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Kang TJ, Lee SY, Yoon S, Kim EG, Kim JO, Kim JS, Park J, Nam KH. PCSK9 inhibitors and the risk of vitiligo: a Mendelian randomization study. J Invest Dermatol 2024:S0022-202X(24)01985-7. [PMID: 39127093 DOI: 10.1016/j.jid.2024.07.021] [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: 03/16/2024] [Revised: 06/22/2024] [Accepted: 07/04/2024] [Indexed: 08/12/2024]
Abstract
Lipid-lowering agents have been suggested as a therapeutic option for vitiligo based on the potential pathogenic role of lipid metabolism abnormalities. We aimed to explore the impact of genetically proxied lipid-lowering agents on the risk of vitiligo and potentially associated mediators. Genome-wide association study summary statistics for European ancestry were extracted from the largest available meta-analysis for vitiligo, the Global Lipids Genetics Consortium for seven lipid profiles, and two large biobanks, UKB and deCODE, for 4,719 proteins. After identifying lipid-lowering agents with genetically proxied protective effects against vitiligo using lipid-lowering and protein-inhibition Mendelian randomization (MR) analyses, multivariable and two-step MR analyses were conducted to identify potential mediators between lipid-lowering agents and vitiligo. Lipid-lowering MR indicated a potential role of PCSK9 in reducing the vitiligo risk (OR[95%CI] = 0.71[0.52-0.95]), which was replicated in PCSK9-inhibition MR analyses across two separate biobanks (UKB: OR[95%CI]=0.82[0.71-0.96]; deCODE: OR[95%CI]=0.78[0.67-0.91]). Multivariable MR suggested that well-known lipid profiles do not mediate the relationship between PCSK9 and vitiligo, while two-step MR analyses identified five potential protein mediators (CCN5, CXCL12, FCRL1, LGMN, and FGF2). Hence, PCSK9 inhibitor may attenuate the vitiligo risk; PCSK9 and the potential protein mediators can serve as promising novel therapeutic targets for its effective treatment.
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Affiliation(s)
- Tae-Jong Kang
- Department of Dermatology, Jeonbuk National University Medical School, Jeonju, South Korea
| | | | | | | | | | - Jong-Seung Kim
- Department of Medical Informatics, Jeonbuk National University, Jeonju, South Korea; Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, South Korea; Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea
| | - Jin Park
- Department of Dermatology, Jeonbuk National University Medical School, Jeonju, South Korea; Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea
| | - Kyung-Hwa Nam
- Department of Dermatology, Jeonbuk National University Medical School, Jeonju, South Korea; Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea.
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Lee KH, Kang DG, Kim DW, Do HK, Kim DY, Kim W. Piperlongumine regulates genes involved in the skin barrier in epidermal keratinocyte HaCaT cells. Anim Cells Syst (Seoul) 2024; 28:326-339. [PMID: 38933927 PMCID: PMC11207940 DOI: 10.1080/19768354.2024.2361144] [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: 03/08/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
Given that the skin is the largest tissue in the human body, performing external barrier functions with innate and adaptive immunity and undergoing substantial changes during aging, it is under investigation as a major target of various bioactive molecules. In the present study, we examined the biological activity of the senolytic piperlongumine by analyzing alterations in mRNA expression of notable skin genes using transformed aneuploid immortal epidermal keratinocytes, HaCaT cells. We observed that piperlongumine increased the mRNA expression of genes playing critical roles in skin barrier function. In addition, piperlongumine increased expression enzymes involved in the synthesis of ceramide, a major component of intercellular lipids. Furthermore, we measured the protein levels of various cytokines secreted by epidermal keratinocytes and found changes in the release of GRO-αβγ, CCL5, and MCP1. Additionally, we observed that piperlongumine treatment modulated the expression of keratinocyte-specific aging markers and influenced telomerase activity. Based on these findings, piperlongumine could regulate the physiological activity of epidermal keratinocytes to induce beneficial effects in human skin by regulating important skin-related genes.
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Affiliation(s)
- Kyung-Ha Lee
- Department of Molecular Biology, Pusan National University, Busan, Korea
| | - Deok Gyeong Kang
- Department of Biochemistry, Department of Convergence Medical Science, and Institute of Medical Sciences, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Dae-Wook Kim
- Department of Orthopedic Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hwan-Kwon Do
- Department of Physical Medicine and Rehabilitation, Cancer Center, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea
| | - Do-Yeon Kim
- Department of Pharmacology, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Wanil Kim
- Department of Biochemistry, Department of Convergence Medical Science, and Institute of Medical Sciences, School of Medicine, Gyeongsang National University, Jinju, Korea
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Migayron L, Bordes S, Closs B, Seneschal J, Boniface K. Type-2 immunity associated with type-1 related skin inflammatory diseases: friend or foe? Front Immunol 2024; 15:1405215. [PMID: 38868763 PMCID: PMC11167106 DOI: 10.3389/fimmu.2024.1405215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/14/2024] [Indexed: 06/14/2024] Open
Abstract
Chronic inflammatory skin diseases are multifactorial diseases that combine genetic predisposition, environmental triggers, and metabolic disturbances associated with abnormal immune responses. From an immunological perspective, the better understanding of their physiopathology has demonstrated a large complex network of immune cell subsets and related cytokines that interact with both epidermal and dermal cells. For example, in type-1-associated diseases such as alopecia areata, vitiligo, and localized scleroderma, recent evidence suggests the presence of a type-2 inflammation that is well known in atopic dermatitis. Whether this type-2 immune response has a protective or detrimental impact on the development and chronicity of these diseases remains to be fully elucidated, highlighting the need to better understand its involvement for the management of patients. This mini-review explores recent insights regarding the potential role of type-2-related immunity in alopecia areata, vitiligo, and localized scleroderma.
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Affiliation(s)
- Laure Migayron
- Univ. Bordeaux, CNRS, Immuno ConcEpT, UMR 5164, Bordeaux, France
- R&D Department, SILAB, Brive-la-Gaillarde, France
| | | | | | - Julien Seneschal
- Univ. Bordeaux, CNRS, Immuno ConcEpT, UMR 5164, Bordeaux, France
- CHU de Bordeaux, Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hôpital Saint-André, UMR 5164, Bordeaux, France
| | - Katia Boniface
- Univ. Bordeaux, CNRS, Immuno ConcEpT, UMR 5164, Bordeaux, France
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4
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Liu LY, He SJ, Chen Z, Ge M, Lyu CY, Gao D, Yu JP, Cai MH, Yuan JX, Zhang JL. The Role of Regulatory Cell Death in Vitiligo. DNA Cell Biol 2024; 43:61-73. [PMID: 38153369 DOI: 10.1089/dna.2023.0188] [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] [Indexed: 12/29/2023] Open
Abstract
Vitiligo is one of the common chronic autoimmune skin diseases in clinic, which is characterized by localized or generalized depigmentation and seriously affects the physical and mental health of patients. At present, the pathogenesis of vitiligo is not clear; mainly, heredity, autoimmunity, oxidative stress, melanocyte (MC) self-destruction, and the destruction, death, or dysfunction of MCs caused by various reasons are always the core of vitiligo. Regulatory cell death (RCD) is an active and orderly death mode of cells regulated by genes, which widely exists in various life activities, plays a pivotal role in maintaining the homeostasis of the organism, and is closely related to the occurrence and development of many diseases. With the deepening of the research and understanding of RCD, people gradually found that there are many different forms of RCD in the lesions and perilesional skin of vitiligo patients, such as apoptosis, autophagy, pyroptosis, ferroptosis, and so on. Different cell death modes have different mechanisms in vitiligo, and different RCDs can interact and regulate each other. In this article, the mechanism related to RCD in the pathogenesis of vitiligo is reviewed, which provides new ideas for exploring the pathogenesis and targeted treatment of vitiligo.
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Affiliation(s)
- Lyu-Ye Liu
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China
| | - Si-Jia He
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, People's Republic of China
| | - Zhao Chen
- First Clinical Medical College Shandong University of Traditional Chinese Medicine, Jinan, People's Republic of China
| | - Man Ge
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China
| | - Chun-Yi Lyu
- First Clinical Medical College Shandong University of Traditional Chinese Medicine, Jinan, People's Republic of China
| | - Dandan Gao
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China
| | - Ji-Peng Yu
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China
| | - Meng-Han Cai
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China
| | - Jin-Xiang Yuan
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China
| | - Jun-Ling Zhang
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, People's Republic of China
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Perez-Bootello J, Cova-Martin R, Naharro-Rodriguez J, Segurado-Miravalles G. Vitiligo: Pathogenesis and New and Emerging Treatments. Int J Mol Sci 2023; 24:17306. [PMID: 38139134 PMCID: PMC10743634 DOI: 10.3390/ijms242417306] [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: 10/31/2023] [Revised: 12/02/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Vitiligo is a complex disease with a multifactorial nature and a high impact on the quality of life of patients. Although there are multiple therapeutic alternatives, there is currently no fully effective treatment for this disease. In the current era, multiple drugs are being developed for the treatment of autoimmune diseases. This review assesses the available evidence on the pathogenesis of vitiligo, and a comprehensive review of treatments available for vitiligo now and in the near future is provided. This qualitative analysis spans 116 articles. We reviewed the mechanism of action, efficacy and safety data of phototherapy, afamelanotide, cyclosporine, phosphodiesterase 4 inhibitors, trichloroacetic acid, basic fibroblast growth factor, tumor necrosis factor (TNF) inhibitors, secukinumab, pseudocatalase and janus kinase (JAK) inhibitors. At the moment, there is no clearly outstanding option or fully satisfactory treatment for vitiligo, so it is necessary to keep up the development of new drugs as well as the publication of long-term effectiveness and safety data for existing treatments.
