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Zhou X, Zhou H, Luo X, Wu RF. Discovery of biomarkers in the psoriasis through machine learning and dynamic immune infiltration in three types of skin lesions. Front Immunol 2024; 15:1388690. [PMID: 38803495 PMCID: PMC11128609 DOI: 10.3389/fimmu.2024.1388690] [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: 02/20/2024] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction Psoriasis is a chronic skin disease characterized by unique scaling plaques. However, during the acute phase, psoriatic lesions exhibit eczematous changes, making them difficult to distinguish from atopic dermatitis, which poses challenges for the selection of biological agents. This study aimed to identify potential diagnostic genes in psoriatic lesions and investigate their clinical significance. Methods GSE182740 datasets from the GEO database were analyzed for differential analysis; machine learning algorithms (SVM-RFE and LASSO regression models) are used to screen for diagnostic markers; CIBERSORTx is used to determine the dynamic changes of 22 different immune cell components in normal skin lesions, psoriatic non-lesional skin, and psoriatic lesional skin, as well as the expression of the diagnostic genes in 10 major immune cells, and real-time quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry are used to validate results. Results We obtained 580 differentially expressed genes (DEGs) in the skin lesion and non-lesion of psoriasis patients, 813 DEGs in mixed patients between non-lesions and lesions, and 96 DEGs in the skin lesion and non-lesion of atopic dermatitis, respectively. Then 144 specific DEGs in psoriasis via a Veen diagram were identified. Ultimately, UGGT1, CCNE1, MMP9 and ARHGEF28 are identified for potential diagnostic genes from these 144 specific DEGs. The value of the selected diagnostic genes was verified by receiver operating characteristic (ROC) curves with expanded samples. The the area under the ROC curve (AUC) exceeded 0.7 for the four diagnosis genes. RT-qPCR results showed that compared to normal human epidermis, the expression of UGGT1, CCNE1, and MMP9 was significantly increased in patients with psoriasis, while ARHGEF28 expression was significantly decreased. Notably, the results of CIBERSORTx showed that CCNE1 was highly expressed in CD4+ T cells and neutrophils, ARHGEF28 was also expressed in mast cells. Additionally, CCNE1 was strongly correlated with IL-17/CXCL8/9/10 and CCL20. Immunohistochemical results showed increased nuclear expression of CCNE1 in psoriatic epidermal cells relative to normal. Conclusion Based on the performance of the four genes in ROC curves and their expression in immune cells from patients with psoriasis, we suggest that CCNE1 possess higher diagnostic value.
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Affiliation(s)
- Xiao Zhou
- Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Han Zhou
- School of Mathematics and Statistics, Central South University, Changsha, Hunan, China
| | - Xin Luo
- Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Rui-Fang Wu
- Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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Mariotti EB, Corrà A, Aimo C, Ruffo di Calabria V, Quintarelli L, Verdelli A, Caproni M. Exacerbation of clinical manifestations of bullous pemphigoid after treatment with dupilumab. Clin Exp Dermatol 2024; 49:399-400. [PMID: 38011325 DOI: 10.1093/ced/llad412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/14/2023] [Accepted: 11/21/2023] [Indexed: 11/29/2023]
Abstract
The article presents an adverse event that occurred after the induction phase of dupilumab, administered in another country to a patient affected by bullous pemphigoid.
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Affiliation(s)
| | - Alberto Corrà
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Cristina Aimo
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Lavinia Quintarelli
- Rare Diseases Unit, Section of Dermatology, Department of Health Sciences, USL Toscana Centre, European Reference Network-Skin Member, University of Florence, Florence, Italy
| | - Alice Verdelli
- Rare Diseases Unit, Section of Dermatology, Department of Health Sciences, USL Toscana Centre, European Reference Network-Skin Member, University of Florence, Florence, Italy
| | - Marzia Caproni
- Rare Diseases Unit, Section of Dermatology, Department of Health Sciences, USL Toscana Centre, European Reference Network-Skin Member, University of Florence, Florence, Italy
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Docampo-Simón A, Belinchón I, Sánchez-Pujol MJ, Berbegal L, Miralles J, Lucas A, Quecedo E, Fuertes A, Mateu-Puchades A, Betlloch I. Psoriasis dermatitis, a common phenotype of early forms of both psoriasis and atopic dermatitis in children: A prospective multicenter study. Int J Dermatol 2024. [PMID: 38433076 DOI: 10.1111/ijd.17100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/27/2024] [Accepted: 02/07/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Psoriasis (Ps) and atopic dermatitis (AD) are chronic systemic immune-mediated diseases that can coexist in an overlapping condition called psoriasis dermatitis (PD). PD patients have intermediate lesions with characteristics of both Ps and AD. PD is very rare in adults but much more frequent in children. Little is known, however, about the course of PD in the pediatric population. The aim of this study was to evaluate the percentage of PD cases in children that evolved to a definite form of Ps or AD and to identify any clinical or epidemiological variables that could predict the course of the disease. METHODS We performed a prospective multicenter cohort study of children diagnosed with PD between January 2018 and December 2020. We collected participants' clinical and epidemiological characteristics, and pediatric dermatologists determined the percentage of participants who developed Ps or AD. RESULTS The study included 24 children with PD, with a median age of 7.0 years. After a median follow-up period of 31 months, 83.3% of cases had evolved to a definite form of Ps or AD (44.4% to Ps and 38.9% to AD). Younger age and family history of Ps were associated with progression to AD. Participants who progressed to AD or Ps had a longer follow-up than those with an unchanged PD diagnosis. CONCLUSIONS Given sufficient time, a large percentage of PD cases in children will evolve into Ps or AD. Long-term clinical follow-up is necessary for a correct diagnosis.
