.
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Affiliation(s)
- Enzo Calautti
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy.
| | - Lidia Avalle
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy.
| | - Valeria Poli
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy.
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15
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Ogawa E, Sato Y, Minagawa A, Okuyama R. Pathogenesis of psoriasis and development of treatment. J Dermatol 2017; 45:264-272. [DOI: 10.1111/1346-8138.14139] [Citation(s) in RCA: 220] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 10/20/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Eisaku Ogawa
- Department of Dermatology; Shinshu University School of Medicine; Matsumoto Japan
| | - Yuki Sato
- Department of Dermatology; Shinshu University School of Medicine; Matsumoto Japan
| | - Akane Minagawa
- Department of Dermatology; Shinshu University School of Medicine; Matsumoto Japan
| | - Ryuhei Okuyama
- Department of Dermatology; Shinshu University School of Medicine; Matsumoto Japan
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16
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Hawkes JE, Chan TC, Krueger JG. Psoriasis pathogenesis and the development of novel targeted immune therapies. J Allergy Clin Immunol 2017; 140:645-653. [PMID: 28887948 DOI: 10.1016/j.jaci.2017.07.004] [Citation(s) in RCA: 598] [Impact Index Per Article: 85.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/14/2017] [Accepted: 07/21/2017] [Indexed: 02/08/2023]
Abstract
Psoriasis is caused by a complex interplay between the immune system, psoriasis-associated susceptibility loci, autoantigens, and multiple environmental factors. Over the last 2 decades, research has unequivocally shown that psoriasis represents a bona fide T cell-mediated disease primarily driven by pathogenic T cells that produce high levels of IL-17 in response to IL-23. The discovery of the central role for the IL-23/type 17 T-cell axis in the development of psoriasis has led to a major paradigm shift in the pathogenic model for this condition. The activation and upregulation of IL-17 in prepsoriatic skin produces a "feed forward" inflammatory response in keratinocytes that is self-amplifying and drives the development of mature psoriatic plaques by inducing epidermal hyperplasia, epidermal cell proliferation, and recruitment of leukocyte subsets into the skin. Clinical trial data for mAbs against IL-17 signaling (secukinumab, ixekizumab, and brodalumab) and newer IL-23p19 antagonists (tildrakizumab, guselkumab, and risankizumab) underscore the central role of these cytokines as predominant drivers of psoriatic disease. Currently, we are witnessing a translational revolution in the treatment and management of psoriasis. Emerging bispecific antibodies offer the potential for even better disease control, whereas small-molecule drugs offer future alternatives to the use of biologics and less costly long-term disease management.
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Affiliation(s)
- Jason E Hawkes
- Laboratory for Investigative Dermatology, Rockefeller University, New York, NY
| | - Tom C Chan
- Laboratory for Investigative Dermatology, Rockefeller University, New York, NY
| | - James G Krueger
- Laboratory for Investigative Dermatology, Rockefeller University, New York, NY.
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17
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Hawkes JE, Gonzalez JA, Krueger JG. Autoimmunity in Psoriasis: Evidence for Specific Autoantigens. CURRENT DERMATOLOGY REPORTS 2017. [DOI: 10.1007/s13671-017-0177-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Structure-Based Drug Designing and Simulation Studies for Finding Novel Inhibitors of Heat Shock Protein (HSP70) as Suppressors for Psoriasis. Interdiscip Sci 2016; 10:271-281. [DOI: 10.1007/s12539-016-0188-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 09/14/2016] [Accepted: 09/18/2016] [Indexed: 10/20/2022]
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19
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Sanin DE, Prendergast CT, Bourke CD, Mountford AP. Helminth Infection and Commensal Microbiota Drive Early IL-10 Production in the Skin by CD4+ T Cells That Are Functionally Suppressive. PLoS Pathog 2015; 11:e1004841. [PMID: 25974019 PMCID: PMC4431738 DOI: 10.1371/journal.ppat.1004841] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 03/30/2015] [Indexed: 12/12/2022] Open
Abstract
The skin provides an important first line of defence and immunological barrier to invasive pathogens, but immune responses must also be regulated to maintain barrier function and ensure tolerance of skin surface commensal organisms. In schistosomiasis-endemic regions, populations can experience repeated percutaneous exposure to schistosome larvae, however little is known about how repeated exposure to pathogens affects immune regulation in the skin. Here, using a murine model of repeated infection with Schistosoma mansoni larvae, we show that the skin infection site becomes rich in regulatory IL-10, whilst in its absence, inflammation, neutrophil recruitment, and local lymphocyte proliferation is increased. Whilst CD4+ T cells are the primary cellular source of regulatory IL-10, they expressed none of the markers conventionally associated with T regulatory (Treg) cells (i.e. FoxP3, Helios, Nrp1, CD223, or CD49b). Nevertheless, these IL-10+ CD4+ T cells in the skin from repeatedly infected mice are functionally suppressive as they reduced proliferation of responsive CD4+ T cells from the skin draining lymph node. Moreover, the skin of infected Rag-/- mice had impaired IL-10 production and increased neutrophil recruitment. Finally, we show that the mechanism behind IL-10 production by CD4+ T cells in the skin is due to a combination of an initial (day 1) response specific to skin commensal bacteria, and then over the following days schistosome-specific CD4+ T cell responses, which together contribute towards limiting inflammation and tissue damage following schistosome infection. We propose CD4+ T cells in the skin that do not express markers of conventional T regulatory cell populations have a significant role in immune regulation after repeated pathogen exposure and speculate that these cells may also help to maintain skin barrier function in the context of repeated percutaneous insult by other skin pathogens. The skin is a major barrier protecting the host from pathogen infection, but is also a site for immune regulation. Using a murine model of repeated percutaneous exposure to infectious Schistosoma mansoni cercariae, we show that, in the skin, CD4+ T cells that do not express markers of conventional regulatory T cells are the main early source of immunoregulatory IL-10 and are functionally suppressive of adaptive immune responses. We demonstrate that the production of regulatory IL-10 in the skin is greatly enhanced after repeated schistosome infection compared to levels present after a single infection and that it limits both neutrophil recruitment and local CD4+ T cell proliferation, thereby preventing excessive inflammation and tissue damage. Initially (day 1), IL-10 producing CD4+ T cells are reactive towards skin commensal bacteria, although over succeeding days they progressively become specific for schistosome antigens. Consequently, our findings highlight a role for early IL-10 produced by dermal CD4+ T cells to mediate immune regulation in advance of later stage chronic infection conventionally associated with the presence of IL-10. Our work provides a mechanistic insight into the triggers of early IL-10 production at barrier sites like the skin, and suggests how tolerance and pathogen clearance might be co-regulated early after exposure to infectious agents.
