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Köhler I, Bivik Eding C, Kasic NK, Verma D, Enerbäck C. NOS2-derived low levels of NO drive psoriasis pathogenesis. Cell Death Dis 2024; 15:449. [PMID: 38926337 PMCID: PMC11208585 DOI: 10.1038/s41419-024-06842-z] [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: 06/28/2023] [Revised: 06/12/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024]
Abstract
Psoriasis is an IL-23/Th17-mediated skin disorder with a strong genetic predisposition. The impact of its susceptibility gene nitric oxide synthase 2 (NOS2) remains unknown. Here, we demonstrate strong NOS2 mRNA expression in psoriatic epidermis, an effect that is IL-17 dependent. However, its complete translation to protein is prevented by the IL-17-induced miR-31 implying marginally upregulated NO levels in psoriatic skin. We demonstrate that lower levels of NO, as opposed to higher levels, increase keratinocyte proliferation and mediate IL-17 downstream effects. We hypothesized that the psoriatic phenotype may be alleviated by either eliminating or increasing cellular NO levels. In fact, using the imiquimod psoriasis mouse model, we found a profound impact on the psoriatic inflammation in both IMQ-treated NOS2 KO mice and wild-type mice treated with IMQ and the NO-releasing berdazimer gel. In conclusion, we demonstrate that IL-17 induces NOS2 and fine-tunes its translation towards a window of proinflammatory and hyperproliferative effects and identify NO donor therapy as a new treatment modality for psoriasis.
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Affiliation(s)
- Ines Köhler
- Ingrid Asp Psoriasis Research Center, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Cecilia Bivik Eding
- Ingrid Asp Psoriasis Research Center, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Nada-Katarina Kasic
- Ingrid Asp Psoriasis Research Center, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Deepti Verma
- Ingrid Asp Psoriasis Research Center, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Charlotta Enerbäck
- Ingrid Asp Psoriasis Research Center, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
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2
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Kim JE, Lee J, Huh YJ, Kim K, Chaparala V, Krueger JG, Kim J. Genomic Profiling of the Overlap Phenotype between Psoriasis and Atopic Dermatitis. J Invest Dermatol 2024; 144:43-52.e6. [PMID: 37419444 PMCID: PMC11060321 DOI: 10.1016/j.jid.2023.06.194] [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: 03/03/2023] [Revised: 06/01/2023] [Accepted: 06/20/2023] [Indexed: 07/09/2023]
Abstract
Clinical overlaps between psoriasis and atopic dermatitis (AD) are sometimes undiscernible, and there is no consensus on whether to treat the overlap phenotype as psoriasis or AD. We enrolled 41 patients diagnosed with either psoriasis or AD and clinically re-stratified them into classic psoriasis (n = 11), classic AD (n = 13), and the overlap phenotype between psoriasis and AD (n = 17). We compared the gene expression profiles of lesional and nonlesional skin biopsy tissues and the proteomic profiles of blood samples among the three comparison groups. Global mRNA expression and T-cell subset cytokine expression in the skin and protein biomarker elevation in the blood of the overlap phenotype were consistent with the profiles of psoriasis and different from the profiles of AD. Unsupervised k-means clustering indicated that the best number of distinct clusters for the total population of the three comparison groups was two, and the two clusters of psoriasis and AD were differentiated by gene expression. Our study suggests that the clinical overlap phenotype between psoriasis and AD has dominant molecular features of psoriasis, and genomic biomarkers can differentiate psoriasis and AD at molecular levels in patients with a spectrum of psoriasis and AD.
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Affiliation(s)
- Jeong Eun Kim
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Republic of Korea; Bio-Bigdata Research Center, Hanyang Insitute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea
| | - Jongmi Lee
- Dermatology Section, Veterans Affairs Northern California Health Care System, Mather, California, USA
| | - Yun Jung Huh
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Katherine Kim
- Dermatology Section, Veterans Affairs Northern California Health Care System, Mather, California, USA
| | - Vasuma Chaparala
- Dermatology Section, Veterans Affairs Northern California Health Care System, Mather, California, USA
| | - James G Krueger
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York, USA
| | - Jaehwan Kim
- Dermatology Section, Veterans Affairs Northern California Health Care System, Mather, California, USA; Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York, USA; Department of Dermatology, University of California Davis, Sacramento, California, USA.
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3
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Eyerich K, Garzorz-Stark N. Back to Broad? How Molecular Profiling Facilitates Targeted Therapies of Overlapping Phenotypes. J Invest Dermatol 2024; 144:3-4. [PMID: 37715751 DOI: 10.1016/j.jid.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 09/18/2023]
Affiliation(s)
- Kilian Eyerich
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Natalie Garzorz-Stark
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.
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4
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Scheurer J, Sauer B, Focken J, Giampetraglia M, Jäger A, Schürch CM, Weigelin B, Schittek B. Histological and functional characterization of 3D human skin models mimicking the inflammatory skin diseases psoriasis and atopic dermatitis. Dis Model Mech 2024; 17:dmm050541. [PMID: 38251799 PMCID: PMC10846593 DOI: 10.1242/dmm.050541] [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: 10/09/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024] Open
Abstract
Three-dimensional (3D) human skin equivalents have emerged as valuable tools in skin research, replacing animal experimentation and precluding the need for patient biopsies. In this study, we advanced 3D skin equivalents to model the inflammatory skin diseases atopic dermatitis and psoriasis by cytokine stimulation, and were successful in integrating TH1 T cells into skin models to develop an immunocompetent 3D psoriasis model. We performed in-depth histological and functional characterization of 3D skin equivalents and validated them in terms of tissue architecture, pathological changes, expression of antimicrobial peptides and Staphylococcus aureus colonization using 3D reconstruction by multiphoton microscopy and phenotyping by highly multiplexed 'co-detection by indexing' (CODEX) microscopy. We show that our skin equivalents have a structural architecture with a well-developed dermis and epidermis, thus resembling human skin. In addition, the skin models of atopic dermatitis and psoriasis show several phenotypic features of inflammatory skin disease, including disturbed epidermal differentiation and alterations in the expression of epidermal barrier genes and antimicrobial peptides, and can be reliably used to test novel treatment strategies. Therefore, these 3D equivalents will be a valuable tool in experimental dermatological research.
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Affiliation(s)
- Jasmin Scheurer
- Department of Dermatology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Birgit Sauer
- Department of Dermatology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Jule Focken
- Department of Dermatology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Martina Giampetraglia
- Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University, 72076 Tübingen, Germany
- Cluster of Excellence iFIT (EXC 2180) “Image-Guided and Functionally Instructed Tumor Therapies”, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
| | - Annika Jäger
- Department of Pathology and Neuropathology, University Hospital and Comprehensive Cancer Center Tübingen, 72076 Tübingen, Germany
| | - Christian M. Schürch
- Department of Pathology and Neuropathology, University Hospital and Comprehensive Cancer Center Tübingen, 72076 Tübingen, Germany
- Cluster of Excellence iFIT (EXC 2180) “Image-Guided and Functionally Instructed Tumor Therapies”, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
| | - Bettina Weigelin
- Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University, 72076 Tübingen, Germany
- Cluster of Excellence iFIT (EXC 2180) “Image-Guided and Functionally Instructed Tumor Therapies”, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
| | - Birgit Schittek
- Department of Dermatology, University Hospital Tübingen, 72076 Tübingen, Germany
- Cluster of Excellence iFIT (EXC 2180) “Image-Guided and Functionally Instructed Tumor Therapies”, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
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5
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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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6
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Bauer A, Brans R, Brehler R, Büttner M, Dickel H, Elsner P, Fartasch M, Herzog C, John SM, Köllner A, Maul JT, Merk H, Molin S, Nast A, Nikolakis GD, Schliemann S, Skudlik C, Weisshaar E, Werfel T, Zidane M, Worm M. S2k-Leitlinie Diagnostik, Prävention und Therapie des Handekzems: S2k guideline diagnosis, prevention and therapy of hand eczema. J Dtsch Dermatol Ges 2023; 21:1054-1076. [PMID: 37700403 DOI: 10.1111/ddg.15179_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/14/2023] [Indexed: 09/14/2023]
Abstract
ZusammenfassungDie S2k‐Leitlinie „Diagnostik, Prävention und Therapie des Handekzems (HE)“ gibt auf der Grundlage eines evidenz‐ und konsensbasierten Ansatzes konkrete Handlungsanweisungen und Empfehlungen für die Diagnostik, Prävention und Therapie des HE. Die Leitlinie wurde auf der Grundlage der deutschen Leitlinie „Management von Handekzemen“ aus dem Jahr 2009 und der aktuellen Leitlinie der European Society of Contact Dermatitis (ESCD) „Guidelines for diagnosis, prevention and treatment of hand eczema“ aus dem Jahr 2022 erstellt. Allgemeines Ziel der Leitlinie ist es, Dermatologen und Allergologen in der Praxis und Klinik eine akzeptierte, evidenzbasierte Entscheidungshilfe für die Auswahl sowie Durchführung einer geeigneten und suffizienten Therapie für Patienten mit Handekzemen zur Verfügung zu stellen. Die Leitlinie basiert auf zwei Cochrane‐Reviews zu therapeutischen und präventiven Interventionen beim HE. Die übrigen Kapitel wurden überwiegend basierend auf nicht systematischen Literaturrecherchen durch die Expertengruppe erarbeitet und konsentiert. Die Expertenkommission bestand aus Mitgliedern von allergologischen und berufsdermatologischen Fachgesellschaften und Arbeitsgruppen, einer Patientenvertretung und Methodikern. Im Rahmen einer Konsensuskonferenz am 15.09.2022 wurden die Vorschläge für die Empfehlungen und Kernaussagen unter Verwendung eines nominalen Gruppenprozesses konsentiert. Der strukturierte Konsensfindungsprozess wurde professionell moderiert. Die vorliegende Leitlinie hat eine Gültigkeit bis zum 22.02.2028.