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Li H, Li X, Kong Y, Sun W. Ubiquitin-specific protease 34 in macrophages limits CD8 T cell-mediated onset of vitiligo in mice. Immunobiology 2023; 228:152383. [PMID: 37043976 DOI: 10.1016/j.imbio.2023.152383] [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: 12/10/2022] [Revised: 03/30/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023]
Abstract
As an autoimmune disorder, vitiligo is characterized by depigmented skin macules. CD8+T cells and macrophages enrichment promote the onset of vitiligo, while the role of macrophages to CD8+T is not well deciphered. To develop a mouse model of vitiligo with prominent epidermal depigmentation, Krt14-Kitl* transgenic mice containing an elevated number of melanocytes in the epidermis with membrane-bound Kit ligand (Kitl*) were adoptively transferred with premelanosome protein (PMEL) CD8+ T cells. On the other hand, Krt14-Kitl* mice were mated with ubiquitin-specific protease 34 (USP34)MKO mice to decipher the role of USP34 in vitiligo. Vitiligo scores and PMEL CD8+ T cell enrichment were detected with flow cytometry. Human peripheral blood mononuclear cells (PBMCs) or mice bone marrow-derived macrophages (BMDMs) were incubated with lipopolysaccharide (LPS), CpG, or co-incubated with KU-55933, an ataxia telangiectasia-mutated (ATM) inhibitor. Chemokine (C-C motif) ligand 2 (CCL2), Ccl5, and interleukin (Il)-12α expression was assayed with real-time PCR, and p-IKKα/β was assayed with Western blots. USP34 was up-regulated in the PBMCs of vitiligo patients and LPS-stimulated BMDMs. USP34 deficiency did not affect the differentiation of CD11b+F4/80+ macrophages in the bone marrow. Immunoprecipitation demonstrated the interaction between USP34 and ATM. USP34 deficiency or KU-55933 administration promoted the induction of Ccl2, Ccl5, Il12α, and p-IKKα/β in LPS or CpG stimulated BMDMs; KU-55933 administration could not affect the expression of the above molecules in USP34 deficient BMDMs. It further revealed that USP34 deficiency promoted the development of vitiligo with increased PMEL CD8+ T cell enrichment, which was not affected by KU-55933 administration. USP34 deficiency in macrophages promotes the onset of vitiligo with increased PMEL CD8+ T cell enrichment, and USP34/ATM complex can be considered as a therapy target.
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Affiliation(s)
- He Li
- Department of Dermatology, the Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huai'an 223300, Jiangsu, China
| | - Xiaoqing Li
- Department of Dermatology, the Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huai'an 223300, Jiangsu, China
| | - Yinghui Kong
- Department of Dermatology, the Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huai'an 223300, Jiangsu, China
| | - Weiguo Sun
- Department of Dermatology, the Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huai'an 223300, Jiangsu, China.
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Chang WL, Ko CH. The Role of Oxidative Stress in Vitiligo: An Update on Its Pathogenesis and Therapeutic Implications. Cells 2023; 12:cells12060936. [PMID: 36980277 PMCID: PMC10047323 DOI: 10.3390/cells12060936] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Vitiligo is an autoimmune skin disorder caused by dysfunctional pigment-producing melanocytes which are attacked by immune cells. Oxidative stress is considered to play a crucial role in activating consequent autoimmune responses related to vitiligo. Melanin synthesis by melanocytes is the main intracellular stressor, producing reactive oxygen species (ROS). Under normal physiological conditions, the antioxidative nuclear factor erythroid 2-related factor 2 (Nrf2) pathway functions as a crucial mediator for cells to resist oxidative stress. In pathological situations, such as with antioxidant defects or under inflammation, ROS accumulate and cause cell damage. Herein, we summarize events at the cellular level under excessive ROS in vitiligo and highlight exposure to melanocyte-specific antigens that trigger immune responses. Such responses lead to functional impairment and the death of melanocytes, which sequentially increase melanocyte cytotoxicity through both innate and adaptive immunity. This report provides new perspectives and advances our understanding of interrelationships between oxidative stress and autoimmunity in the pathogenesis of vitiligo. We describe progress with targeted antioxidant therapy, with the aim of providing potential therapeutic approaches.
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Affiliation(s)
- Wei-Ling Chang
- International Ph.D. Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Chi-Hsiang Ko
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
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Speeckaert R, Belpaire A, Speeckaert MM, van Geel N. A meta-analysis of chemokines in vitiligo: Recruiting immune cells towards melanocytes. Front Immunol 2023; 14:1112811. [PMID: 36911664 PMCID: PMC9999440 DOI: 10.3389/fimmu.2023.1112811] [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: 11/30/2022] [Accepted: 02/16/2023] [Indexed: 03/14/2023] Open
Abstract
Chemokine research offers insightful information on the pathogenesis of cutaneous immune disorders, such as vitiligo. Compared to cytokines, the higher detectable levels of chemokines display promising potential as future disease biomarkers. Nonetheless, some published study results are contradictory, which can be attributed to patient characteristics and methodological differences. In this study, a meta-analysis was performed to compare chemokine expression in blood and skin samples from vitiligo patients versus healthy controls. Furthermore, the relationship between chemokine expression and disease activity was evaluated. Chemokine levels were investigated in 15 articles in the circulation and in 9 articles in vitiligo skin. Overall, some clear trends were observed. CXCR3 signaling by CXCL10 and CXCL9 has been confirmed by several reports, although CXCL10 showed more robust findings in blood samples. In this meta-analysis, CCL5, CXCL8, CXCL12, and CXCL16 levels were also significantly elevated. This indicates a complex immune pathway activation in vitiligo that overall supports a Th1-dominant response. Chemokines linked to the Th2 and Th17 pathways were less prevalent. Despite these findings, study protocols that examine a broader range of chemokines are encouraged, because current research is mostly focused on a small number of chemokines that were differentially expressed in previous studies.
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Affiliation(s)
| | - Arno Belpaire
- Department of Dermatology, Ghent University Hospital, Gent, Belgium
| | | | - Nanja van Geel
- Department of Dermatology, Ghent University Hospital, Gent, Belgium
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Chaudhary A, Patel M, Singh S. Current Debates on Etiopathogenesis and Treatment Strategies for Vitiligo. Curr Drug Targets 2022; 23:1219-1238. [PMID: 35388753 DOI: 10.2174/1389450123666220406125645] [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: 07/07/2021] [Revised: 12/12/2021] [Accepted: 12/31/2021] [Indexed: 01/25/2023]
Abstract
Vitiligo is an acquired, chronic, and progressive depigmentation or hypopigmentation characterized by the destruction of melanocytes and the occurrence of white patches or macules in the skin, mucosal surface of eyes, and ears. Melanocytes are the melanin pigment-producing cells of the skin which are destroyed in pathological conditions called vitiligo. Approximately 0.5 - 2.0% of the population is suffering from vitiligo, and a higher prevalence rate of up to 8.8% has been reported in India. It is caused by various pathogenic factors like genetic predisposition, hyperimmune activation, increased oxidative stress, and alteration in neuropeptides level. Genetic research has revealed a multi- genetic inheritance that exhibits an overlap with other autoimmune disorders. However, melanocytes specific genes are also affected (such as DDR1, XBP1, NLRP1, PTPN22, COMT, FOXP3, ACE, APE, GSTP1, TLR, SOD, and CTLA-4). A number of therapeutic options are employed for the treatment of vitiligo. The topical corticosteroids and immunomodulators are currently in practice for the management of vitiligo. Phototherapies alone and in combinations with other approaches are used in those patients who do not respond to the topical treatment. The main focus of this review is on the etiopathological factors, pharmacological management (phototherapy, topical, systemic, and surgical therapy), and herbal drugs used to treat vitiligo.
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Affiliation(s)
- Ankit Chaudhary
- Department of Pharmacology, Neuropharmacology Division, ISF College of Pharmacy, Moga, Punjab 142001, India
| | - Mayank Patel
- Department of Pharmacology, Neuropharmacology Division, ISF College of Pharmacy, Moga, Punjab 142001, India
| | - Shamsher Singh
- Department of Pharmacology, Neuropharmacology Division, ISF College of Pharmacy, Moga, Punjab 142001, India
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Speeckaert R, Belpaire A, Speeckaert M, van Geel N. The delicate relation between melanocytes and skin immunity: A game of hide and seek. Pigment Cell Melanoma Res 2022; 35:392-407. [PMID: 35298085 DOI: 10.1111/pcmr.13037] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/13/2022] [Accepted: 03/09/2022] [Indexed: 01/19/2023]
Abstract
Melanocytes exhibit a complex and intriguing relationship with the skin immune response, leading to several clinical conditions. In some disorders, inappropriate melanocyte destruction (e.g., vitiligo, halo naevi) is problematic, while in others, immune tolerance should be broken (melanoma). Important parts of the dysregulated pathways have been unraveled in pigment disorders, ranging from upregulated interferon (IFN)-γ signaling to memory T cells, regulatory T cells, and immune checkpoints. Although a network of many factors is involved, targeting key players such as IFN-γ or checkpoint inhibitors (e.g., programmed death-ligand 1 (PD-L1)] can shift the balance and lead to impressive outcomes. In this review, we focus on the immunological mechanisms of the most common inflammatory disorders where the interaction of the immune system with melanocytes plays a crucial role. This can provide new insights into the current state of melanocyte research.