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Affiliation(s)
- Alexandre Docampo-Simón
- Dermatology Department, Hospital General Universitario Dr Balmis, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Isabel Belinchón
- Dermatology Department, Hospital General Universitario Dr Balmis, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Department of Clinical Medicine, Universidad Miguel Hernández, Elche, Spain
| | - María J Sánchez-Pujol
- Dermatology Department, Hospital General Universitario Dr Balmis, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Laura Berbegal
- Dermatology Department, Hospital de Dénia-Marina Salud, Denia, Spain
| | - Julia Miralles
- Dermatology Department, Hospital Universitario San Juan de Alicante, Sant Joan, Spain
| | - Ana Lucas
- Dermatology Department, Hospital General Universitario de Elda, Elda, Spain
| | - Esther Quecedo
- Dermatology Department, Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - Amparo Fuertes
- Dermatology Department, Hospital Universitario Dr Peset, Valencia, Spain
| | | | - Isabel Betlloch
- Dermatology Department, Hospital General Universitario Dr Balmis, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Department of Clinical Medicine, Universidad Miguel Hernández, Elche, Spain
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Sheng Y, Liu J, Zheng S. Identification of distinct gene co-expression modules and specific hub genes in skin lesions of atopic dermatitis and psoriasis by WGCNA. FEBS Open Bio 2023; 13:1887-1894. [PMID: 37548115 PMCID: PMC10549218 DOI: 10.1002/2211-5463.13686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 07/04/2023] [Accepted: 08/03/2023] [Indexed: 08/08/2023] Open
Abstract
Atopic dermatitis (AD) and psoriasis are among the most common chronic inflammatory skin diseases. Although AD and psoriasis are distinguished using clinical criteria, the lesions of these two diseases are sometimes highly similar, making diagnosis difficult. In addition, the mechanisms underlying these two diseases are not fully clear. Here, we aimed to identify potential genes and regulatory mechanisms in AD and psoriasis patients to aid in the diagnosis and treatment of AD and psoriasis. The GSE121212 dataset was obtained from the NCBI Gene Expression Omnibus database and weighted gene co-expression network analysis (WGCNA) was applied. The functions of genes in modules of interest were determined using Gene Ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes analysis with the ggplot2 package of r. The hub genes were obtained using the Search Tool for the Retrieval of Interacting Genes database and then visualized using cytoscape. The MEgreen and MEbrown modules were identified to associate with AD and psoriasis, respectively, and the biological functions and pathways of genes in clinically significant modules were detected and analyzed. Hub genes in these two modules and details on potential protein interactions were also revealed. The genes and modules identified by WGCNA might contribute to our understanding of the molecular mechanisms of AD and psoriasis and aid in their diagnosis and treatment.
