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Speeckaert R, Caelenberg EV, Belpaire A, Speeckaert MM, Geel NV. Vitiligo: From Pathogenesis to Treatment. J Clin Med 2024; 13:5225. [PMID: 39274437 PMCID: PMC11396398 DOI: 10.3390/jcm13175225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Revised: 08/28/2024] [Accepted: 09/01/2024] [Indexed: 09/16/2024] Open
Abstract
Recent advances in vitiligo have provided promising treatment options, particularly through understanding the immune-mediated mechanisms leading to depigmentation. The inflammatory components in both vitiligo (non-segmental) and segmental vitiligo have similarities. Both are believed to result from an immune-based destruction of melanocytes by anti-melanocyte-specific cytotoxic T cells. The JAK-STAT pathway is activated with IFN-γ as the crucial cytokine and Th1-associated chemokines such as CXCL9 and CXCL10 recruit immune cells towards vitiligo skin. Nonetheless, clear differences are also present, such as the localized nature of segmental vitiligo, likely due to somatic mosaicism and increased presence of poliosis. The differing prevalence of poliosis suggests that the follicular immune privilege, which is known to involve immune checkpoints, may be more important in vitiligo (non-segmental). Immunomodulatory therapies, especially those targeting the JAK-IFNγ pathway, are currently at the forefront, offering effective inhibition of melanocyte destruction by cytotoxic T cells. Although Janus Kinase (JAK) inhibitors demonstrate high repigmentation rates, optimal results can take several months to years. The influence of environmental UV exposure on repigmentation in patients receiving immunomodulating drugs remains largely underexplored. Nonetheless, the combined effect of phototherapy with JAK inhibitors is impressive and suggests a targeted immune-based treatment may still require additional stimulation of melanocytes for repigmentation. Identifying alternative melanocyte stimulants beyond UV light remains crucial for the future management of vitiligo.
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Affiliation(s)
| | | | - Arno Belpaire
- Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium
| | | | - Nanja van Geel
- Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium
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Fowler EA, Farias Amorim C, Mostacada K, Yan A, Amorim Sacramento L, Stanco RA, Hales ED, Varkey A, Zong W, Wu GD, de Oliveira CI, Collins PL, Novais FO. Neutrophil-mediated hypoxia drives pathogenic CD8+ T cell responses in cutaneous leishmaniasis. J Clin Invest 2024; 134:e177992. [PMID: 38833303 PMCID: PMC11245163 DOI: 10.1172/jci177992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/17/2024] [Indexed: 06/06/2024] Open
Abstract
Cutaneous leishmaniasis caused by Leishmania parasites exhibits a wide range of clinical manifestations. Although parasites influence disease severity, cytolytic CD8+ T cell responses mediate disease. Although these responses originate in the lymph node, we found that expression of the cytolytic effector molecule granzyme B was restricted to lesional CD8+ T cells in Leishmania-infected mice, suggesting that local cues within inflamed skin induced cytolytic function. Expression of Blimp-1 (Prdm1), a transcription factor necessary for cytolytic CD8+ T cell differentiation, was driven by hypoxia within the inflamed skin. Hypoxia was further enhanced by the recruitment of neutrophils that consumed oxygen to produce ROS and ultimately increased the hypoxic state and granzyme B expression in CD8+ T cells. Importantly, lesions from patients with cutaneous leishmaniasis exhibited hypoxia transcription signatures that correlated with the presence of neutrophils. Thus, targeting hypoxia-driven signals that support local differentiation of cytolytic CD8+ T cells may improve the prognosis for patients with cutaneous leishmaniasis, as well as for other inflammatory skin diseases in which cytolytic CD8+ T cells contribute to pathogenesis.
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Affiliation(s)
- Erin A. Fowler
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | | | - Klauss Mostacada
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Allison Yan
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | | | - Rae A. Stanco
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Emily D.S. Hales
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Aditi Varkey
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Wenjing Zong
- Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gary D. Wu
- Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Camila I. de Oliveira
- Instituto Gonçalo Moniz, FIOCRUZ, Salvador, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, Salvador, Brazil
| | - Patrick L. Collins
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Fernanda O. Novais
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, Ohio, USA
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3
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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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Yamaguchi HL, Yamaguchi Y, Peeva E. Pathogenesis of Alopecia Areata and Vitiligo: Commonalities and Differences. Int J Mol Sci 2024; 25:4409. [PMID: 38673994 PMCID: PMC11049978 DOI: 10.3390/ijms25084409] [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: 03/26/2024] [Revised: 04/13/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024] Open
Abstract
Both alopecia areata (AA) and vitiligo are distinct, heterogenous, and complex disease entities, characterized by nonscarring scalp terminal hair loss and skin pigment loss, respectively. In AA, inflammatory cell infiltrates are in the deep reticular dermis close to the hair bulb (swarm of bees), whereas in vitiligo the inflammatory infiltrates are in the epidermis and papillary dermis. Immune privilege collapse has been extensively investigated in AA pathogenesis, including the suppression of immunomodulatory factors (e.g., transforming growth factor-β (TGF-β), programmed death-ligand 1 (PDL1), interleukin-10 (IL-10), α-melanocyte-stimulating hormone (α-MSH), and macrophage migration inhibitory factor (MIF)) and enhanced expression of the major histocompatibility complex (MHC) throughout hair follicles. However, immune privilege collapse in vitiligo remains less explored. Both AA and vitiligo are autoimmune diseases that share commonalities in pathogenesis, including the involvement of plasmacytoid dendritic cells (and interferon-α (IFN- α) signaling pathways) and cytotoxic CD8+ T lymphocytes (and activated IFN-γ signaling pathways). Blood chemokine C-X-C motif ligand 9 (CXCL9) and CXCL10 are elevated in both diseases. Common factors that contribute to AA and vitiligo include oxidative stress, autophagy, type 2 cytokines, and the Wnt/β-catenin pathway (e.g., dickkopf 1 (DKK1)). Here, we summarize the commonalities and differences between AA and vitiligo, focusing on their pathogenesis.
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Affiliation(s)
| | - Yuji Yamaguchi
- Inflammation & Immunology Research Unit, Pfizer, Collegeville, PA 19426, USA
| | - Elena Peeva
- Inflammation & Immunology Research Unit, Pfizer, Cambridge, MA 02139, USA;
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Migayron L, Merhi R, Seneschal J, Boniface K. Resident memory T cells in nonlesional skin and healed lesions of patients with chronic inflammatory diseases: Appearances can be deceptive. J Allergy Clin Immunol 2024; 153:606-614. [PMID: 37995858 DOI: 10.1016/j.jaci.2023.11.017] [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: 09/12/2023] [Revised: 10/30/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023]
Abstract
Tissue-resident memory T (TRM) cells serve as a first line of defense in peripheral tissues to protect the organism against foreign pathogens. However, autoreactive TRM cells are increasingly implicated in autoimmunity, as evidenced in chronic autoimmune and inflammatory skin conditions. This highlights the need to characterize their phenotype and understand their role for the purpose of targeting them specifically without affecting local immunity. To date, the investigation of TRM cells in human skin diseases has focused mainly on lesional tissues of patients. Accumulating evidence suggests that self-reactive TRM cells are still present in clinically healed lesions of patients and play a role in disease flares, but TRM cells also populate skin that is apparently normal. This review discusses the ontogeny of TRM cells in the skin as well as recent insights regarding the presence of self-reactive TRM cells in both clinically healed skin and nonlesional skin of patients with autoimmune and inflammatory skin conditions, with a particular focus on psoriasis, atopic dermatitis, and vitiligo.
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Affiliation(s)
- Laure Migayron
- University of Bordeaux, CNRS, ImmunoConcEpT, UMR5164, F-33000, Bordeaux, France; R&D Department, SILAB, Brive-la-Gaillarde, France
| | - Ribal Merhi
- University of Bordeaux, CNRS, ImmunoConcEpT, UMR5164, F-33000, Bordeaux, France
| | - Julien Seneschal
- University of Bordeaux, CNRS, ImmunoConcEpT, UMR5164, F-33000, Bordeaux, France; CHU de Bordeaux, Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hôpital Saint-André, UMR Bordeaux, Bordeaux, France
| | - Katia Boniface
- University of Bordeaux, CNRS, ImmunoConcEpT, UMR5164, F-33000, Bordeaux, France.
