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Gavrilita E, Silion SI, Bitca ML, Tatu AL. Insights into Intrinsic Atopic Dermatitis: immunogenicity, Dysbiosis, and Imaging (Reflectance Confocal Microscopy, Optical Coherence Tomography). Clin Cosmet Investig Dermatol 2024; 17:1377-1386. [PMID: 38881699 PMCID: PMC11179656 DOI: 10.2147/ccid.s459096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/18/2024] [Indexed: 06/18/2024]
Abstract
Atopic dermatitis (AD) is a frequent inflammatory condition that usually begins during early childhood, but it increasingly starts to debut, even in the elderly. Based on immunoglobulin E (IgE) levels and clinical features, two subsets of this disease have been recognized: intrinsic and extrinsic. When speaking about AD, most specialists think about filaggrin (FLG) mutations resulting in epidermal barrier defects, which is the case in most atopic patients, but some have a normal barrier, as seen by imaging, and still have specific clinical lesions along with metal allergies. Specific molecules (IL-10, IFN-γ, and HBD-3) have been shown to greatly impact the interactions between internal and external factors in this peculiar form of AD. A less-known protein, suprabasin, has been highlighted as a promising explanation for nickel anomalies in intrinsic AD.
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Affiliation(s)
- Elena Gavrilita
- Dermatology Department, "Sf. Cuvioasa Parascheva" Clinical Hospital of Infectious Diseases, Galați, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR, "Dunărea de Jos" University, Galați, Romania
| | - Simona Ioana Silion
- Dermatology Department, "Sf. Cuvioasa Parascheva" Clinical Hospital of Infectious Diseases, Galați, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR, "Dunărea de Jos" University, Galați, Romania
| | - Miruna Lorelei Bitca
- Dermatology Department, "Sf. Cuvioasa Parascheva" Clinical Hospital of Infectious Diseases, Galați, Romania
| | - Alin Laurentiu Tatu
- Dermatology Department, "Sf. Cuvioasa Parascheva" Clinical Hospital of Infectious Diseases, Galați, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR, "Dunărea de Jos" University, Galați, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
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Suzuki T, Kondo S, Ogura Y, Otsuka M, Tokura Y. How Do Classical Subtypes Correspond to Endotypes in Atopic Dermatitis? Int J Mol Sci 2023; 25:265. [PMID: 38203432 PMCID: PMC10779290 DOI: 10.3390/ijms25010265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Since atopic dermatitis (AD) is a heterogeneous condition, the subtyping of AD is a crucial issue. The classical subtypes of AD are represented by extrinsic and intrinsic subtypes, European-American and Asian subtypes, and adult and pediatric subtypes. While the subtyping of AD was historically conducted based on the phenotype, recent findings on the mechanisms of AD have revealed the importance of the endotype, which can characterize individual patients more accurately. Considering the current development of AD therapies, AD endotyping is a prerequisite for a personalized therapeutic choice. Endotypes of AD can be stratified from different viewpoints, including cytokine expression patterns, allergen properties, epidermal barrier conditions, ceramide variation, the involvement of innate immunity, and serum biomarkers. Among them, the cytokine-based endotype seems to be the most useful one and is categorized into type 2 cytokine (IL-4, IL-13 and IL-31)-high, type 1 cytokine (IFN-γ)-high, and/or type 3 cytokine (IL-22 and IL-17)-high, or mixed subtypes. Recently proposed biomarker endotyping aims at individualized treatment options, although the daily clinical use of endotypes is a future issue. To better understand the endotypes for clinicians, attempts to adjust each of the classical subtypes to endotypes are required. This review will discuss the correspondence of the classical subtypes to the various endotypes that have recently been proposed.
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Affiliation(s)
- Tsuyoshi Suzuki
- Department of Dermatology & Skin Oncology, Chutoen General Medical Center, 1-1 Shobugaike, Kakegawa 436-8555, Japan; (T.S.); (S.K.); (Y.O.); (M.O.)
| | - Shumpei Kondo
- Department of Dermatology & Skin Oncology, Chutoen General Medical Center, 1-1 Shobugaike, Kakegawa 436-8555, Japan; (T.S.); (S.K.); (Y.O.); (M.O.)
| | - Yasuaki Ogura
- Department of Dermatology & Skin Oncology, Chutoen General Medical Center, 1-1 Shobugaike, Kakegawa 436-8555, Japan; (T.S.); (S.K.); (Y.O.); (M.O.)
| | - Masaki Otsuka
- Department of Dermatology & Skin Oncology, Chutoen General Medical Center, 1-1 Shobugaike, Kakegawa 436-8555, Japan; (T.S.); (S.K.); (Y.O.); (M.O.)
| | - Yoshiki Tokura
- Department of Dermatology & Skin Oncology, Chutoen General Medical Center, 1-1 Shobugaike, Kakegawa 436-8555, Japan; (T.S.); (S.K.); (Y.O.); (M.O.)
