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Jordan TJM, Mamo LB, Olivry T, Liu Z, Bizikova P. Re-evaluating the prevalence of anti-desmocollin-1 IgA autoantibodies in canine pemphigus foliaceus. Vet Immunol Immunopathol 2024; 273:110773. [PMID: 38820947 PMCID: PMC11268094 DOI: 10.1016/j.vetimm.2024.110773] [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: 03/12/2024] [Revised: 04/22/2024] [Accepted: 05/01/2024] [Indexed: 06/02/2024]
Abstract
Pemphigus foliaceus (PF) is an autoimmune skin disease of dogs characterized by intraepidermal pustules containing neutrophils and dissociated keratinocytes that develop in association with circulating and tissue-bound IgG autoantibodies. A subset of IgG autoantibodies in canine PF target desmocollin-1 (DSC1), a component of intercellular adhesion complexes within the epidermis. Passive transfer of IgG autoantibodies from canine PF sera to mice was previously shown to induce skin disease in the absence of infiltrating neutrophils. In attempts to identify a mechanism responsible for neutrophil recruitment, past studies evaluated the prevalence of IgA autoantibodies in canine PF sera where they were found in <20% of affected dogs. We re-evaluated the prevalence of anti-DSC1 IgA in canine PF due to concerns regarding the sensitivity of previously used methods. We hypothesized that anti-DSC1 IgA are present in most dogs with PF but have been under-detected due to competition with concurrent anti-DSC1 IgG for binding to their mutual antigenic target. Despite removing approximately 80% of IgG from patient sera using affinity chromatography, we did not detect an increase in anti-DSC1 IgA by performing indirect immunofluorescence on canine DSC1-transfected HEK293T cells. Taken together, our results do not support a role for pathogenic IgA in canine PF.
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Affiliation(s)
- Tyler J M Jordan
- North Caroline State University, College of Veterinary Medicine, Department of Clinical Sciences, 1060 William Moore Drive, Raleigh, NC 27607, USA; University of North Carolina School of Medicine, Department of Dermatology, 3122 Neuroscience Research Bldg., 115 Mason Farm Road, Chapel Hill, NC 27599, USA
| | - Lisa B Mamo
- North Caroline State University, College of Veterinary Medicine, Department of Clinical Sciences, 1060 William Moore Drive, Raleigh, NC 27607, USA
| | - Thierry Olivry
- North Caroline State University, College of Veterinary Medicine, Department of Clinical Sciences, 1060 William Moore Drive, Raleigh, NC 27607, USA
| | - Zhi Liu
- University of North Carolina School of Medicine, Department of Dermatology, 3122 Neuroscience Research Bldg., 115 Mason Farm Road, Chapel Hill, NC 27599, USA; University of North Carolina School of Medicine, Department of Microbiology and Immunology, 6th Floor Marsico Hall, 125 Mason Farm Road, Chapel Hill, NC 27599, USA; University of North Carolina School of Medicine, Lineberger Comprehensive Cancer Center, 450 West Drive, Chapel Hill, NC 27514, USA
| | - Petra Bizikova
- North Caroline State University, College of Veterinary Medicine, Department of Clinical Sciences, 1060 William Moore Drive, Raleigh, NC 27607, USA.
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Starr H, Howerth E, Gogal R, Barber J, Leon R, Blubaugh A, Banovic F. Characterization of the serum and skin inflammatory profile in canine pemphigus foliaceus using multiplex assay and quantitative real-time polymerase chain reaction (qRT-PCR). Vet Immunol Immunopathol 2023; 262:110631. [PMID: 37473673 DOI: 10.1016/j.vetimm.2023.110631] [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: 05/30/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/22/2023]
Abstract
Canine pemphigus foliaceus (PF) is a common autoimmune skin disease characterized by autoantibodies binding to epithelial adhesion molecules resulting inflammatory response. The immune network of cytokine and chemokine abnormalities that characterize the immune response in canine PF are poorly explored. This study evaluated serum and lesional skin cytokine and chemokine profiles of dogs diagnosed with PF compared to healthy control dogs. Serum samples obtained from 11 PF dogs and 16 healthy control dogs were analyzed using commercially available canine multiplex assay for 13 biomarkers (Canine Milliplex assay). Eight lesional skin samples from seven PF dogs and five healthy site-matched samples from five healthy dogs were evaluated for 20 immune markers using quantitative real-time PCR. Immunomodulating medications were suspended for at least four weeks in all dogs before obtaining serum and skin samples. PF patients showed significantly higher serum concentrations of tumor necrosis factor-α, interleukin (IL)- 6, IL-8, IL-18, CCL2, KC-like, and granulocyte-macrophages colony-stimulating factor when compared to healthy controls (Mann-Whitney U test; p < 0.05 for all). Lesional PF skin exhibited significant expression and upregulation of pro-inflammatory/T helper (Th1) 1 markers IL-1β, MX1, GZMB, OAS1, and IFN-γ as well as Th2 cytokines IL-13, IL-33, TSLP, IL-31 and Th17/22 markers IL-17A and IL-22 (Mann-Whitney U test; p < 0.05 for all). Taken together, the findings from this study describe the role of numerous cytokines and chemokines associated with immune response in the skin and serum of canine PF patients. Further larger-sample proteomics and RNA-sequencing transcriptomics studies are needed to understand the immune pathogenesis of canine PF skin lesions.
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Affiliation(s)
- Haley Starr
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine University of Georgia, Athens, GA 30602, USA
| | - Elizabeth Howerth
- Department of Pathology, College of Veterinary Medicine University of Georgia, Athens, GA 30602, USA
| | - Robert Gogal
- Department of Biosciences and Diagnostic Imaging, University of Georgia, Athens, GA 30602, USA
| | - Jamie Barber
- Department of Infectious Disease, University of Georgia, Athens, GA 30602, USA
| | - Renato Leon
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine University of Georgia, Athens, GA 30602, USA
| | - Amanda Blubaugh
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine University of Georgia, Athens, GA 30602, USA
| | - Frane Banovic
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine University of Georgia, Athens, GA 30602, USA.
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Papara C, Danescu S, Rogojan L, Leucuta DC, Candrea E, Zillikens D, Baican A. Lymphocyte-predominant lesional inflammatory infiltrates of the skin are associated with mucosal-dominant phenotype in pemphigus. J Cutan Pathol 2023. [PMID: 36680509 DOI: 10.1111/cup.14395] [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: 04/09/2022] [Revised: 12/19/2022] [Accepted: 01/14/2023] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Pemphigus is a potentially life-threatening autoimmune blistering disease. To date, studies assessing the association of histopathology with clinical phenotype are lacking. We sought to evaluate the main histopathologic findings and, also, the potential links between cutaneous inflammatory infiltrates and clinical characteristics in pemphigus. METHODS We conducted a retrospective cohort study in patients diagnosed with pemphigus vulgaris (PV) and pemphigus foliaceus (PF) in a referral center for autoimmune blistering diseases. RESULTS A total of 124 patients were included in the study (97 had PV and 27 had PF). On biopsy specimens, PV was more frequently associated with the "row of tombstones" feature (36.1% vs. 11.1%, p = 0.013), and PF was associated with acanthosis (44.4% vs. 23.7%, p = 0.034). Acantholysis was found in the upper half of the epidermis in PF (96.3% vs. 5.15%, p < 0.001), as opposed to the lower half in PV (75.2% vs. 0%, p = 0.002). Patients with lymphocyte-predominant inflammatory infiltrates in lesional skin specimens presented with a higher frequency of the mucosal-dominant phenotype (25.5% vs. 9.1%, p = 0.014), higher-density cellular infiltrate (100% vs. 41.6%, p < 0.001), and more frequent acantholytic cells (42.6% vs. 23.4%, p = 0.025). Neutrophil-predominant infiltrates in specimens from lesional skin were linked to a milder disease based on median Pemphigus Disease Area Index (38.9% vs. 13.2%, p = 0.036) and Autoimmune Bullous Skin Disorder Intensity Score (20.2 vs. 36.3, p = 0.019), while eosinophil-predominant inflammatory infiltrates were more often associated with eosinophilic spongiosis (100% vs. 23.1%, p = 0.014). CONCLUSIONS Lymphocyte-predominant infiltrates in lesional skin specimens of pemphigus patients predict a mucosal-dominant phenotype, while neutrophil-predominant infiltrates are associated with a milder disease.