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Affiliation(s)
- David E. Sanin
- Centre for Immunology and Infection, Department of Biology, University of York, York, United Kingdom
| | - Catriona T. Prendergast
- Centre for Immunology and Infection, Department of Biology, University of York, York, United Kingdom
| | - Claire D. Bourke
- Centre for Immunology and Infection, Department of Biology, University of York, York, United Kingdom
| | - Adrian P. Mountford
- Centre for Immunology and Infection, Department of Biology, University of York, York, United Kingdom
- * E-mail:
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20
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Egbuniwe IU, Karagiannis SN, Nestle FO, Lacy KE. Revisiting the role of B cells in skin immune surveillance. Trends Immunol 2015; 36:102-11. [PMID: 25616715 DOI: 10.1016/j.it.2014.12.006] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 12/18/2014] [Accepted: 12/18/2014] [Indexed: 12/18/2022]
Abstract
Whereas our understanding of the skin immune system has increased exponentially in recent years, the role of B cells in cutaneous immunity remains poorly defined. Recent studies have revealed the presence of B cells within lymphocytic infiltrates in chronic inflammatory skin diseases and cutaneous malignancies including melanoma, and have examined their functional significance in these settings. We review these findings and discuss them in the context of the current understanding of the role of B cells in normal skin physiology, as well as in both animal and human models of skin pathology. We integrate these findings into a model of cutaneous immunity wherein crosstalk between B cells and other skin-resident immune cells plays a central role in skin immune homeostasis.
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Affiliation(s)
- Isioma U Egbuniwe
- Cutaneous Medicine and Immunotherapy Unit, St. John's Institute of Dermatology, Division of Genetics and Molecular Medicine, and National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' Hospitals and King's College London, London SE1 9RT, UK
| | - Sophia N Karagiannis
- Cutaneous Medicine and Immunotherapy Unit, St. John's Institute of Dermatology, Division of Genetics and Molecular Medicine, and National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' Hospitals and King's College London, London SE1 9RT, UK
| | - Frank O Nestle
- Cutaneous Medicine and Immunotherapy Unit, St. John's Institute of Dermatology, Division of Genetics and Molecular Medicine, and National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' Hospitals and King's College London, London SE1 9RT, UK.
| | - Katie E Lacy
- Cutaneous Medicine and Immunotherapy Unit, St. John's Institute of Dermatology, Division of Genetics and Molecular Medicine, and National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' Hospitals and King's College London, London SE1 9RT, UK.
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21
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Kim TG, Kim DS, Kim HP, Lee MG. The pathophysiological role of dendritic cell subsets in psoriasis. BMB Rep 2014; 47:60-8. [PMID: 24411465 PMCID: PMC4163895 DOI: 10.5483/bmbrep.2014.47.2.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Indexed: 12/17/2022] Open
Abstract
Psoriasis is a chronic inflammatory disorder characterized by an erythematous scaly plaque of the skin and is occasionally accompanied by systemic complications. In the psoriatic lesions, an increased number of cytokine-producing dendritic cells and activated T cells are observed, which indicate that psoriasis is a prototype of an immune-mediated dermatosis. During the last decade, emerging studies demonstrate novel roles for the dendritic cell subsets in the process of disease initiation and maintenance of psoriasis. In addition, recently discovered anti-psoriatic therapies, which specifically target inflammatory cytokines produced by lesional dendritic cells, bring much better clinical improvement compared to conventional treatments. These new therapies implicate the crucial importance of dendritic cells in psoriasis pathogenesis. This review will summarize and discuss the dendritic cell subsets of the human skin and their pathophysiological involvement in psoriasis based on mouse- and patient-oriented studies. [BMB Reports 2014; 47(2): 60-68]
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Affiliation(s)
- Tae-Gyun Kim
- Department of Environmental Medical Biology, Institute of Tropical Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea; Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 120-752, Korea
| | - Dae Suk Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul 120-752, Korea
| | - Hyoung-Pyo Kim
- Department of Environmental Medical Biology, Institute of Tropical Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea
| | - Min-Geol Lee
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul 120-752, Korea; Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 120-752, Korea
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22
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Samaka RM, Gaber MA, Metwe NA. Perforin expression in plaque psoriasis: an immunohistochemical study. Ultrastruct Pathol 2014; 39:110-20. [PMID: 25222509 DOI: 10.3109/01913123.2014.952471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Psoriasis (PsO) is T-cell-mediated disease resulting from aberrant activation of both innate and adaptive immunity. Perforin is a multi-domain, pore-forming protein. It is located within the cytoplasm of CD 8 cytotoxic T cells (CTLs) and natural killer cells (NK). The aim of this study was to evaluate the immunohistochemical (IHC) expression of perforin in lesional and perilesional skin of chronic plaque psoriatic patient and correlate its expression with the standard clinico-pathological variables. This prospective case-control study was conducted on 50 PsO patients and 30 age- and gender-matched healthy subjects as a control group. There were high-significant differences between lesional and perilesional skin of plaque PsO patients as regards to IHC perforin status and localization (p < 0.001 for both). There was a high-significant difference between positive and negative perforin cases as regards to psoriasis area severity index (PASI) (p < 0.000). There were significant differences between mild and moderate-to-severe intensity of IHC perforin expression as regards to triggering factors and PASI (p = 0.02 and 0.03, respectively). Localization of IHC perforin positive lymphocytes in both epidermis and dermis was significantly associated with higher degree of acanthosis and higher degree of inflammatory infiltrates in comparison with positive cells located in dermis (p = 0.001 for both). Perforin might have a putative signaling in early and late plaque PsO. Plaque psoriatic patients with positive perforin expression could be a candidate for a future target therapy to stop the proposed scenario and achieve a therapeutic response.