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Cao GZ, Tian LL, Hou JY, Zhang Y, Xu H, Yang HJ, Zhang JJ. Integrating RNA-sequencing and network analysis to explore the mechanism of topical Pien Tze Huang treatment on diabetic wounds. Front Pharmacol 2024; 14:1288406. [PMID: 38293673 PMCID: PMC10826880 DOI: 10.3389/fphar.2023.1288406] [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: 09/27/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction: Diabetic ulcers have become one of the major complications of diabetes mellitus (DM) and are a leading cause of death and disabling disease. However, current therapies are not effective enough to meet clinical needs. A traditional Chinese medicine (TCM) formula, Pien Tze Huang (PZH), is known as a medicine that is used to treat diabetic ulcers. Methods: In this study, PZH (0.05 g/cm2 and 0.15 g/cm2) and the positive drug-rhEGF were topically administered in a high-fat diet (HFD) and streptozotocin (STZ)-induced diabetic full-thickness incisional wounds, respectively. Wound healing was assessed by wound closure rate, two-photon microscope (SHG), staining with Hematoxylin and eosin (H&E), and Masson's trichrome (MTC). Then, RNA sequencing (RNA-seq) analysis, Enzyme-linked immunosorbent assay (ELISA), western blotting, and immunofluorescence (IF), network analysis, were performed. Results and discussion: The results showed that PZH significantly accelerated wound healing, as well as enhanced the expression of collagen. RNA-seq analysis showed that PZH has functions on various biological processes, one of the key biological processes is inflammatory response. Tlr9, Klrk1, Nod2, Tlr2, and Ifng were identified as vital targets and the NF-κB signaling pathway was identified as the vital pathway. Additionally, PZH profoundly reduced the levels of Cleaved caspase-3 and promoted the expression of CD31 and TGF-β1. Mechanically, PZH significantly decreased expression of NKG2-D, NOD2, and TLR2, and further inhibited the activation of downstream NF-κB signaling pathway and inhibited expression of inflammatory factors (IFN-γ and IL-1β). Importantly, we found that several active ingredients may play a significant role in diabetic wound healing, including Notoginsenoside R1, Deoxycorticosterone, Ursolic acid, and 4-Methoxyphenol. In summary, our study sheds light on the complicated mechanisms underlying the promising anti-diabetic wounds of PZH and provides the discovery of agents treating diabetic ulcers.
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Affiliation(s)
- Guang-Zhao Cao
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Liang-Liang Tian
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jing-Yi Hou
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yi Zhang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - He Xu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hong-Jun Yang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jing-Jing Zhang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
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Nicolàs LSDS, Czarnowicki T, Akdis M, Pujol RM, Lozano-Ojalvo D, Leung DYM, Guttman-Yassky E, Santamaria-Babí LF. CLA+ memory T cells in atopic dermatitis. Allergy 2024; 79:15-25. [PMID: 37439317 DOI: 10.1111/all.15816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/07/2023] [Accepted: 06/29/2023] [Indexed: 07/14/2023]
Abstract
Circulating skin-homing cutaneous lymphocyte-associated antigen (CLA)+ T cells constitute a small subset of human memory T cells involved in several aspects of atopic dermatitis: Staphylococcus aureus related mechanisms, the abnormal Th2 immune response, biomarkers, clinical aspects of the patients, pruritus, and the mechanism of action of targeted therapies. Superantigens, IL-13, IL-31, pruritus, CCL17 and early effects on dupilumab-treated patients have in common that they are associated with the CLA+ T cell mechanisms in atopic dermatitis patients. The function of CLA+ T cells corresponds with the role of T cells belonging to the skin-associated lymphoid tissue and could be a reason why they reflect different mechanisms of atopic dermatitis and many other T cell mediated skin diseases. The goal of this review is to gather all this translational information of atopic dermatitis pathology.
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Affiliation(s)
- Lídia Sans-de San Nicolàs
- Immunologia Translacional, Departament de Biologia Cel·lular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona (UB), Parc Científic de Barcelona (PCB), Barcelona, Spain
| | - Tali Czarnowicki
- Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos-Wolfgang, Switzerland
| | - Ramon M Pujol
- Departament de Dermatologia, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Daniel Lozano-Ojalvo
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Donald Y M Leung
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA
| | - Emma Guttman-Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Luis F Santamaria-Babí
- Immunologia Translacional, Departament de Biologia Cel·lular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona (UB), Parc Científic de Barcelona (PCB), Barcelona, Spain
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Kuznetsov D, Kalyuzhin O, Mironov A, Neschisliaev V, Kuznetsova A. A case of vitiligo after COVID-19 vaccination: a possible role of thymic dysfunction. J Zhejiang Univ Sci B 2023; 24:1141-1150. [PMID: 38057270 PMCID: PMC10710914 DOI: 10.1631/jzus.b2300025] [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: 01/09/2023] [Accepted: 06/06/2023] [Indexed: 12/08/2023]
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, vaccines help control the spread of infection. To date, 47 vaccines have been approved, with another 227 candidates in various stages of development. In the short period of time since the beginning of their use, evidence has begun to emerge of complications following vaccination in the form of the development or exacerbation of a number of pathological conditions (Block et al., 2022; Haseeb et al., 2022). For example, a population-based study in France identified 1612 cases of myocarditis and 1613 cases of pericarditis requiring hospital treatment within five months of vaccination (le Vu et al., 2022).
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Affiliation(s)
- Denis Kuznetsov
- G N. Gabrichevsky Scientific and Research Institute of Epidemiology and Microbiology, Moscow 125212, Russia.
| | - Oleg Kalyuzhin
- I M. Sechenov First Moscow State Medical University, Moscow 119991, Russia
| | - Andrey Mironov
- G N. Gabrichevsky Scientific and Research Institute of Epidemiology and Microbiology, Moscow 125212, Russia
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Fowler EA, Amorim CF, Mostacada K, Yan A, Sacramento LA, Stanco RA, Hales EDS, Varkey A, Zong W, Wu GD, de Oliveira CI, Collins PL, Novais FO. Pathogenic CD8 T cell responses are driven by neutrophil-mediated hypoxia in cutaneous leishmaniasis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.18.562926. [PMID: 37904953 PMCID: PMC10614852 DOI: 10.1101/2023.10.18.562926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Cutaneous leishmaniasis caused by Leishmania parasites exhibits a wide range of clinical manifestations. Although parasites influence disease severity, cytolytic CD8 T cell responses mediate disease. While these responses originate in the lymph node, we find that expression of the cytolytic effector molecule granzyme B is restricted to lesional CD8 T cells in Leishmania - infected mice, suggesting that local cues within inflamed skin induce cytolytic function. Expression of Blimp-1 ( Prdm1 ), a transcription factor necessary for cytolytic CD8 T cell differentiation, is driven by hypoxia within the inflamed skin. Hypoxia is further enhanced by the recruitment of neutrophils that consume oxygen to produce reactive oxygen species, ultimately increasing granzyme B expression in CD8 T cells. Importantly, lesions from cutaneous leishmaniasis patients exhibit hypoxia transcription signatures that correlate with the presence of neutrophils. Thus, targeting hypoxia-driven signals that support local differentiation of cytolytic CD8 T cells may improve the prognosis for patients with cutaneous leishmaniasis, as well as other inflammatory skin diseases where cytolytic CD8 T cells contribute to pathogenesis.