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Affiliation(s)
- Cristian Papara
- Department of Dermatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sorina Danescu
- Department of Dermatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Liliana Rogojan
- Department of Pathology, County Emergency Hospital Cluj-Napoca, Cluj-Napoca, Romania
| | - Daniel Corneliu Leucuta
- Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Elisabeta Candrea
- Department of Dermatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Detlef Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Adrian Baican
- Department of Dermatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Oleszycka E, Kwiecien K, Kwiecinska P, Morytko A, Pocalun N, Camacho M, Brzoza P, Zabel BA, Cichy J. Soluble mediators in the function of the epidermal-immune-neuro unit in the skin. Front Immunol 2022; 13:1003970. [PMID: 36330530 PMCID: PMC9623011 DOI: 10.3389/fimmu.2022.1003970] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/05/2022] [Indexed: 09/19/2023] Open
Abstract
Skin is the largest, environmentally exposed (barrier) organ, capable of integrating various signals into effective defensive responses. The functional significance of interactions among the epidermis and the immune and nervous systems in regulating and maintaining skin barrier function is only now becoming recognized in relation to skin pathophysiology. This review focuses on newly described pathways that involve soluble mediator-mediated crosstalk between these compartments. Dysregulation of these connections can lead to chronic inflammatory diseases and/or pathologic conditions associated with chronic pain or itch.
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Affiliation(s)
- Ewa Oleszycka
- Department of Immunology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Kamila Kwiecien
- Department of Immunology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Patrycja Kwiecinska
- Department of Immunology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Agnieszka Morytko
- Department of Immunology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Natalia Pocalun
- Department of Immunology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Michelle Camacho
- Department of Immunology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Piotr Brzoza
- Department of Immunology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Brian A. Zabel
- Palo Alto Veterans Institute for Research, VA Palo Alto Health Care System, Palo Alto, CA, United States
| | - Joanna Cichy
- Department of Immunology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
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5
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Mathachan SR, Arora P, Sardana K, Paliwal P. Pemphigus Foliaceous With Prominent Neutrophilic Pustules: A Rare Variant Responsive to Colchicine. Indian J Dermatol 2022; 67:481. [PMID: 36578702 PMCID: PMC9792025 DOI: 10.4103/ijd.ijd_672_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Sinu Rose Mathachan
- From the Department of Dermatology, Venereology and Leprosy, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Pooja Arora
- From the Department of Dermatology, Venereology and Leprosy, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Kabir Sardana
- From the Department of Dermatology, Venereology and Leprosy, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Purnima Paliwal
- Department of Pathology, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India E-mail:
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Raef HS, Piedra-Mora C, Wong NB, Ma DJ, David CN, Robinson NA, Almela RM, Richmond JM. Gene Expression Analysis in Four Dogs With Canine Pemphigus Clinical Subtypes Reveals B Cell Signatures and Immune Activation Pathways Similar to Human Disease. Front Med (Lausanne) 2021; 8:723982. [PMID: 34660634 PMCID: PMC8511432 DOI: 10.3389/fmed.2021.723982] [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: 06/11/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Pemphigus is a group of autoimmune-mediated mucocutaneous blistering diseases characterized by acantholysis. Pemphigus has also been recognized in dogs and shares similar clinical characteristics and variants with human pemphigus. While relationships between human and canine pemphigus have been reported, gene expression patterns across species have not been described in the literature. We sought to perform gene expression analysis of lesional skin tissue from four dogs with various forms of pemphigus to examine gene expression during spontaneous disease in dogs. We found increased T and B cell signatures in canine pemphigus lesions compared to controls, as well as significant upregulation of CCL3, CCL4, CXCL10, and CXCL8 (IL8), among other genes. Similar chemokine/cytokine expression patterns and immune infiltrates have been reported in humans, suggesting that these genes play a role in spontaneous disease. Direct comparison of our dataset to previously published human pemphigus datasets revealed five conserved differentially expressed genes: CD19, WIF1, CXCL10, CD86, and S100A12. Our data expands our understanding of pemphigus and facilitates identification of biomarkers for prediction of disease prognosis and treatment response, which may be useful for future veterinary and human clinical trials.
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Affiliation(s)
- Haya S Raef
- Department of Dermatology, UMass Medical School, Worcester, MA, United States.,Tufts University School of Medicine, Boston, MA, United States
| | - Cesar Piedra-Mora
- Clinical Sciences Department, Tufts Cummings School of Veterinary Medicine, Grafton, MA, United States
| | - Neil B Wong
- Department of Dermatology, UMass Medical School, Worcester, MA, United States
| | - Diana Junyue Ma
- Department of Dermatology, UMass Medical School, Worcester, MA, United States
| | | | - Nicholas A Robinson
- Clinical Sciences Department, Tufts Cummings School of Veterinary Medicine, Grafton, MA, United States
| | - Ramón M Almela
- Clinical Sciences 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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7
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Passelli K, Billion O, Tacchini-Cottier F. The Impact of Neutrophil Recruitment to the Skin on the Pathology Induced by Leishmania Infection. Front Immunol 2021; 12:649348. [PMID: 33732265 PMCID: PMC7957080 DOI: 10.3389/fimmu.2021.649348] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/04/2021] [Indexed: 12/29/2022] Open
Abstract
Leishmania (L.) are obligate intracellular protozoan parasites that cause the leishmaniases, a spectrum of neglected infectious vector-borne diseases with a broad range of clinical manifestations ranging from local cutaneous, to visceral forms of the diseases. The parasites are deposited in the mammalian skin during the blood meal of an infected female phlebotomine sand fly. The skin is a complex organ acting as the first line of physical and immune defense against pathogens. Insults to skin integrity, such as that occurring during insect feeding, induces the local secretion of pro-inflammatory molecules generating the rapid recruitment of neutrophils. At the site of infection, skin keratinocytes play a first role in host defense contributing to the recruitment of inflammatory cells to the infected dermis, of which neutrophils are the first recruited cells. Although neutrophils efficiently kill various pathogens including Leishmania, several Leishmania species have developed mechanisms to survive in these cells. In addition, through their rapid release of cytokines, neutrophils modulate the skin microenvironment at the site of infection, a process shaping the subsequent development of the adaptive immune response. Neutrophils may also be recruited later on in unhealing forms of cutaneous leishmaniasis and to the spleen and liver in visceral forms of the disease. Here, we will review the mechanisms involved in neutrophil recruitment to the skin following Leishmania infection focusing on the role of keratinocytes in this process. We will also discuss the distinct involvement of neutrophils in the outcome of leishmaniasis.
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Affiliation(s)
- Katiuska Passelli
- Department of Biochemistry, WHO Collaborative Centre for Research and Training in Immunology, University of Lausanne, Lausanne, Switzerland
| | - Oaklyne Billion
- Department of Biochemistry, WHO Collaborative Centre for Research and Training in Immunology, University of Lausanne, Lausanne, Switzerland
| | - Fabienne Tacchini-Cottier
- Department of Biochemistry, WHO Collaborative Centre for Research and Training in Immunology, University of Lausanne, Lausanne, Switzerland
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8
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Abstract
Eosinophilic dermatoses encompass a broad spectrum of diseases of different etiologies hallmarked by eosinophilic infiltration of the skin and/or mucous membranes, with or without associated blood eosinophilia. The wide range of dermatological manifestations of this spectrum, including nodules and plaques, pustules, blisters, ulcers, and urticarial lesions, is reflected in a non-univocal classification system. We identified six groups of eosinophilic dermatoses based on the predominant anatomic level of involvement: (1) epidermal; (2) of the dermal-epidermal junction; (3) dermal; (4) of the hypodermis and muscle fascia; (5) of the pilosebaceous unit; and (6) vascular/perivascular. We review clinicopathologic features and management of diseases belonging to each group, particularly: (1) pemphigus herpetiformis and atopic dermatitis as prototypes of the epidermal group; (2) bullous pemphigoid as prototypic eosinophilic dermatosis of the dermal-epidermal junction; (3) eosinophilic cellulitis (Wells syndrome), hypereosinophilic syndromes, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome, eosinophilic dermatosis of hematologic malignancy and chronic spontaneous urticaria as paradigmatic dermal eosinophilic dermatoses; (4) eosinophilic fasciitis as an eosinophilic dermatosis with predominant involvement of the hypodermis and muscle fascia; (5) eosinophilic pustular folliculitis as a model of the pilosebaceous unit involvement; and (6) granuloma faciale, angiolymphoid hyperplasia with eosinophilia, and eosinophilic granulomatosis with polyangiitis, belonging to the vascular/perivascular group.