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Guarneri F, Cannavò SP, Minciullo PL, Gangemi S. Pityriasis rosea of Gibert: immunological aspects. J Eur Acad Dermatol Venereol 2014; 29:21-5. [PMID: 25200809 DOI: 10.1111/jdv.12701] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Accepted: 07/17/2014] [Indexed: 01/22/2023]
Abstract
More than 200 years after first description and 150 years after complete definition by Gibert, pityriasis rosea (PR) is still a clinical entity with many obscure aspects. Although great interest was focused on aetiology, studies on immunological mechanisms associated with this disease were rather discontinuous. We present a review of the literature on immunological features of PR, aimed to outline a unified picture of currently available knowledge in this field and create a useful starting point for future research.
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Affiliation(s)
- F Guarneri
- Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Sako N, Schiavon V, Bounfour T, Dessirier V, Ortonne N, Olive D, Ram-Wolff C, Michel L, Sicard H, Marie-Cardine A, Bagot M, Bensussan A, Schmitt C. Membrane expression of NK receptors CD160 and CD158k contributes to delineate a unique CD4+T-lymphocyte subset in normal and mycosis fungoides skin. Cytometry A 2014; 85:869-82. [DOI: 10.1002/cyto.a.22512] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 05/07/2014] [Accepted: 07/03/2014] [Indexed: 01/08/2023]
Affiliation(s)
- Nouhoum Sako
- INSERM; U976, F-75010 Paris France
- Univ Paris Diderot, Sorbonne Paris Cité; UMR-S 976, F-75739 Paris France
| | - Valérie Schiavon
- INSERM; U976, F-75010 Paris France
- Univ Paris Diderot, Sorbonne Paris Cité; UMR-S 976, F-75739 Paris France
| | - Touda Bounfour
- INSERM; U976, F-75010 Paris France
- Univ Paris Diderot, Sorbonne Paris Cité; UMR-S 976, F-75739 Paris France
| | - Valérie Dessirier
- INSERM; U976, F-75010 Paris France
- Univ Paris Diderot, Sorbonne Paris Cité; UMR-S 976, F-75739 Paris France
| | - Nicolas Ortonne
- Department of Pathology; AP-HP, Groupe Hospitalier Henri Mondor-Albert Chenevier, Henri Mondor Hospital; Créteil France
| | - Daniel Olive
- INSERM, UMR 891; Université de la Méditerranée, Institut Paoli Calmettes, Laboratoire d'Immunologie des Tumeurs; Marseille F-13009 France
| | - Caroline Ram-Wolff
- INSERM; U976, F-75010 Paris France
- Univ Paris Diderot, Sorbonne Paris Cité; UMR-S 976, F-75739 Paris France
- Dermatology Department; AP-HP, Hôp Saint Louis; F-75475 Paris France
| | - Laurence Michel
- INSERM; U976, F-75010 Paris France
- Univ Paris Diderot, Sorbonne Paris Cité; UMR-S 976, F-75739 Paris France
| | | | - Anne Marie-Cardine
- INSERM; U976, F-75010 Paris France
- Univ Paris Diderot, Sorbonne Paris Cité; UMR-S 976, F-75739 Paris France
| | - Martine Bagot
- INSERM; U976, F-75010 Paris France
- Univ Paris Diderot, Sorbonne Paris Cité; UMR-S 976, F-75739 Paris France
- Dermatology Department; AP-HP, Hôp Saint Louis; F-75475 Paris France
| | - Armand Bensussan
- INSERM; U976, F-75010 Paris France
- Univ Paris Diderot, Sorbonne Paris Cité; UMR-S 976, F-75739 Paris France
| | - Christian Schmitt
- INSERM; U976, F-75010 Paris France
- Univ Paris Diderot, Sorbonne Paris Cité; UMR-S 976, F-75739 Paris France
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Turner DL, Farber DL. Mucosal resident memory CD4 T cells in protection and immunopathology. Front Immunol 2014; 5:331. [PMID: 25071787 PMCID: PMC4094908 DOI: 10.3389/fimmu.2014.00331] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 06/30/2014] [Indexed: 12/21/2022] Open
Abstract
Tissue-resident memory T cells (TRM) comprise a newly defined subset, which comprises a major component of lymphocyte populations in diverse peripheral tissue sites, including mucosal tissues, barrier surfaces, and in other non-lymphoid and lymphoid sites in humans and mice. Many studies have focused on the role of CD8 TRM in protection; however, there is now accumulating evidence that CD4 TRM predominate in tissue sites, and are integral for in situ protective immunity, particularly in mucosal sites. New evidence suggests that mucosal CD4 TRM populations differentiate at tissue sites following the recruitment of effector T cells by local inflammation or infection. The resulting TRM populations are enriched in T-cell specificities associated with the inducing pathogen/antigen. This compartmentalization of memory T cells at specific tissue sites may provide an optimal design for future vaccination strategies. In addition, emerging evidence suggests that CD4 TRM may also play a role in immunoregulation and immunopathology, and therefore, targeting TRM may be a viable therapeutic approach to treat inflammatory diseases in mucosal sites. This review will summarize our current understanding of CD4 TRM in diverse tissues, with an emphasis on their role in protective immunity and the mechanisms by which these populations are established and maintained in diverse mucosal sites.