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Affiliation(s)
- Andrea Bauer
- Klinik für Dermatologie und Poliklinik, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Deutschland
| | - Richard Brans
- Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück, Osnabrück, Deutschland und Institut für Interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück, Osnabrück, Deutschland
| | - Randolf Brehler
- Allergologie, Berufsdermatologie und Umweltmedizin an der Hautklinik, Universitätsklinikum Münster, Münster, Deutschland
| | | | - Heinrich Dickel
- Bochum Klinik für Dermatologie, Venerologie und Allergologie, St. Josef-Hospital, Universitätsklinikum, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Peter Elsner
- Privatpraxis für Dermatologie und Allergologie, SRH Krankenhaus Gera, Gera, Deutschland
| | - Manigé Fartasch
- Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung (IPA), Institut der Ruhr-Universität Bochum, Bochum, Deutschland
| | - Claudia Herzog
- Universitätskrebszentrum, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Deutschland
| | - Swen-Malte John
- Fachbereich Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück, Osnabrück, Deutschland und Institut für interdisziplinäre dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück, Osnabrück, Deutschland
| | - Arno Köllner
- Dermatologische Gemeinschaftspraxis, Duisburg, Deutschland
| | | | - Hans Merk
- Professor für Dermatologie und Allergologie, ehemaliger Direktor der Hautklinik, RWTH Aachen, Deutschland
| | - Sonja Molin
- Abteilung für Dermatologie, Fachbereich Medizin, Queen's University, Kingston, Kanada
| | - Alexander Nast
- Klinik für Dermatologie, Venerologie und Allergologie, Abteilung für Evidenzbasierte Medizin (dEBM), Charité - Universitätsmedizin Berlin, gemeinsames Mitglied der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Georgios D Nikolakis
- Klinik für Dermatologie, Venerologie, Allergologie und Immunologie, Städtisches Klinikum Dessau, Medizinische Hochschule Brandenburg Theodor Fontane und Fakultät für Gesundheitswissenschaften Brandenburg, Dessau, Deutschland
| | | | - Christoph Skudlik
- Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück, Osnabrück, Deutschland und Institut für Interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück, Osnabrück, Deutschland
| | - Elke Weisshaar
- Berufsdermatologie, Abteilung Dermatologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Thomas Werfel
- Klinik für Dermatologie und Allergologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Miriam Zidane
- Klinik für Dermatologie, Venerologie und Allergologie, Abteilung für Evidenzbasierte Medizin (dEBM), Charité - Universitätsmedizin Berlin, gemeinsames Mitglied der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Margitta Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, korporatives Mitglied der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Berlin, Deutschland
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7
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Bauer A, Brans R, Brehler R, Büttner M, Dickel H, Elsner P, Fartasch M, Herzog C, John SM, Köllner A, Maul JT, Merk H, Molin S, Nast A, Nikolakis GD, Schliemann S, Skudlik C, Weisshaar E, Werfel T, Zidane M, Worm M. S2k guideline diagnosis, prevention, and therapy of hand eczema. J Dtsch Dermatol Ges 2023; 21:1054-1074. [PMID: 37700424 DOI: 10.1111/ddg.15179] [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: 05/09/2023] [Accepted: 06/14/2023] [Indexed: 09/14/2023]
Abstract
The consensus-based guideline "Diagnosis, prevention, and treatment of hand eczema (HE)" provides concrete instructions and recommendations for diagnosis, prevention, and therapy of HE based on an evidence- and consensus-based approach. The guideline was created based on the German guideline "Management von Handekzemen" from 2009 and the current guideline of the European Society of Contact Dermatitis (ESCD) "Guidelines for diagnosis, prevention, and treatment of hand eczema" from 2022. The general goal of the guideline is to provide dermatologists and allergologists in practice and clinics with an accepted, evidence-based decision-making tool for selecting and conducting suitable and sufficient therapy for patients with hand eczema. The guideline is based on two Cochrane reviews of therapeutic and preventive interventions for HE. The remaining chapters were mainly developed and consented based on non-systematic literature research by the expert group. The expert group consisted of members of allergological and occupational dermatological professional associations and working groups, a patient representative, and methodologists. The proposals for recommendations and key statements were consented by using a nominal group process during a consensus conference on September 15, 2022. The structured consensus-building process was professionally moderated. This guideline is valid until February 22, 2028.
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Affiliation(s)
- Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Germany
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany and Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Randolf Brehler
- Department of Allergy, Occupational Dermatology and Environmental Medicine, University Hospital Münster, Münster, Germany
| | | | - Heinrich Dickel
- Bochum Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Center, Ruhr University Bochum, Bochum, Germany
| | - Peter Elsner
- Privat practice for dermatology and allergology, SRH Hospital Gera, Germany
| | - Manigé Fartasch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr University Bochum, Bochum, Germany
| | - Claudia Herzog
- University Cancer Center, University Hospital Carl Gustav Carus, Technical University Dresden, Germany
| | - Swen-Malte John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany and Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | | | - Julia-Tatjana Maul
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Hans Merk
- Professor of Dermatology and Allergology, Former Chairman of the Department of Dermatology, RWTH University, Aachen, Germany
| | - Sonja Molin
- Division of Dermatology, Department of Medicine, Queen's University, Kingston, Canada
| | - Alexander Nast
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Georgios D Nikolakis
- Departments of Dermatology, Venereology, Allergology and Immunology, Staedtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | | | - Christoph Skudlik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany and Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Miriam Zidane
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Margitta Worm
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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8
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Mortlock RD, Ma EC, Cohen JM, Damsky W. Assessment of Treatment-Relevant Immune Biomarkers in Psoriasis and Atopic Dermatitis: Toward Personalized Medicine in Dermatology. J Invest Dermatol 2023; 143:1412-1422. [PMID: 37341663 PMCID: PMC10830170 DOI: 10.1016/j.jid.2023.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/10/2023] [Accepted: 04/13/2023] [Indexed: 06/22/2023]
Abstract
Immunologically targeted therapies have revolutionized the treatment of inflammatory dermatoses, including atopic dermatitis and psoriasis. Although immunologic biomarkers hold great promise for personalized classification of skin disease and tailored therapy selection, there are no approved or widely used approaches for this in dermatology. This review summarizes the translational immunologic approaches to measuring treatment-relevant biomarkers in inflammatory skin conditions. Tape strip profiling, microneedle-based biomarker patches, molecular profiling from epidermal curettage, RNA in situ hybridization tissue staining, and single-cell RNA sequencing have been described. We discuss the advantages and limitations of each and open questions for the future of personalized medicine in inflammatory skin disease.
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Affiliation(s)
- Ryland D Mortlock
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA; Medical Scientist Training Program, Yale School of Medicine, New Haven, Connecticut, USA
| | - Emilie C Ma
- Yale College, Yale University, New Haven, Connecticut, USA
| | - Jeffrey M Cohen
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - William Damsky
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA; Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA.