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9
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Morais KL, Miyamoto D, Orfali RL, Maruta CW, Santi CG, Sotto MN, da Silva LFF, Branco ACCC, Sato MN, Aoki V. Increased expression of in situ IL-31RA and circulating CXCL8 and CCL2 in pemphigus herpetiformis suggests participation of the IL-31 family in the pathogenesis of the disease. J Eur Acad Dermatol Venereol 2020; 34:2890-2897. [PMID: 32531145 DOI: 10.1111/jdv.16730] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 05/11/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Pemphigus herpetiformis (PH) is a rare clinical subtype of pemphigus with the presence of urticarial plaques, severe pruritus, rare acantholysis and eosinophilic spongiosis. OBJECTIVES The aim of this study was to investigate the influence of IL-31 and pro-inflammatory cytokines/chemokines in the pathogenesis of PH. METHODS Twenty-five patients with PH and three groups: pemphigus foliaceus (PF = 14), pemphigus vulgaris (PV = 15) and healthy controls (HC = 20) were selected for this study. The groups were analysed by immunohistochemistry utilizing IL-31, IL-31RA, IL-4, IL-17 and TNF-α antibodies. Serum levels of IL-4, IL-13, TNF, CXCL8, CCL5 and CCL2 were evaluated by cytometric bead array. RESULTS Analysis of IL-31 family of PH patients revealed the following findings: (i) Enhanced in situ expression of IL-31 in PH samples, compared to PF and to PV (epidermis); (ii) Cutaneous IL-31RA expression in PH samples was higher than in PF, PV and HC groups (epidermis and dermis); (iii) PF patients that evolved to PH showed significant increased IL-31RA epidermal expression during the PH phase. Profile of pro-inflammatory cytokines (IL-4, IL-17 and TNF-α) in PH patients' skin exhibited: (i) Enhanced IL-4 expression, when compared to patients with PF (epidermis and dermis) and with PV (epidermis); (ii) Augmented IL-17 expression than PF and PV patients (epidermis); (iii) Augmented expression of TNF-α when compared to PF at the epidermal level. Evaluation of circulating cytokines and chemokines showed higher levels of CXCL8 and CCL2 in PH sera compared to HC group. CONCLUSIONS IL-31 and IL-31RA, cytokines related to pruritus, and pro-inflammatory chemokines (CXCL8 and CCL2) seem to exert a role in the pathogenesis of PH. These findings support future studies to clarify the role of IL-31 pathway as a potential therapeutic target for patients with PH.
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Affiliation(s)
- K L Morais
- Department of Dermatology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - D Miyamoto
- Department of Dermatology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - R L Orfali
- Department of Dermatology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.,Laboratory of Medical Investigation-56, Department of Dermatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - C W Maruta
- Department of Dermatology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - C G Santi
- Department of Dermatology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - M N Sotto
- Department of Pathology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - L F F da Silva
- Department of Pathology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - A C C C Branco
- Laboratory of Medical Investigation-56, Department of Dermatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - M N Sato
- Laboratory of Medical Investigation-56, Department of Dermatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - V Aoki
- Department of Dermatology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.,Laboratory of Medical Investigation-56, Department of Dermatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
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10
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Pathogenic and protective roles of cytokines in pemphigus: A systematic review. Cytokine 2020; 129:155026. [DOI: 10.1016/j.cyto.2020.155026] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 01/02/2020] [Accepted: 01/31/2020] [Indexed: 12/23/2022]
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11
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Kohlmann J, Simon JC, Kunz M, Treudler R. [Possible effect of interleukin-17 blockade in pemphigus foliaceus and neutrophilic diseases]. Hautarzt 2019; 70:641-644. [PMID: 31076811 DOI: 10.1007/s00105-019-4414-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The role of interleukin-17 (IL-17) in pemphigoid diseases is not fully understood. Both pemphigus vulgaris (PV) as well as pemphigus foliaceus (PF) show intralesional IL-17 positive cells. A patient with initially assumed coexisting PF and psoriasis pustulosa (PP) was treated with the anti-IL-17 antibody secukinumab. The clinical skin picture markedly improved and the level of anti-desmoglein-1 antibodies clearly decreased; however, with the prolongation of injection intervals of secukinumab, autoantibody levels started to rise again. A dose-dependent effect of secukinumab on autoantibody production in PF is suspected. Retrospectively, a neutrophilic PF can be discussed in the present case, where almost complete healing was achieved under IL-17 blockade treatment.
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Affiliation(s)
- Johannes Kohlmann
- Klinik für Dermatologie, Venerologie und Allergologie, Universität Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland.
| | - Jan Christoph Simon
- Klinik für Dermatologie, Venerologie und Allergologie, Universität Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
| | - Manfred Kunz
- Klinik für Dermatologie, Venerologie und Allergologie, Universität Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
| | - Regina Treudler
- Klinik für Dermatologie, Venerologie und Allergologie, Universität Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
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12
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Costa LMC, Cappel MA, Keeling JH. Clinical, pathologic, and immunologic features of pemphigus herpetiformis: a literature review and proposed diagnostic criteria. Int J Dermatol 2019; 58:997-1007. [DOI: 10.1111/ijd.14395] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/21/2018] [Accepted: 01/17/2019] [Indexed: 12/12/2022]
Affiliation(s)
| | - Mark A. Cappel
- Department of Dermatology Mayo Clinic Jacksonville FL USA
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13
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Giusti D, Le Jan S, Gatouillat G, Bernard P, Pham BN, Antonicelli F. Biomarkers related to bullous pemphigoid activity and outcome. Exp Dermatol 2018; 26:1240-1247. [PMID: 29105148 DOI: 10.1111/exd.13459] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 12/11/2022]
Abstract
Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disease of the skin. Investigation of the BP-associated pathophysiological processes during the last decades showed that the generation of autoantibodies directed against the hemidesmosome proteins BP180 and BP230, a hallmark of the BP-associated autoimmune response, leads to the recruitment of inflammatory immune cells at the dermal-epidermal junction, and subsequently to the release of a large amount of inflammatory molecules involved in blister formation. Analysis in transversal and longitudinal studies of autoantibodies and inflammatory molecules production both at the time of diagnosis and under treatment was mainly performed within the serum but also in the blister fluid. Some autoimmune or inflammatory molecules expression was related to the presence of clinical signs, while others were mere bystanders. In this review, we focused on the autoimmune and inflammatory molecules that have been identified as potential biomarkers of BP development and outcome.
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Affiliation(s)
- Delphine Giusti
- Laboratory of Dermatology, Faculty of Medicine of Reims, IFR CAP Santé, University of Reims Champagne-Ardenne, Reims, France.,Laboratory of Immunology, Reims University Hospital, University of Reims Champagne-Ardenne, Reims, France
| | - Sébastien Le Jan
- Laboratory of Dermatology, Faculty of Medicine of Reims, IFR CAP Santé, University of Reims Champagne-Ardenne, Reims, France
| | - Gregory Gatouillat
- Laboratory of Dermatology, Faculty of Medicine of Reims, IFR CAP Santé, University of Reims Champagne-Ardenne, Reims, France.,Laboratory of Immunology, Reims University Hospital, University of Reims Champagne-Ardenne, Reims, France
| | - Philippe Bernard
- Laboratory of Dermatology, Faculty of Medicine of Reims, IFR CAP Santé, University of Reims Champagne-Ardenne, Reims, France.,Department of Dermatology, Reims University Hospital, University of Reims Champagne-Ardenne, Reims, France
| | - Bach Nga Pham
- Laboratory of Dermatology, Faculty of Medicine of Reims, IFR CAP Santé, University of Reims Champagne-Ardenne, Reims, France.,Laboratory of Immunology, Reims University Hospital, University of Reims Champagne-Ardenne, Reims, France
| | - Frank Antonicelli
- Laboratory of Dermatology, Faculty of Medicine of Reims, IFR CAP Santé, University of Reims Champagne-Ardenne, Reims, France.,Department of Biological Sciences, Immunology, UFR Odontology, University of Reims Champagne-Ardenne, Reims, France
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Timóteo RP, Silva MV, da Silva DAA, Catarino JDS, Alves FHC, Rodrigues Júnior V, Roselino AM, Sales-Campos H, Oliveira CJF. Cytokine and Chemokines Alterations in the Endemic Form of Pemphigus Foliaceus (Fogo Selvagem). Front Immunol 2017; 8:978. [PMID: 28855908 PMCID: PMC5557772 DOI: 10.3389/fimmu.2017.00978] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 07/31/2017] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION The endemic form (fogo selvagem-FS) of pemphigus foliaceus is an autoimmune disease characterized by the presence of IgG autoantibodies against desmoglein-1. Despite the array of findings, the role of chemokines and cytokines that dictate the immune response and disease outcome is still poorly investigated. MATERIALS AND METHODS Serum from 64 patients diagnosed with FS was used to draw and establish the levels of these molecules on this disease and establish the levels of these molecules with the severity of FS, and influence of treatment. RESULTS In comparison to healthy subjects, FS patients, newly diagnosed and still without therapeutic intervention, had higher levels of IL-22 and CXCL-8, and reduced levels of IFN-γ, IL-2, IL-15, and CCL-11. Furthermore, treatment using immunosuppressant drugs augmented the production of IFN-γ, IL-2, CCL-5, and CCL-11 besides reducing the levels of IL-22 and CXCL-10. Immunosuppressive therapy seemed to have long-lasting effects on the production of higher amounts of IFN-γ, IL-2, and CCL-5, besides keeping lowered the levels of IL-22 in remission FS patients. CONCLUSION Taken together, our findings suggest a putative role of IL-22 in the pathogenesis of FS. Finally, data presented here may contribute for better understanding the immune aspects that control disease outcome.