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Passeron T, King B, Seneschal J, Steinhoff M, Jabbari A, Ohyama M, Tobin DJ, Randhawa S, Winkler A, Telliez JB, Martin D, Lejeune A. Inhibition of T-cell activity in alopecia areata: recent developments and new directions. Front Immunol 2023; 14:1243556. [PMID: 38022501 PMCID: PMC10657858 DOI: 10.3389/fimmu.2023.1243556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
Alopecia areata (AA) is an autoimmune disease that has a complex underlying immunopathogenesis characterized by nonscarring hair loss ranging from small bald patches to complete loss of scalp, face, and/or body hair. Although the etiopathogenesis of AA has not yet been fully characterized, immune privilege collapse at the hair follicle (HF) followed by T-cell receptor recognition of exposed HF autoantigens by autoreactive cytotoxic CD8+ T cells is now understood to play a central role. Few treatment options are available, with the Janus kinase (JAK) 1/2 inhibitor baricitinib (2022) and the selective JAK3/tyrosine kinase expressed in hepatocellular carcinoma (TEC) inhibitor ritlecitinib (2023) being the only US Food and Drug Administration-approved systemic medications thus far for severe AA. Several other treatments are used off-label with limited efficacy and/or suboptimal safety and tolerability. With an increased understanding of the T-cell-mediated autoimmune and inflammatory pathogenesis of AA, additional therapeutic pathways beyond JAK inhibition are currently under investigation for the development of AA therapies. This narrative review presents a detailed overview about the role of T cells and T-cell-signaling pathways in the pathogenesis of AA, with a focus on those pathways targeted by drugs in clinical development for the treatment of AA. A detailed summary of new drugs targeting these pathways with expert commentary on future directions for AA drug development and the importance of targeting multiple T-cell-signaling pathways is also provided in this review.
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Affiliation(s)
- Thierry Passeron
- University Côte d’Azur, Centre Hospitalier Universitaire Nice, Department of Dermatology, Nice, France
- University Côte d’Azur, INSERM, U1065, C3M, Nice, France
| | - Brett King
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, United States
| | - Julien Seneschal
- Department of Dermatology and Paediatric Dermatology, National Reference Centre for Rare Skin Diseases, Saint-André Hospital, University of Bordeaux, Bordeaux, France
- Bordeaux University, Centre national de la recherche scientifique (CNRS), ImmunoConcept, UMR5164, Bordeaux, France
| | - Martin Steinhoff
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Department of Dermatology and Venereology, Weill Cornell Medicine-Qatar, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
- Department of Dermatology, Weill Cornell Medicine, New York, NY, United States
- College of Health and Life Sciences, Hamad Bin Khalifa University-Qatar, Doha, Qatar
| | - Ali Jabbari
- Department of Dermatology, University of Iowa, Iowa City, IA, United States
- Iowa City VA Medical Center, Iowa City, IA, United States
| | - Manabu Ohyama
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Desmond J. Tobin
- Charles Institute of Dermatology, UCD School of Medicine, University College Dublin, Dublin, Ireland
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Lajevardi V, Hosseini ZSS, Heidari S. Efficacy of using oral methotrexate with phototherapy in the treatment of vitiligo in comparison with single phototherapy treatment: A double-blinded randomized controlled trial. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2023; 39:657-662. [PMID: 37859524 DOI: 10.1111/phpp.12918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/20/2023] [Accepted: 10/03/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Vitiligo is an acquired skin disease with a worldwide prevalence of 0.5%-2% and a tendency to involve both genders. Although the exact pathologic mechanism is unknown, there is some evidence for the role of autoimmunity in this disease. Based on this theory, various immunosuppressive agents, such as topical or systemic corticosteroids and phototherapy (including narrowband ultraviolet B), are used. Methotrexate is another immunosuppressant that has recently become popular as a single treatment for vitiligo; however, the synergistic effect and its superiority over other treatments are two crucial factors that are still obscure. This study aimed to compare the efficacy of methotrexate+ NB-UVB versus placebo+ NB-UVB in vitiligo patients. METHODS In this double-blinded, randomized controlled trial, 42 patients were randomly allocated into two groups: the first group received three times weekly NB-UVB plus placebo, and the second group was treated with three times weekly NB-UVB in combination with a weekly dose of 12.5 mg MTX. The total duration of treatment was 6 months, patients were followed up every 2 months, and the assessment tools were VASI (repigmentation indicator) and VIDA (disease activity indicator) scores. RESULTS Both treatment groups showed improvement in VASI and VIDA scores during 6-month follow-up, but no statistical significance was found between the two treatment methods. CONCLUSION This study demonstrated that both treatment modalities were equally effective, and further studies are required to evaluate the efficacy of MTX with other medications with longer follow-up and a larger sample size.
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Affiliation(s)
- Vahide Lajevardi
- Department of Dermatology, RAZI Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sama Heidari
- Department of Dermatology, RAZI Hospital, Tehran University of Medical Sciences, Tehran, Iran
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12
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Strobl J, Haniffa M. Functional heterogeneity of human skin-resident memory T cells in health and disease. Immunol Rev 2023; 316:104-119. [PMID: 37144705 PMCID: PMC10952320 DOI: 10.1111/imr.13213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/11/2023] [Accepted: 04/15/2023] [Indexed: 05/06/2023]
Abstract
The human skin is populated by a diverse pool of memory T cells, which can act rapidly in response to pathogens and cancer antigens. Tissue-resident memory T cells (TRM ) have been implicated in range of allergic, autoimmune and inflammatory skin diseases. Clonal expansion of cells with TRM properties is also known to contribute to cutaneous T-cell lymphoma. Here, we review the heterogeneous phenotypes, transcriptional programs, and effector functions of skin TRM . We summarize recent studies on TRM formation, longevity, plasticity, and retrograde migration and contextualize the findings to skin TRM and their role in maintaining skin homeostasis and altered functions in skin disease.
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Affiliation(s)
- Johanna Strobl
- Department of DermatologyMedical University of ViennaViennaAustria
- CeMM Research Center for Molecular MedicineViennaAustria
| | - Muzlifah Haniffa
- Wellcome Sanger InstituteCambridgeUK
- Department of Dermatology and NIHR Newcastle Biomedical Research CentreNewcastle Hospitals NHS Foundation TrustNewcastle upon TyneUK
- Biosciences InstituteNewcastle UniversityNewcastle upon TyneUK
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Chen J, Guo W, Du P, Cui T, Yang Y, Wang Y, Kang P, Zhang Z, Wang Q, Ye Z, Liu L, Jian Z, Gao T, Bian H, Li S, Li C. MIF inhibition alleviates vitiligo progression by suppressing CD8 + T cell activation and proliferation. J Pathol 2023; 260:84-96. [PMID: 36852981 DOI: 10.1002/path.6073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/18/2023] [Accepted: 02/22/2023] [Indexed: 03/01/2023]
Abstract
In vitiligo, autoreactive CD8+ T cells have been established as the main culprit considering its pathogenic role in mediating epidermal melanocyte-specific destruction. Macrophage migration inhibitory factor (MIF) is a pleiotropic molecule that plays a central role in various immune processes including the activation and proliferation of T cells; but whether MIF is intertwined in vitiligo development and progression and its involvement in aberrantly activated CD8+ T cells remains ill-defined. In this study, we found that MIF was overabundant in vitiligo patients and a mouse model for human vitiligo. Additionally, inhibiting MIF ameliorated the disease progression in vitiligo mice, which manifested as less infiltration of CD8+ T cells and more retention of epidermal melanocytes in the tail skin. More importantly, in vitro experiments indicated that MIF-inhibition suppressed the activation and proliferation of CD8+ T cells from the lymph nodes of vitiligo mice, and the effect extended to CD8+ T cells in peripheral blood mononuclear cells of vitiligo patients. Finally, CD8+ T cells derived from MIF-inhibited vitiligo mice also exhibited an impaired capacity for activation and proliferation. Taken together, our results show that MIF might be clinically targetable in vitiligo treatment, and its inhibition might ameliorate vitiligo progression by suppressing autoreactive CD8+ T cell activation and proliferation. © 2023 The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Jianru Chen
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
| | - Weinan Guo
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
| | - Pengran Du
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
| | - Tingting Cui
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
| | - Yuqi Yang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
| | - Yinghan Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
| | - Pan Kang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
| | - Zhe Zhang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
| | - Qi Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
| | - Zhubiao Ye
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
| | - Ling Liu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
| | - Zhe Jian
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
| | - Tianwen Gao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
| | - Huijie Bian
- National Translational Science Center for Molecular Medicine and Department of Cell Biology, Fourth Military Medical University, Xi'an, PR China
| | - Shuli Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
| | - Chunying Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China
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Gallo D, Baci D, Kustrimovic N, Lanzo N, Patera B, Tanda ML, Piantanida E, Mortara L. How Does Vitamin D Affect Immune Cells Crosstalk in Autoimmune Diseases? Int J Mol Sci 2023; 24:ijms24054689. [PMID: 36902117 PMCID: PMC10003699 DOI: 10.3390/ijms24054689] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/16/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023] Open
Abstract
Vitamin D is a secosteroid hormone that is highly involved in bone health. Mounting evidence revealed that, in addition to the regulation of mineral metabolism, vitamin D is implicated in cell proliferation and differentiation, vascular and muscular functions, and metabolic health. Since the discovery of vitamin D receptors in T cells, local production of active vitamin D was demonstrated in most immune cells, addressing the interest in the clinical implications of vitamin D status in immune surveillance against infections and autoimmune/inflammatory diseases. T cells, together with B cells, are seen as the main immune cells involved in autoimmune diseases; however, growing interest is currently focused on immune cells of the innate compartment, such as monocytes, macrophages, dendritic cells, and natural killer cells in the initiation phases of autoimmunity. Here we reviewed recent advances in the onset and regulation of Graves' and Hashimoto's thyroiditis, vitiligo, and multiple sclerosis in relation to the role of innate immune cells and their crosstalk with vitamin D and acquired immune cells.