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9
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Technau-Hafsi K, Garzorz-Stark N, Eyerich K. [Molecular diagnosis of hand eczema]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023:10.1007/s00105-023-05148-z. [PMID: 37272967 DOI: 10.1007/s00105-023-05148-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Because hand eczema is a diagnostic challenge even for experienced dermatologists, a correct diagnosis is essential to ensure success of specific therapies. OBJECTIVES Prerequisites for successful molecular diagnostics in general and in hand eczema in particular are discussed. MATERIALS AND METHODS Basic research and opinion statement on new developments in molecular diagnostics are considered with a special focus on hand eczema. RESULTS The first molecular classifier to distinguish psoriasis from (hand) eczema signature has been introduced as CE-marked in vitro diagnostics (CE-IVD); many more biomarkers associated with diagnostics, theranostics, or natural course of the disease are currently being investigated. CONCLUSIONS Diagnosis of hand eczema will be supported by molecular diagnostics in the near future; we are at the beginning of the molecular era in dermatology.
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Affiliation(s)
- Kristin Technau-Hafsi
- Klinik für Dermatologie und Venerologie, Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland.
- Universitäts-Hautklinik Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland.
| | - Natalie Garzorz-Stark
- Division of Dermatology, Department of Medicine, Karolinska Insitutet, Stockholm, Schweden
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, München, Deutschland
- Dermagnostix GmbH, Hamburg, Deutschland
| | - Kilian Eyerich
- Klinik für Dermatologie und Venerologie, Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland
- Division of Dermatology, Department of Medicine, Karolinska Insitutet, Stockholm, Schweden
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10
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Bauer A, Worm M. [New guideline and treatment options for hand eczema]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023:10.1007/s00105-023-05143-4. [PMID: 37222755 DOI: 10.1007/s00105-023-05143-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 05/25/2023]
Abstract
Due to its high prevalence and associated socioeconomic consequences, hand eczema is a burden for those affected and for society. The various hand eczema subtypes must be differentiated from each other through structured anamnesis and diagnostics in order to initiate cause-related preventive measures in addition to symptomatic therapy. There are new developments in the diagnosis, prevention, and treatment of hand eczema. The diagnostic possibilities are being expanded through molecular methods. Modern topical and systemic therapies offer promising treatment options for patients with atopic but also chronic hand eczema regardless of the underlying etiology.
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Affiliation(s)
- Andrea Bauer
- Klinik und Poliklinik für Dermatologie, Universitäts AllergieCentrum, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - Margitta Worm
- Allergologie und Immunologie, Klinik für Dermatologie, Venerologie und Allergologie, Campus Charité Mitte, Universitätsmedizin Berlin, Berlin, Deutschland
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11
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Lauffer F, Eyerich K. Ekzematisierte Psoriasis - eine häufige, aber oft vernachlässigte Variante der Plaque-Psoriasis. J Dtsch Dermatol Ges 2023; 21:445-454. [PMID: 37183739 DOI: 10.1111/ddg.14991_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/20/2022] [Indexed: 05/16/2023]
Affiliation(s)
- Felix Lauffer
- Klinik für Dermatologie und Allergologie, Technische Universität München, München, Deutschland
| | - Kilian Eyerich
- Abteilung für Dermatologie und Venerologie, Medizinische Klinik Solna und Zentrum für Molekularmedizin, Karolinska Institutet, Stockholm, Schweden
- Abteilung für Dermatologie und Venerologie, Medizinisches Zentrum, Universität Freiburg, Freiburg, Deutschland
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12
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Fischer F, Doll A, Uereyener D, Roenneberg S, Hillig C, Weber L, Hackert V, Meinel M, Farnoud A, Seiringer P, Thomas J, Anand P, Graner L, Schlenker F, Zengerle R, Jonsson P, Jargosch M, Theis FJ, Schmidt-Weber CB, Biedermann T, Howell M, Reich K, Eyerich K, Menden M, Garzorz-Stark N, Lauffer F, Eyerich S. Gene expression based molecular test as diagnostic aid for the differential diagnosis of psoriasis and eczema in formalin fixed and paraffin embedded tissue, microbiopsies and tape strips. J Invest Dermatol 2023:S0022-202X(23)00156-2. [PMID: 36889660 DOI: 10.1016/j.jid.2023.02.015] [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: 10/20/2022] [Revised: 01/28/2023] [Accepted: 02/14/2023] [Indexed: 03/08/2023]
Abstract
Highly effective targeted therapies are available to treat non-communicable chronic inflammatory skin diseases (ncISD). In contrast, the exact diagnosis of ncISD is complicated by their complex pathogenesis and clinical and histological overlap. Particularly, differential diagnosis of psoriasis and eczema can be challenging in special cases and molecular diagnostic tools need to be developed to support gold standard diagnosis. Aim of this work was to develop a real-time PCR based molecular classifier to distinguish psoriasis from eczema in FFPE-fixed skin samples and to evaluate the use of minimally invasive microbiopsies and tape strips for molecular diagnosis. Here, we present a FFPE-based molecular classifier (MC) that determines the probability for psoriasis with a sensitivity/specificity of 92%/100%, respectively, and an AUC of 0.97 delivering comparable results to our previous published RNAprotect-based MC. The psoriasis probability, as well as levels of NOS2 expression positively correlated with disease hallmarks of psoriasis and negatively with eczema hallmarks. Furthermore, minimally invasive tape strips and microbiopsies were effectively used to differentiate psoriasis from eczema. In summary, the MC offers broad usage in pathology laboratories as well as outpatient settings and can support the differential diagnosis of ncISD on a molecular level FFPE tissue, microbiopsies and tape strips.
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Affiliation(s)
- Felix Fischer
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - Anais Doll
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Deniz Uereyener
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - Sophie Roenneberg
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Christina Hillig
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | | | | | - Martin Meinel
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - Ali Farnoud
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - Peter Seiringer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Jenny Thomas
- ZAUM-Center of Allergy and Environment, Technical University of Munich and Helmholtz Center Munich, Munich, Germany
| | - Philipp Anand
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | | | | | - Roland Zengerle
- Laboratory for MEMS Applications, Department of Microsystems Engineering - IMTEK, University of Freiburg, Freiburg, Germany; Hahn-Schickard, Freiburg, Germany
| | - Pontus Jonsson
- Karolinska Universitetssjukhuset - Hudkliniken Stockholm, Stockholm, Sweden
| | - Manja Jargosch
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany; ZAUM-Center of Allergy and Environment, Technical University of Munich and Helmholtz Center Munich, Munich, Germany
| | - Fabian J Theis
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany; Department of Mathematics, Technical University of Munich, Garching, Germany
| | - Carsten B Schmidt-Weber
- ZAUM-Center of Allergy and Environment, Technical University of Munich and Helmholtz Center Munich, Munich, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | | | - Kristian Reich
- Translational Research in Inflammatory Skin Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kilian Eyerich
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Michael Menden
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - Natalie Garzorz-Stark
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Felix Lauffer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Stefanie Eyerich
- ZAUM-Center of Allergy and Environment, Technical University of Munich and Helmholtz Center Munich, Munich, Germany.
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13
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Lauffer F, Eyerich K. Eczematized psoriasis - a frequent but often neglected variant of plaque psoriasis. J Dtsch Dermatol Ges 2023; 21:445-453. [PMID: 36772926 DOI: 10.1111/ddg.14991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/20/2022] [Indexed: 02/12/2023]
Abstract
Psoriasis is a common chronic inflammatory skin disease that causes systemic inflammation and severely impacts the patient's quality of life. Several highly effective therapeutics for psoriasis have been approved in recent years. However, in real life, a high proportion of patients either do not experience the clinical improvement observed in clinical trials or develop a secondary loss of efficacy. This may be a result of unrecognized endotypes of psoriasis that need to be characterized in greater depth to enable selection of an appropriate therapy. Eczematized psoriasis, which occurs in approximately 5-10% of patients with psoriasis, is an often-neglected variant of psoriasis. The term "eczematized psoriasis" refers to patients developing psoriasis with similarities to eczema. These patients typically present with severe itching, and skin biopsies often reveal eosinophil granulocytes, serum crusts, or spongiosis, which are frequently observed in eczema. From an immunological perspective, additional signaling pathways that are responsible for eczema reactions might be activated in eczematized psoriasis compared to classical plaque psoriasis. This review summarizes the key clinical, histological, and immunological features of eczematized psoriasis, proposes diagnostic criteria, and evaluates the therapeutic options for eczematized psoriasis.