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Affiliation(s)
| | - Arno Belpaire
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | | | - Nanja van Geel
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
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Zhang Y, Liu K, Cheng J, Zhou C, Zhang M, Fan Y. FAP
‐α
+
immunofibroblasts in oral lichen planus promote
CD4
+
T cell infiltration via
CCL5
secretion. Exp Dermatol 2022; 31:1421-1430. [PMID: 35598279 DOI: 10.1111/exd.14613] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/19/2022] [Accepted: 05/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Yuyao Zhang
- Department of Oral Mucosal Diseases The Affiliated Stomatological Hospital of Nanjing Medical University Nanjing China
- Jiangsu Province Key Laboratory of Oral Diseases Nanjing Medical University Nanjing China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine Nanjing China
| | - Kefan Liu
- Department of Oral Mucosal Diseases The Affiliated Stomatological Hospital of Nanjing Medical University Nanjing China
- Jiangsu Province Key Laboratory of Oral Diseases Nanjing Medical University Nanjing China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine Nanjing China
| | - Juehua Cheng
- Department of Oral Mucosal Diseases The Affiliated Stomatological Hospital of Nanjing Medical University Nanjing China
- Jiangsu Province Key Laboratory of Oral Diseases Nanjing Medical University Nanjing China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine Nanjing China
| | - Chenyu Zhou
- Department of Oral Mucosal Diseases The Affiliated Stomatological Hospital of Nanjing Medical University Nanjing China
- Jiangsu Province Key Laboratory of Oral Diseases Nanjing Medical University Nanjing China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine Nanjing China
| | - Mengna Zhang
- Department of Oral Mucosal Diseases The Affiliated Stomatological Hospital of Nanjing Medical University Nanjing China
- Jiangsu Province Key Laboratory of Oral Diseases Nanjing Medical University Nanjing China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine Nanjing China
| | - Yuan Fan
- Department of Oral Mucosal Diseases The Affiliated Stomatological Hospital of Nanjing Medical University Nanjing China
- Jiangsu Province Key Laboratory of Oral Diseases Nanjing Medical University Nanjing China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine Nanjing China
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12
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Ng CY, Chiu YC, Chan YP, Lin YJ, Chung PH, Chung WH, Ku CL. Skin Interstitial Fluid and Plasma Multiplex Cytokine Analysis Reveals IFN-γ Signatures and Granzyme B as Useful Biomarker for Activity, Severity and Prognosis Assessment in Vitiligo. Front Immunol 2022; 13:872458. [PMID: 35464413 PMCID: PMC9021541 DOI: 10.3389/fimmu.2022.872458] [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: 02/09/2022] [Accepted: 03/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background The course of vitiligo is unpredictable, with periods of disease flare-ups and prolonged recovery periods. It is essential to establish a biomarker profile as a substitute marker for disease activity to predict disease activity, severity, and prognosis prediction. The use of localized skin interstitial fluid as biomarkers has recently gained interest, but extensive studies of the association between skin interstitial fluid, plasma, and the disease course is lacking. This study aims to evaluate the cytokine expression profiles in the skin and plasma and the utility of the biomarker panel in assessing disease activity, severity, and prognosis in patients with vitiligo. Methods In this prospective cohort study, 86 patients and 34 healthy controls were recruited from the outpatient department of a tertiary medical center from March 2019 to September 2021. All patients were of Asian ethnicity. Two independent investigators evaluated disease activity and severity with longitudinal follow-ups for treatment response for a-12 month period. Ultrasensitive multiplex cytokine panel and single-molecule counting technology immunoassays were used to study the cytokine expression in skin interstitial fluid and plasma. Results IFN-γ and its’ signature cytokines, including CXCL9, CXCL10, and GzmB, are most highly expressed in the vitiligo patients’ lesion skin interstitial fluid and plasma compared to healthy control. By way of comparison, no significant changes in IL-1β, IL-13, IL-15, IL-17A, IL-18 were observed. Receiver operating characteristic analysis revealed that IFN-γ is the most sensitive and specific marker in predicting disease activity, followed by CXCL10 and GzmB. CXCL-9 was sensitive and specific in diagnosing vitiligo disease severity. The decrease in IFN-γ expression level is positively correlated with the treatment response. Conclusion IFN-γ, CXCL9, CXCL10, and GzmB are highly expressed in vitiligo patients’ lesion skin and plasma and may serve as biomarkers for the clinical activity, severity, and prognosis prediction in vitiligo patients. Among all, IFN-γ exerts the highest predictive value in disease activity and treatment response, supporting the critical role of IFN-γ in the pathogenesis of vitiligo.
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Affiliation(s)
- Chau Yee Ng
- Vitiligo Clinic and Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yen-Chuan Chiu
- Vitiligo Clinic and Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Yu-Pei Chan
- Vitiligo Clinic and Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Yu-Jr Lin
- Department of Statistics, Chang Gung University, Taoyuan, Taiwan
| | - Pei-Han Chung
- Department of Pharmacology, Elixiron Immunotherapeutics Inc., Taipei City, Taiwan
| | - Wen-Hung Chung
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Cheng-Lung Ku
- Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,Center for Molecular and Clinical Immunology, Chang Gung University, Taoyuan, Taiwan
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13
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Li S, Zenkel M, Kruse FE, Gießl A, Schlötzer-Schrehardt U. Identification, Isolation, and Characterization of Melanocyte Precursor Cells in the Human Limbal Stroma. Int J Mol Sci 2022; 23:ijms23073756. [PMID: 35409129 PMCID: PMC8998324 DOI: 10.3390/ijms23073756] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 02/06/2023] Open
Abstract
Given their vital role in the homeostasis of the limbal stem cell niche, limbal melanocytes have emerged as promising candidates for tissue engineering applications. This study aimed to isolate and characterize a population of melanocyte precursors in the limbal stroma, compared with melanocytes originating from the limbal epithelium, using magnetic-activated cell sorting (MACS) with positive (CD117/c-Kit microbeads) or negative (CD326/EpCAM or anti-fibroblast microbeads) selection approaches. Both approaches enabled fast and easy isolation and cultivation of pure limbal epithelial and stromal melanocyte populations, which differed in phenotype and gene expression, but exhibited similar functional properties regarding proliferative potential, pigmentation, and support of clonal growth of limbal epithelial stem/progenitor cells (LEPCs). In both melanocyte populations, limbus-specific matrix (laminin 511-E8) and soluble factors (LEPC-derived conditioned medium) stimulated melanocyte adhesion, dendrite formation, melanogenesis, and expression of genes involved in UV protection and immune regulation. The findings provided not only a novel protocol for the enrichment of pure melanocyte populations from limbal tissue applying easy-to-use MACS technology, but also identified a population of stromal melanocyte precursors, which may serve as a reservoir for the replacement of damaged epithelial melanocytes and an alternative resource for tissue engineering applications.
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14
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Kawakami T. Surgical procedures and innovative approaches for vitiligo regenerative treatment and melanocytorrhagy. J Dermatol 2022; 49:391-401. [PMID: 35178747 DOI: 10.1111/1346-8138.16316] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/12/2022] [Accepted: 01/24/2022] [Indexed: 12/01/2022]
Abstract
Surgical treatments for vitiligo are a safe and effective treatment modality for select patients with vitiligo. Many techniques of vitiligo surgery exist, each with unique advantages and disadvantages. We reviewed the various surgical therapies and innovative approaches for vitiligo regenerative treatment reported in the literature. Surgical therapies can be subdivided into tissue grafting methods and cellular grafting methods. Tissue grafting methods mainly include mini punch grafts, suction blister roof grafts, and hair follicle grafts. Cellular grafting methods include cultured and non-cultured treatments. The efficacy needs to be improved largely due to the poor proliferation and quality of the autologous melanocytes. Rho-associated protein kinase inhibitor enhances primary melanocyte culture proliferation from vitiligo patients to prevent apoptosis. Innovative approaches using stem cell methods could prove invaluable in developing a novel cell therapy for patients suffering from vitiligo. We succeeded in inducing melanin pigmentation in mice skin in vivo using our human induced pluripotent stem cell-derived melanocytes. In addition, we reviewed melanocytorrhagy, detachment and transepidermal loss of melanocytes, and melanocyte-related adhesion molecules. These adhesion molecules include epithelial cadherin, discoidin domain receptor tyrosine kinase 1, glycoprotein non-metastatic melanoma protein B, macrophage migration inhibiting factor, 17β-hydroxysteroid dehydrogenase 1, and E26 transformation-specific 1.
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Affiliation(s)
- Tamihiro Kawakami
- Division of Dermatology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
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15
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The Promising Role of Chemokines in Vitiligo: From Oxidative Stress to the Autoimmune Response. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:8796735. [PMID: 35096274 PMCID: PMC8791757 DOI: 10.1155/2022/8796735] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/09/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022]
Abstract
Vitiligo is a common chronic autoimmune skin disorder featured with depigmented patches and underlying destruction of melanocytes in the lesional skin. Multiple factors and mechanisms have been proposed for the etiopathogenesis of vitiligo, among which oxidative stress has been widely accepted as a key factor in initiating melanocyte loss. The altered redox status caused by oxidative stress, including the overproduction of reactive oxygen species (ROS) and the decreased activity of the antioxidant system in the skin, surrenders the resistance of melanocytes to exogenous or endogenous stimuli and eventually impairs the normal defense mechanism, leading to the absence of melanocytes. Considering the important role of innate and adaptive immunity in vitiligo, there is mounting evidence revealing an association between oxidative stress and autoimmunity. Since the significant changes of chemokines have been documented in vitiligo in many recent studies, it has been suggested that ROS-mediated chemotactic signals are not only the biomarkers of disease progression and prognosis but also are involved in the pathogenesis of vitiligo by facilitating the innate and adaptive immune cells, especially melanocyte-specific T cells, trafficking to the lesional areas of vitiligo. In this review, we discuss the interaction between oxidative stress and autoimmune response orchestrated by chemokines, including CXCL16-CXCR6 axis, CXCL9/CXCL10-CXCR3 axis, and other altered chemokines in vitiligo, and we also try to provide insight into potential therapeutic options through targeting these pathways.