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Affiliation(s)
- Daniela Gallo
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Denisa Baci
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy
- Molecular Cardiology Laboratory, IRCCS-Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
| | - Natasa Kustrimovic
- Center for Translational Research on Autoimmune and Allergic Disease—CAAD, Università del Piemonte Orientale, 28100 Novara, Italy
| | - Nicola Lanzo
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Bohdan Patera
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Maria Laura Tanda
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Eliana Piantanida
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Lorenzo Mortara
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy
- Correspondence:
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15
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Zhang M, Xia T, Lin F, Yu J, Yang Y, Lei W, Zhang T. Vitiligo: An immune disease and its emerging mesenchymal stem cell therapy paradigm. Transpl Immunol 2023; 76:101766. [PMID: 36464219 DOI: 10.1016/j.trim.2022.101766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/31/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022]
Abstract
Melanocyte damage, innate immune response, adaptive immune response, and immune inflammatory microenvironment disorders are involved in the development of the immunological pathogenic mechanism of vitiligo. Mesenchymal stem cells are considered an ideal type of cells for the treatment of vitiligo owing to their low immunogenicity, lower rates of transplant rejection, and ability to secrete numerous growth factors, exosomes, and cytokines in vivo. The regulation of signaling pathways related to oxidative stress and immune imbalance in the immunological pathogenesis of vitiligo can improve the immune microenvironment of tissue injury sites. In addition, co-transplantation with melanocytes can reverse the progression of vitiligo. Therefore, continuous in-depth research on the immunopathogenic mechanism involved in this disease and mesenchymal stem cell-based therapy is warranted for the treatment of vitiligo in the future.
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Affiliation(s)
- Meng Zhang
- Key Laboratory of Cell Engineering of Guizhou Province, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Tingting Xia
- Department of Dermatology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Fengqin Lin
- Key Laboratory of Cell Engineering of Guizhou Province, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Jiang Yu
- Key Laboratory of Cell Engineering of Guizhou Province, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China; The Clinical Stem Cell Research Institute, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Ying Yang
- Department of Dermatology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Wei Lei
- Department of Dermatology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Tao Zhang
- Key Laboratory of Cell Engineering of Guizhou Province, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China; The Clinical Stem Cell Research Institute, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China; Department of Dermatology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
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Aydýngoz İ, Bingül İ, Vural P, Doğru-Abbasoğlu S. Major histocompatibility complex class I-related chain A and macrophage migration inhibitory factor gene polymorphisms in a Turkish patient population with vitiligo. TURKISH JOURNAL OF DERMATOLOGY 2023. [DOI: 10.4103/tjd.tjd_52_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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17
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Liu L, Chen Y, Chen J, Xue Y, Chen T, Li Y, Shao X, Chen J. Association between frontal fibrosing Alopecia and Rosacea: Results from clinical observational studies and gene expression profiles. Front Immunol 2022; 13:985081. [PMID: 36091020 PMCID: PMC9448884 DOI: 10.3389/fimmu.2022.985081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundIn recent years, frontal fibrosing alopecia (FFA), a type of scarring alopecia, has attracted increasing attention. Several studies have reported the frequent occurrence of rosacea in FFA; however, the association between FFA and rosacea and the underlying pathogenesis have not been thoroughly clarified. Thus, this study aimed to quantify these relationships and investigate their shared molecular mechanisms.MethodsWe evaluated the association between FFA and rosacea by analyzing clinical data from nine observational studies. We then analyzed the gene expression profiles of FFA and rosacea. First, differential expression analysis and weighted gene co-expression network analysis were used to identify the common differentially expressed genes (DEGs). Later, we conducted a functional enrichment analysis and protein-protein interaction network and used seven algorithms to identify hub genes. Then, we performed a correlation analysis between the hub genes and the gene set variation analysis scores of common pathways in the gene set enrichment analysis (GSEA). The results were validated using different datasets. Finally, transcription factors were predicted and verified, and CIBERSORT and single-sample GSEA were used to estimate the infiltrating immune cells.ResultsPatients with FFA had significantly higher odds for rosacea (pooled odds ratio [OR], 2.46; 95% confidence interval [CI], 1.78–3.40), and the pooled prevalence of rosacea in patients with FFA was 23% (95% CI, 14–23%). Furthermore, we identified 115 co-DEGs and 13 hub genes (CCR5, CCL19, CD2, CD38, CD83, CXCL8, CXCL9, CXCL10, CXCL11, CXCR4, IRF1, IRF8, and PTPRC). Seven pathways showed a high correlation with these hub genes. In addition, one TF, STAT1, was highly expressed in both diseases, and the results of the immune infiltration analysis indicated the importance of M1 macrophages and effector memory CD8+ T cells.ConclusionThis study contributes to the understanding of the relationship between FFA and rosacea, and based on the hub genes, we reveal the potential pathologies shared by the two diseases. This finding provides new insights of underlying molecular mechanisms and it may inspire future research on this comorbidity.
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Affiliation(s)
- Lin Liu
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yangmei Chen
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiayi Chen
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuzhou Xue
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China
| | - Tingqiao Chen
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuxin Li
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xinyi Shao
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jin Chen
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Jin Chen,
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Hlača N, Žagar T, Kaštelan M, Brajac I, Prpić-Massari L. Current Concepts of Vitiligo Immunopathogenesis. Biomedicines 2022; 10:biomedicines10071639. [PMID: 35884944 PMCID: PMC9313271 DOI: 10.3390/biomedicines10071639] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/20/2022] [Accepted: 07/04/2022] [Indexed: 12/11/2022] Open
Abstract
Vitiligo is an acquired immune-mediated disorder of pigmentation clinically characterized by well-defined depigmented or chalk-white macules and patches on the skin. The prevalence of vitiligo varies by geographical area, affecting 0.5% to 2% of the population. The disease imposes a significant psychological burden due to its major impact on patients’ social and emotional aspects of life. Given its autoimmune background, vitiligo is frequently associated with other autoimmune diseases or immune-mediated diseases. Vitiligo is a multifaceted disorder that involves both genetic predisposition and environmental triggers. In recent years, major predisposing genetic loci for the development of vitiligo have been discovered. The current findings emphasize the critical role of immune cells and their mediators in the immunopathogenesis of vitiligo. Oxidative-stress-mediated activation of innate immunity cells such as dendritic cells, natural killer, and ILC-1 cells is thought to be a key event in the early onset of vitiligo. Innate immunity cells serve as a bridge to adaptive immunity cells including T helper 1 cells, cytotoxic T cells and resident memory T cells. IFN-γ is the primary cytokine mediator that activates the JAK/STAT pathway, causing keratinocytes to produce the key chemokines CXCL9 and CXCL10. Complex interactions between immune and non-immune cells finally result in apoptosis of melanocytes. This paper summarizes current knowledge on the etiological and genetic factors that contribute to vitiligo, with a focus on immunopathogenesis and the key cellular and cytokine players in the disease’s inflammatory pathways.