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Affiliation(s)
- Felix Lauffer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Kilian Eyerich
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Dermatology and Venereology, Medical Center, University of Freiburg, Freiburg, Germany
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14
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Schäbitz A, Hillig C, Mubarak M, Jargosch M, Farnoud A, Scala E, Kurzen N, Pilz AC, Bhalla N, Thomas J, Stahle M, Biedermann T, Schmidt-Weber CB, Theis F, Garzorz-Stark N, Eyerich K, Menden MP, Eyerich S. Spatial transcriptomics landscape of lesions from non-communicable inflammatory skin diseases. Nat Commun 2022; 13:7729. [PMID: 36513651 PMCID: PMC9747967 DOI: 10.1038/s41467-022-35319-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Abundant heterogeneous immune cells infiltrate lesions in chronic inflammatory diseases and characterization of these cells is needed to distinguish disease-promoting from bystander immune cells. Here, we investigate the landscape of non-communicable inflammatory skin diseases (ncISD) by spatial transcriptomics resulting in a large repository of 62,000 spatially defined human cutaneous transcriptomes from 31 patients. Despite the expected immune cell infiltration, we observe rather low numbers of pathogenic disease promoting cytokine transcripts (IFNG, IL13 and IL17A), i.e. >125 times less compared to the mean expression of all other genes over lesional skin sections. Nevertheless, cytokine expression is limited to lesional skin and presented in a disease-specific pattern. Leveraging a density-based spatial clustering method, we identify specific responder gene signatures in direct proximity of cytokines, and confirm that detected cytokine transcripts initiate amplification cascades of up to thousands of specific responder transcripts forming localized epidermal clusters. Thus, within the abundant and heterogeneous infiltrates of ncISD, only a low number of cytokine transcripts and their translated proteins promote disease by initiating an inflammatory amplification cascade in their local microenvironment.
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Affiliation(s)
- A. Schäbitz
- grid.4714.60000 0004 1937 0626Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - C. Hillig
- grid.4567.00000 0004 0483 2525Institute of Computational Biology, Helmholtz Zentrum München—German Research Centre for Environmental Health, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
| | - M. Mubarak
- grid.6936.a0000000123222966Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - M. Jargosch
- grid.6936.a0000000123222966Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Biedersteinerstrasse 29, 80802 Munich, Germany ,grid.6936.a0000000123222966Department of Dermatology and Allergy, Technical University of Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - A. Farnoud
- grid.4567.00000 0004 0483 2525Institute of Computational Biology, Helmholtz Zentrum München—German Research Centre for Environmental Health, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
| | - E. Scala
- grid.4714.60000 0004 1937 0626Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden ,grid.5963.9Department of Dermatology and Venerology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - N. Kurzen
- grid.6936.a0000000123222966Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - A. C. Pilz
- grid.6936.a0000000123222966Department of Dermatology and Allergy, Technical University of Munich, Biedersteinerstrasse 29, 80802 Munich, Germany ,grid.5963.9Department of Dermatology and Venerology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - N. Bhalla
- grid.5037.10000000121581746Department of Gene Technology, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Stockholm, Sweden
| | - J. Thomas
- grid.6936.a0000000123222966Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - M. Stahle
- grid.4714.60000 0004 1937 0626Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - T. Biedermann
- grid.6936.a0000000123222966Department of Dermatology and Allergy, Technical University of Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - C. B. Schmidt-Weber
- grid.6936.a0000000123222966Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - F. Theis
- grid.4567.00000 0004 0483 2525Institute of Computational Biology, Helmholtz Zentrum München—German Research Centre for Environmental Health, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
| | - N. Garzorz-Stark
- grid.4714.60000 0004 1937 0626Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden ,grid.6936.a0000000123222966Department of Dermatology and Allergy, Technical University of Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - K. Eyerich
- grid.4714.60000 0004 1937 0626Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden ,grid.5963.9Department of Dermatology and Venerology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany ,grid.24381.3c0000 0000 9241 5705Department of Dermatology and Venereology, Unit of Dermatology, Karolinska University Hospital, Stockholm, Sweden
| | - M. P. Menden
- grid.4567.00000 0004 0483 2525Institute of Computational Biology, Helmholtz Zentrum München—German Research Centre for Environmental Health, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany ,grid.5252.00000 0004 1936 973XDepartment of Biology, Ludwig-Maximilians University, Goßhadernerstrasse 2, Martinsried, 82152 Germany ,grid.452622.5German Center for Diabetes Research (DZD e.V.), Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
| | - S. Eyerich
- grid.6936.a0000000123222966Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
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15
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Yu L, Li L. Potential biomarkers of atopic dermatitis. Front Med (Lausanne) 2022; 9:1028694. [PMID: 36465933 PMCID: PMC9712451 DOI: 10.3389/fmed.2022.1028694] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/31/2022] [Indexed: 11/12/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic, recurrent inflammatory skin disease with a wide range of heterogeneity. Accurate biomarkers or predictors are the keys to instructing personalized tailored precise treatment. The development of technology such as transcriptomics, genomics, and proteomics provides novel insights into the possibility to find potential biomarkers. Meanwhile, emerging minimally invasive methods such as tape stripping were used to reveal different profiles of patients' skin without biopsy. Several potential biomarkers or predictors have been found. In this review, we summarized the current development of potential biomarkers of AD. Nitric oxide synthase 2/inducible nitric oxide synthase (NOS2/iNOS), human beta-defensin-2 (hBD-2), and matrix metalloproteinases 8/9 (MMP8/9) may be the candidate biomarkers for AD diagnosis. Filaggrin (FLG) gene mutation increased the occurrence risk of AD. Fatty-acid-binding protein 5 (FABP5) may serve as an effective biomarker for the atopic march (AM). Squamous cell carcinoma antigen 2 (SCCA2), serum thymus and activation-regulated chemokine (TARC), cutaneous T-cell-attracting chemokine (CTACK), eosinophil-derived neurotoxin (EDN), macrophage-derived chemokine (MDC), lactate dehydrogenase (LDH), and interleukin (IL)-18 can be the candidate biomarkers for disease severity monitoring. IL-17, IL-23, IL-33, and indoleamine 2,3-dioxygenase (IDO1) can be used as predictive biomarkers for AD comorbidities. LDH, TARC, pulmonary and activation-regulated chemokine (PARC), periostin, IL-22, eotaxin-1/3, and IL-8 may be the candidate biomarkers for monitoring treatment effects. There are still unmet needs and a long way to go for more convenient, non-invasive, and effective predictors and biomarkers to better guide personalized precise treatment.
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Affiliation(s)
- Ling Yu
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Department of Dermatology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Dermatology, Zhengzhou University People’s Hospital, Zhengzhou, China
| | - Linfeng Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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16
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Couckuyt A, Seurinck R, Emmaneel A, Quintelier K, Novak D, Van Gassen S, Saeys Y. Challenges in translational machine learning. Hum Genet 2022; 141:1451-1466. [PMID: 35246744 PMCID: PMC8896412 DOI: 10.1007/s00439-022-02439-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 02/08/2022] [Indexed: 11/25/2022]
Abstract
Machine learning (ML) algorithms are increasingly being used to help implement clinical decision support systems. In this new field, we define as "translational machine learning", joint efforts and strong communication between data scientists and clinicians help to span the gap between ML and its adoption in the clinic. These collaborations also improve interpretability and trust in translational ML methods and ultimately aim to result in generalizable and reproducible models. To help clinicians and bioinformaticians refine their translational ML pipelines, we review the steps from model building to the use of ML in the clinic. We discuss experimental setup, computational analysis, interpretability and reproducibility, and emphasize the challenges involved. We highly advise collaboration and data sharing between consortia and institutes to build multi-centric cohorts that facilitate ML methodologies that generalize across centers. In the end, we hope that this review provides a way to streamline translational ML and helps to tackle the challenges that come with it.