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Affiliation(s)
- Damian Lanz Turner
- Columbia Center for Translational Immunology, Columbia University Medical Center , New York, NY , USA ; Department of Medicine, Columbia University Medical Center , New York, NY , USA
| | - Donna L Farber
- Columbia Center for Translational Immunology, Columbia University Medical Center , New York, NY , USA ; Department of Surgery, Columbia University Medical Center , New York, NY , USA ; Department of Microbiology and Immunology, Columbia University Medical Center , New York, NY , USA
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Dermal Clusters of Mature Dendritic Cells and T Cells Are Associated with the CCL20/CCR6 Chemokine System in Chronic Psoriasis. J Invest Dermatol 2014; 134:1462-1465. [DOI: 10.1038/jid.2013.534] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Yang C, Mosam A, Mankahla A, Dlova N, Saavedra A. HIV infection predisposes skin to toxic epidermal necrolysis via depletion of skin-directed CD4⁺ T cells. J Am Acad Dermatol 2014; 70:1096-102. [PMID: 24629995 DOI: 10.1016/j.jaad.2013.12.025] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 12/16/2013] [Accepted: 12/18/2013] [Indexed: 01/17/2023]
Abstract
BACKGROUND A greater incidence of adverse cutaneous drug eruptions, including toxic epidermal necrolysis (TEN), occurs among HIV-infected patients. OBJECTIVE We sought to determine if immunophenotypical differences exist in the inflammatory infiltrates of TEN lesions from HIV-infected individuals versus noninfected individuals. METHODS The inflammatory infiltrates in 12 cases of TEN from HIV-positive patients were characterized and compared with the infiltrates present in 12 cases of TEN from HIV-negative patients. RESULTS TEN infiltrates consisted of CD3, CD4, and CD8 immunoreactive T lymphocytes in both the dermis and epidermis. HIV infection was associated with an 8-fold increase in the ratio of CD8(+) to CD4(+) T cells infiltrating the dermis (P = .006) and a decrease in the number of dermal CD4(+) cells (P = .044). There was also a significant decrease in the ratio of CD25(+) to CD4(+) cells in the epidermis of HIV-infected skin (P = .011). LIMITATIONS This study is limited by small sample sizes. CONCLUSION A decrease in the number of skin-directed CD4(+) cells and an increase in the ratio of CD8(+) to CD4(+) cells exists in TEN lesions among HIV-infected individuals and likely contribute to an increased risk of developing drug reactions because of the loss of skin-protective CD4(+)CD25(+) regulatory T cells.
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Affiliation(s)
- Chao Yang
- Department of Dermatology at Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Anisa Mosam
- Department of Dermatology, Nelson R. Mandela School of Medicine, Durban, South Africa
| | - Avumile Mankahla
- Department of Dermatology, Nelson R. Mandela School of Medicine, Durban, South Africa
| | - Ncoza Dlova
- Department of Dermatology, Nelson R. Mandela School of Medicine, Durban, South Africa
| | - Arturo Saavedra
- Department of Dermatology at Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
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CXCL16 and CXCR6 Are Upregulated in Psoriasis and Mediate Cutaneous Recruitment of Human CD8+ T Cells. J Invest Dermatol 2012; 132:626-34. [DOI: 10.1038/jid.2011.371] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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30
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Huss DJ, Winger RC, Cox GM, Guerau-de-Arellano M, Yang Y, Racke MK, Lovett-Racke AE. TGF-β signaling via Smad4 drives IL-10 production in effector Th1 cells and reduces T-cell trafficking in EAE. Eur J Immunol 2011; 41:2987-96. [PMID: 21728174 DOI: 10.1002/eji.201141666] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 05/31/2011] [Accepted: 06/24/2011] [Indexed: 12/15/2022]
Abstract
Effector Th1 cells perpetuate inflammatory damage in a number of autoimmune diseases, including MS and its animal model EAE. Recently, a self-regulatory mechanism was described in which effector Th1 cells produce the immunomodulatory cytokine IL-10 to dampen the inflammatory response in both normal and autoimmune inflammation. While the presence of TGF-β has been suggested to enhance and stabilize an IFN-γ(+) IL-10(+) phenotype, the molecular mechanism is poorly understood. Additionally, in the context of adoptive transfer EAE, it is unclear whether IL-10 acts on the transferred Th1 cells or on endogenous host cells. In the present study, using myelin-specific TCR-Tg mice, we show that repetitive Ag stimulation of effector Th1 cells in the presence of TGF-β increases the population of IFN-γ(+) IL-10(+) cells, which correlates with a decrease in EAE severity. Additionally, TGF-β signaling causes binding of Smad4 to the IL-10 promoter, providing molecular evidence for TGF-β-mediated IL-10 production from Th1 effector cells. Finally, this study demonstrates that IL-10 not only reduces encephalitogenic markers such as IFN-γ and T-bet on Th1 effector cells expressing the IL-10R but also prevents recruitment of both transferred and host-derived inflammatory T cells. These data establish a regulatory mechanism by which highly activated Th1 effector cells modulate their pathogenicity through the induction of IL-10.