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16
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Chang WL, Lee WR, Kuo YC, Huang YH. Vitiligo: An Autoimmune Skin Disease and its Immunomodulatory Therapeutic Intervention. Front Cell Dev Biol 2022; 9:797026. [PMID: 34970551 PMCID: PMC8712646 DOI: 10.3389/fcell.2021.797026] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
Vitiligo is a chronic autoimmune depigmenting skin disorder characterized by patches of the skin losing functional melanocytes. Multiple combinatorial factors are involved in disease development, among which immune T cells play a prominent role. The immune cells implicated in melanocyte destruction through adaptive immunity include CD8+ cytotoxic T cells and regulatory T cells, and aberrantly activated skin-resident memory T cells also play a role in melanocyte destruction. Over the past several years, major progress in understanding vitiligo pathogenesis has led to the development of targeted therapies. Janus kinase (JAK) inhibitors, which share the similar mechanism that autoactivates CD8+ T cells in chronic inflammatory diseases, have been reported to have therapeutic significance in vitiligo. Recently, immunomodulatory therapeutic interventions in vitiligo have been emerging. Mesenchymal stem cells (MSCs) regulate cytokine secretion and the balance of T-cell subsets, which makes them a promising cell-based treatment option for autoimmune diseases. The induction of MSC-mediated immunomodulation is complicated and occurs by contact-dependent mechanisms and soluble extracellular vesicle (EV) mediators. EVs released from MSCs contain various growth factors and cytokines with anti-inflammatory effects in the skin immune response. Here, we summarize and discuss the progress to date in targeted therapies that immunomodulate the niche environment of vitiligo, from the clinical trial of JAK inhibitors to the potential of MSCs and MSC-EVs. The available information was collected to highlight the need for further research into the treatment of vitiligo.
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Affiliation(s)
- Wei-Ling Chang
- TMU Research Center of Cell Therapy and Regeneration Medicine, Taipei Medical University, Taipei, Taiwan.,International Ph.D. Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Woan-Ruoh Lee
- Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan
| | - Yung-Che Kuo
- TMU Research Center of Cell Therapy and Regeneration Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yen-Hua Huang
- TMU Research Center of Cell Therapy and Regeneration Medicine, Taipei Medical University, Taipei, Taiwan.,International Ph.D. Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Biochemistry and Molecular Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan.,TMU Research Center of Cancer Translational Medicine, Taipei Medical University, Taipei, Taiwan.,Center for Reproductive Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.,Comprehensive Cancer Center of Taipei Medical University, Taipei, Taiwan.,PhD Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
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17
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Li S, Dai W, Wang S, Kang P, Ye Z, Han P, Zeng K, Li C. Clinical Significance of Serum Oxidative Stress Markers to Assess Disease Activity and Severity in Patients With Non-Segmental Vitiligo. Front Cell Dev Biol 2021; 9:739413. [PMID: 34977005 PMCID: PMC8716723 DOI: 10.3389/fcell.2021.739413] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
Non-segmental vitiligo (NSV) is a chronic autoimmune disease characterized by progressive depigmentation of the skin. Oxidative stress (OS) has been proposed as one among the main principal causes in the development and establishment of a sustained autoimmune state in patients with NSV. However, the disease-associated OS biomarkers in clinical practice are not well studied. In this study, we found significantly reduced antioxidant enzymes [catalase (CAT) and superoxide dismutase (SOD)], total antioxidant capacity (TAC), and increased levels of lipid oxidation product malondialdehyde (MDA) and oxidative DNA damage byproduct [8-hydroxy-2-deoxyguanosine (8-OHdG)] in serum of NSV patients compared with healthy controls (HC). Serum TAC, MDA, and 8-OHdG levels were correlated with disease activity in all patients with NSV and much lower in patients receiving conventional treatment in the past 1 year compared to that without treatment. In addition, both serum MDA and 8-OHdG levels were significantly correlated with CXCL10 expression in patients with NSV. And the serum TAC, MDA, and 8-OHdG levels were also correlated with affected body surface area and Vitiligo Area Scoring Index score in patients with NSV. This study demonstrates dysregulated OS status in patients with NSV and provides the evidence that the serum TAC, MDA, and 8-OHdG have a capacity to indicate the activity and severity in patients with NSV.
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Affiliation(s)
- Shuli Li
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangdong, China
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Wei Dai
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - Sijia Wang
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - Pan Kang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Zhubiao Ye
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Peng Han
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangdong, China
- Department of Otolaryngology, First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Kang Zeng
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - Chunying Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
- *Correspondence: Chunying Li,
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18
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Martins C, Migayron L, Drullion C, Jacquemin C, Lucchese F, Rambert J, Merhi R, Michon P, Taieb A, Rezvani HR, de Rinaldis E, Seneschal J, Boniface K. Vitiligo skin T cells are prone to produce type 1- and type 2-cytokines to induce melanocyte dysfunction and epidermal inflammatory response through JAK signaling. J Invest Dermatol 2021; 142:1194-1205.e7. [PMID: 34655610 DOI: 10.1016/j.jid.2021.09.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/27/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
Vitiligo is a T cell-mediated inflammatory skin disorder characterized by the loss of epidermal melanocytes. However, the contribution of melanocytes to the physiopathology of the disease in response to the T cell microenvironment remains unclear. Here, using NanoString technology and multiplex ELISA, we show that active vitiligo perilesional skin is characterized by prominent type 1 and 2 associated immune responses. The vitiligo skin T cell secretome downregulated melanocyte function and adhesion, while increasing melanocyte mitochondrial metabolism and expression of inflammatory cytokines and chemokines by epidermal cells. The JAK1/2 inhibitor ruxolitinib strongly inhibited such effects on epidermal cells. Our data highlight that vitiligo is more complex than previously thought with prominent combined activities of both Th1- and Th2-related cytokines inducing inflammatory responses of epidermal cells. Melanocytes do not appear only to be a target of T cells in vitiligo but could actively contribute to perpetuate inflammation. JAK inhibitors could prevent the impact of T cells on epidermal cells and pigmentation, highlighting their potential clinical benefit in vitiligo.
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Affiliation(s)
| | - Laure Migayron
- Univ. Bordeaux, INSERM, BMGIC, U1035, F-33000 Bordeaux, France; R&D Department, SILAB, Brive-la-Gaillarde, France
| | - Claire Drullion
- Univ. Bordeaux, INSERM, BMGIC, U1035, F-33000 Bordeaux, France
| | | | | | | | - Ribal Merhi
- Univ. Bordeaux, INSERM, BMGIC, U1035, F-33000 Bordeaux, France
| | - Pauline Michon
- Univ. Bordeaux, INSERM, BMGIC, U1035, F-33000 Bordeaux, France
| | - Alain Taieb
- Univ. Bordeaux, INSERM, BMGIC, U1035, F-33000 Bordeaux, France; Department of Dermatology and Pediatric Dermatology; National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Bordeaux, France
| | - Hamid-Reza Rezvani
- Univ. Bordeaux, INSERM, BMGIC, U1035, F-33000 Bordeaux, France; AQUIDERM, University of Bordeaux
| | - Emanuele de Rinaldis
- Sanofi Immunology and Inflammation Research Therapeutic Area, Precision Immunology Cluster, Cambridge, MA, 02139, USA
| | - Julien Seneschal
- Univ. Bordeaux, INSERM, BMGIC, U1035, F-33000 Bordeaux, France; Department of Dermatology and Pediatric Dermatology; National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Bordeaux, France
| | - Katia Boniface
- Univ. Bordeaux, INSERM, BMGIC, U1035, F-33000 Bordeaux, France.
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19
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Khaitan BK, Sindhuja T. Autoimmunity in vitiligo: Therapeutic implications and opportunities. Autoimmun Rev 2021; 21:102932. [PMID: 34506987 DOI: 10.1016/j.autrev.2021.102932] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 12/13/2022]
Abstract
Vitiligo is an acquired chronic pigmentary disorder affecting the melanocytes, mainly in the skin and mucosae. It occurs due to the dynamic interaction between genetic and environmental factors leading to autoimmune destruction of melanocytes. Defects in melanocyte adhesion and increased oxidative stress further augment the immune response in vitiligo. It is a cosmetically disfiguring condition with a substantial psychological burden. Its autoimmune nature with resultant chronicity, variable responses to therapeutic modalities, and frequent recurrences have further diminished the quality of life. Hence, treatment should aim to provide more extended remission periods, prevent recurrences, provide good cosmetic outcomes and ensure patient satisfaction. These treatment goals seem plausible with the recent progress in our understanding of the complex pathogenic mechanisms underlying vitiligo at a molecular and genetic level. We provide a literature review of the pathogenic mechanisms and the therapies targeting these mechanisms.
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Affiliation(s)
- Binod K Khaitan
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
| | - Tekumalla Sindhuja
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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20
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Chen Z, Gao Z, Xia L, Wang X, Lu L, Wu X. Dysregulation of DPP4-CXCL12 Balance by TGF-β1/SMAD Pathway Promotes CXCR4 + Inflammatory Cell Infiltration in Keloid Scars. J Inflamm Res 2021; 14:4169-4180. [PMID: 34483675 PMCID: PMC8408422 DOI: 10.2147/jir.s326385] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/18/2021] [Indexed: 01/10/2023] Open
Abstract
Purpose Recent studies have confirmed the important role of chronic inflammation in keloid; however, mechanism of chronic inflammation in keloid tissue remains largely unclear, especially the dynamic of infiltrated inflammatory cells. Patients and Methods Tissue and blood samples collected from keloid patients and healthy subjects were studied by immunohistochemistry and flow cytometry. Fibroblasts from keloid scars and normal skin were isolated by enzymic digestion. Results We found that CXCL12 expression was elevated which was correlated with decreased dipeptidyl peptidase-4 (DPP4) expression in keloid scars relative to mature scars. In vitro studies suggested that autocrine transforming growth factor β1 (TGF-β1) in keloid-derived fibroblasts negatively regulated DPP4 expression which inhibited the reduction of extracellular CXCL12 levels by DPP4. Furthermore, immunofluorescence showed that most fibroblasts in keloid scars were DPP4lowTGFβ1high compared with DPP4highTGFβ1low fibroblasts in normal skin tissue, which facilitated extracellular CXCL12 accumulation in fibroblasts in keloid scars. Furthermore, we found that most circulating leukocytes in peripheral blood and tissue-infiltrated inflammatory cells in keloid scars expressed the C-X-C motif chemokine receptor 4 (CXCR4) instead of CXCR7, indicating that the chemotaxis driven by CXCL12 is likely to be mediated mainly by CXCR4. Conclusion Our study indicated that the TGF-β/DPP4/CXCL12 axis may contribute to chronic inflammation in keloid scars by recruiting inflammatory cells through the CXCR4 receptor.