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Affiliation(s)
- Artuur Couckuyt
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Gent, Belgium
- Data Mining and Modeling for Biomedicine, VIB-UGent Center for Inflammation Research, Gent, Belgium
| | - Ruth Seurinck
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Gent, Belgium
- Data Mining and Modeling for Biomedicine, VIB-UGent Center for Inflammation Research, Gent, Belgium
| | - Annelies Emmaneel
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Gent, Belgium
- Data Mining and Modeling for Biomedicine, VIB-UGent Center for Inflammation Research, Gent, Belgium
| | - Katrien Quintelier
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Gent, Belgium
- Data Mining and Modeling for Biomedicine, VIB-UGent Center for Inflammation Research, Gent, Belgium
- Department of Pulmonary Diseases, Erasmus MC, Rotterdam, The Netherlands
| | - David Novak
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Gent, Belgium
- Data Mining and Modeling for Biomedicine, VIB-UGent Center for Inflammation Research, Gent, Belgium
| | - Sofie Van Gassen
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Gent, Belgium
- Data Mining and Modeling for Biomedicine, VIB-UGent Center for Inflammation Research, Gent, Belgium
| | - Yvan Saeys
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Gent, Belgium.
- Data Mining and Modeling for Biomedicine, VIB-UGent Center for Inflammation Research, Gent, Belgium.
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17
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Mastraftsi S, Vrioni G, Bakakis M, Nicolaidou E, Rigopoulos D, Stratigos AJ, Gregoriou S. Atopic Dermatitis: Striving for Reliable Biomarkers. J Clin Med 2022; 11:jcm11164639. [PMID: 36012878 PMCID: PMC9410433 DOI: 10.3390/jcm11164639] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/02/2022] [Accepted: 08/07/2022] [Indexed: 11/16/2022] Open
Abstract
Atopic dermatitis (AD) is a highly heterogeneous inflammatory disease regarding both its pathophysiology and clinical manifestations. However, it is treated according to the “one-size-fits-all” approach, which may restrict response to treatment. Thus, there is an unmet need for the stratification of patients with AD into distinct endotypes and clinical phenotypes based on biomarkers that will contribute to the development of precision medicine in AD. The development of reliable biomarkers that may distinguish which patients with AD are most likely to benefit from specific targeted therapies is a complex procedure and to date none of the identified candidate biomarkers for AD has been validated for use in routine clinical practice. Reliable biomarkers in AD are expected to improve diagnosis, evaluate disease severity, predict the course of disease, the development of comorbidities, or the therapeutic response, resulting in effective and personalized treatment of AD. Among the studied AD potential biomarkers, thymus and activation-regulated chemokine/C-C motif ligand 17 (TARC/CCL17) has the greatest evidence-based support for becoming a reliable biomarker in AD correlated with disease severity in both children and adults. In this review, we present the most prominent candidate biomarkers in AD and their suggested use.
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Affiliation(s)
- Styliani Mastraftsi
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
- Correspondence: ; Tel.: +30-6974819341
| | - Georgia Vrioni
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Michail Bakakis
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Electra Nicolaidou
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Dimitrios Rigopoulos
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Alexander J. Stratigos
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Stamatios Gregoriou
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
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18
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Papp KA, Hong CH, Lansang MP, Turchin I, Adam DN, Beecker JR, Bissonnette R, Gooderham MJ, Jack C, Joseph M, Lynde CW, Shear NH. Practical Management of Patients with Atopic Dermatitis on Dupilumab. Dermatol Ther (Heidelb) 2021; 11:1805-1828. [PMID: 34510403 PMCID: PMC8435113 DOI: 10.1007/s13555-021-00586-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/25/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Dupilumab is approved to treat moderate-to-severe atopic dermatitis (AD) in several countries in patients as young as 6 years of age. Since its approval, practical issues related to the use of dupilumab for AD have arisen, with particular interest in transitioning from current therapies and managing medication overlap, considerations for special populations of patients with AD, and management of potential adverse events. METHODS This article aims to review the literature addressing several practical management issues related to dupilumab use for AD and to provide a framework for clinical decision-making in these circumstances and sub-populations. Each statement was reviewed, revised and voted on by authors to provide their level of agreement and degree of uncertainty for each statement. RESULTS An agreement level > 80% was achieved for all of the statements. CONCLUSION The expert panel provides statements considering the practical management of patients with AD taking dupilumab to inform clinical decision-making in specific but frequently encountered clinical situations.
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Affiliation(s)
- Kim A Papp
- Probity Medical Research, Waterloo, ON, Canada.
- K. Papp Clinical Research, 135 Union St E, Waterloo, ON, N2J 1C4, Canada.
| | - Chih-Ho Hong
- Probity Medical Research, Waterloo, ON, Canada
- Dr. Chih-ho Hong Medical, Inc, Surrey, BC, Canada
| | - M Perla Lansang
- Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Section of Dermatology, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Irina Turchin
- Probity Medical Research, Waterloo, ON, Canada
- Brunswick Dermatology Centre, Fredericton, NB, Canada
| | - David N Adam
- Probity Medical Research, Waterloo, ON, Canada
- Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- CCA Medical Research, Ajax, ON, Canada
| | - Jennifer R Beecker
- Probity Medical Research, Waterloo, ON, Canada
- Division of Dermatology, The Ottawa Hospital, Ottawa, ON, Canada
- Division of Dermatology, University of Ottawa, Ottawa, ON, Canada
| | | | - Melinda J Gooderham
- Probity Medical Research, Waterloo, ON, Canada
- SKiN Centre for Dermatology, Peterborough, ON, Canada
| | - Carolyn Jack
- Division of Dermatology, McGill University, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Marissa Joseph
- Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Dermatology, Women's College Hospital, Toronto, ON, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Charles W Lynde
- Probity Medical Research, Waterloo, ON, Canada
- Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Lynderm Research, Markham, ON, Canada
| | - Neil H Shear
- Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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19
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Baur V, Schultz ES. Handekzeme: Ätiologie, Diagnostik und therapeutisches Management. AKTUELLE DERMATOLOGIE 2021. [DOI: 10.1055/a-1106-9108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Schäbitz A, Eyerich K, Garzorz-Stark N. So close, and yet so far away: The dichotomy of the specific immune response and inflammation in psoriasis and atopic dermatitis. J Intern Med 2021; 290:27-39. [PMID: 33428274 DOI: 10.1111/joim.13235] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/13/2020] [Accepted: 12/09/2020] [Indexed: 12/11/2022]
Abstract
Characterization of the complex interplay between cytokines, chemokines and microorganisms has led to a better understanding of the pathogenesis of both psoriasis and AD and resulted in new therapeutics targeting distinct immune responses. Psoriasis and AD share many characteristics: they are highly prevalent, chronic, cause primarily skin inflammation, but are associated with comorbidities, and come with a devastating quality of life due to itch and stigmatization. However, the pathogenesis of psoriasis and AD is opposing - psoriasis is dominated by a Th17 immune response that causes neutrophil migration, induction of innate immunity and exaggerated epithelial metabolism. Leading cytokines of this Th17 immune response are IL-17A and F, IL-22 and TNF-a. AD is characterized by Th2 immunity characterized by the signature cytokines IL-4 and IL-13 leading to an impaired epidermal barrier, dampened innate immunity and eosinophil migration. This review compares genetics, microbiome and T-cell infiltrate and resulting epithelial response in psoriasis and AD. Whilst the antagonistic course of psoriasis and AD is confirmed by response to specific biologics targeting the key cytokines of inflammation in psoriasis and AD, respectively, clinically overlapping phenotypes are challenging in our daily clinical practice. We conclude this review by summarizing what is known about these mixed phenotypes and how the identification of clinically relevant endotypes and molecular-driven decision-making is the next step in the field of dermato-immunology.