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Affiliation(s)
- David J Huss
- Department of Molecular Virology, Immunology, and Medical Genetics, The Ohio State University Medical Center, Columbus, OH, USA
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Res PCM, Piskin G, de Boer OJ, van der Loos CM, Teeling P, Bos JD, Teunissen MBM. Overrepresentation of IL-17A and IL-22 producing CD8 T cells in lesional skin suggests their involvement in the pathogenesis of psoriasis. PLoS One 2010; 5:e14108. [PMID: 21124836 PMCID: PMC2991333 DOI: 10.1371/journal.pone.0014108] [Citation(s) in RCA: 237] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Accepted: 10/19/2010] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Although recent studies indicate a crucial role for IL-17A and IL-22 producing T cells in the pathogenesis of psoriasis, limited information is available on their frequency and heterogeneity and their distribution in skin in situ. METHODOLOGY/PRINCIPAL FINDINGS By spectral imaging analysis of double-stained skin sections we demonstrated that IL-17 was mainly expressed by mast cells and neutrophils and IL-22 by macrophages and dendritic cells. Only an occasional IL-17(pos), but no IL-22(pos) T cell could be detected in psoriatic skin, whereas neither of these cytokines was expressed by T cells in normal skin. However, examination of in vitro-activated T cells by flow cytometry revealed that substantial percentages of skin-derived CD4 and CD8 T cells were able to produce IL-17A alone or together with IL-22 (i.e. Th17 and Tc17, respectively) or to produce IL-22 in absence of IL-17A and IFN-γ (i.e. Th22 and Tc22, respectively). Remarkably, a significant proportional rise in Tc17 and Tc22 cells, but not in Th17 and Th22 cells, was found in T cells isolated from psoriatic versus normal skin. Interestingly, we found IL-22 single-producers in many skin-derived IL-17A(pos) CD4 and CD8 T cell clones, suggesting that in vivo IL-22 single-producers may arise from IL-17A(pos) T cells as well. CONCLUSIONS/SIGNIFICANCE The increased presence of Tc17 and Tc22 cells in lesional psoriatic skin suggests that these types of CD8 T cells play a significant role in the pathogenesis of psoriasis. As part of the skin-derived IL-17A(pos) CD4 and CD8 T clones developed into IL-22 single-producers, this demonstrates plasticity in their cytokine production profile and suggests a developmental relationship between Th17 and Th22 cells and between Tc17 and Tc22 cells.
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Affiliation(s)
- Pieter C. M. Res
- Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Gamze Piskin
- Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Onno J. de Boer
- Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Chris M. van der Loos
- Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter Teeling
- Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan D. Bos
- Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Marcel B. M. Teunissen
- Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Trimble CL, Clark RA, Thoburn C, Hanson NC, Tassello J, Frosina D, Kos F, Teague J, Jiang Y, Barat NC, Jungbluth AA. Human papillomavirus 16-associated cervical intraepithelial neoplasia in humans excludes CD8 T cells from dysplastic epithelium. THE JOURNAL OF IMMUNOLOGY 2010; 185:7107-14. [PMID: 21037100 DOI: 10.4049/jimmunol.1002756] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
High-grade cervical dysplasia caused by human papillomavirus (HPV) type 16 is a lesion that should be susceptible to an HPV-specific immune response; disease initiation and persistence is predicated on expression of two viral Ags, E6 and E7. In immune-competent subjects, at least 25% of HPV16(+) high-grade cervical dysplasia lesions undergo complete regression. However, in the peripheral blood, naturally occurring IFN-γ T cell responses to HPV E6 and E7 are weak, requiring ex vivo sensitization to detect, and are not sufficiently sensitive to predict regression. In this study, we present immunologic data directly assessing cervical lymphocytes from this cohort. We found that nearly all cervical tissue T cells express the mucosal homing receptor, α(4)β(7) surface integrin. T cells isolated from dysplastic mucosa were skewed toward a central memory phenotype compared with normal mucosal resident T cells, and dysplastic lesions expressed transcripts for CCL19 and CCL21, raising the possibility that the tissue itself sustains a response that is not detectable in the blood. Moreover, lesion regression in the study window could retrospectively be predicted at study entry by the ability of CD8(+) T cells to gain access to lesional epithelium. Vascular endothelial expression of mucosal addressin cell adhesion molecule-1, the ligand that supports entry of α(4)β(7)(+) T cells into tissues, colocalized tightly with the distribution of CD8 T cells and was not expressed in persistent dysplastic epithelium. These findings suggest that dysregulated expression of vascular adhesion molecules plays a role in immune evasion very early in the course of HPV disease.
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Affiliation(s)
- Cornelia L Trimble
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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Zhu K, Ye J, Wu M, Cheng H. Expression of Th1 and Th2 cytokine-associated transcription factors, T-bet and GATA-3, in peripheral blood mononuclear cells and skin lesions of patients with psoriasis vulgaris. Arch Dermatol Res 2010; 302:517-23. [DOI: 10.1007/s00403-010-1048-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 03/08/2010] [Accepted: 03/11/2010] [Indexed: 11/29/2022]
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Abstract
The cutaneous surface of a normal adult individual contains approximately 20 billion T cells, nearly twice the number present in the entire circulation. Recent studies have shown a role for these cells in both normal immunity and in inflammatory skin diseases such as psoriasis. Regulatory T cells protect against autoimmune reactions to self antigens and assist in the resolution of cutaneous inflammation. However, they can also shield tumors from immune detection, allow latent infections to persist and can dysfunction under the conditions present in inflammatory skin diseases. Th17 T cells protect organisms against extracellular pathogens but also have a key role in the pathogenesis of psoriasis. Evidence suggests that effector memory T cells produced during immune reactions survive and persist long term within the skin, providing local and rapid protection against pathogen reexposure. This review summarizes the current understanding of how skin-resident T cells contribute to normal and aberrant immunity in the skin.