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Affiliation(s)
- ZongAn Chen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, People's Republic of China
| | - Zhen Gao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, People's Republic of China
| | - LingLing Xia
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, People's Republic of China
| | - XiaoQing Wang
- Department of Orthopedics, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, People's Republic of China
| | - LiMing Lu
- Shanghai Institute of Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - XiaoLi Wu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, People's Republic of China
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21
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El-Domyati M, El-Din WH, Rezk AF, Chervoneva I, Lee JB, Farber M, Uitto J, Igoucheva O, Alexeev V. Systemic CXCL10 is a predictive biomarker of vitiligo lesional skin infiltration, PUVA, NB-UVB and corticosteroid treatment response and outcome. Arch Dermatol Res 2021; 314:275-284. [PMID: 33866437 DOI: 10.1007/s00403-021-02228-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 02/24/2021] [Accepted: 04/03/2021] [Indexed: 10/21/2022]
Abstract
Vitiligo is an acquired pigmentary skin disorder that currently lacks standardized treatment and validated biomarkers to objectively evaluate disease state or therapeutic response. Although prior studies have linked vitiligo autoimmunity with CXCL10/CXCL9-mediated recruitment of leukocytes to the skin, only limited clinical data are available regarding CXCL10 as vitiligo biomarker. To evaluate the utility of systemic CXCL10 as a predictor of disease progression and treatment response on a large cohort of vitiligo patients. CXCL10 levels in lesional, perilesional, and unaffected skin of vitiligo patient (n = 30) and in the serum (n = 51) were measured by quantitative ELISA. CXCL10 expression, recruitment of leukocytes, and inflammatory infiltrates were evaluated by histochemical (n = 32) and immunofluorescence (n = 10) staining. Rigorous cross-sectional and longitudinal biostatistical analysis were employed to correlate CXCL10 levels with disease variables, treatment response, and outcome. We demonstrated that elevated CXCL10 level (2 pg/mm2 and higher) in lesional skin correlates with increased leukocytic infiltrate, disease duration (< 2 year), and its higher level in the serum (50 pg/ml and higher). Changes in CXCL10 serum levels in patients treated with psoralen plus UVA (PUVA) phototherapy, narrowband UVB (NB-UVB) phototherapy, and systemic steroids (SS) correlated with changes in the intralesional CXCL10 levels in repigmented skin. NB-UVB and SS regimens provided most consistent CXCL10 mean change, suggesting that these regimens are most effective in harnessing CXCR3-mediated inflammatory response. Serum CXCL10 is a useful vitiligo biomarker, which predicts lesional skin leukocytic infiltration, and vitiligo treatment response and outcome.
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Affiliation(s)
- M El-Domyati
- Department of Dermatology, STDs and Andrology At Minia University, Minia, Egypt.
| | - W H El-Din
- Department of Dermatology, STDs and Andrology At Minia University, Minia, Egypt
| | - A F Rezk
- Department of Dermatology, STDs and Andrology At Minia University, Minia, Egypt.,Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - I Chervoneva
- Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, 1015 Chestnut Street, Philadelphia, PA, 19107, USA
| | - J B Lee
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - M Farber
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - J Uitto
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - O Igoucheva
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - Vitali Alexeev
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA.
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22
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Said-Fernandez SL, Sanchez-Domínguez CN, Salinas-Santander MA, Martinez-Rodriguez HG, Kubelis-Lopez DE, Zapata-Salazar NA, Vazquez-Martinez OT, Wollina U, Lotti T, Ocampo-Candiani J. Novel immunological and genetic factors associated with vitiligo: A review. Exp Ther Med 2021; 21:312. [PMID: 33717255 PMCID: PMC7885061 DOI: 10.3892/etm.2021.9743] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 09/15/2020] [Indexed: 12/18/2022] Open
Abstract
Vitiligo is a skin disorder characterized by depigmentation of the skin due to a lack of melanin. This condition affects men and woman of all ages and its incidence is not restricted by ethnicity or region. Vitiligo is a multifactorial disease, in which melanocytes, which serve important functions in skin pigmentation and immune processes, are impaired. There is sufficient evidence that immunological and genetic factors are primarily responsible for the destruction and dysfunction of melanocytes. Therefore, genetic DNA sequence variants that participate in skin homeostasis, pigmentation and immune response regulation, as well as altered expression patterns, may contribute to the risk of developing vitiligo. The current review presented an overview of the mechanism of pigmentation and of currently known factors involved in depigmentation, as well as the classification, epidemiology, associated comorbidities, risk factors, immunopathogenesis and several genetic and molecular changes associated with vitiligo.
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Affiliation(s)
- Salvador Luis Said-Fernandez
- Department of Biochemistry and Molecular Medicine, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | - Celia Nohemi Sanchez-Domínguez
- Department of Biochemistry and Molecular Medicine, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | | | - Herminia Guadalupe Martinez-Rodriguez
- Department of Biochemistry and Molecular Medicine, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | - David Emmanuel Kubelis-Lopez
- Dermatology Service, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | - Natalia Aranza Zapata-Salazar
- Dermatology Service, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | - Osvaldo Tomas Vazquez-Martinez
- Dermatology Service, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | - Uwe Wollina
- Department of Dermatology and Allergology, Skin Cancer Center, Städtisches Klinikum, D-01067 Dresden, Germany
| | - Torello Lotti
- Department of Dermatology and Venereology, University Guglielmo Marconi of Rome, I-00193 Rome, Italy
| | - Jorge Ocampo-Candiani
- Dermatology Service, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
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23
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Chen J, Li S, Li C. Mechanisms of melanocyte death in vitiligo. Med Res Rev 2021; 41:1138-1166. [PMID: 33200838 PMCID: PMC7983894 DOI: 10.1002/med.21754] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/16/2020] [Accepted: 11/01/2020] [Indexed: 12/12/2022]
Abstract
Vitiligo is an autoimmune depigment disease results from extensive melanocytes destruction. The destruction of melanocyte is thought to be of multifactorial causation. Genome-wide associated studies have identified single-nucleotide polymorphisms in a panel of susceptible loci as risk factors in melanocyte death. But vitiligo onset can't be solely attributed to a susceptive genetic background. Oxidative stress triggered by elevated levels of reactive oxygen species accounts for melanocytic molecular and organelle dysfunction, a minority of melanocyte demise, and melanocyte-specific antigens exposure. Of note, the self-responsive immune function directly contributes to the bulk of melanocyte deaths in vitiligo. The aberrantly heightened innate immunity, type-1-skewed T helper, and incompetent regulatory T cells tip the balance toward autoreaction and CD8+ cytotoxic T lymphocytes finally execute the killing of melanocytes, possibly alarmed by resident memory T cells. In addition to the well-established apoptosis and necrosis, we discuss several death modalities like oxeiptosis, ferroptosis, and necroptosis that are probably employed in melanocyte destruction. This review focuses on the various mechanisms of melanocytic death in vitiligo pathogenesis to demonstrate a panorama of that. We hope to provide new insights into vitiligo pathogenesis and treatment strategies by the review.
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Affiliation(s)
- Jianru Chen
- Department of DermatologyXijing hospital, Fourth Military Medical UniversityXi'anShannxiChina
| | - Shuli Li
- Department of DermatologyXijing hospital, Fourth Military Medical UniversityXi'anShannxiChina
| | - Chunying Li
- Department of DermatologyXijing hospital, Fourth Military Medical UniversityXi'anShannxiChina
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24
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Bergqvist C, Ezzedine K. Vitiligo: A focus on pathogenesis and its therapeutic implications. J Dermatol 2021; 48:252-270. [DOI: 10.1111/1346-8138.15743] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Christina Bergqvist
- Department of Dermatology AP‐HP Henri Mondor University Hospital UPEC Créteil France
| | - Khaled Ezzedine
- Department of Dermatology AP‐HP Henri Mondor University Hospital UPEC Créteil France
- EA 7379 EpidermE Université Paris‐Est Créteil, UPEC Créteil France
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25
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Egbeto IA, Garelli CJ, Piedra-Mora C, Wong NB, David CN, Robinson NA, Richmond JM. Case Series: Gene Expression Analysis in Canine Vogt-Koyanagi-Harada/Uveodermatologic Syndrome and Vitiligo Reveals Conserved Immunopathogenesis Pathways Between Dog and Human Autoimmune Pigmentary Disorders. Front Immunol 2020; 11:590558. [PMID: 33384688 PMCID: PMC7770226 DOI: 10.3389/fimmu.2020.590558] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 11/02/2020] [Indexed: 12/18/2022] Open
Abstract
Vogt-Koyanagi-Harada syndrome (VKH) and vitiligo are autoimmune diseases that target melanocytes. VKH affects several organs such as the skin, hair follicle, eyes, ears, and meninges, whereas vitiligo is often limited to the skin and mucosa. Many studies have identified immune genes, pathways and cells that drive the pathogeneses of VKH and vitiligo, including interleukins, chemokines, cytotoxic T-cells, and other leukocytes. Here, we present case studies of 2 canines with VKH and 1 with vitiligo, which occurred spontaneously in client-owned companion dogs. We performed comparative transcriptomics and immunohistochemistry studies on lesional skin biopsies from these cases in order to determine if the immunopathogenesis of autoimmune responses against melanocytes are conserved. In dogs, we found enrichment of T cell gene signatures, with upregulation of IFNG, TNF, PRF1, IL15, CTSW, CXCL10, and CCL5 in both VKH and vitiligo in dogs compared to healthy controls. Similar findings were reported in humans, suggesting that these genes play a role in the pathogenesis of spontaneous VKH and vitiligo. T cell-associated genes, including FOXP3 and TBX21, were enriched, while IGFBP5, FOXO1, and PECAM1 were decreased compared to healthy controls. Further, we identified TGFB3, SFRP2, and CXCL7 as additional potential drivers of autoimmune pigmentary disorders. Future studies exploring the immunopathogenesis of spontaneous autoimmunity will expand our understanding of these disorders, and will be useful in developing targeted therapies, repurposing drugs for veterinary and human medicine, and predicting disease prognosis and treatment response.