- Allergic Disease Research Center, Chutoen General Medical Center, 1-1 Shobugaike, Kakegawa 436-8555, Japan
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Tokura Y, Hayano S. Subtypes of atopic dermatitis: From phenotype to endotype. Allergol Int 2022; 71:14-24. [PMID: 34344611 DOI: 10.1016/j.alit.2021.07.003] [Citation(s) in RCA: 84] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/21/2021] [Indexed: 12/20/2022] Open
Abstract
Atopic dermatitis (AD) is a heterogenous disorder and can be classified into different types. Stratification of subtypes may enable personalized medicine approaches. AD can be categorized into the IgE-high, extrinsic subtype and the IgE-normal, intrinsic subtype. While extrinsic AD is the major subtype possessing skin barrier impairment (high incidence of filaggrin mutations), intrinsic AD occupies about 20% of AD with female dominance and preserved barrier. Extrinsic AD exhibits protein allergy and food allergy, but intrinsic AD shows metal allergy possibly in association with suprabasin deficiency. In particular, accumulated knowledge of food allergy has more clearly characterized extrinsic AD. European American (EA) and Asian AD subtypes have been also proposed. Asian patients with AD are characterized by a unique blended immune dysregulation and barrier feature phenotype between EA patients with AD and those with psoriasis. In another ethnic study, filaggrin loss-of-function mutations are not prevalent in African American patients with AD, and Th1/Th17 attenuation and Th2/Th22 skewing were seen in these patients. Recent endotype classification provides new insights for AD and other allergic disorders. Endotype is defined as the molecular mechanisms underlying the visible features/phenotype. Endotype repertoire harbors activation of type 2 cytokines, type 1 cytokines, and IL-17/IL-22, impairment of epidermal barrier, and abnormalities of intercellular lipids. Classification of endotype has been attempted with serum markers. These lines of evidence indicate a need for personalized or precision medicine appropriate for each subtype of AD.
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Affiliation(s)
- Yoshiki Tokura
- Allergic Disease Research Center, Chutoen General Medical Center, Kakegawa, Japan; Department of Dermatology, Chutoen General Medical Center, Kakegawa, Japan.
| | - Satoshi Hayano
- Allergic Disease Research Center, Chutoen General Medical Center, Kakegawa, Japan; Department of Pediatrics, Chutoen General Medical Center, Kakegawa, Japan
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Suprabasin: Role in human cancers and other diseases. Mol Biol Rep 2021; 49:1453-1461. [PMID: 34775572 DOI: 10.1007/s11033-021-06897-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/29/2021] [Indexed: 10/19/2022]
Abstract
Suprabasin (SBSN), a gene with unknown function located in q13 region of chromosome 19, was first found to be expressed in the basal layer of the stratified epithelium in mouse and human tissues and was thought to be a potential precursor of keratinized capsules. However, in recent years, significant progress has been made in the study of SBSN in a variety of human diseases. One common theme appears to be the effect of SBSN on tumor progression, such as invasion, metastasis and resistance. However, the function and mechanism of action of SBSN is still elusive. In this study, we reviewed the literature on SBSN in the PubMed database to identify the basic characteristics, biological functions, and roles of SBSN in cancer and other diseases. In particular, we focused on the potential mechanisms of SBSN activity, to improve our understanding of the complex function of this protein and provide a theoretical basis for further research on the role of SBSN in cancer and other diseases.
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Sawada Y, Saito-Sasaki N, Mashima E, Nakamura M. Daily Lifestyle and Inflammatory Skin Diseases. Int J Mol Sci 2021; 22:ijms22105204. [PMID: 34069063 PMCID: PMC8156947 DOI: 10.3390/ijms22105204] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 12/13/2022] Open
Abstract
Throughout life, it is necessary to adapt to the Earth’s environment in order to survive. A typical example of this is that the daily Earth cycle is different from the circadian rhythm in human beings; however, the ability to adapt to the Earth cycle has contributed to the development of human evolution. In addition, humans can consume and digest Earth-derived foods and use luxury materials for nutrition and enrichment of their lives, as an adaptation to the Earth’s environment. Recent studies have shown that daily lifestyles are closely related to human health; however, less attention has been paid to the fact that obesity due to excessive energy intake, smoking, and alcohol consumption contributes to the development of inflammatory skin diseases. Gluten or wheat protein, smoking and alcohol, sleep disturbance, and obesity drive the helper T (Th)1/Th2/Th17 immune response, whereas dietary fiber and omega-3 fatty acids negatively regulate inflammatory cytokine production. In this review, we have focused on daily lifestyles and the mechanisms involved in the pathogenesis of inflammatory skin diseases.