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Affiliation(s)
- Rachael A Clark
- Department of Dermatology, Harvard Skin Disease Research Center, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
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Rutter KJ, Watson RE, Cotterell LF, Brenn T, Griffiths CE, Rhodes LE. Severely Photosensitive Psoriasis: A Phenotypically Defined Patient Subset. J Invest Dermatol 2009; 129:2861-7. [DOI: 10.1038/jid.2009.156] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Vissers WHPM, van Duijnhoven M, van Erp PEJ, de Jong EMGJ, van de Kerkhof PCM. The effect of alefacept on T‐cell subsets and cells expressing NK receptors in lesional psoriatic skin: The effects of monotherapy and combination treatment with calcipotriol. J DERMATOL TREAT 2009; 19:344-50. [DOI: 10.1080/09546630802050472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hastrup N, Pallesen G, Ralfikiaer E. Use of Monoclonal Antibodies for the Diagnosis of T-cell Malignancies: Applications and Limitations. Leuk Lymphoma 2009; 2:35-45. [DOI: 10.3109/10428199009042512] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
Abnormal production of inflammatory mediators is believed to play an important role in the pathogenesis of psoriasis. Emerging data, both in mice and in humans, put the spotlight on a new subset of T helper (Th) cells, in part characterized by their production of IL-17 and accordingly named Th17 cells. Here, we review the development, characterization, and function of human Th17 cells as well as the crucial role of IL-23 in the context of Th17-cell-dependent chronic inflammation in psoriasis. We further discuss recent clinical trials targeting the IL-23/Th17 axis in psoriasis.
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Abstract
Alefacept is the first biologic agent approved by the US Food and Drug Administration for the treatment of psoriasis. To date, more than 1000 patients with moderate to severe psoriasis have been enrolled in phase III clinical trials of alefacept. More than 30% of patients treated with 2 courses of alefacept reached a Physician's Global Assessment of clear to almost clear, and approximately 40% and 70% of patients achieved a Psoriasis Area Severity Index score of 75 and 50 after the same regimen. Alefacept is well tolerated, and there have been no reports of significant systemic toxicity or serious treatment-related adverse events.
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Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a complex pathogenesis. It is clinically well-defined and represents one manifestation of the atopic state, along with asthma, food allergy and/or allergic rhinitis. Within the last several decades, there has been much evidence to support the contribution of immune mechanisms in the pathogenesis of AD. It has also been documented that the prevalence of all atopic disease, including AD, has been increasing, although the environmental factors that may be contributing to this increase are not clearly defined. A better understanding of the underlying immunopathogenesis of AD should aid in better clinical management and development of new treatment options.
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Affiliation(s)
- Elif Dokmeci
- Department of Pediatrics, Section of Immunobiology, Yale University School of Medicine, New Haven, CT 06520, USA.
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41
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Guttman-Yassky E, Lowes MA, Fuentes-Duculan J, Zaba LC, Cardinale I, Nograles KE, Khatcherian A, Novitskaya I, Carucci JA, Bergman R, Krueger JG. Low expression of the IL-23/Th17 pathway in atopic dermatitis compared to psoriasis. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2008; 181:7420-7. [PMID: 18981165 PMCID: PMC3470474 DOI: 10.4049/jimmunol.181.10.7420] [Citation(s) in RCA: 268] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The classical Th1/Th2 paradigm previously defining atopic dermatitis (AD) and psoriasis has recently been challenged with the discovery of Th17 T cells that synthesize IL-17 and IL-22. Although it is becoming evident that many Th1 diseases including psoriasis have a strong IL-17 signal, the importance of Th17 T cells in AD is still unclear. We examined and compared skin biopsies from AD and psoriasis patients by gene microarray, RT-PCR, immunohistochemistry, and immunofluorescence. We found a reduced genomic expression of IL-23, IL-17, and IFN-gamma in AD compared with psoriasis. To define the effects of IL-17 and IL-22 on keratinocytes, we performed gene array studies with cytokine-treated keratinocytes. We found lipocalin 2 and numerous other innate defense genes to be selectively induced in keratinocytes by IL-17. IFN-gamma had no effect on antimicrobial gene-expression in keratinocytes. In AD skin lesions, protein and mRNA expression of lipocalin 2 and other innate defense genes (hBD2, elafin, LL37) were reduced compared with psoriasis. Although AD has been framed by the Th1/Th2 paradigm as a Th2 polar disease, we present evidence that the IL-23/Th17 axis is largely absent, perhaps accounting for recurrent skin infections in this disease.