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Affiliation(s)
- Ista A Egbeto
- Department of Dermatology, UMass Medical School, Worcester, MA, United States.,Tufts University School of Medicine, Boston, MA, United States
| | - Colton J Garelli
- Department of Dermatology, UMass Medical School, Worcester, MA, United States
| | - Cesar Piedra-Mora
- Pathology Department, Tufts Cummings School of Veterinary Medicine, Grafton, MA, United States
| | - Neil B Wong
- Department of Dermatology, UMass Medical School, Worcester, MA, United States
| | | | - Nicholas A Robinson
- Pathology Department, Tufts Cummings School of Veterinary Medicine, Grafton, MA, United States
| | - Jillian M Richmond
- Department of Dermatology, UMass Medical School, Worcester, MA, United States
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26
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Seok SH, Kim DH. Pathogenesis of vitiligo. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2020. [DOI: 10.5124/jkma.2020.63.12.725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Vitiligo is an autoimmune disease in which CD8+ T-cells target and destroy melanocytes, leaving areas of skin without pigment production. Nonsegmental vitiligo, the classical form of the disease, results in symmetrical, bilateral white patches. Vitiligo is a chronic, unpredictable disease, characterized by flares, with depigmentation and periods of disease arrest alternating. This process can be stressful and negatively impact one’s quality of life. Various hypotheses have been offered, including cellular stress causing degeneration of melanocytes, chemical toxicity causing melanocyte death, and neural changes that influence melanocytes or their ability to produce melanin. Recently, the interaction between oxidative stress and autoimmune-mediated melanocyte loss has been proposed as the primary pathogenesis of vitiligo. It is now well accepted that interferon-γ and/or C-X-C motif chemokine ligand 10 axis is functionally required for both progression and maintenance of vitiligo, making this pathway a potential therapeutic target. Most therapeutic interventions in the management of vitiligo have been developed based on this immunopathogenesis. This article aims to review the current understanding of the vitiligo pathogenesis.
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Garcia-Orozco A, Martinez-Magaña IA, Riera-Leal A, Muñoz-Valle JF, Martinez-Guzman MA, Quiñones-Venegas R, Sánchez-Zuno GA, Fafutis-Morris M. Macrophage inhibitory factor (MIF) gene polymorphisms are associated with disease susceptibility and with circulating MIF levels in active non-segmental vitiligo in patients from western Mexico. Mol Genet Genomic Med 2020; 8:e1416. [PMID: 32705792 PMCID: PMC7549602 DOI: 10.1002/mgg3.1416] [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: 03/04/2020] [Revised: 06/08/2020] [Accepted: 07/01/2020] [Indexed: 12/17/2022] Open
Abstract
Background The macrophage migration inhibiting factor (MIF) is a protein that promotes the activation of immune cells and the production of other proinflammatory cytokines such as TNF‐α, IL‐1β, and IFN‐γ, which have proposed to play an essential role in the pathogenesis of vitiligo. The study aimed to assess the association between MIF polymorphisms (−794 CATT5‐8 and −173 G>C), MIF in situ expression, and MIF serum concentrations with susceptibility and disease activity in patients with non‐segmental vitiligo (NSV) from western Mexico. Methods The study included 111 patients with NSV and 201 control subjects. Genotyping was performed by conventional PCR (−794 CATT5‐8) and PCR‐RFLP (−173 G>C) methods. MIF mRNA expression was quantified by real‐time PCR and MIF serum concentrations were determined by ELISA kit. Histopathological samples were analyzed by automated immunohistochemistry. Results The MIF polymorphisms were associated with NSV susceptibility. Serum concentrations of MIF were higher in patients with active NSV and correlated negatively with the years of evolution. The depigmented skin from patients with active vitiligo showed a high expression of MIF. Conclusion MIF polymorphisms increase the risk of NSV in the western Mexican population. The serum concentrations of MIF and in situ expression are associated with active NSV.
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Affiliation(s)
- Alejandra Garcia-Orozco
- Centro de Investigación en Inmunología y Dermatología/Instituto Dermatológico de Jalisco "Dr. José Barba Rubio", Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Zapopan, Mexico.,Doctorado en Ciencias Biomédicas con Orientación en Inmunología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | | | - Annie Riera-Leal
- Doctorado en Ciencias Biomédicas con Orientación en Inmunología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - José Francisco Muñoz-Valle
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Marco Alonso Martinez-Guzman
- Centro de Investigación en Inmunología y Dermatología/Instituto Dermatológico de Jalisco "Dr. José Barba Rubio", Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Zapopan, Mexico
| | - Ricardo Quiñones-Venegas
- Instituto Dermatológico de Jalisco "Dr. José Barba Rubio", Secretaría de Salud Jalisco, Zapopan, Mexico
| | - Gabriela Athziri Sánchez-Zuno
- Doctorado en Ciencias Biomédicas con Orientación en Inmunología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico.,Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Mary Fafutis-Morris
- Centro de Investigación en Inmunología y Dermatología/Instituto Dermatológico de Jalisco "Dr. José Barba Rubio", Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Zapopan, Mexico
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Zhuang T, Yi X, Chen J, Kang P, Chen X, Chen J, Cui T, Chang Y, Ye Z, Ni Q, Wang Y, Du P, Li B, Liu L, Jian Z, Li K, Gao T, Li S, Li C. Intracellular virus sensor MDA5 exacerbates vitiligo by inducing the secretion of chemokines in keratinocytes under virus invasion. Cell Death Dis 2020; 11:453. [PMID: 32532953 PMCID: PMC7293308 DOI: 10.1038/s41419-020-2665-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 12/19/2022]
Abstract
Vitiligo is a disfiguring disease featuring chemokines-mediated cutaneous infiltration of autoreactive CD8+ T cells that kill melanocytes. Copious studies have indicated that virus invasion participates in the pathogenesis of vitiligo. IFIH1, encoding MDA5 which is an intracellular virus sensor, has been identified as a vitiligo susceptibility gene. However, the specific role of MDA5 in melanocyte death under virus invasion is not clear. In this study, we first showed that the expression of anti-CMV IgM and MDA5 was higher in vitiligo patients than healthy controls. Then, by using Poly(I:C) to imitate virus invasion, we clarified that virus invasion significantly activated MDA5 and further potentiated the keratinocyte-derived CXCL10 and CXCL16 which are the two vital chemokines for the cutaneous infiltration of CD8+ T cells in vitiligo. More importantly, IFN-β mediated by the MDA5-MAVS-NF-κB/IRF3 signaling pathway orchestrated the secretion of CXCL10 via the JAK1-STAT1 pathway and MDA5-meidiated IRF3 transcriptionally induced the production of CXCL16 in keratinocytes under virus invasion. In summary, our results demonstrate that MDA5 signaling orchestrates the aberrant skin immunity engaging in melanocyte death via mediating CXCL10 and CXCL16 secretion, which supports MDA5 as a potential therapeutic target for vitiligo under virus invasion.
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Affiliation(s)
- Tongtian Zhuang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Xiuli Yi
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Jianru Chen
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Pan Kang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Xuguang Chen
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Jiaxi Chen
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Tingting Cui
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Yuqian Chang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Zhubiao Ye
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Qingrong Ni
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Yinghan Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Pengran Du
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Baizhang Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Ling Liu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Zhe Jian
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Kai Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Tianwen Gao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China
| | - Shuli Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China.
| | - Chunying Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, No 127 of West Changle Road, Xi'an, Shaanxi, 710032, China.
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Richmond JM, Strassner JP, Essien KI, Harris JE. T-cell positioning by chemokines in autoimmune skin diseases. Immunol Rev 2019; 289:186-204. [PMID: 30977191 PMCID: PMC6553463 DOI: 10.1111/imr.12762] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/18/2019] [Accepted: 03/21/2019] [Indexed: 12/12/2022]
Abstract
Autoimmune skin diseases are complex processes in which autoreactive cells must navigate through the skin tissue to find their targets. Regulatory T cells in the skin help to mitigate autoimmune inflammation and may in fact be responsible for the patchy nature of these conditions. In this review, we will discuss chemokines that are important for global recruitment of T cell populations to the skin during disease, as well as signals that fine-tune their localization and function. We will describe prototypical disease responses and chemokine families that mediate these responses. Lastly, we will include an overview of chemokine-targeting drugs that have been tested as new treatment strategies for autoimmune skin diseases.