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Affiliation(s)
- Rodolfo Pessato Timóteo
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Marcos Vinicius Silva
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Djalma Alexandre Alves da Silva
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Jonatas Da Silva Catarino
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Fernando Henrique Canhoto Alves
- Division of Dermatology, Department of Medical Clinics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Virmondes Rodrigues Júnior
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Ana Maria Roselino
- Division of Dermatology, Department of Medical Clinics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Helioswilton Sales-Campos
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Carlo José Freire Oliveira
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, Brazil
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15
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Lee SH, Hong WJ, Kim SC. Analysis of Serum Cytokine Profile in Pemphigus. Ann Dermatol 2017; 29:438-445. [PMID: 28761292 PMCID: PMC5500709 DOI: 10.5021/ad.2017.29.4.438] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/26/2016] [Accepted: 09/29/2016] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Pemphigus is a group of autoimmune blistering diseases affecting skin and mucous membranes. While pemphigus is an autoantibody mediated disease, the role of T cells and cytokines in the pathogenesis is being increasingly recognized. OBJECTIVE This study was conducted to observe alterations in the serum cytokine levels of patients with pemphigus vulgaris (PV), pemphigus foliaceous (PF), paraneoplastic pemphigus (PNP) and compare with bullous pemphigoid (BP) and healthy subjects. METHODS A total of 75 subjects (28 PV, 13 PF, 7 PNP, 7 BP, and 20 healthy controls) were included, all patients in active disease state. Serum levels of interferon (IFN)-γ, interleukin (IL)-4, IL-6, IL-17A, IL-10, tumor necrosis factor (TNF)-α, and IL-8 were measured by enzyme-linked immunosorbent assay. RESULTS The median concentration of IFN-γ was lower in PV and BP patients compared to control (0.77, 0.34 and 1.63 pg/ml, respectively). IL-6 and IL-10 was significantly higher in PNP patients compared to control (4.92 and 0.24 pg/ml for IL-6, 0.86 and <0.12 pg/ml for IL-10, respectively). IL-8 was increased significantly in PV and PNP patients compared with control (11.85, 31.5 and 8.31 pg/ml, respectively). For IL-4, IL-17A and TNF-α, no significant difference was observed between the five groups. CONCLUSION The decreased level of IFN-γ in PV may imply suppressed Th1 response in the active disease stage. A Th2 predominant response is suggested in the active stage of PNP, with elevated serum levels of IL-6 and IL-10. Increased level of proinflammatory cytokine IL-8 is observed in the sera of PV and PNP patients.
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Affiliation(s)
- Sang Hee Lee
- Department of Dermatology and Cutaneous Biology Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Won Jin Hong
- Department of Dermatology and Cutaneous Biology Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Soo-Chan Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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16
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Mangold AR, Costello CM, Pittelkow MR, DiCaudo DJ. Concomitant pemphigus herpetiformis and sarcoidosis. JAAD Case Rep 2016; 2:436-438. [PMID: 27981211 PMCID: PMC5144745 DOI: 10.1016/j.jdcr.2016.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Collin M Costello
- Department of Medical Education, University of Arizona, Scottsdale, Arizona
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17
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Méndez-Flores S, Avalos-Diaz E, Dominguez-Cherit J, Saeb-Lima M, Esquivel-Pedraza L. Pemphigus foliaceus with circinated plaques and neutrophil pustules. J Cutan Pathol 2016; 43:1062-1066. [DOI: 10.1111/cup.12793] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/27/2016] [Accepted: 08/08/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Silvia Méndez-Flores
- Department of Dermatology; Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”; Mexico City Mexico
| | | | - Judith Dominguez-Cherit
- Department of Dermatology; Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”; Mexico City Mexico
| | - Marcela Saeb-Lima
- Pathology Department; Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”; Mexico City Mexico
| | - Lilly Esquivel-Pedraza
- Department of Dermatology; Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”; Mexico City Mexico
- Health Care Department; Universidad Autonoma Metropolitana; Mexico City Mexico
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18
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Kim SB, Kim JE, Kang OH, Mun SH, Seo YS, Kang DH, Yang DW, Ryu SY, Lee YM, Kwon DY. Protective effect of ixerisoside A against UVB-induced pro-inflammatory cytokine production in human keratinocytes. Int J Mol Med 2015; 35:1411-8. [PMID: 25738262 DOI: 10.3892/ijmm.2015.2120] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 02/19/2015] [Indexed: 11/06/2022] Open
Abstract
Human skin is the first line of defense for the protection of the internal organs of the body from different stimuli. Ultraviolet B (UVB), one of the harmful radiations for skin, is widely known to induce abnormally increased cytokine release from keratinocytes leading to inflammatory skin disorders. IL-6 and IL-8 induce an acute-phase response and stimulate leukocyte infiltration in the skin. Previous studies have shown that chronic exposure to UVB radiation increases cyclooxygenase-2 (COX‑2) expression through various cell signaling pathways, resulting in skin cancer. Recent studies have shown that the activation of extracellular signal-regulated kinase (ERK), c-Jun NH2-terminal kinase (JNK), and p38 MAPK is strongly correlated with acute inflammation and development of skin cancer caused by an increased expression of COX-2. Ixerisoside A (IXA) is an active constituent of Ixeris dentata of the Compositae (Asteraceae) family. The effect of IXA on skin inflammation has yet to be elucidated. To determine the anti-inflammatory effects of IXA, we examined its effect on UVB-induced pro-inflammatory cytokine production in human keratinocytes (HaCaT cells) by observing these cells in the presence or absence of IXA. In this study, pro-inflammatory cytokine production was determined by enzyme-linked immunosorbent assay (ELISA), reverse transcription-polymerase chain reaction (rt-pcr), and western blot analysis to evaluate the activation of mitogen-activated protein kinases (MAPKs). IXA inhibited UVB-induced production of the pro-inflammatory cytokines IL-6 and IL-8 in a dose-dependent manner. Moreover, IXA inhibited the expression of COX-2, ERK, JNK, and p38 MAPKs, indicating that the secretion of the pro-inflammatory cytokines IL-6 and IL-8, and COX-2 expression was inhibited by blocking MAPK phosphorylation. These results indicated that IXA potentially protects against UVB-induced skin inflammation.