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Affiliation(s)
- A Schäbitz
- From the, Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - K Eyerich
- From the, Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Dermatology and Venereology, Unit of Dermatology, Karolinska University Hospital, Stockholm, Sweden.,Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - N Garzorz-Stark
- From the, Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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21
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Wang A, Fogel AL, Murphy MJ, Panse G, McGeary MK, McNiff JM, Bosenberg M, Vesely MD, Cohen JM, Ko CJ, King BA, Damsky W. Cytokine RNA In Situ Hybridization Permits Individualized Molecular Phenotyping in Biopsies of Psoriasis and Atopic Dermatitis. JID INNOVATIONS 2021; 1:100021. [PMID: 34909719 PMCID: PMC8659380 DOI: 10.1016/j.xjidi.2021.100021] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/23/2021] [Accepted: 03/30/2021] [Indexed: 12/13/2022] Open
Abstract
Detection of individual cytokines in routine biopsies from patients with inflammatory skin diseases has the potential to personalize diagnosis and treatment selection, but this approach has been limited by technical feasibility. We evaluate whether a chromogen-based RNA in situ hybridization approach can be used to detect druggable cytokines in psoriasis and atopic dermatitis. A series of psoriasis (n = 20) and atopic dermatitis (n = 26) biopsies were stained using RNA in situ hybridization for IL4, IL12B (IL-12/23 p40), IL13, IL17A, IL17F, IL22, IL23A (IL-23 p19), IL31, and TNF (TNF-α). NOS2 and IFNG, canonical psoriasis biomarkers, were also included. All 20 of the psoriasis cases were positive for IL17A, which tended to be the predominant cytokine, although some cases had relatively higher levels of IL12B, IL17F, or IL23A. The majority of cytokine expression in psoriasis was epidermal. A total of 22 of 26 atopic dermatitis cases were positive for IL13, also at varying levels; a subset of cases had significant IL4, IL22, or IL31 expression. Patterns were validated in independent bulk RNA-sequencing and single-cell RNA-sequencing datasets. Overall, RNA in situ hybridization for cytokines appears highly specific with virtually no background staining and may allow for individualized evaluation of treatment-relevant cytokine targets in biopsies from patients with inflammatory skin disorders.
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22
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Biomarkers in atopic dermatitis—a review on behalf of the International Eczema Council. J Allergy Clin Immunol 2021; 147:1174-1190.e1. [DOI: 10.1016/j.jaci.2021.01.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/22/2020] [Accepted: 01/15/2021] [Indexed: 12/13/2022]
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23
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Baumann R, Untersmayr E, Zissler UM, Eyerich S, Adcock IM, Brockow K, Biedermann T, Ollert M, Chaker AM, Pfaar O, Garn H, Thwaites RS, Togias A, Kowalski ML, Hansel TT, Jakwerth CA, Schmidt‐Weber CB. Noninvasive and minimally invasive techniques for the diagnosis and management of allergic diseases. Allergy 2021; 76:1010-1023. [PMID: 33128851 DOI: 10.1111/all.14645] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/13/2020] [Accepted: 10/25/2020] [Indexed: 12/12/2022]
Abstract
Allergic diseases of the (upper and lower) airways, the skin and the gastrointestinal tract, are on the rise, resulting in impaired quality of life, decreased productivity, and increased healthcare costs. As allergic diseases are mostly tissue-specific, local sampling methods for respective biomarkers offer the potential for increased sensitivity and specificity. Additionally, local sampling using noninvasive or minimally invasive methods can be cost-effective and well tolerated, which may even be suitable for primary or home care sampling. Non- or minimally invasive local sampling and diagnostics may enable a more thorough endotyping, may help to avoid under- or overdiagnosis, and may provide the possibility to approach precision prevention, due to early diagnosis of these local diseases even before they get systemically manifested and detectable. At the same time, dried blood samples may help to facilitate minimal-invasive primary or home care sampling for classical systemic diagnostic approaches. This EAACI position paper contains a thorough review of the various technologies in allergy diagnosis available on the market, which analytes or biomarkers are employed, and which samples or matrices can be used. Based on this assessment, EAACI position is to drive these developments to efficiently identify allergy and possibly later also viral epidemics and take advantage of comprehensive knowledge to initiate preventions and treatments.
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Affiliation(s)
- Ralf Baumann
- Medical Faculty Institute for Molecular Medicine Medical School Hamburg (MSH) – Medical University Hamburg Germany
- RWTH Aachen University Hospital Institute for Occupational, Social and Environmental Medicine Aachen Germany
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research Center of Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Ulrich M. Zissler
- Center of Allergy and Environment (ZAUM) Technical University and Helmholtz Zentrum München München Germany
- Member of the German Center of Lung Research (DZL) and the Helmholtz I&I Initiative Munich Germany
| | - Stefanie Eyerich
- Center of Allergy and Environment (ZAUM) Technical University and Helmholtz Zentrum München München Germany
- Member of the German Center of Lung Research (DZL) and the Helmholtz I&I Initiative Munich Germany
| | - Ian M. Adcock
- National Heart and Lung Institute Imperial College London, and Royal Brompton and Harefield NHS Trust London UK
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein School of Medicine Technische Universität München Munich Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy Biederstein School of Medicine Technische Universität München Munich Germany
| | - Markus Ollert
- Department of Infection and Immunity Luxembourg Institute of Health (LIH) Esch‐sur‐Alzette Luxembourg
- Department of Dermatology and Allergy Center Odense Research Centre for Anaphylaxis (ORCA) University of Southern Denmark Odense Denmark
| | - Adam M. Chaker
- Center of Allergy and Environment (ZAUM) Technical University and Helmholtz Zentrum München München Germany
- Member of the German Center of Lung Research (DZL) and the Helmholtz I&I Initiative Munich Germany
- Department of Otolaryngology Allergy Section Klinikum Rechts der Isar Technical University of Munich Munich Germany
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery University Hospital Marburg Philipps‐Universität Marburg Marburg Germany
| | - Holger Garn
- Biochemical Pharmacological Center (BPC) ‐ Molecular Diagnostics, Translational Inflammation Research Division & Core Facility for Single Cell Multiomics Philipps University of Marburg ‐ Medical Faculty Member of the German Center for Lung Research (DZL) Universities of Giessen and Marburg Lung Center (UGMLC) Marburg Germany
| | - Ryan S. Thwaites
- National Heart and Lung Institute Imperial College London, and Royal Brompton and Harefield NHS Trust London UK
| | - Alkis Togias
- Division of Allergy, Immunology and Transplantation National Institute of Allergy and Infectious Diseases National Institutes of Health Bethesda MD USA
| | - Marek L. Kowalski
- Department of Immunology and Allergy Medical University of Lodz Lodz Poland
| | - Trevor T. Hansel
- National Heart and Lung Institute Imperial College London, and Royal Brompton and Harefield NHS Trust London UK
| | - Constanze A. Jakwerth
- Center of Allergy and Environment (ZAUM) Technical University and Helmholtz Zentrum München München Germany
- Member of the German Center of Lung Research (DZL) and the Helmholtz I&I Initiative Munich Germany
| | - Carsten B. Schmidt‐Weber
- Center of Allergy and Environment (ZAUM) Technical University and Helmholtz Zentrum München München Germany
- Member of the German Center of Lung Research (DZL) and the Helmholtz I&I Initiative Munich Germany
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24
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[Cohort study for long-term follow-up of patients in whom the so-called "molecular classifier" is used to distinguish eczema from psoriasis : Background and implementation]. Hautarzt 2021; 72:354-357. [PMID: 33655344 DOI: 10.1007/s00105-021-04774-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2021] [Indexed: 10/22/2022]
Abstract
A cohort of occupational dermatology patients will be set up at the University Hospital Heidelberg, Germany. In a 3-year prospective cohort study, the so-called molecular classifier will be applied in 262 patients to better differentiate between eczema and psoriasis. A retrospective cohort of 282 occupational health patients with the same suspected diagnosis but no molecular classifier designation was used as a control group. In 5 follow-up visits during 3 years, data will be obtained on diagnoses, disease course and severity, absence from work, occupation and quality of life. The research questions address whether early diagnoses will help to better identify the efficient treatment, disease course, absence from work and continuance of occupation. The study is sponsored by the public statutory employers' liability insurance (Deutsche Gesetzliche Unfallversicherung [DGUV]).
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25
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Enjalbert F, Dewan P, Caley MP, Jones EM, Morse MA, Kelsell DP, Enright AJ, O'Toole EA. 3D model of harlequin ichthyosis reveals inflammatory therapeutic targets. J Clin Invest 2021; 130:4798-4810. [PMID: 32544098 PMCID: PMC7456239 DOI: 10.1172/jci132987] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 06/10/2020] [Indexed: 02/04/2023] Open
Abstract
The biology of harlequin ichthyosis (HI), a devastating skin disorder caused by loss-of-function mutations in the gene ABCA12, is poorly understood, and to date, no satisfactory treatment has been developed. We sought to investigate pathomechanisms of HI that could lead to the identification of new treatments for improving patients' quality of life. In this study, RNA-Seq and functional assays were performed to define the effects of loss of ABCA12 using HI patient skin samples and an engineered CRISPR/Cas9 ABCA12 KO cell line. The HI living skin equivalent (3D model) recapitulated the HI skin phenotype. The cytokines IL-36α and IL-36γ were upregulated in HI skin, whereas the innate immune inhibitor IL-37 was strongly downregulated. We also identified STAT1 and its downstream target inducible nitric oxide synthase (NOS2) as being upregulated in the in vitro HI 3D model and HI patient skin samples. Inhibition of NOS2 using the inhibitor 1400W or the JAK inhibitor tofacitinib dramatically improved the in vitro HI phenotype by restoring the lipid barrier in the HI 3D model. Our study has identified dysregulated pathways in HI skin that are feasible therapeutic targets.