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Affiliation(s)
- Emma Guttman-Yassky
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY 10021
| | - Michelle A. Lowes
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY 10021
| | | | | | - Irma Cardinale
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY 10021
| | - Kristine E. Nograles
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY 10021
| | - Artemis Khatcherian
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY 10021
| | - Inna Novitskaya
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY 10021
| | - John A. Carucci
- The Section of Mohs Micrographic and Dermatologic Surgery, Weill-Cornell Medical College of Cornell, New York
| | - Reuven Bergman
- Department of Dermatology, Rambam Medical Center and the Technion, Haifa, Israel
| | - James G. Krueger
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY 10021
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Phenotypical characteristics of the immune cells in allergic contact dermatitis, atopic dermatitis and pityriasis rosea. Pathol Oncol Res 2008; 15:73-9. [PMID: 18798012 DOI: 10.1007/s12253-008-9103-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2008] [Accepted: 09/02/2008] [Indexed: 10/21/2022]
Abstract
Allergic contact dermatitis (ACD) is a cell-mediated, delayed type IV immunologic reaction. Atopic dermatitis (AD) is a chronic inflammatory skin disease that results from a complex interaction between immunologic, genetic, and environmental factors. Pityriasis rosea (PR) is a self-limited eruption of unknown etiology. Immune cell infiltrate is a constant feature in the inflammatory skin diseases. Here, we performed phenotypical characterization of the immune cells in ACD, AD and PR (ten cases each). We performed immunohistochemical stains for B cells (CD20), T cells (CD3), histiocytes (CD68) and T cells with cytotoxic activity (granzyme-B). The data were compared with findings in 20 specimens of normal skin. The results were scored as mean values of positively stained immune cells. Immunohistochemistry showed significantly high counts of immune cells in lesional skin (ACD, AD and PR) compared to the normal one (p < 0.05). In the lesional skin, the immune cells were composed predominantly of CD3(+) T lymphocytes and CD68(+) cells (histiocytes). Some of the CD3(+) cells were granzyme B(+). The counts of some immune cells (CD3(+) and CD68(+)) were high in ACD compared to AD and PR. The counts of CD20(+) and granzyme B(+) cells were high in PR compared to ACD and AD. However, these differences did not reach the level of statistical significance. The present data describe the profile of the immune cell infiltrate in AD, ACD and PR. The cell-mediated immunity seems to have critical role in the development of these lesions.
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Abstract
Psoriasis is a common chronic skin disease. Its pathogenesis has intensively been investigated in the last 3 decades. In the 1970s, the observed increased proliferation of keratinocytes and their altered differentiation were considered to be the most important signs and causes of psoriatic skin lesions. Since the early 1980s, T cells slid into the focus of psoriasis research. It was then postulated that a subpopulation of T cells, so-called T1 cells, and their prominent cytokine interferon-gamma, had a dominant role in the pathogenesis of psoriasis. In the last decade, new data regarding macrophages and dendritic cells and the high therapeutic success of anti-tumor necrosis factor alpha biologics led to the assumption that antigen-presenting cells are important not only in the induction of psoriasis but also in its maintenance. The knowledge gained over the past 3 decades let us postulate that psoriasis is an immunologically induced, overshot, regeneration-like reaction of the skin in which various cells play a dominant role at different stages. This hypothesis is also supported by the very recent discoveries about interleukin (IL)-22, IL-20, and IL-23.
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Eyerich K, Huss-Marp J, Darsow U, Wollenberg A, Foerster S, Ring J, Behrendt H, Traidl-Hoffmann C. Pollen Grains Induce a Rapid and Biphasic Eczematous Immune Response in Atopic Eczema Patients. Int Arch Allergy Immunol 2007; 145:213-23. [PMID: 17914273 DOI: 10.1159/000109290] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2006] [Accepted: 07/04/2007] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Eczematous reactions to type I allergy-inducing antigens are documented in a subgroup of patients with atopic eczema. Yet, the underlying immunological mechanisms are not well understood. MATERIAL AND METHODS To delineate the effect of native pollen grains on human skin of healthy and atopic individuals we performed patch tests (atopy patch test with native pollen grains, PPT). Nickel patch tests (NPT) served as an established model of contact dermatitis. Skin site biopsies were taken 6-96 h after allergen application and investigated immunohistochemically. RESULTS Histology of positive patch tests showed an influx of mononuclear cells (predominantly CD4+, CD25+, CD45RO+). This influx was detected earlier in the PPT reaction than in the immune response to nickel. A biphasic cytokine response could be detected in the PPT: IL-5 dominated in the early, IFN-gamma in the late phase. The NPT was continuously dominated by IFN-gamma. Dendritic cell subpopulations imitated the earlier kinetics of the mononuclear infiltrate. DISCUSSION Thus, pollen grains induce eczematous reactions in susceptible individuals. This reaction appears clinically and immunohistochemically similar to the contact hypersensitivity reaction to nickel but follows a faster kinetic and a biphasic course: Th2 and IgE in the early (24 h) and Th1 predominance in the late (96 h) phase.
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Affiliation(s)
- Kilian Eyerich
- Division of Environmental Dermatology and Allergy GSF, ZAUM-Center for Allergy and Environment, Technical University, Munich, Germany
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Sabat R, Philipp S, Höflich C, Kreutzer S, Wallace E, Asadullah K, Volk HD, Sterry W, Wolk K. Immunopathogenesis of psoriasis. Exp Dermatol 2007; 16:779-98. [PMID: 17845210 DOI: 10.1111/j.1600-0625.2007.00629.x] [Citation(s) in RCA: 232] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Psoriasis is a chronic skin disease that affects about 1.5% of the Caucasian population and is characterized by typical macroscopic and microscopic skin alterations. Psoriatic lesions are sharply demarcated, red and slightly raised lesions with silver-whitish scales. The microscopic alterations of psoriatic plaques include an infiltration of immune cells in the dermis and epidermis, a dilatation and an increase in the number of blood vessels in the upper dermis, and a massively thickened epidermis with atypical keratinocyte differentiation. It is considered a fact that the immune system plays an important role in the pathogenesis of psoriasis. Since the early 1990s, it has been assumed that T1 cells play the dominant role in the initiation and maintenance of psoriasis. However, the profound success of anti-tumor necrosis factor-alpha therapy, when compared with T-cell depletion therapies, should provoke us to critically re-evaluate the current hypothesis for psoriasis pathogenesis. Recently made discoveries regarding other T-cell populations such as Th17 and regulatory T cells, dendritic cells, macrophages, the keratinocyte signal transduction and novel cytokines including interleukin (IL)-22, IL-23 and IL-20, let us postulate that the pathogenesis of psoriasis consists of distinct subsequent stages, in each of them different cell types playing a dominant role. Our model helps to explain the varied effectiveness of the currently tested immune modulating therapies and may enable the prediction of the success of future therapies.