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Affiliation(s)
- Sung-Bae Kim
- BK21 Plus Team, Professional Graduate School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk 570‑749, Republic of Korea
| | - Ji-Eun Kim
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang‑Oriental Medicines Research Institute, Institute of Biotechnology, Wonkwang University, Iksan, Jeonbuk 570‑749, Republic of Korea
| | - Ok-Hwa Kang
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang‑Oriental Medicines Research Institute, Institute of Biotechnology, Wonkwang University, Iksan, Jeonbuk 570‑749, Republic of Korea
| | - Su-Hyun Mun
- BK21 Plus Team, Professional Graduate School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk 570‑749, Republic of Korea
| | - Yun-Soo Seo
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang‑Oriental Medicines Research Institute, Institute of Biotechnology, Wonkwang University, Iksan, Jeonbuk 570‑749, Republic of Korea
| | - Da-Hye Kang
- BK21 Plus Team, Professional Graduate School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk 570‑749, Republic of Korea
| | - Da-Wun Yang
- BK21 Plus Team, Professional Graduate School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk 570‑749, Republic of Korea
| | - Shi-Yong Ryu
- Korea Research Institute of Chemical Technology, Daejeon 305‑600, Republic of Korea
| | - Young-Mi Lee
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang‑Oriental Medicines Research Institute, Institute of Biotechnology, Wonkwang University, Iksan, Jeonbuk 570‑749, Republic of Korea
| | - Dong-Yeul Kwon
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang‑Oriental Medicines Research Institute, Institute of Biotechnology, Wonkwang University, Iksan, Jeonbuk 570‑749, Republic of Korea
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Porro AM, Caetano LDVN, Maehara LDSN, Enokihara MMDS. Non-classical forms of pemphigus: pemphigus herpetiformis, IgA pemphigus, paraneoplastic pemphigus and IgG/IgA pemphigus. An Bras Dermatol 2014; 89:96-106. [PMID: 24626654 PMCID: PMC3938360 DOI: 10.1590/abd1806-4841.20142459] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Accepted: 02/14/2013] [Indexed: 12/13/2022] Open
Abstract
The pemphigus group comprises the autoimmune intraepidermal blistering diseases
classically divided into two major types: pemphigus vulgaris and pemphigus
foliaceous. Pemphigus herpetiformis, IgA pemphigus, paraneoplastic pemphigus and
IgG/IgA pemphigus are rarer forms that present some clinical, histological and
immunopathological characteristics that are different from the classical types. These
are reviewed in this article. Future research may help definitively to locate the
position of these forms in the pemphigus group, especially with regard to pemphigus
herpetiformis and the IgG/ IgA pemphigus.
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Affiliation(s)
- Adriana Maria Porro
- Federal University of São Paulo, Paulista School of Medicine, Dermatology Department, São PauloSP, Brazil, Dermatologist. Masters Degree and PhD . Adjunct Professor and Coordinator of Bullous Dermatosis at the Dermatology Department, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP) - São Paulo (SP), Brazil
| | - Livia de Vasconcelos Nasser Caetano
- Federal University of São Paulo, Paulista School of Medicine, Dermatology Department, São PauloSP, Brazil, Dermatologist with specialization in Bullous Dermatosis at the Dermatology Department, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP) - São Paulo (SP), Brazil
| | - Laura de Sena Nogueira Maehara
- Federal University of São Paulo, Paulista School of Medicine, Dermatology Department, Dermatologist with specialization in Bullous Dermatosis and Pediatric Dermatology at the Dermatology Department, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP). PhD-candidate at UNIFESP (Translational Medicine) and the University of Groningen (Center for Blistering Diseases, Groningen University Medical Center, Netherlands)
| | - Milvia Maria dos Santos Enokihara
- Federal University of São Paulo, Paulista School of Medicine, Dermatology and Pathology Departments, São PauloSP, Brazil, Pathologist. Masters Degree and PhD. Dermatopathologist at the Dermatology and Pathology Departments, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP) - São Paulo (SP), Brazil
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20
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Kitajima Y. 150(th) anniversary series: Desmosomes and autoimmune disease, perspective of dynamic desmosome remodeling and its impairments in pemphigus. ACTA ACUST UNITED AC 2014; 21:269-80. [PMID: 25078507 DOI: 10.3109/15419061.2014.943397] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Desmosomes are the most important intercellular adhering junctions that adhere two adjacent keratinocytes directly with desmosomal cadherins, that is, desmogleins (Dsgs) and desmocollins, forming an epidermal sheet. Recently, two cell-cell adhesion states of desmosomes, that is, "stable hyper-adhesion" and "dynamic weak-adhesion" conditions have been recognized. They are mutually reversible through cell signaling events involving protein kinase C (PKC), Src and epidermal growth factor receptor (EGFR) during Ca(2+)-switching and wound healing. This remodeling is impaired in pemphigus vulgaris (PV, an autoimmune blistering disease), caused by anti-Dsg3 antibodies. The antibody binding to Dsg3 activates PKC, Src and EGFR, linked to generation of dynamic weak-adhesion desmosomes, followed by p38MAPK-mediated endocytosis of Dsg3, resulting in the specific depletion of Dsg3 from desmosomes and acantholysis. A variety of pemphigus outside-in signaling may explain different clinical (non-inflammatory, inflammatory, and necrolytic) types of pemphigus. Pemphigus could be referred to a "desmosome-remodeling disease involving pemphigus IgG-activated outside-in signaling events".
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Affiliation(s)
- Yasuo Kitajima
- Department of Dermatology, Kizawa Memorial Hospital, Professor Emeritus Gifu University School of Medicine , Minokamo City, Gifu Prefecture , Japan
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21
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Fuentes-Finkelstein P, Barnadas M, Gelpi C, Puig L. Pemphigus Herpetiformis With Progression to Pemphigus Foliaceus: A Case Report. ACTAS DERMO-SIFILIOGRAFICAS 2014. [DOI: 10.1016/j.adengl.2014.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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22
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Kato K, Hanafusa T, Igawa K, Tatsumi M, Takahashi Y, Yamanaka T, Katayama I. A rare case of annular pustular psoriasis associated with pemphigus foliaceus. Ann Dermatol 2014; 26:260-1. [PMID: 24882987 PMCID: PMC4037685 DOI: 10.5021/ad.2014.26.2.260] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 04/11/2013] [Accepted: 04/19/2013] [Indexed: 11/08/2022] Open
Affiliation(s)
- Kenichi Kato
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan. ; Department of Dermatology, Kansai Rosai Hospital, Hyogo, Japan
| | - Takaaki Hanafusa
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ken Igawa
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | - Yuji Takahashi
- Department of Dermatology, Kansai Rosai Hospital, Hyogo, Japan
| | | | - Ichiro Katayama
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
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23
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Pemphigus herpetiformis: From first description until now. J Am Acad Dermatol 2014; 70:780-787. [DOI: 10.1016/j.jaad.2013.11.043] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 10/22/2013] [Accepted: 11/30/2013] [Indexed: 11/18/2022]
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24
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Fuentes-Finkelstein P, Barnadas M, Gelpi C, Puig L. Pemphigus herpetiformis with progression to pemphigus foliaceus: a case report. ACTAS DERMO-SIFILIOGRAFICAS 2013; 105:526-8. [PMID: 24168913 DOI: 10.1016/j.ad.2013.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 08/05/2013] [Accepted: 08/07/2013] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - M Barnadas
- Servicio Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - C Gelpi
- Servicio de Inmunología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - L Puig
- Servicio Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
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Miura T, Kawakami Y, Oyama N, Ohtsuka M, Suzuki Y, Ohyama B, Hashimoto T, Motoki Y, Yamamoto T. A case of pemphigus herpetiformis with absence of antibodies to desmogleins 1 and 3. J Eur Acad Dermatol Venereol 2010; 24:101-3. [DOI: 10.1111/j.1468-3083.2009.03331.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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26
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Miyakura T, Yamamoto T, Okubo Y, Ishii N, Oyama B, Hashimoto T, Tsuboi R. Pemphigus foliaceus with prominent neutrophilic pustules initially presenting as erythroderma. Clin Exp Dermatol 2009; 34:e46-9. [DOI: 10.1111/j.1365-2230.2008.03190.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Olivry T, Dunston SM, Walker RH, Alhaidari Z, Messinger L, Liu Z. Investigations on the nature and pathogenicity of circulating antikeratinocyte antibodies in dogs with pemphigus foliaceus. Vet Dermatol 2009; 20:42-50. [DOI: 10.1111/j.1365-3164.2008.00723.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stern JNH, Keskin DB, Barteneva N, Zuniga J, Yunis EJ, Ahmed AR. Possible role of natural killer cells in pemphigus vulgaris - preliminary observations. Clin Exp Immunol 2008; 152:472-81. [PMID: 18373702 DOI: 10.1111/j.1365-2249.2008.03638.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Pemphigus vulgaris (PV) is an autoimmune blistering disease that affects the skin and multiple mucous membranes, and is caused by antibodies to desmoglein (Dsg) 1 and 3. Natural killer (NK) cells have a role in autoimmunity, but their role in PV is not known. NK cells in the peripheral blood leucocytes (PBL) of 15 untreated Caucasian patients with active PV were studied and compared with healthy controls for the expression of major histocompatibility complex (MHC) class II and co-stimulatory molecules. CD56+ CD16- CD3- NK or CD56+ CD16+ CD3- NK cells from the PBL of PV patients co-express MHC class II and co-stimulatory molecule B7-H3 without exogenous stimulation. CD4+ T cells from the PBL and perilesional skin of PV patients were co-cultured with CD56+ CD3- NK cells from the PBL of the same patients; in the presence of Dsg3 peptides underwent statistically significant proliferation, indicating that NK cells functioned as antigen-presenting cells. Supernatants from these co-cultures and serum of the same patients with active PV had statistically significantly elevated levels of interleukin (IL)-6, IL-8 and interferon-gamma, compared with controls indicating that the NK cells stimulated CD4+ T cells to produce proinflammatory cytokines. In these experiments, we present preliminary evidence that NK cells may play a role in the pathobiology of PV.