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Affiliation(s)
- Florence Enjalbert
- Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Priya Dewan
- Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Matthew P Caley
- Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Eleri M Jones
- Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Mary A Morse
- Adaptive Immunity Research Unit, GlaxoSmithKline Medicine's Research Centre, Stevenage, United Kingdom
| | - David P Kelsell
- Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Anton J Enright
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Edel A O'Toole
- Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Centre for Inflammation and Therapeutic Innovation, Queen Mary University of London, London, United Kingdom.,Department of Dermatology, Royal London Hospital, Barts Health NHS Trust ERN-Skin, London, United Kingdom
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26
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Tape strips detect distinct immune and barrier profiles in atopic dermatitis and psoriasis. J Allergy Clin Immunol 2021; 147:199-212. [DOI: 10.1016/j.jaci.2020.05.048] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/21/2020] [Accepted: 05/19/2020] [Indexed: 12/13/2022]
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27
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Neuhauser R, Eyerich K, Boehner A. Generalized pustular psoriasis—Dawn of a new era in targeted immunotherapy. Exp Dermatol 2020; 29:1088-1096. [DOI: 10.1111/exd.14171] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/01/2020] [Accepted: 08/05/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Ruth Neuhauser
- Department of Dermatology and Allergy Biederstein Technical University of Munich Munich Germany
| | - Kilian Eyerich
- Department of Dermatology and Allergy Biederstein Technical University of Munich Munich Germany
- Division of Dermatology and Venereology Department of Medicine Solna, and Center for molecular medicine Karolinska Institutet Stockholm Sweden
- Unit of Dermatology Karolinska University hospital Stockholm Sweden
| | - Alexander Boehner
- Department of Dermatology and Allergy Biederstein Technical University of Munich Munich Germany
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28
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Lauffer F, Jargosch M, Baghin V, Krause L, Kempf W, Absmaier‐Kijak M, Morelli M, Madonna S, Marsais F, Lepescheux L, Albanesi C, Müller N, Theis F, Schmidt‐Weber C, Eyerich S, Biedermann T, Vandeghinste N, Steidl S, Eyerich K. IL‐17C amplifies epithelial inflammation in human psoriasis and atopic eczema. J Eur Acad Dermatol Venereol 2020; 34:800-809. [DOI: 10.1111/jdv.16126] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 11/19/2019] [Indexed: 12/11/2022]
Affiliation(s)
- F. Lauffer
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - M. Jargosch
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - V. Baghin
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - L. Krause
- Institute of Computational Biology Helmholtz Center Munich Neuherberg Germany
| | - W. Kempf
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - M. Absmaier‐Kijak
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - M. Morelli
- Laboratory of Experimental Immunology IDI‐IRCCS Rome Italy
| | - S. Madonna
- Laboratory of Experimental Immunology IDI‐IRCCS Rome Italy
| | | | | | - C. Albanesi
- Laboratory of Experimental Immunology IDI‐IRCCS Rome Italy
| | - N.S. Müller
- Institute of Computational Biology Helmholtz Center Munich Neuherberg Germany
| | - F.J. Theis
- Institute of Computational Biology Helmholtz Center Munich Neuherberg Germany
- Department of Mathematics Technical University of Munich Garching Germany
| | - C. Schmidt‐Weber
- Center of Allergy and Environment (ZAUM) Helmholtzzentrum Munich Technical University of Munich Munich Germany
- German Center of Lung Research (DZL) Gießen Germany
| | - S. Eyerich
- Center of Allergy and Environment (ZAUM) Helmholtzzentrum Munich Technical University of Munich Munich Germany
| | - T. Biedermann
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | | | | | - K. Eyerich
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
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29
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Eyerich S, Metz M, Bossios A, Eyerich K. New biological treatments for asthma and skin allergies. Allergy 2020; 75:546-560. [PMID: 31444793 DOI: 10.1111/all.14027] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 02/06/2023]
Abstract
Allergies are typically endemic, complex and heterogeneous diseases with a high impact at quality of life. Mechanistically, type 2 immune responses involving eosinophil and basophil granulocytes, mast cells and humoral factors such as IgE are key drivers of allergic diseases. Fighting allergic diseases knows three strategies: prevention, symptomatic and causative therapy. While remarkable progress was made in understanding molecular events in allergies as a prerequisite for effective prevention and desensitization, this review article focuses on the most efficient symptomatic treatments-that is using more and more specific antibodies neutralizing particular immune pathways. We highlight and classify recent and upcoming developments in the three prototype chronic allergic diseases allergic asthma, chronic spontaneous urticaria and atopic eczema. In all three examples, biologics such as dupilumab or omalizumab become reliable and efficient therapeutic options. Finally, we give an outlook how a diagnostic and therapeutic workflow might look like in the near future for these three major burdens of society.
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Affiliation(s)
- Stefanie Eyerich
- Center of Allergy and Environment (ZAUM) Helmholtz Center and Technical University of Munich Munich Germany
| | - Martin Metz
- Dermatological Allergology Department of Dermatology and Allergy Charité‐Universitätsmedizin Berlin Germany
| | - Apostolos Bossios
- Department of Respiratory Medicine and Allergy Karolinska University Hospital, Huddinge, and Department of Medicine, Huddinge Karolinska Institutet Stockholm Sweden
- Centre for Allergy Research Karolinska Institutet Stockholm Sweden
| | - Kilian Eyerich
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
- Unit of Dermatology and Venerology Department of Medicine Karolinska Institutet Karolinska University Hospital Stockholm Sweden
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30
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Eyerich K. Assessing genotypes to predict therapeutic outcome in psoriasis. J Eur Acad Dermatol Venereol 2020; 34:11-12. [DOI: 10.1111/jdv.16047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 11/04/2019] [Indexed: 11/28/2022]
Affiliation(s)
- K. Eyerich
- Department of Medicine Division of Dermatology Karolinska Institutet and Karolinska University Hospital Stockholm Sweden
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
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31
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Megna M, Fabbrocini G. Psoriasis and atopic dermatitis: different entities with unsolved challenges. Br J Dermatol 2019; 183:12. [PMID: 31885075 DOI: 10.1111/bjd.18789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- M Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - G Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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32
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Abstract
BACKGROUND Using current diagnostic tools for hand eczema, namely clinical picture and histology, differential diagnoses such as psoriasis palmaris usually cannot be ruled out. OBJECTIVES Discussion of current diagnostic possibilities for hand eczema; presentation and critical evaluation of proposed biomarkers for molecular diagnostics and outlook how diagnostics in dermatology will change in the near future. MATERIALS AND METHODS In this article, we discuss basic research and provide a review of the literature. RESULTS Molecular diagnostics has the potential to substantially improve diagnosis of hand eczema; prerequisites are prospective validation of proposed markers and availability of valid and cost-effective diagnostics. CONCLUSIONS In the near future, the diagnosis of hand eczema will be complemented by software algorithms and artificial intelligence on the one hand and simple, precise, and economic molecular diagnostic devices on the other.
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33
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Abstract
BACKGROUND The pathogenesis of hand eczema is multifactorial. Exogenous factors such as skin irritation and contact sensitization contribute to this as well as an endogenous atopic predisposition. OBJECTIVE This article provides a review of the pathogenetic factors relevant to the development of hand eczema. MATERIAL AND METHODS An evaluation of the current literature on the pathogenesis of hand eczema was carried out. RESULTS Impairment of the epidermal barrier function plays an essential role for the development of hand eczema. The molecular biological basis and the possible significance of a genetic predisposition beyond atopy are not yet fully understood. Immunological processes involved in the pathogenesis of allergic contact dermatitis and atopic eczema are likely to play a role in the development of certain subtypes of hand eczema. This might contribute to an expansion of the therapeutic armamentarium for hand eczema in the future. CONCLUSION The exact understanding of the individual pathogenesis in single hand eczema patients is essential in order to provide specific advice on allergen avoidance, skin protection and basic treatment and to initiate appropriate therapeutic measures.