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19
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Marchioro HZ, Castro CCSD, Fava VM, Sakiyama PH, Dellatorre G, Miot HA. Update on the pathogenesis of vitiligo. An Bras Dermatol 2022; 97:478-490. [PMID: 35643735 PMCID: PMC9263675 DOI: 10.1016/j.abd.2021.09.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/15/2021] [Accepted: 09/21/2021] [Indexed: 11/16/2022] Open
Abstract
Vitiligo is a complex disease whose pathogenesis results from the interaction of genetic components, metabolic factors linked to cellular oxidative stress, melanocyte adhesion to the epithelium, and immunity (innate and adaptive), which culminate in aggression against melanocytes. In vitiligo, melanocytes are more sensitive to oxidative damage, leading to the increased expression of proinflammatory proteins such as HSP70. The lower expression of epithelial adhesion molecules, such as DDR1 and E-cadherin, facilitates damage to melanocytes and exposure of antigens that favor autoimmunity. Activation of the type 1-IFN pathway perpetuates the direct action of CD8+ cells against melanocytes, facilitated by regulatory T-cell dysfunction. The identification of several genes involved in these processes sets the stage for disease development and maintenance. However, the relationship of vitiligo with environmental factors, psychological stress, comorbidities, and the elements that define individual susceptibility to the disease are a challenge to the integration of theories related to its pathogenesis.
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20
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Faraj S, Kemp EH, Gawkrodger DJ. Patho-immunological mechanisms of vitiligo: the role of the innate and adaptive immunities and environmental stress factors. Clin Exp Immunol 2022; 207:27-43. [PMID: 35020865 PMCID: PMC8802175 DOI: 10.1093/cei/uxab002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 10/04/2021] [Accepted: 10/15/2021] [Indexed: 12/17/2022] Open
Abstract
Epidermal melanocyte loss in vitiligo, triggered by stresses ranging from trauma to emotional stress, chemical exposure or metabolite imbalance, to the unknown, can stimulate oxidative stress in pigment cells, which secrete damage-associated molecular patterns that then initiate innate immune responses. Antigen presentation to melanocytes leads to stimulation of autoreactive T-cell responses, with further targeting of pigment cells. Studies show a pathogenic basis for cellular stress, innate immune responses and adaptive immunity in vitiligo. Improved understanding of the aetiological mechanisms in vitiligo has already resulted in successful use of the Jak inhibitors in vitiligo. In this review, we outline the current understanding of the pathological mechanisms in vitiligo and locate loci to which therapeutic attack might be directed.
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Affiliation(s)
- Safa Faraj
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | | | - David John Gawkrodger
- Department of Infection, Immunology and Cardiovascular Disease, University of Sheffield, Sheffield, UK
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21
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Carmena Moratalla A, Carpentier Solorio Y, Lemaitre F, Farzam-Kia N, Levert A, Zandee SEJ, Lahav B, Guimond JV, Haddad E, Girard M, Duquette P, Larochelle C, Prat A, Arbour N. Stress Signal ULBP4, an NKG2D Ligand, Is Upregulated in Multiple Sclerosis and Shapes CD8 + T-Cell Behaviors. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2022; 9:9/1/e1119. [PMID: 34873031 PMCID: PMC8656234 DOI: 10.1212/nxi.0000000000001119] [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: 08/17/2021] [Accepted: 10/19/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVES We posit the involvement of the natural killer group 2D (NKG2D) pathway in multiple sclerosis (MS) pathology via the presence of specific NKG2D ligands (NKG2DLs). We aim to evaluate the expression of NKG2DLs in the CNS and CSF of patients with MS and to identify cellular stressors inducing the expression of UL16-binding protein 4 (ULBP4), the only detectable NKG2DL. Finally, we evaluate the impact of ULBP4 on functions such as cytokine production and motility by CD8+ T lymphocytes, a subset largely expressing NKG2D, the cognate receptor. METHODS Human postmortem brain samples and CSF from patients with MS and controls were used to evaluate NKG2DL expression. In vitro assays using primary cultures of human astrocytes and neurons were performed to identify stressors inducing ULBP4 expression. Human CD8+ T lymphocytes from MS donors and age/sex-matched healthy controls were isolated to evaluate the functional impact of soluble ULBP4. RESULTS We detected mRNA coding for the 8 identified human NKG2DLs in brain samples from patients with MS and controls, but only ULBP4 protein expression was detectable by Western blot. ULBP4 levels were greater in patients with MS, particularly in active and chronic active lesions and normal-appearing white matter, compared with normal-appearing gray matter from MS donors and white and gray matter from controls. Soluble ULBP4 was also detected in CSF of patients with MS and controls, but a smaller shed/soluble form of 25 kDa was significantly elevated in CSF from female patients with MS compared with controls and male patients with MS. Our data indicate that soluble ULBP4 affects various functions of CD8+ T lymphocytes. First, it enhanced the production of the proinflammatory cytokines GM-CSF and interferon-γ (IFNγ). Second, it increased CD8+ T lymphocyte motility and favored a kinapse-like behavior when cultured in the presence of human astrocytes. CD8+ T lymphocytes from patients with MS were especially altered by the presence of soluble ULBP4 compared with healthy controls. DISCUSSION Our study provides new evidence for the involvement of NKG2D and its ligand ULBP4 in MS pathology. Our results point to ULBP4 as a viable target to specifically block 1 component of the NKG2D pathway without altering immune surveillance involving other NKG2DL.