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Affiliation(s)
- J N H Stern
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
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29
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Kitajima Y, Aoyama Y. A perspective of pemphigus from bedside and laboratory-bench. Clin Rev Allergy Immunol 2008; 33:57-66. [PMID: 18094947 DOI: 10.1007/s12016-007-0036-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Pemphigus represents a distinct organ-specific acquired autoimmune disease characterized by intra-epidermal blistering, which is induced by autoantibodies against desmosomal cadherins, desmoglein 1 (Dsg1), and Dsg3. Pemphigus is currently divided into three distinct varieties, i.e., pemphigus vulgaris (PV), pemphigus foliaceus (PF) and other variants of pemphigus (mostly associated with inflammation), depending on clinical features, the level of separation in the epidermis, and immunologic characteristics of auto-antigens. Blistering pathomechanisms differ for each of the types of pemphigus. Pemphigus, which results from autoantibodies against desmogleins and possibly to other proteins, binds to the cell surface antigens. This binding may cause steric hindrance to homophilic adhesion of desmogleins, and may, in turn, lead to internalization of desmogleins and inhibition of desmogleins' integration into desmosomes, resulting in the formation of Dsg3-depleted desmosomes in PV or Dsg1-depleted desmosomes in PF. Furthermore, PV-IgG activates an "outside-in" signaling pathway to induce disassembly of desmosomal components from the inside of the cells by phosphorylation of proteins, including Dsg3. On the other hand, Pemphigus-IgG-augmented signaling pathways may be linked to the secretion of cytokines such as in case of pemphigus herpetiformis and chemokines that initiate or activate inflammation. In this article, the classification of pemphigus and the characteristic pathomechanisms for acantholysis will be reviewed, with particular emphasis on the molecular and biochemical cell biology of these diseases.
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Affiliation(s)
- Yasuo Kitajima
- Department of Dermatology, Gifu University School of Medicine, Gifu City, Japan.
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30
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Hussein MR, Ali FMN, Omar AEMM. Immunohistological analysis of immune cells in blistering skin lesions. J Clin Pathol 2007; 60:62-71. [PMID: 17213348 PMCID: PMC1860590 DOI: 10.1136/jcp.2006.037010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Bullous skin lesions are characterised by the presence of intraepidermal or subepidermal bullae. Although inflammatory cell infiltrate is a constant feature in these lesions, their immunophenotypic characterisation is still incomplete. AIM To determine whether the development of bullous skin diseases is associated with changes in the inflammatory cell infiltrate. MATERIALS AND METHODS 34 cases representing lesions with both intraepidermal and subepidermal bullae were examined using immunoperoxidase staining methods and antibodies targeting antigens for histiocytes (CD68), B cells (CD20+), T cells (CD3+), T cells with cytotoxic potential (T cell intracellular associated antigen, TIA1+) and activity (granzyme B, GRB+). The adjacent normal skin (lesions) and an additional five cases of normal skin were also examined (controls). RESULTS The transition from normal skin to lesional skin (lesions with intraepidermal and subepidermal bullae) was associated with a significant increase (p< or =0.05) in the density of total inflammatory cell infiltrate, CD68+ cells, CD3+ T lymphocytes, CD20+ B lymphocytes, TIA1+ -resting cytotoxic T cells and GRB+ T cells with cytotoxic activity. CONCLUSIONS The increase in inflammatory cell infiltrate during the transition from normal to lesional skin may reflect the presence of an increased antigenicity of the lesional cells or a response to some basement membrane components. CD68+ and CD3+ cells, especially the resting cytotoxic ones, achieved numerical dominance in these lesions. Cell-mediated immunity seems to have critical role in the development of these lesions.
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Affiliation(s)
- Mahmoud R Hussein
- Department of Pathology, Faculty of Medicine, Assiut University Hospitals, Assiut University, Assiut, Egypt.
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Schmidt E, Wehr B, Wolf K, Sitaru C, Bröcker EB, Zillikens D. Localisation of bullous pemphigoid antigen 180 (BP180) in cultured human keratinocytes: functionally relevant modification by calcium. Arch Dermatol Res 2006; 298:283-90. [PMID: 16906396 DOI: 10.1007/s00403-006-0690-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2005] [Revised: 04/26/2006] [Accepted: 07/19/2006] [Indexed: 10/24/2022]
Abstract
The expression of BP180 has previously been demonstrated to be influenced by both calcium (Ca(2+)) concentration and binding of anti-BP180-antibodies in cultured keratinocytes of the skin squamous cell carcinoma line DJM-1. Here, BP180 expression was studied in cultured normal human epidermal keratinocytes by confocal laser scanning microscopy. We exploited an experimental system, in which BP180 was previously shown to mediate, upon incubation with anti-BP180 antibodies, a specific signal-transducing event that leads to the release of inflammatory mediators, such as IL-8 from cultured normal human epidermal keratinocytes (NHEK). We found that without addition of BP180-specific IgG, BP180 is predominantly expressed on the cell surface irrespective of the Ca(2+) concentration. In contrast, cell surface BP180 was greatly reduced in NHEK kept in high Ca(2+) medium after incubation with BP180-specific IgG for 12 h compared to low Ca(2+) medium. This effect was seen with antibodies to both N- and C-terminal fragments of the BP180 ectodomain, respectively. In addition, a slightly higher BP180 expression was found in NHEK cultured in low compared to high Ca(2+) medium by Western blotting. Interestingly, in contrast to NHEK kept under low Ca(2+ )conditions, in NHEK grown in high Ca(2+) medium, no elevated levels of IL-8 were released after treatment of cells with anti-BP180 IgG compared to normal IgG. Our data indicate that the Ca(2+)-modulated expression of BP180 is functionally relevant. This finding sheds further light on the complex pathomechanism in blister formation of BP180-related autoimmune blistering skin diseases.
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Affiliation(s)
- Enno Schmidt
- Department of Dermatology, University of Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany.
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Affiliation(s)
- Patrizia Zappasodi
- Division of Hematology and Department of Dermatology, University of Pavia, IRCCS Policlinico San Matteo, Italy.
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Abstract
Pemphigus is an infrequent, organ-specific, autoimmune bullous disease, which affects the skin, mucous membranes and appendages. Histopathologically, it is characterized by acantholysis. Pemphigus has classically been divided into two major groups, pemphigus vulgaris and pemphigus foliaceus, with their respective clinical variants pemphigus vegetans and pemphigus erythematosus. In recent years, new variants of pemphigus have been described: paraneoplastic pemphigus, IgA pemphigus and pemphigus herpetiformis. This article reviews the epidemiology, etiopathogenesis, clinical symptoms, diagnosis, treatment and prognosis of pemphigus. Advances in molecular biology techniques have made it possible to more precisely identify the different antigens against which antibodies are directed, and to fine-tune ELISA diagnostic techniques. Treating pemphigus vulgaris and foliaceus with general steroids has modified their prognosis; it is estimated that mortality in recent decades is less than 10 %. Managing the clinical complications that appear during the evolution of the pemphigus has contributed to reducing morbidity and mortality.
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Pap T. Direct interaction of immunoglobulins with synovial fibroblasts: a missing link in the pathogenesis of rheumatoid arthritis? Arthritis Res Ther 2004; 7:44-6. [PMID: 15642154 PMCID: PMC1064902 DOI: 10.1186/ar1493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Thomas Pap
- Division of Molecular Medicine of Musculoskeletal Tissue, University Hospital Münster, Germany.