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Affiliation(s)
- Jillian M Richmond
- Department of Dermatology, UMass Medical School, Worcester, Massachusetts
| | - James P Strassner
- Department of Dermatology, UMass Medical School, Worcester, Massachusetts
| | - Kingsley I Essien
- Department of Dermatology, UMass Medical School, Worcester, Massachusetts
| | - John E Harris
- Department of Dermatology, UMass Medical School, Worcester, Massachusetts
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30
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Tam I, Dzierżęga-Lęcznar A, Stępień K. Differential expression of inflammatory cytokines and chemokines in lipopolysaccharide-stimulated melanocytes from lightly and darkly pigmented skin. Exp Dermatol 2019; 28:551-560. [PMID: 30801846 DOI: 10.1111/exd.13908] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 02/11/2019] [Indexed: 01/02/2023]
Abstract
Increasing evidence suggests that human epidermal melanocytes play an important role in the skin immune system; however, a role of their pigmentation in immune and inflammatory responses is poorly examined. In the study, the expression of Toll-like receptor 4 (TLR4) and inflammatory cytokines and chemokines by cultured normal melanocytes derived from lightly and darkly pigmented skin was investigated after cell stimulation with lipopolysaccharide (LPS). The basal TLR4 mRNA level in heavily pigmented cells was higher as compared to their lightly pigmented counterparts. Melanocyte exposure to LPS upregulated the expression of TLR4 mRNA and enhanced the DNA-binding activity of NF-κB p50 and p65. We found substantial differences in the LPS-stimulated expression of numerous genes encoding inflammatory cytokines and chemokines between the cells with various melanin contents. In lightly pigmented melanocytes, the most significantly upregulated genes were nicotinamide phosphoribosyltransferase (NAMPT/visfatin), the chemokines CCL2 and CCL20, and IL6, while the genes for CXCL12, IL-16 and the chemokine receptor CCR4 were the most significantly upregulated in heavily pigmented cells. Moreover, the lightly pigmented melanocytes secreted much more NAMPT, CCL2 and IL-6. The results of our study suggest modulatory effect of melanogenesis on the immune properties of normal epidermal melanocytes.
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Affiliation(s)
- Irena Tam
- Department of Instrumental Analysis, School of Pharmacy with the Division of Laboratory Medicine, Medical University of Silesia in Katowice, Sosnowiec, Poland
| | - Anna Dzierżęga-Lęcznar
- Department of Instrumental Analysis, School of Pharmacy with the Division of Laboratory Medicine, Medical University of Silesia in Katowice, Sosnowiec, Poland
| | - Krystyna Stępień
- Department of Instrumental Analysis, School of Pharmacy with the Division of Laboratory Medicine, Medical University of Silesia in Katowice, Sosnowiec, Poland
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31
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Das D, Akhtar S, Kurra S, Gupta S, Sharma A. Emerging role of immune cell network in autoimmune skin disorders: An update on pemphigus, vitiligo and psoriasis. Cytokine Growth Factor Rev 2019; 45:35-44. [PMID: 30773437 DOI: 10.1016/j.cytogfr.2019.01.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 01/18/2019] [Indexed: 12/15/2022]
Abstract
Autoimmune skin diseases are a group of disorders that arise due to a deregulated immune system resulting in skin tissue destruction. In the majority of these conditions, either autoreactive immune cells or the autoantibodies are generated against self-antigens of the skin. Although the etiology of these diseases remains elusive, biochemical, genetic, and environmental factors such as infectious agents, toxins damage the skin tissue leading to self-antigen generation, autoantibody attack and finally results in autoimmunity of skin. Immune dysregulation, which involves predominantly T helper 1/17 (Th1/Th17) polarization and the inability of regulatory T cells to regress immune response, is implicated in autoimmune skin diseases. The emerging roles of immune cells, cytokines, and chemokines in the pathogenesis of common autoimmune skin diseases like pemphigus, vitiligo, and psoriasis are discussed in this review. The main focus is on the interplay between immune cell network including the innate and adaptive immune system, regulatory cells, immune checkpoints and recently identified tissue-resident memory cells (TRMs) in disease pathogenesis and relapse. We also attempt to highlight on the immune mechanisms common to these diseases which can be targeted for designing novel therapeutics.
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Affiliation(s)
- Dayasagar Das
- Department of Biochemistry, All India Institute of Medical Sciences, AIIMS, New Delhi, India
| | - Shamima Akhtar
- Department of Biochemistry, All India Institute of Medical Sciences, AIIMS, New Delhi, India
| | - Santosh Kurra
- Department of Biochemistry, All India Institute of Medical Sciences, AIIMS, New Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, AIIMS, New Delhi, India
| | - Alpana Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, AIIMS, New Delhi, India.
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Pei M, Liu X, Zhao C, Gao F, Tao Y, Zhang M. Chemokine and Adhesion Molecule Profiles in Aqueous Humor of Clinically Quiescent Uveitic Cataracts. Curr Eye Res 2018; 44:194-199. [PMID: 30288998 DOI: 10.1080/02713683.2018.1532012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE To investigate the chemokine and adhesion molecule profiles in aqueous humor (AH) of eyes with inactive uveitis and their correlations with inflammation relapse after cataract surgery. METHODS Patients with inactive uveitis who underwent cataract surgery between July 2014 and January 2016 at our center were included. Undiluted AH samples (100-120 µl) were obtained through lateral corneal incisions during surgery, and concentrations of monocyte chemoattractant protein 1 (MCP-1/CCL2), macrophage inflammatory protein 1 (MIP-1), interleukin 8 (IL-8), regulated on activation, normal T cell expressed and secreted (RANTES/CCL5), soluble vascular cell adhesion molecule (sVCAM) and soluble intercellular adhesion molecule (sICAM) were measured by cytometric bead array (BD Bioscience, San Jose, CA). AH levels of these inflammatory factors were compared between different uveitis entities and non-inflammatory control. Risk factors for postoperative inflammation relapse were also analysed in uveitic eyes. RESULTS As compared with the control group, the panuveitis group had significantly higher aqueous concentrations of MCP-1, IL-8, sVCAM, sICAM; the anterior uveitis group had significantly higher concentrations of MCP-1, MIP-1, sVCAM. Uveitic cataracts with postoperative inflammation relapse had significantly higher levels of MCP-1 and IL-8 in AH than those without. And multivariate cox regression analysis revealed that high AH levels of MCP-1 was an independent predictor for postoperative inflammation relapse. CONCLUSIONS Clinically quiescent uveitic eyes have elevated levels of chemokines and soluble adhesion molecules in AH, of which MCP-1 is associate with inflammation relapses after cataract surgery.
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Affiliation(s)
- Minghang Pei
- a Department of Ophthalmology, Peking Union Medical College Hospital , Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Xinshu Liu
- b Department of Ophthalmology , The Fourth People's Hospital of Shenyang , Shenyang , Liaoning , China
| | - Chan Zhao
- a Department of Ophthalmology, Peking Union Medical College Hospital , Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Fei Gao
- a Department of Ophthalmology, Peking Union Medical College Hospital , Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Yong Tao
- c Department of Ophthalmology, Beijing Chao-Yang Hospital , Capital Medical University , Beijing , China
| | - Meifen Zhang
- a Department of Ophthalmology, Peking Union Medical College Hospital , Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
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Boniface K, Seneschal J, Picardo M, Taïeb A. Vitiligo: Focus on Clinical Aspects, Immunopathogenesis, and Therapy. Clin Rev Allergy Immunol 2018; 54:52-67. [PMID: 28685247 DOI: 10.1007/s12016-017-8622-7] [Citation(s) in RCA: 124] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Vitiligo is an acquired chronic depigmenting disorder of the skin, with an estimated prevalence of 0.5% of the general population, characterized by the development of white macules resulting from a loss of epidermal melanocytes. The nomenclature has been revised after an extensive international work within the vitiligo global issues consensus conference, and vitiligo (formerly non-segmental vitiligo) is now a consensus umbrella term for all forms of generalized vitiligo. Two other subsets of vitiligo are segmental vitiligo and unclassified/undetermined vitiligo, which corresponds to focal disease and rare variants. A series of hypopigmented disorders may masquerade as vitiligo, and some of them need to be ruled out by specific procedures including a skin biopsy. Multiple mechanisms are involved in melanocyte disappearance, namely genetic predisposition, environmental triggers, metabolic abnormalities, impaired renewal, and altered inflammatory and immune responses. The auto-immune/inflammatory theory is the leading hypothesis because (1) vitiligo is often associated with autoimmune diseases; (2) most vitiligo susceptibility loci identified through genome-wide association studies encode immunomodulatory proteins; and (3) prominent immune cell infiltrates are found in the perilesional margin of actively depigmenting skin. However, other studies support melanocyte intrinsic abnormalities with poor adaptation of melanocytes to stressors leading to melanocyte instability in the basal layer, and release of danger signals important for the activation of the immune system. Recent progress in the understanding of immune pathomechanisms opens interesting perspectives for innovative treatment strategies. The proof of concept in humans of targeting of the IFNγ /Th1 pathway is much awaited. The interplay between oxidative stress and altered immune responses suggests that additional strategies aiming at limiting type I interferon activation pathway as background stabilizing therapies could be an interesting approach in vitiligo. This review covers classification and clinical aspects, pathophysiology with emphasis on immunopathogenesis, and promising therapeutic approaches.
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Affiliation(s)
- Katia Boniface
- INSERM U1035, ATIP-AVENIR, Université de Bordeaux, Bordeaux, France
| | - Julien Seneschal
- INSERM U1035, ATIP-AVENIR, Université de Bordeaux, Bordeaux, France.,Department of Dermatology and Paediatric Dermatology, National Centre for Rare Skin disorders, Saint-André and Pellegrin Hospital, Bordeaux, France
| | | | - Alain Taïeb
- INSERM U1035, ATIP-AVENIR, Université de Bordeaux, Bordeaux, France. .,Department of Dermatology and Paediatric Dermatology, National Centre for Rare Skin disorders, Saint-André and Pellegrin Hospital, Bordeaux, France. .,Department of Dermatology and Pediatric Dermatology, St André Hospital, Bordeaux University Hospitals, 1 Rue Jean Burguet, 33075, Bordeaux, France.