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Affiliation(s)
- Ana Carmena Moratalla
- From the Department of Neurosciences (A.C.M., Y.C.S., F.L., N.F-k., A.L., S.E.J.Z., M.G., P.D., C.L., A.P., N.A.), Université de Montréal and Centre de Recherche du CHUM (CRCHUM) Montreal; MS-CHUM Clinic (B.L., M.G., P.D., C.L., A.P.); CLSC des Faubourgs (J.V.G.), CIUSSS du Centre-Sud-de-l'Ile-de-Montréal; and Department of Microbiology, Infectious Diseases, and Immunology and Department of Pediatrics (E.H.), Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Yves Carpentier Solorio
- From the Department of Neurosciences (A.C.M., Y.C.S., F.L., N.F-k., A.L., S.E.J.Z., M.G., P.D., C.L., A.P., N.A.), Université de Montréal and Centre de Recherche du CHUM (CRCHUM) Montreal; MS-CHUM Clinic (B.L., M.G., P.D., C.L., A.P.); CLSC des Faubourgs (J.V.G.), CIUSSS du Centre-Sud-de-l'Ile-de-Montréal; and Department of Microbiology, Infectious Diseases, and Immunology and Department of Pediatrics (E.H.), Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Florent Lemaitre
- From the Department of Neurosciences (A.C.M., Y.C.S., F.L., N.F-k., A.L., S.E.J.Z., M.G., P.D., C.L., A.P., N.A.), Université de Montréal and Centre de Recherche du CHUM (CRCHUM) Montreal; MS-CHUM Clinic (B.L., M.G., P.D., C.L., A.P.); CLSC des Faubourgs (J.V.G.), CIUSSS du Centre-Sud-de-l'Ile-de-Montréal; and Department of Microbiology, Infectious Diseases, and Immunology and Department of Pediatrics (E.H.), Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Negar Farzam-Kia
- From the Department of Neurosciences (A.C.M., Y.C.S., F.L., N.F-k., A.L., S.E.J.Z., M.G., P.D., C.L., A.P., N.A.), Université de Montréal and Centre de Recherche du CHUM (CRCHUM) Montreal; MS-CHUM Clinic (B.L., M.G., P.D., C.L., A.P.); CLSC des Faubourgs (J.V.G.), CIUSSS du Centre-Sud-de-l'Ile-de-Montréal; and Department of Microbiology, Infectious Diseases, and Immunology and Department of Pediatrics (E.H.), Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Annie Levert
- From the Department of Neurosciences (A.C.M., Y.C.S., F.L., N.F-k., A.L., S.E.J.Z., M.G., P.D., C.L., A.P., N.A.), Université de Montréal and Centre de Recherche du CHUM (CRCHUM) Montreal; MS-CHUM Clinic (B.L., M.G., P.D., C.L., A.P.); CLSC des Faubourgs (J.V.G.), CIUSSS du Centre-Sud-de-l'Ile-de-Montréal; and Department of Microbiology, Infectious Diseases, and Immunology and Department of Pediatrics (E.H.), Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Stephanie E J Zandee
- From the Department of Neurosciences (A.C.M., Y.C.S., F.L., N.F-k., A.L., S.E.J.Z., M.G., P.D., C.L., A.P., N.A.), Université de Montréal and Centre de Recherche du CHUM (CRCHUM) Montreal; MS-CHUM Clinic (B.L., M.G., P.D., C.L., A.P.); CLSC des Faubourgs (J.V.G.), CIUSSS du Centre-Sud-de-l'Ile-de-Montréal; and Department of Microbiology, Infectious Diseases, and Immunology and Department of Pediatrics (E.H.), Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Boaz Lahav
- From the Department of Neurosciences (A.C.M., Y.C.S., F.L., N.F-k., A.L., S.E.J.Z., M.G., P.D., C.L., A.P., N.A.), Université de Montréal and Centre de Recherche du CHUM (CRCHUM) Montreal; MS-CHUM Clinic (B.L., M.G., P.D., C.L., A.P.); CLSC des Faubourgs (J.V.G.), CIUSSS du Centre-Sud-de-l'Ile-de-Montréal; and Department of Microbiology, Infectious Diseases, and Immunology and Department of Pediatrics (E.H.), Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Jean Victor Guimond
- From the Department of Neurosciences (A.C.M., Y.C.S., F.L., N.F-k., A.L., S.E.J.Z., M.G., P.D., C.L., A.P., N.A.), Université de Montréal and Centre de Recherche du CHUM (CRCHUM) Montreal; MS-CHUM Clinic (B.L., M.G., P.D., C.L., A.P.); CLSC des Faubourgs (J.V.G.), CIUSSS du Centre-Sud-de-l'Ile-de-Montréal; and Department of Microbiology, Infectious Diseases, and Immunology and Department of Pediatrics (E.H.), Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Elie Haddad
- From the Department of Neurosciences (A.C.M., Y.C.S., F.L., N.F-k., A.L., S.E.J.Z., M.G., P.D., C.L., A.P., N.A.), Université de Montréal and Centre de Recherche du CHUM (CRCHUM) Montreal; MS-CHUM Clinic (B.L., M.G., P.D., C.L., A.P.); CLSC des Faubourgs (J.V.G.), CIUSSS du Centre-Sud-de-l'Ile-de-Montréal; and Department of Microbiology, Infectious Diseases, and Immunology and Department of Pediatrics (E.H.), Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Marc Girard
- From the Department of Neurosciences (A.C.M., Y.C.S., F.L., N.F-k., A.L., S.E.J.Z., M.G., P.D., C.L., A.P., N.A.), Université de Montréal and Centre de Recherche du CHUM (CRCHUM) Montreal; MS-CHUM Clinic (B.L., M.G., P.D., C.L., A.P.); CLSC des Faubourgs (J.V.G.), CIUSSS du Centre-Sud-de-l'Ile-de-Montréal; and Department of Microbiology, Infectious Diseases, and Immunology and Department of Pediatrics (E.H.), Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Pierre Duquette
- From the Department of Neurosciences (A.C.M., Y.C.S., F.L., N.F-k., A.L., S.E.J.Z., M.G., P.D., C.L., A.P., N.A.), Université de Montréal and Centre de Recherche du CHUM (CRCHUM) Montreal; MS-CHUM Clinic (B.L., M.G., P.D., C.L., A.P.); CLSC des Faubourgs (J.V.G.), CIUSSS du Centre-Sud-de-l'Ile-de-Montréal; and Department of Microbiology, Infectious Diseases, and Immunology and Department of Pediatrics (E.H.), Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Catherine Larochelle
- From the Department of Neurosciences (A.C.M., Y.C.S., F.L., N.F-k., A.L., S.E.J.Z., M.G., P.D., C.L., A.P., N.A.), Université de Montréal and Centre de Recherche du CHUM (CRCHUM) Montreal; MS-CHUM Clinic (B.L., M.G., P.D., C.L., A.P.); CLSC des Faubourgs (J.V.G.), CIUSSS du Centre-Sud-de-l'Ile-de-Montréal; and Department of Microbiology, Infectious Diseases, and Immunology and Department of Pediatrics (E.H.), Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Alexandre Prat
- From the Department of Neurosciences (A.C.M., Y.C.S., F.L., N.F-k., A.L., S.E.J.Z., M.G., P.D., C.L., A.P., N.A.), Université de Montréal and Centre de Recherche du CHUM (CRCHUM) Montreal; MS-CHUM Clinic (B.L., M.G., P.D., C.L., A.P.); CLSC des Faubourgs (J.V.G.), CIUSSS du Centre-Sud-de-l'Ile-de-Montréal; and Department of Microbiology, Infectious Diseases, and Immunology and Department of Pediatrics (E.H.), Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Nathalie Arbour
- From the Department of Neurosciences (A.C.M., Y.C.S., F.L., N.F-k., A.L., S.E.J.Z., M.G., P.D., C.L., A.P., N.A.), Université de Montréal and Centre de Recherche du CHUM (CRCHUM) Montreal; MS-CHUM Clinic (B.L., M.G., P.D., C.L., A.P.); CLSC des Faubourgs (J.V.G.), CIUSSS du Centre-Sud-de-l'Ile-de-Montréal; and Department of Microbiology, Infectious Diseases, and Immunology and Department of Pediatrics (E.H.), Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine), Montreal, Quebec, Canada.
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22
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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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23
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Mojic M, Shitaoka K, Ohshima C, Ucche S, Lyu F, Hamana H, Tahara H, Kishi H, Hayakawa Y. NKG2D defines tumor-reacting effector CD8 + T cells within tumor microenvironment. Cancer Sci 2021; 112:3484-3490. [PMID: 34187084 PMCID: PMC8409295 DOI: 10.1111/cas.15050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 01/08/2023] Open
Abstract
For successful immunotherapy for cancer, it is important to understand the immunological status of tumor antigen-specific CD8+ T cells in the tumor microenvironment during tumor progression. In this study, we monitored the behavior of B16OVA-Luc cells in mice immunized with a model tumor antigen ovalbumin (OVA). Using bioluminescence imaging, we identified the time series of OVA-specific CD8+ T-cell responses during tumor progression: initial progression, immune control, and the escape phase. As a result of analyzing the status of tumor antigen-specific CD8+ cells in those 3 different phases, we found that the expression of NKG2D defines tumor-reacting effector CD8+ T cells. NKG2D may control the fate and TOX expression of tumor-reacting CD8+ T cells, considering that NKG2D blockade in OVA-vaccinated mice delayed the growth of the B16OVA-Luc2 tumor and increased the presence of tumor-infiltrating OVA-specific CD8+ T cells.