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Pritchard J, Tsui S, Horst N, Cruikshank WW, Smith TJ. Synovial fibroblasts from patients with rheumatoid arthritis, like fibroblasts from Graves' disease, express high levels of IL-16 when treated with Igs against insulin-like growth factor-1 receptor. THE JOURNAL OF IMMUNOLOGY 2004; 173:3564-9. [PMID: 15322222 DOI: 10.4049/jimmunol.173.5.3564] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We have reported recently that IgG from patients with Graves' disease (GD) can induce the expression of the CD4-specific T lymphocyte chemoattractant, IL-16, and RANTES, a C-C chemokine, in their fibroblasts. This induction is mediated through the insulin-like growth factor-1 receptor (IGF-1R) pathway. We now report that Abs from individuals with active rheumatoid arthritis (RA-IgG) stimulate in their synovial fibroblasts the expression of these same cytokines. IgG from individuals without known autoimmune disease fails to elicit this chemoattractant production. Furthermore, RA-IgG fails to induce IL-16 or RANTES expression in synovial fibroblasts from donors with osteoarthritis. RA-IgG-provoked IL-16 and RANTES production also appears to involve the IGF-1R because receptor-blocking Abs prevent the response. RA fibroblasts transfected with a dominant-negative mutant IGF-1R fail to respond to RA-IgG. IGF-1 and the IGF-1R-specific analog Des(1-3) also induce cytokine production in RA fibroblasts. RA-IgG-provoked IL-16 expression is inhibited by rapamycin, a specific macrolide inhibitor of the Akt/FRAP/mammalian target of rapamycin/p70(s6k) pathway, and by dexamethasone. GD-IgG can also induce IL-16 in RA fibroblasts, and RA-IgG shows similar activity in GD fibroblasts. Thus, IgGs from patients with RA, like those associated with GD, activate IGF-1R, and in so doing provoke T cell chemoattraction expression in fibroblasts, suggesting a potential common pathway in the two diseases. Immune-competent cell trafficking to synovial tissue is integral to the pathogenesis of RA. Recognition of this novel RA-IgG/fibroblast interaction and its functional consequences may help identify therapeutic targets.
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Affiliation(s)
- Jane Pritchard
- Division of Molecular Medicine, Harbor-University of California, Los Angeles Medical Center, Torrance, CA 90502, USA
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36
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Takeuchi F, Sterilein RD, Hall RP. Increased E-selectin, IL-8 and IL-10 gene expression in human skin after minimal trauma. Exp Dermatol 2004; 12:777-83. [PMID: 14714557 DOI: 10.1111/j.0906-6705.2003.00088.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
While clinical observations suggest that trauma to the skin plays a critical role in the induction of skin lesions in some skin diseases, the mechanism by which these lesions are induced is not known. We have postulated that minor trauma to the skin may lead to the expression of critical adhesion molecules on epidermal endothelial cells (E-selectin) and pro-inflammatory cytokines, which would predispose these areas to the development of skin lesions. In order to test this hypothesis normal inner arm skin of 11 normal subjects was gently rubbed with a pencil eraser for 2 min. Four hours after rubbing, skin biopsies were obtained from the rubbed site and from adjacent normal, unrubbed inner arm skin. Expression of E-selectin, intercellular adhesion molecules (ICAM-1) and the mRNA of selected cytokines was studied utilizing real time polymerase chain reactions. Biopsies were also examined for the presence of an inflammatory infiltrate and for the presence of E-selectin and ICAM-1. No clinical or histologic changes were seen in the skin expression/unrubbed skin expression = 9.0; (median ratio rubbed skin expression/unrubbed skin expression range 0.9-161.0), ICAM-1 (median rubbed skin expression/unrubbed skin expression = 3.2; range 0.9-19.8), IL-8 (median rubbed skin expression/unrubbed skin expression = 6.6; range 2.6-57.3) and IL-10 (median rubbed skin expression/unrubbed skin expression = 13.1; range 2.4-29.0) was noted. Immunohistochemistry revealed the presence of E-selectin in the dermal blood vessels in three of four subjects 4 h after rubbing but not in the unrubbed skin. Changes in ICAM -1 or HLA-DR deposits were seen in the rubbed compared with the unrubbed skin. These findings demonstrated that minor trauma to skin may induce expression of E-selectin, ICAM-1 and IL-8, which may make the skin a more permissive site for the development of inflammatory reactions. These findings may play an important role in the development of skin lesions in areas of minor trauma.
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Affiliation(s)
- Fumiko Takeuchi
- Department of Medicine, Duke University Medical Centre and Durham VA Medical Center, Durham, NC 27710, USA
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Sanchez-Palacios C, Chan LS. Development of pemphigus herpetiformis in a patient with psoriasis receiving UV-light treatment. J Cutan Pathol 2004; 31:346-9. [PMID: 15005694 DOI: 10.1111/j.0303-6987.2004.0188.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pemphigus is an autoimmune blistering disease of the skin and mucous membranes. Pemphigus herpetiformis, a rare variant of pemphigus, is characterized by erythematous, vesicular, bullous, or papular lesions in a herpetiform pattern, often associated with pruritus. Clinical cases documenting the development of pemphigus in patients with a history of psoriasis have been reported in the literature. METHODS We used immunological methods to study a case in which pemphigus herpetiformis occurred in a woman with a history of psoriasis, shortly after a course of ultraviolet B (UVB) therapy. RESULTS Histopathology revealed a subcorneal blister with prominent neutrophilic infiltration. Immunopathology detected in situ bound and circulating immunoglobulin G (IgG) autoantibodies to epithelial cell surfaces and circulating IgG autoantibodies against desmoglein 1. The patient was also found to have Hashimoto's thyroiditis. CONCLUSIONS This case illuminates a possible role of UV therapy in the induction of pemphigus herpetiformis through an epitope-spreading mechanism. The patient's autoimmune thyroiditis may also contribute to the predisposition for pemphigus development. The histopathological findings in pemphigus patients with a history of psoriasis may resemble Munro's microabscesses of psoriasis and should therefore alert pathologists and clinicians in considering additional diagnostic methods such as direct and indirect immunofluorescence.
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Affiliation(s)
- Carla Sanchez-Palacios
- Department of Dermatology, Northwestern University Medical School, Chicago, IL 60612, USA
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Abstract
Recent rapid advances in the basic research into pemphigus have provided many insights into its pathophysiology. In particular, a recently developed enzyme-linked immunosorbent assay (ELISA) for desmogleins 1 and 3 (Dsg1 and Dsg3), antigens for pemphigus foliaceus (PF) and pemphigus vulgaris (PV), respectively, has led to great progress in the diagnosis and classification of pemphigus, as well as in understanding its pathomechanisms. Studies with the anti-Dsg1 and anti-Dsg3 antibodies have indicated that there are two types of PV, the mucosal dominant type and the mucocutaneous type. The same ELISA has identified the antigens in pemphigus herpetiformis. The autoantigens detected by this ELISA correlate well with the clinical features in pemphigus patients in showing the shift between PV and PF. In addition, the Dsg compensation theory proposed by Stanley and Amagai can reasonably explain the different depths of skin lesions and the different occurrences of skin and oral mucosal lesions between PV and PF. Furthermore, a complicated profile of autoantigens in paraneoplastic pemphigus (PNP) has been indicated in various biochemical studies, and IgG anti-Dsg1 and anti-Dsg3 antibodies have been detected in serum from all the PNP patients by the above ELISA. On the other hand, serum from subcorneal pustular dermatosis type IgA pemphigus patients have been shown to react with Dsc1, another type of desmosomal cadherin, by a novel cDNA transfection method. In addition, IgA anti-Dsg1 and anti-Dsg3 antibodies have been detected in a few patients with IgA pemphigus by an ELISA for IgA antibodies. Various autoimmune bullous diseases, including several types of pemphigus, are the only diseases in which the pathogenic role of circulating autoantibodies has been confirmed using the newborn mouse animal model. Therefore, studies of the pathophysiology of pemphigus are extremely important as a paradigm for research into various types of autoimmune diseases in other fields.
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Affiliation(s)
- Takashi Hashimoto
- Department of Dermatology, Kurume University School of Medicine, 67 Asahimachi, 830-0011 Kurume, Fukuoka, Japan.