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Affiliation(s)
- Yu Sheng
- Department of DermatologyThe First Affiliated Hospital of Harbin Medical UniversityChina
| | - Jing Liu
- Department of DermatologyThe First Affiliated Hospital of Harbin Medical UniversityChina
| | - Shuyun Zheng
- Department of DermatologyThe First Affiliated Hospital of Harbin Medical UniversityChina
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Trave I, Salvi I, Burlando M, Cozzani E, Parodi A. "De Novo" Psoriasis and Relapse of Psoriasis Induced by Dupilumab: Three New Cases and Review of the Literature. J Clin Med 2023; 12:6291. [PMID: 37834935 PMCID: PMC10573833 DOI: 10.3390/jcm12196291] [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: 08/22/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Atopic dermatitis and psoriasis are traditionally considered diseases that cannot coexist, since they are described as the result of the activation of opposing inflammatory pathways. However, this belief has been debunked, and numerous cases of psoriasis induced by dupilumab, a biologic treatment for atopic dermatitis, have been reported. We report three cases of dupilumab-induced psoriasis and we present a literature review including cases of "de novo" psoriasis and of the relapse of psoriasis that occurred during treatment with dupilumab. In total, 39 publications met the inclusion criteria, including 112 AD patients, 101 of whom developed "de novo" psoriasis, and 11 with a flare of pre-existent psoriasis. In the first group, patients more frequently developed plaque psoriasis on the scalp and extremities, after an average latency period from the initiation of dupilumab of 5 months. In the second group, the incidence of dupilumab-induced relapses of psoriasis was 43%, after an average of 4 months since the first administration. The most common psoriasis type was plaque psoriasis, with the involvement of the scalp and upper extremities. Dupilumab was interrupted in 38% of patients with "de novo" psoriasis and in 50% of relapsed patients, leading, in most cases, to an improvement of psoriasis. In conclusion, atopic dermatitis and psoriasis can definitely co-exist, and biologic drugs used to treat the former can promote the latter. It is thus crucial to perform a careful personal and familiar anamnesis before prescribing any biologic treatment. Moreover, a study of cytokine expression and blood proteomic markers could be considered in these patients.
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Affiliation(s)
| | | | - Martina Burlando
- Section of Dermatology, DISSAL, University of Genoa, IRCCS Ospedale Policlinico San Martino, 16044 Genova, Italy
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Liu L, Chen J, Tang K, Li F, Li S, Ding X. Pustular Psoriasis in a Patient Treated with Dupilumab for Atopic Dermatitis: A Case Report. Clin Cosmet Investig Dermatol 2023; 16:2217-2221. [PMID: 37601418 PMCID: PMC10437099 DOI: 10.2147/ccid.s420904] [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: 06/08/2023] [Accepted: 08/01/2023] [Indexed: 08/22/2023]
Abstract
Psoriasis and atopic dermatitis are relatively common in clinical practice, but it is rare for the two diseases to co-occur in the same patient. Dupilumab, an anti-IL-4/IL-13 monoclonal antibody, has been approved for treating moderate to severe AD. In addition to its therapeutic effects, dupilumab may induce new cutaneous adverse reactions. We report a rare case of pustular psoriasis induced during the treatment of atopic dermatitis with dupilumab. This case demonstrates the need for caution while treating patients with moderate to severe atopic dermatitis and staying vigilant for the emergence of new symptoms, especially with biological agents.
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Affiliation(s)
- Li Liu
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, People’s Republic of China
| | - Jie Chen
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, People’s Republic of China
| | - Kangheng Tang
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, People’s Republic of China
| | - Feng Li
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, People’s Republic of China
| | - Si Li
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, People’s Republic of China
| | - Xiaojie Ding
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, People’s Republic of China
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Controne I, Scoditti E, Buja A, Pacifico A, Kridin K, Fabbro MD, Garbarino S, Damiani G. Do Sleep Disorders and Western Diet Influence Psoriasis? A Scoping Review. Nutrients 2022; 14:nu14204324. [PMID: 36297008 PMCID: PMC9608488 DOI: 10.3390/nu14204324] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
Abstract
Western diet may trigger sleep disorders and vice versa, but their single and mutual effects on systemic inflammatory diseases (i.e., psoriasis) are far from being fully elucidated. At the same time, psoriatic patients display a great burden of sleep disorders and dysmetabolisms related to an unhealthy lifestyle (i.e., diet). These patients are also affected by a chronic disorder deeply modulated by environmental factors (i.e., sleep and diet) capable to influence drug-response and disease progression. Thus, we aimed to summarize the evidence in the literature that may highlight a potential link among psoriasis–diet–sleep in order to further promote a multidisciplinary approach to psoriatic patients in the scientific community.
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Affiliation(s)
- Ilaria Controne
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
| | - Egeria Scoditti
- Institute of Clinical Physiology, National Research Council (CNR), 73100 Lecce, Italy
| | - Alessandra Buja
- Department of Cardiologic, Vascular and Thoracic Sciences, and Public Health, University of Padova, 35128 Padova, Italy
| | - Alessia Pacifico
- Clinical Dermatology Department, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, 23562 Lübeck, Germany
| | - Massimo Del Fabbro
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- IRCCS Fondazione Ca’ Granda IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal/Child Sciences (DINOGMI), University of Genoa, 16132 Genoa, Italy
| | - Giovanni Damiani
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-02-662141
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