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Affiliation(s)
- Marija Mojic
- Institute of Natural Medicine, University of Toyama, Toyama, Japan
| | - Kiyomi Shitaoka
- Department of Immunology, Graduate School of Medicine and Pharmaceutical Sciences (Medicine), Toyama, Japan
| | - Chikako Ohshima
- Institute of Natural Medicine, University of Toyama, Toyama, Japan
| | - Sisca Ucche
- Institute of Natural Medicine, University of Toyama, Toyama, Japan
| | - Fulian Lyu
- Department of Immunology, Graduate School of Medicine and Pharmaceutical Sciences (Medicine), Toyama, Japan
| | - Hiroshi Hamana
- Department of Immunology, Graduate School of Medicine and Pharmaceutical Sciences (Medicine), Toyama, Japan
| | - Hideaki Tahara
- The, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.,Department of Cancer Drug Discovery and Development, Research Center, Osaka International Cancer Institute, Osaka, Japan
| | - Hiroyuki Kishi
- Department of Immunology, Graduate School of Medicine and Pharmaceutical Sciences (Medicine), Toyama, Japan
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24
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Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo. Clin Rev Allergy Immunol 2021; 61:299-323. [PMID: 34283349 DOI: 10.1007/s12016-021-08868-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 12/19/2022]
Abstract
Vitiligo is an autoimmune disease of the skin characterized by epidermal melanocyte loss resulting in white patches, with an approximate prevalence of 0.5-2% worldwide. Several precipitating factors by chemical exposure and skin injury present commonly in patients with vitiligo. Although the diagnosis appears to be straightforward for the distinct clinical phenotype and specific histological features, vitiligo provides many challenges including chronicity, treatment resistance, frequent relapse, associated profound psychosocial effect, and negative impact on quality of life. Multiple mechanisms are involved in melanocyte disappearance, including genetics, environmental factors, and immune-mediated inflammation. Compelling evidence supports the melanocyte intrinsic abnormalities with poor adaptation to stressors leading to instability and release of danger signals, which will activate dendritic cells, natural killer cells, and innate lymphoid cells to initiate innate immunity, ultimately resulting in T-cell mediated adaptive immune response and melanocyte destruction. Importantly, the cross- talk between keratinocytes, melanocytes, and immune cells, such as interferon (IFN)-γ signaling pathway, builds inflammatory loops that give rise to the disease deterioration. Improved understanding of the immune pathogenesis of vitiligo has led to the development of new therapeutic options including Janus kinase (JAK) inhibitors targeting IFN-γ signaling pathways, which can effectively reverse depigmentation. Furthermore, definition of treatment goals and integration of comorbid diseases into vitiligo management have revolutionized the way vitiligo is treated. In this review, we highlight recent developments in vitiligo clinical aspects and immune pathogenesis. Our key objective is to raise awareness of the complexity of this disease, the potential of prospective therapy strategies, and the need for early and comprehensive management.
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25
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Immunophenotypic Analysis Reveals Differences in Circulating Immune Cells in the Peripheral Blood of Patients with Segmental and Nonsegmental Vitiligo. J Invest Dermatol 2021; 142:876-883.e3. [PMID: 34166674 DOI: 10.1016/j.jid.2021.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 12/14/2022]
Abstract
Accumulating studies have indicated immune-based destruction of melanocytes in both segmental vitiligo (SV) and non-SV (NSV). Whereas SV often occurs unilaterally during childhood and stabilizes after an initial period of activity, the disease course of NSV is usually slowly progressive, with new lesions occurring bilaterally during life. This suggests an involvement of distinct pathophysiology pathways, specifically increased systemic immune activation in patients with NSV but not in patients with SV. This research aimed to identify the differences in immune cells in the blood of patients with SV and NSV through immunophenotyping of circulating cells. Regulatory T cells were unaffected in patients with SV compared with that in healthy controls but decreased in patients with NSV. In patients with NSV, the reduction in regulatory T cells was associated with the presence of other systemic autoimmune comorbidities, which were less present in SV. Similarly, the absence of a melanocyte-specific antibody response in patients with SV suggests less involvement of B-cell immunity in SV. These data show that in contrast to patients with NSV, no increased systemic immunity is found in patients with SV, indicating that SV pathogenesis is associated with a localized cytotoxic reaction targeting epidermal melanocytes.
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26
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Ryan GE, Harris JE, Richmond JM. Resident Memory T Cells in Autoimmune Skin Diseases. Front Immunol 2021; 12:652191. [PMID: 34012438 PMCID: PMC8128248 DOI: 10.3389/fimmu.2021.652191] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/06/2021] [Indexed: 12/15/2022] Open
Abstract
Tissue resident memory T cells (TRM) are a critical component of the immune system, providing the body with an immediate and highly specific response against pathogens re-infecting peripheral tissues. More recently, however, it has been demonstrated that TRM cells also form during autoimmunity. TRM mediated autoimmune diseases are particularly destructive, because unlike foreign antigens, the self-antigens are never cleared, continuously activating self-reactive TRM T cells. In this article, we will focus on how TRMs mediate disease in autoimmune skin conditions, specifically vitiligo, psoriasis, cutaneous lupus erythematosus, alopecia areata and frontal fibrosing alopecia.
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Affiliation(s)
- Grace E. Ryan
- Department of Dermatology, University of Massachusetts Medical School, Worcester, MA, United States
| | | | - Jillian M. Richmond
- Department of Dermatology, University of Massachusetts Medical School, Worcester, MA, United States
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27
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Boniface K, Passeron T, Seneschal J, Tulic MK. Targeting Innate Immunity to Combat Cutaneous Stress: The Vitiligo Perspective. Front Immunol 2021; 12:613056. [PMID: 33936032 PMCID: PMC8079779 DOI: 10.3389/fimmu.2021.613056] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/22/2021] [Indexed: 02/06/2023] Open
Abstract
Multiple factors are involved in the process leading to melanocyte loss in vitiligo including environmental triggers, genetic polymorphisms, metabolic alterations, and autoimmunity. This review aims to highlight current knowledge on how danger signals released by stressed epidermal cells in a predisposed patient can trigger the innate immune system and initiate a cascade of events leading to an autoreactive immune response, ultimately contributing to melanocyte disappearance in vitiligo. We will explore the genetic data available, the specific role of damage-associated-molecular patterns, and pattern-recognition receptors, as well as the cellular players involved in the innate immune response. Finally, the relevance of therapeutic strategies targeting this pathway to improve this inflammatory and autoimmune condition is also discussed.
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Affiliation(s)
- Katia Boniface
- Univ. Bordeaux, INSERM, BMGIC, U1035, Immuno-dermatology Team, Bordeaux, France
| | - Thierry Passeron
- INSERM U1065, Centre Méditerranéen de Médecine Moléculaire (C3M), Côte d'Azur University, Nice, France.,Côte d'Azur University, Department of Dermatology, CHU Nice, Nice, France
| | - Julien Seneschal
- Univ. Bordeaux, INSERM, BMGIC, U1035, Immuno-dermatology Team, Bordeaux, France.,Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Bordeaux, France
| | - Meri K Tulic
- INSERM U1065, Centre Méditerranéen de Médecine Moléculaire (C3M), Côte d'Azur University, Nice, France
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28
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Abstract
Vitiligo is a disease of the skin characterized by the appearance of white spots. Significant progress has been made in understanding vitiligo pathogenesis over the past 30 years, but only through perseverance, collaboration, and open-minded discussion. Early hypotheses considered roles for innervation, microvascular anomalies, oxidative stress, defects in melanocyte adhesion, autoimmunity, somatic mosaicism, and genetics. Because theories about pathogenesis drive experimental design, focus, and even therapeutic approach, it is important to consider their impact on our current understanding about vitiligo. Animal models allow researchers to perform mechanistic studies, and the development of improved patient sample collection methods provides a platform for translational studies in vitiligo that can also be applied to understand other autoimmune diseases that are more difficult to study in human samples. Here we discuss the history of vitiligo translational research, recent advances, and their implications for new treatment approaches.