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34
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Recent Advances in Pathogenesis and Medical Management of Vitiligo. PIGMENTARY SKIN DISORDERS 2018. [DOI: 10.1007/978-3-319-70419-7_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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35
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Lamurias A, Ferreira JD, Clarke LA, Couto FM. Generating a Tolerogenic Cell Therapy Knowledge Graph from Literature. Front Immunol 2017; 8:1656. [PMID: 29238346 PMCID: PMC5712582 DOI: 10.3389/fimmu.2017.01656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 11/13/2017] [Indexed: 11/13/2022] Open
Abstract
Tolerogenic cell therapies provide an alternative to conventional immunosuppressive treatments of autoimmune disease and address, among other goals, the rejection of organ or stem cell transplants. Since various methodologies can be followed to develop tolerogenic therapies, it is important to be aware and up to date on all available studies that may be relevant to their improvement. Recently, knowledge graphs have been proposed to link various sources of information, using text mining techniques. Knowledge graphs facilitate the automatic retrieval of information about the topics represented in the graph. The objective of this work was to automatically generate a knowledge graph for tolerogenic cell therapy from biomedical literature. We developed a system, ICRel, based on machine learning to extract relations between cells and cytokines from abstracts. Our system retrieves related documents from PubMed, annotates each abstract with cell and cytokine named entities, generates the possible combinations of cell–cytokine pairs cooccurring in the same sentence, and identifies meaningful relations between cells and cytokines. The extracted relations were used to generate a knowledge graph, where each edge was supported by one or more documents. We obtained a graph containing 647 cell–cytokine relations, based on 3,264 abstracts. The modules of ICRel were evaluated with cross-validation and manual evaluation of the relations extracted. The relation extraction module obtained an F-measure of 0.789 in a reference database, while the manual evaluation obtained an accuracy of 0.615. Even though the knowledge graph is based on information that was already published in other articles about immunology, the system we present is more efficient than the laborious task of manually reading all the literature to find indirect or implicit relations. The ICRel graph will help experts identify implicit relations that may not be evident in published studies.
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Affiliation(s)
- Andre Lamurias
- LaSIGE, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
| | - João D Ferreira
- LaSIGE, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
| | - Luka A Clarke
- BioISI: Biosystems & Integrative Sciences Institute, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
| | - Francisco M Couto
- LaSIGE, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
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Mahesh S, Mallappa M, Tsintzas D, Vithoulkas G. Homeopathic Treatment of Vitiligo: A Report of Fourteen Cases. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:1276-1283. [PMID: 29196612 PMCID: PMC5723025 DOI: 10.12659/ajcr.905340] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Case series Patient: — Final Diagnosis: — Symptoms: Skin lesions Medication: — Clinical Procedure: — Specialty: Dermatology
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Affiliation(s)
- Seema Mahesh
- Centre for Classical Homeopathy, Vijayanagar, Bangalore, Karnataka, India
| | - Mahesh Mallappa
- Centre for Classical Homeopathy, Vijayanagar, Bangalore, Karnataka, India
| | - Dionysios Tsintzas
- Department of Orthopedics, General Hospital of Aitoloakarnania, Agrinio, Greece
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Abstract
The pathophysiology of vitiligo is becoming increasingly clarified. In non-segmental vitiligo, early factors include activation of innate immunity, inflammasome activation, oxidative stress, and loss of melanocyte adhesion. Nonetheless, the main mechanism leading to non-segmental vitiligo involves an immune-mediated destruction of melanocytes. Anti-melanocyte-specific cytotoxic T cells exert a central role in the final effector stage. Genetic research revealed a multi-genetic inheritance displaying an overlap with other autoimmune disorders. However, some melanocyte-specific genes were also affected. Segmental vitiligo carries a different pathogenesis with most evidence indicating a mosaic skin disorder. Current management includes topical corticosteroids and immunomodulators. Narrow-band ultraviolet B can be used in patients not responding to topical treatment or in patients with extensive disease. Pigment cell transplantation offers an alternative for the treatment of segmental vitiligo or stable non-segmental lesions. Recent findings have revealed new targets for treatment that could lead to more efficient therapies. Targeted immunotherapy may halt the active immune pathways, although combination therapy may still be required to induce satisfying repigmentation. A recently established core set of outcome measures, new measurement instruments, and biomarker research pave the way for future standardized clinical trials.
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Affiliation(s)
- Reinhart Speeckaert
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
| | - Nanja van Geel
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
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Alexeev V, Salas-Alanis JC, Palisson F, Mukhtarzada L, Fortuna G, Uitto J, South A, Igoucheva O. Pro-Inflammatory Chemokines and Cytokines Dominate the Blister Fluid Molecular Signature in Patients with Epidermolysis Bullosa and Affect Leukocyte and Stem Cell Migration. J Invest Dermatol 2017; 137:2298-2308. [PMID: 28736230 DOI: 10.1016/j.jid.2017.07.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 06/05/2017] [Accepted: 07/03/2017] [Indexed: 12/21/2022]
Abstract
Hereditary epidermolysis bullosa (EB) is associated with skin blistering and the development of chronic nonhealing wounds. Although clinical studies have shown that cell-based therapies improve wound healing, the recruitment of therapeutic cells to blistering skin and to more advanced skin lesions remains a challenge. Here, we analyzed cytokines and chemokines in blister fluids of patients affected by dystrophic, junctional, and simplex EB. Our analysis revealed high levels of CXCR1, CXCR2, CCR2, and CCR4 ligands, particularly dominant in dystrophic and junctional EB. In vitro migration assays demonstrated the preferential recruitment of CCR4+ lymphocytes and CXCR1+, CXCR2+, and CCR2+ myeloid cells toward EB-derived blister fluids. Immunophenotyping of skin-infiltrating leukocytes confirmed substantial infiltration of EB-affected skin with resting (CD45RA+) and activated (CD45RO+) T cells and CXCR2+ CD11b+ cells, many of which were identified as CD16b+ neutrophils. Our studies also showed that abundance of CXCR2 ligand in blister fluids also creates a favorable milieu for the recruitment of the CXCR2+ stem cells, as validated by in vitro and in-matrix migration assays. Collectively, this study identified several chemotactic pathways that control the recruitment of leukocytes to the EB-associated skin lesions. These chemotactic axes could be explored for the refinement of the cutaneous homing of the therapeutic stem cells.
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Affiliation(s)
- Vitali Alexeev
- Department of Dermatology and Cutaneous Biology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Julio Cesar Salas-Alanis
- Department of Basic Sciences, Health Sciences Division, University of Monterrey, Monterrey, Mexico
| | - Francis Palisson
- Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Lila Mukhtarzada
- Department of Dermatology and Cutaneous Biology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Giulio Fortuna
- Department of Diagnostic Science, Louisiana State University School of Dentistry, New Orleans, Louisiana, USA
| | - Jouni Uitto
- Department of Dermatology and Cutaneous Biology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Andrew South
- Department of Dermatology and Cutaneous Biology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Olga Igoucheva
- Department of Dermatology and Cutaneous Biology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
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Speeckaert R, Speeckaert M, De Schepper S, van Geel N. Biomarkers of disease activity in vitiligo: A systematic review. Autoimmun Rev 2017; 16:937-945. [PMID: 28698094 DOI: 10.1016/j.autrev.2017.07.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 05/29/2017] [Indexed: 12/18/2022]
Abstract
The pathophysiology of vitiligo is complex although recent research has discovered several markers which are linked to vitiligo and associated with disease activity. Besides providing insights into the driving mechanisms of vitiligo, these findings could reveal potential biomarkers. Activity markers can be used to monitor disease activity in clinical trials and may also be useful in daily practice. The aim of this systematic review was to document which factors have been associated with vitiligo activity in skin and blood. A second goal was to determine how well these factors are validated in terms of sensitivity and specificity as biomarkers to determine vitiligo activity. Both in skin (n=43) as in blood (n=66) an adequate number of studies fulfilled the predefined inclusion criteria. These studies used diverse methods and investigated a broad range of plausible biomarkers. Unfortunately, sensitivity and specificity analyses were scarce. In skin, simple histopathology with or without supplemental CD4 and CD8 stainings can still be considered as the gold standard, although more recently chemokine (C-X-C motif) ligand (CXCL) 9 and NLRP1 have demonstrated a good and possibly even better association with progressive disease. Regarding circulating biomarkers, cytokines (IL-1β, IL-17, IFN-γ, TGF-β), autoantibodies, oxidative stress markers, immune cells (Tregs), soluble CDs (sCD25, sCD27) and chemokines (CXCL9, CXCL10) are still competing. However, the two latter may be preferable as both chemokines and soluble CDs are easy to measure and the available studies display promising results. A large multicenter study could make more definitive statements regarding their sensitivity and specificity.
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Affiliation(s)
- R Speeckaert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium.
| | - M Speeckaert
- Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - S De Schepper
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - N van Geel
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
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Alexeev V. CXCL12 as a Predictor of Vitiligo Activity and Disease Progression. J Invest Dermatol 2017; 137:1588-1590. [PMID: 28365260 DOI: 10.1016/j.jid.2017.03.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 03/14/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Vitali Alexeev
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
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Alterations of CXCL12 in Serum of Patients with Vitiligo. J Invest Dermatol 2017; 137:1586-1588. [PMID: 28238843 DOI: 10.1016/j.jid.2017.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 02/09/2017] [Indexed: 10/20/2022]
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