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Affiliation(s)
- Robert Sabat
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, University Hospital Charité, Berlin, Germany.
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Abstract
Psoriasis comprises a host of abnormalities, and various aspects of the pathogenesis of psoriasis have been suggested to be of primary relevance. The aim of this review is to identity driving factors in the pathogenesis of psoriasis and to explore the dynamics of processes eventually resulting in a psoriatic lesion. In this review observations on the evolution from the symptomless skin to lesional skin in patients with psoriasis will be integrated with observations in various animal models of psoriasis.
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Affiliation(s)
- P C M van de Kerkhof
- Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Gottlieb AB, Cooper KD, McCormick TS, Toichi E, Everitt DE, Frederick B, Zhu Y, Pendley CE, Graham MA, Mascelli MA. A phase 1, double-blind, placebo-controlled study evaluating single subcutaneous administrations of a human interleukin-12/23 monoclonal antibody in subjects with plaque psoriasis. Curr Med Res Opin 2007; 23:1081-92. [PMID: 17519075 DOI: 10.1185/030079907x182112] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate safety, pharmacokinetics, pharmacodynamics, and clinical response of single subcutaneous (s.c.) administrations of a human monoclonal antibody against the p40 subunit of IL-12/23 (IL-12/23 mAb) in subjects with moderate-to-severe psoriasis. METHODS Twenty-one subjects were enrolled sequentially into 4 dose cohorts (0.27, 0.675, 1.35, and 2.7 mg/kg) and randomized to IL-12/23 mAb or placebo in a 4:1 ratio. Laboratory/clinical parameters and pharmacokinetics were evaluated through Week 24; mRNA cytokine expression was measured in psoriatic plaques at Week 1. RESULTS Mostly mild adverse events and no serious adverse events were reported. The pharmacokinetics (Cmax and AUC) of IL-12/23 mAb increased in an approximately dose-proportional manner. Of the 17 subjects who received IL-12/23 mAb, 13 achieved PASI 75 (compared with no placebo subjects). mRNA expression of IL-8, IL-18, and IFN-gamma in psoriatic plaques decreased in subjects with sustained Psoriasis Area and Severity Index (PASI) improvement. LIMITATIONS Interpretation of results is limited due to the small sample size in each dose cohort. CONCLUSION A single s.c. administration of IL-12/23 mAb was well tolerated and showed clinical response in subjects with moderate-to-severe psoriasis.
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Affiliation(s)
- Alice B Gottlieb
- Department of Dermatology, Tufts-New England Medical Center, Boston, MA 02111, USA.
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Vestergaard C, Deleuran M, Kragballe K. Two cases of atopic dermatitis-like conditions induced in psoriasis patients treated with infliximab. J Eur Acad Dermatol Venereol 2007; 21:1272-4. [PMID: 17894730 DOI: 10.1111/j.1468-3083.2007.02165.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Philipp S, Wolk K, Kreutzer S, Wallace E, Ludwig N, Roewert J, Höflich C, Volk HD, Sterry W, Sabat R. The evaluation of psoriasis therapy with biologics leads to a revision of the current view of the pathogenesis of this disorder. Expert Opin Ther Targets 2007; 10:817-31. [PMID: 17105370 DOI: 10.1517/14728222.10.6.817] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Psoriasis is a common chronic, recurring skin disease that is characterised by typical macroscopic and microscopic skin alterations. It is widely accepted that the immune system plays an important role in the pathogenesis of this disorder. Since the early 1990s, the dominant role of a subpopulation of T cells, so-called T1 cells, and their prominent cytokine IFN-gamma has been assumed in the pathogenesis of psoriasis. Surprisingly, the comparison of the therapeutic success of treatments with recombinant proteins directed against defined immunological structures shows that those that directly affect T cells (alefacept, efalizumab, Hu-max-CD4, OKTcdr4a) were clearly less effective than those targeting TNF-alpha (etanercept, adalimumab, infliximab). For this reason, the authors critically re-evaluated the view of psoriasis pathogenesis and postulate that in the majority of patients the T1 cells do not play a dominant role in the clinical, visible stage of this disease.
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Affiliation(s)
- Sandra Philipp
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, University Hospital Charité, Charitéplatz 1, D-10117 Berlin, Germany
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50
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Abstract
Psoriasis is a common inflammatory skin disease characterized by infiltration of inflammatory cells into the epidermis and altered keratinocyte differentiation. Psoriasis is currently thought of as a T-cell mediated 'Type-1' autoimmune disease. Gene expression changes in psoriasis lesions have been well documented, and strongly support an important role for tumor necrosis factor and interferon gamma signal pathways in its pathogenesis. The strongest genetic determinant of psoriasis identified to date lies within the class I region of the multiple histocompatibility locus antigen cluster, although its low penetrance implicates a requirement for other genetic risk factors. Multiple genome-wide linkage and an increasing number of association studies have been carried out, leading to multiple linkage peaks, and the identification of potential low risk variants. A number of these variants lie within genes encoding components of the immune system. However, the functional relationships between predisposing genetic variation is unclear, and presumably involves genetic susceptibility factors affecting both immune cell activation and keratinocyte differentiation. The interaction of environmental trigger factors with genetic effects is also not understood, but provide further evidence for the complex basis of this disease.
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Affiliation(s)
- Y Liu
- Department of Genetics, Washington University School of Medicine, St Louis, MO 63110, USA
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