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Affiliation(s)
| | - John E. Harris
- Department of Medicine, Division of Dermatology, University of Massachusetts Medical School, Worcester, MA, United States
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29
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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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30
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Plaza-Rojas L, Guevara-Patiño JA. The Role of the NKG2D in Vitiligo. Front Immunol 2021; 12:624131. [PMID: 33717132 PMCID: PMC7952755 DOI: 10.3389/fimmu.2021.624131] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/02/2021] [Indexed: 12/16/2022] Open
Abstract
Vitiligo is an acquired multifactorial disease that affects melanocytes and results in skin depigmentation. In this review, we examine the role of cells stress and self-reactive T cells responses. Given the canonical and non-canonical functions of NKG2D, such as authenticating stressed target and enhance TCR signaling, we examine how melanocyte stress leads to the expression of ligands that are recognized by the activating receptor NKG2D, and how its signaling results in the turning of T cells against self (melanocyte suicide by proxy). We also discuss how this initiation phase is followed by T cell perpetuation, as NKG2D signaling results in self-sustained long-lasting T cells, with improved cytolytic properties.
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Affiliation(s)
- Lourdes Plaza-Rojas
- Department of Cancer Biology, Loyola University Chicago, Chicago, IL, United States
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31
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Seneschal J, Boniface K, D'Arino A, Picardo M. An update on Vitiligo pathogenesis. Pigment Cell Melanoma Res 2020; 34:236-243. [PMID: 33278065 DOI: 10.1111/pcmr.12949] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/10/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022]
Abstract
Vitiligo, the most common depigmenting disorder of the skin, is undergoing a period of intense advances in both disease understanding and therapeutic possibilities leading the way to the beginning of a new era for the disorder. Its pathophysiology has gathered the attention of researchers for years, and many advances have been made in the clarification of the interaction between different factors that result in depigmented macule formation. The complex interplay between non-immunological and immunological factors in vitiligo is key for the development of the disease, and the participation of cells other than melanocytes, such as keratinocytes, fibroblasts, natural killer cells, and innate lymphoid cells, has been shown. Recent advances have also brought to the understanding of the complex part played by a specific subtype of T cells: T-resident memory cells. This review analyzes some of the most recent insights in vitiligo pathogenesis underlining the interactions between different cell types, which are the basis for the therapeutic approaches under development.
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Affiliation(s)
- Julien Seneschal
- INSERM U1035, Biotherapy of Genetic Diseases, Inflammatory Disorders and Cancers (BMGIC), Immunodermatology ATIP-AVENIR, University of Bordeaux, FHU ACRONIM, Bordeaux, France.,Department of Dermatology and Pediatric Dermatology and National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Bordeaux, France
| | - Katia Boniface
- INSERM U1035, Biotherapy of Genetic Diseases, Inflammatory Disorders and Cancers (BMGIC), Immunodermatology ATIP-AVENIR, University of Bordeaux, FHU ACRONIM, Bordeaux, France
| | - Andrea D'Arino
- San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Mauro Picardo
- San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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32
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Abstract
Vitiligo is a chronic inflammatory skin disease leading to the loss of epidermal melanocytes. To date, treatment options for vitiligo patients are limited, lack sustained efficacy, and are mainly based on off-label use of immunosuppressive agents, such as systemic or topical steroids or topical calcineurin inhibitors, in association with the use of ultraviolet light. However, recent insights into the understanding of the immune pathogenesis of the disease have led to the identification of several therapeutic targets and the development of targeted therapies that are now being tested in clinical trials. In this review, based on the physiopathology of the disease, we summarize emerging targets that could be developed for the treatment of vitiligo and discuss recent and ongoing developments of drugs for the management of the disease.
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33
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Guevara-Patiño JA, Plaza-Rojas L. It Takes Two to Tango. J Invest Dermatol 2020; 140:1131-1133. [PMID: 32446332 DOI: 10.1016/j.jid.2020.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 11/15/2022]
Abstract
In the study by Jacquemin et al., the authors reported that ligands for NKG2D are upregulated in vitiligo perilesional skin and especially in patients with active disease. The reasons for the elevated expression of NKG2D ligands are unknown. This study, however, provides a framework for understanding vitiligo: Skin resident CD8 T cells recognize and kill melanocytes through NKG2D signaling. This event results in the increased production and release of cyto/chemokines and the development of long-lasting CD8 T cells, which in turn causes the recruitment of new T cells, thus perpetuating and disseminating the disease.
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Affiliation(s)
- José A Guevara-Patiño
- Department of Surgery and Cancer Biology, Loyola University Chicago, Maywood, Illinois, USA.
| | - Lourdes Plaza-Rojas
- Department of Surgery and Cancer Biology, Loyola University Chicago, Maywood, Illinois, USA
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34
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Martins C, Darrigade AS, Jacquemin C, Barnetche T, Taieb A, Ezzedine K, Boniface K, Seneschal J. Phenotype and function of circulating memory T cells in human vitiligo. Br J Dermatol 2020; 183:899-908. [PMID: 32012221 DOI: 10.1111/bjd.18902] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Vitiligo is a chronic inflammatory skin disorder characterized by the loss of melanocytes. While a T helper cell (Th)1/cytotoxic T cell (Tc)1-skewed immune response is now well demonstrated in vitiligo, recent data suggest that the T-cell component could be more complex, involving different combinatorial T-cell subsets. OBJECTIVES To analyse the phenotype and function of circulating CD4+ and CD8+ memory T-cell subsets in patients with stable and active vitiligo, in comparison with patients with psoriasis and healthy controls. METHODS This is a monocentric, prospective, descriptive and exploratory study. Multiparametric flow cytometry analyses were performed to evaluate the surface expression of homing and T-cell-subset markers together with intracellular cytokine production in peripheral blood mononuclear cells from 60 patients with vitiligo, 25 patients with psoriasis and 28 healthy donors. RESULTS Vitiligo peripheral blood circulating effector and central memory T cells expressed similar proportions of skin-homing markers. Decrease in the frequencies of circulating CD4+ and CD8+ Th1/Tc1, Th17/Tc17, and Th1/Th17 or Tc1/Tc17 effector memory T-cell subsets were observed in patients with vitiligo compared with healthy donors. Similar observations were made in psoriasis. In contrast, vitiligo circulating T cells showed a similar capacity for proinflammatory cytokine production compared with those in psoriasis and healthy controls. CONCLUSIONS The decreased frequencies of circulating Th1/Tc1, Th17/Tc17 and Th1/Th17-Tc1/Tc17 cells suggest a possible migration of these T-cell subsets into the skin of patients with vitiligo. These could be targeted to prevent flares of the disease. What is already known about this topic? Vitiligo is a chronic inflammatory skin disorder associated with the loss of melanocytes. Vitiligo is characterized by a T helper cell (Th)1/cytotoxic T cell (Tc)1-skewed immune response in the skin. What does this study add? A thorough analysis of the phenotype and function of circulating memory T cells suggests the migration of Th1/Tc1, Th17/Tc17 and Th1/Th17-Tc1/Tc17 cell subsets in the skin. What is the translational message? A better understanding of the different immune T-cell subsets involved in vitiligo could lead to better therapeutic options. Linked Comment: Matos. Br J Dermatol 2020; 183:803.
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Affiliation(s)
- C Martins
- INSERM U1035, BMGIC, Immuno-Dermatology Team, University of Bordeaux, Bordeaux, France
| | - A-S Darrigade
- INSERM U1035, BMGIC, Immuno-Dermatology Team, University of Bordeaux, Bordeaux, France.,Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Bordeaux, France
| | - C Jacquemin
- INSERM U1035, BMGIC, Immuno-Dermatology Team, University of Bordeaux, Bordeaux, France
| | - T Barnetche
- Department of Rheumatology, National Reference Center for Severe Systemic Auto-Immune Diseases, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - A Taieb
- INSERM U1035, BMGIC, Immuno-Dermatology Team, University of Bordeaux, Bordeaux, France.,Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Bordeaux, France
| | - K Ezzedine
- Department of Dermatology, AP-HP, Hôpital Henri-Mondor, Créteil, France
| | - K Boniface
- INSERM U1035, BMGIC, Immuno-Dermatology Team, University of Bordeaux, Bordeaux, France.,Fédération Hospitalo-Universitaire, ACRONIM, Bordeaux, France
| | - J Seneschal
- INSERM U1035, BMGIC, Immuno-Dermatology Team, University of Bordeaux, Bordeaux, France.,Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Bordeaux, France.,Fédération Hospitalo-Universitaire, ACRONIM, Bordeaux, France
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