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Suprabasin-null mice retain skin barrier function and show high contact hypersensitivity to nickel upon oral nickel loading. Sci Rep 2020; 10:14559. [PMID: 32884021 PMCID: PMC7471289 DOI: 10.1038/s41598-020-71536-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 08/06/2020] [Indexed: 12/22/2022] Open
Abstract
Suprabasin (SBSN) is expressed not only in epidermis but also in epithelial cells of the upper digestive tract where metals such as nickel are absorbed. We have recently shown that SBSN level is decreased in the stratum corneum and serum of atopic dermatitis (AD) patients, especially in intrinsic AD, which is characterized by metal allergy. By using SBSN-null (Sbsn–/–) mice, this study was conducted to investigate the outcome of SBSN deficiency in relation to AD. Sbsn–/– mice exhibited skin barrier dysfunction on embryonic day 16.5, but after birth, their barrier function was not perturbed despite the presence of ultrastructural changes in stratum corneum and keratohyalin granules. Sbsn–/– mice showed a comparable ovalbumin-specific skin immune response to wild type (WT) mice and rather lower contact hypersensitivity (CHS) responses to haptens than did WT mice. The blood nickel level after oral feeding of nickel was significantly higher in Sbsn–/– mice than in WT mice, and CHS to nickel was elevated in Sbsn–/– mice under nickel-loading condition. Our study suggests that the completely SBSN deficient mice retain normal barrier function, but harbor abnormal upper digestive tract epithelium that promotes nickel absorption and high CHS to nickel, sharing the features of intrinsic AD.
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Botoni LS, Torres SMF, Koch SN, Heinemann MB, Costa‐Val AP. Comparison of demographic data, disease severity and response to treatment, between dogs with atopic dermatitis and atopic‐like dermatitis: a retrospective study. Vet Dermatol 2018; 30:10-e4. [DOI: 10.1111/vde.12708] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Larissa S. Botoni
- Department of Veterinary Clinical Sciences and Surgery Universidade Federal de Minas Gerais 6627 Antônio Carlos Ave Belo Horizonte 31270‐901 Brazil
| | - Sheila M. F. Torres
- Department of Veterinary Clinical Sciences University of Minnesota 1365 Gortner Avenue Saint Paul MN 55108 USA
| | - Sandra N. Koch
- Department of Veterinary Clinical Sciences University of Minnesota 1365 Gortner Avenue Saint Paul MN 55108 USA
| | - Marcos B. Heinemann
- Department of Preventive Veterinary Medicine and Animal Health Universidade de São Paulo 87 Prof. Dr. Orlando Marques de Paiva Ave São Paulo 05508‐270 Brazil
| | - Adriane P. Costa‐Val
- Department of Veterinary Clinical Sciences and Surgery Universidade Federal de Minas Gerais 6627 Antônio Carlos Ave Belo Horizonte 31270‐901 Brazil
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Hiragun T, Hiragun M, Ishii K, Kan T, Hide M. Sweat allergy: Extrinsic or intrinsic? J Dermatol Sci 2017; 87:3-9. [DOI: 10.1016/j.jdermsci.2017.03.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/01/2017] [Accepted: 03/06/2017] [Indexed: 11/15/2022]
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Kim D, Lee NR, Park SY, Jun M, Lee K, Kim S, Park CS, Liu KH, Choi EH. As in Atopic Dermatitis, Nonlesional Skin in Allergic Contact Dermatitis Displays Abnormalities in Barrier Function and Ceramide Content. J Invest Dermatol 2016; 137:748-750. [PMID: 27826010 DOI: 10.1016/j.jid.2016.10.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 09/21/2016] [Accepted: 10/02/2016] [Indexed: 01/05/2023]
Affiliation(s)
- Donghye Kim
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Noo Ri Lee
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sang-Yeon Park
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Myungsoo Jun
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyohoon Lee
- Department of Chemical and Biochemical Engineering, Dongguk University, Seoul, Korea
| | - Sunki Kim
- Department of Chemical and Biochemical Engineering, Dongguk University, Seoul, Korea
| | - Chang Seo Park
- Department of Chemical and Biochemical Engineering, Dongguk University, Seoul, Korea
| | - Kwang-Hyeon Liu
- BK21 Plus KNU Multi-Omics based Creative Drug Research Team, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Korea
| | - Eung Ho Choi
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea.
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