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Kitajima Y. Current and prospective understanding of clinical classification, pathomechanisms and therapy in pemphigus. Arch Dermatol Res 2003; 295 Suppl 1:S17-23. [PMID: 12677428 DOI: 10.1007/s00403-002-0368-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yasuo Kitajima
- Department of Dermatology, Gifu University School of Medicine, 40 Tsukasamachi, 500-8705 Gifu City, Japan.
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40
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Kozlowska A, Hashimoto T, Jarzabek-Chorzelska M, Amagai A, Nagata Y, Strasz Z, Jablonska S. Pemphigus herpetiformis with IgA and IgG antibodies to desmoglein 1 and IgG antibodies to desmocollin 3. J Am Acad Dermatol 2003; 48:117-22. [PMID: 12522381 DOI: 10.1067/mjd.2003.23] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We describe a case with clinical and histologic features of pemphigus herpetiformis associated with IgG and IgA anti-keratinocyte cell surface antibodies to desmoglein 1 (Dsg1) and exclusively IgG antibodies to desmocollin 3 (Dsc3). The clinical presentation was somewhat similar to IgA pemphigus; the main difference was the prevailing association with IgG antibodies to Dsg1. The presence of IgA anti-Dsg1 antibodies was confirmed by IgA enzyme-linked immunosorbent assay and IgG anti-Dsc3 antibodies were detected by a novel enzyme-linked immunosorbent assay with the use of baculovirus expressing recombinant Dscs for IgG and IgA. The reactivity of IgG antibodies with Dsc3 was confirmed by COS-7 cell cDNA transfection method using cDNA of human Dsc1 to Dsc3. We discuss the differentiation of pemphigus herpetiformis, associated with both IgG and IgA antibodies, from IgA pemphigus, particularly in regard to the autoimmune reaction with Dsgs and Dscs.
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Affiliation(s)
- A Kozlowska
- Department of Dermatology, Warsaw School of Medicine, Warsaw, Poland
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41
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Abstract
The skin has long been recognized as a major producer of cytokines, but the keratinocyte as principal epidermal cell has received less attention as potential source and target of cytokines. Nevertheless, keratinocytes produce a plethora of cytokines including interleukin (IL)-1, -6, -7, -8, -10, -12, -15, -18, and -20, and tumor necrosis factor alpha (TNF). The production by keratinocytes of pro-inflammatory (IL)-1, -6, -8, and TNF was recognized early and is well studied. Keratinocyte-derived IL-7 and -15 are considered to be significant in T-cell trafficking, possibly even in the pathogenesis of cutaneous T-cell lymphoma. Immunomodulatory IL-10 and -12 originating from keratinocytes are considered to be responsible for systemic effects, and IL-18 perhaps has a similar action. Keratinocytes were fairly recently recognized as being source or target of other IL-10 family members like IL-20 and IL-24 and the role of these cytokines in specific diseases is under investigation. In addition, a variety of cytokine receptors are present on keratinocytes like those for IL-4, -13, and -17 and to lesser degree IL-2. The ability to study the expression of cytokines by keratinocytes in vivo and in vitro using primary cells, immortalized cells or even organotypic culture systems offers many possibilities to further investigate the role of cytokine production in keratinocyte biology and disease.
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Affiliation(s)
- A Gröne
- Institut für Tierpathologie, Universität Bern, Länggassstr. 122, 3012 Bern, Switzerland.
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42
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Jean-Baptiste S, O'Toole EA, Chen M, Guitart J, Paller A, Chan LS. Expression of eotaxin, an eosinophil-selective chemokine, parallels eosinophil accumulation in the vesiculobullous stage of incontinentia pigmenti. Clin Exp Immunol 2002; 127:470-8. [PMID: 11966763 PMCID: PMC1906303 DOI: 10.1046/j.1365-2249.2002.01755.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Incontinentia pigmenti (IP) is an X-linked dominant genodermatosis primarily affecting female children. The initial vesiculobullous stage of IP is characterized clinically by inflammatory papules, blisters, and pustules, and histopathologically by acanthosis, keratinocyte necrosis, epidermal spongiosis and massive epidermal eosinophil infiltration. The cause of this multisystem disease is attributed to the mutations of an X-linked regulatory gene, termed nuclear factor-kappaB essential modulator (NEMO). The exact mechanism of epidermal eosinophil accumulation has not yet been determined. We explored the possible role of an eosinophil-selective, nuclear factor-kappaB-activated chemokine, eotaxin, in the accumulation of eosinophils in the initial stage of the disease. Monoclonal antibody (6H9) specific for human eotaxin strongly labelled the suprabasal epidermis of IP skin, paralleling the upper epidermal accumulation of eosinophils, but did not label the epidermis of normal skin or lesional skin from patients with other inflammatory skin diseases not characterized by prominent eosinophil accumulation, namely dermatitis herpetiformis and selected cases of atopic dermatitis lacking significant numbers of eosinophils. In addition, endothelial cells in lesional skin of IP also exhibited strong expression of eotaxin, which correlated with perivascular and intravascular eosinophil infiltration. We also examined the in vitro effects on epidermally derived eotaxin of several cytokines that were nuclear factor-kappaB-activated and/or known to induce eotaxin expression. In normal human keratinocytes, proinflammatory cytokines either independently (IL-1alpha) or synergistically (tumour necrosis factor-alpha (TNF-alpha)/ interferon-gamma (IFN-gamma) and TNF-alpha/IL-4) up-regulated eotaxin expression. These studies suggest that release of cytokines during the initial inflammatory stage of IP induces epidermal expression of eotaxin, which may play a role in the epidermal accumulation of eosinophils.
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Affiliation(s)
- S Jean-Baptiste
- Department of Dermatology, Northwestern University Medical School, Chicago, IL, USA
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43
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Pritchard J, Horst N, Cruikshank W, Smith TJ. Igs from patients with Graves' disease induce the expression of T cell chemoattractants in their fibroblasts. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2002; 168:942-50. [PMID: 11777993 DOI: 10.4049/jimmunol.168.2.942] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Thyroid-associated ophthalmopathy and dermopathy are connective tissue manifestations of Graves' disease (GD). Tissue remodeling is a prominent feature of both and is apparently driven by recruited T cells. In this study, we report that IgG isolated from patients with GD (GD-IgG) up-regulates T lymphocyte chemoattractant activity in GD-derived fibroblasts from orbit, thyroid, and several regions of skin. This chemoattractant activity, absent in fibroblasts from donors without known thyroid disease, is partially susceptible to neutralization by anti-IL-16 and anti-RANTES Abs. IL-16 is a CD4(+)-specific chemoattractant and RANTES is a C-C-type chemokine. IL-16 and RANTES protein levels, as determined by specific ELISAs, are substantially increased by GD-IgG in GD fibroblasts. Addition of the macrolide, rapamycin, to fibroblast culture medium blocked the up-regulation by GD-IgG of IL-16, implicating the FRAP/mTOR/p70(s6k) pathway in the induction of IL-16 expression. These findings suggest a specific mechanism for activation of fibroblasts in GD resulting in the recruitment of T cells. They may provide insight into a missing link between the glandular and extrathyroidal manifestations of GD.
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Affiliation(s)
- Jane Pritchard
- Department of Medicine, Division of Molecular Medicine, Harbor-University of California, Los Angeles Medical Center, Torrance, CA 90502, USA
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44
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Affiliation(s)
- T Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina 27606, USA.
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45
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Hertl M, Riechers R. Autoreactive T cells as potential targets for immunotherapy of autoimmune bullous skin diseases. Clin Dermatol 2001; 19:592-7. [PMID: 11604306 DOI: 10.1016/s0738-081x(00)00171-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- M Hertl
- Department of Dermatology, University of Erlangen, Erlangen, Germany.
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46
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Matsuo K, Komai A, Ishii K, Futei Y, Amagai M, Deguchi H, Danno K, Hashimoto T. Pemphigus foliaceus with prominent neutrophilic pustules. Br J Dermatol 2001; 145:132-6. [PMID: 11453922 DOI: 10.1046/j.1365-2133.2001.04297.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe four patients with generalized scaly and pustular skin lesions showing extensive neutrophilic infiltration in the subcorneal region of the epidermis. Immunofluorescence, immunoblot and enzyme-linked immunosorbent assay analyses detected IgG antibodies reacting exclusively with desmoglein 1, the pemphigus foliaceus antigen. This study indicates that pemphigus foliaceus may show prominent neutrophilic pustular skin lesions.
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Affiliation(s)
- K Matsuo
- Department of Dermatology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan
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