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Affiliation(s)
- Sonja Molin
- Division of Dermatology, Queen's University, 166 Brock Street, ON K7L 5G2, Kingston, Kanada.
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34
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Tsoi LC, Rodriguez E, Degenhardt F, Baurecht H, Wehkamp U, Volks N, Szymczak S, Swindell WR, Sarkar MK, Raja K, Shao S, Patrick M, Gao Y, Uppala R, Perez White BE, Getsios S, Harms PW, Maverakis E, Elder JT, Franke A, Gudjonsson JE, Weidinger S. Atopic Dermatitis Is an IL-13-Dominant Disease with Greater Molecular Heterogeneity Compared to Psoriasis. J Invest Dermatol 2019; 139:1480-1489. [PMID: 30641038 DOI: 10.1016/j.jid.2018.12.018] [Citation(s) in RCA: 265] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 11/29/2018] [Accepted: 12/05/2018] [Indexed: 02/03/2023]
Abstract
Atopic dermatitis (AD) affects up to 20% of children and adults worldwide. To gain a deeper understanding of the pathophysiology of AD, we conducted a large-scale transcriptomic study of AD with deeply sequenced RNA-sequencing samples using long (126-bp) paired-end reads. In addition to the comparisons against previous transcriptomic studies, we conducted in-depth analysis to obtain a high-resolution view of the global architecture of the AD transcriptome and contrasted it with that of psoriasis from the same cohort. By using 147 RNA samples in total, we found striking correlation between dysregulated genes in lesional psoriasis and lesional AD skin with 81% of AD dysregulated genes being shared with psoriasis. However, we described disease-specific molecular and cellular features, with AD skin showing dominance of IL-13 pathways, but with near undetectable IL-4 expression. We also demonstrated greater disease heterogeneity and larger proportion of dysregulated long noncoding RNAs in AD, and illustrated the translational impact, including skin-type classification and drug-target prediction. This study is by far the largest study comparing the AD and psoriasis transcriptomes using RNA sequencing and demonstrating the shared inflammatory components, as well as specific discordant cytokine signatures of these two skin diseases.
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Affiliation(s)
- Lam C Tsoi
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA; Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA; Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, USA
| | - Elke Rodriguez
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Frauke Degenhardt
- Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Hansjörg Baurecht
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Ulrike Wehkamp
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Natalie Volks
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Silke Szymczak
- Institute of Medical Informatics and Statistics, Kiel University, Kiel, Germany
| | - William R Swindell
- Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Mrinal K Sarkar
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Kalpana Raja
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Shuai Shao
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Matthew Patrick
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Yilin Gao
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA
| | - Ranjitha Uppala
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | | | - Spiro Getsios
- Department of Dermatology, Northwestern University, Chicago, Illinois, USA
| | - Paul W Harms
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Emanual Maverakis
- Department of Dermatology, School of Medicine, UC Davis Medical Center, Sacramento, California, USA
| | - James T Elder
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA; Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA
| | - Andre Franke
- Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
| | - Stephan Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
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36
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Zahran A, Attia A, Mansell H, Shoker A. Contribution of diminished kidney transplant GFR to increased circulating chemokine ligand 27 level. JOURNAL OF INFLAMMATION-LONDON 2018; 15:18. [PMID: 30214382 PMCID: PMC6131940 DOI: 10.1186/s12950-018-0194-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 09/03/2018] [Indexed: 12/20/2022]
Abstract
Background Inflammatory chemokine ligands (CCLs) play an important role in cardiovascular disease and allograft injury. CCLs may independently associate with diminished estimated glomerular filtration rate (eGFR) in stable renal transplant recipients (RTR). Methods Plasma levels of 19 CCLs (1, 2, 3, 4, 5, 8, 11, 13, 15, 17, 21, 24, 26, 27, CXCL5, 8, 10, 12 and 13) were measured in a cohort of 101 RTR. The cohort was divided according to CKD-EPI equation into three groups; group 1: eGFR ≥ 60 ml/min, group 2: eGFR 30–59.9 ml/min and group 3 eGFR ≤ 29.9 ml/min. ANOVA, Krusklwallis, Mann- Whitney Spearman correlation and regression analysis tests were used to determine association between reduced eGFR and inflammatory CCLs plasma levels measured by multiplex techniques. 20 healthy subjects with eGFR above 90 ml/min were included as control. Significance was sat at < 0.05. Results Levels of CCLs 1, 4, 15, 27, CXCL8 and CXCL10 were significantly different among the four studied groups. Multivariate regression analysis (MVA) between eGFR and all CCLs demonstrated that CCL27 was the only ligand to remain significantly associated with diminished eGFR {P = 0.021 and r = − 0.35,(P = 0.001)}. In a second MVA between CCL 27 and patient’s demographics and laboratory variables, diminished eGFR, and elevated PTH, out of the twenty one available variables remained significantly associated with elevated CCL27levels. Conclusion Diminished eGFR in stable RTR is associated with elevated plasma levels of CCL27. This association may explain, at least in part, the independent contribution of reduced eGFR to enhanced inflammation in RTR.
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Affiliation(s)
- Ahmed Zahran
- 1Nephrology Unit, Department of Medicine, Faculty of Medicine, University of Menoufia, Shibin El Kom, Egypt
| | - Ahmed Attia
- 2National Liver Institute, University of Menoufia, Shibin El Kom, Egypt
| | - Holly Mansell
- 3College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK Canada
| | - Ahmed Shoker
- 4Department of Medicine, University of Saskatchewan, Saskatoon, SK Canada.,5Saskatchewan Transplant Program, St Paul's Hospital, 1702- 20th Street West, Saskatoon, SK S7M 0Z9 Canada
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Abstract
About 20% of the general population is contact-sensitized to common haptens such as fragrances, preservatives, and metals. Many also develop allergic contact dermatitis (ACD), the clinical manifestation of contact sensitization. ACD represents a common health issue and is also one of the most important occupational diseases. Although this inflammatory skin disease is mediated predominantly by memory T lymphocytes recognizing low-molecular-weight chemicals after skin contact, the innate immune system also plays an important role. Along that line, the presence of irritants may increase the risk of ACD and therefore ACD is often seen in the context of irritant contact dermatitis. In this review article, we discuss recent progress in basic research that has dramatically increased our understanding of the pathomechanisms of ACD and provides a basis for the development of novel diagnostic and therapeutic measures. Current methods for diagnosis as well as treatment options of ACD are also discussed.
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Affiliation(s)
- Stefan F Martin
- Allergy Research Group, Department of Dermatology, Faculty of Medicine, University of Freiburg, Freiburg, D-79104, Germany
| | - Thomas Rustemeyer
- Department of Dermatology, VU University Medical Centre (VUmc), De Boelelaan 1117, Amsterdam, 1081HV, Netherlands
| | - Jacob P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, DK-2900, Denmark
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38
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Berekméri A, Latzko A, Alase A, Macleod T, Ainscough JS, Laws P, Goodfield M, Wright A, Helliwell P, Edward S, Brown GD, Reid DM, Wenzel J, Stacey M, Wittmann M. Detection of IL-36γ through noninvasive tape stripping reliably discriminates psoriasis from atopic eczema. J Allergy Clin Immunol 2018; 142:988-991.e4. [PMID: 29782895 PMCID: PMC6127028 DOI: 10.1016/j.jaci.2018.04.031] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 03/09/2018] [Accepted: 04/04/2018] [Indexed: 02/08/2023]
Affiliation(s)
- Anna Berekméri
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, United Kingdom; National Institute of Health Research (NIHR), Leeds Biomedical Research Centre (BRC), Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Anne Latzko
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, United Kingdom; Faculty of Biological Sciences, School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Adewonuola Alase
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, United Kingdom; National Institute of Health Research (NIHR), Leeds Biomedical Research Centre (BRC), Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Tom Macleod
- Faculty of Biological Sciences, School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Joseph S Ainscough
- Faculty of Biological Sciences, School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Philip Laws
- National Institute of Health Research (NIHR), Leeds Biomedical Research Centre (BRC), Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Mark Goodfield
- National Institute of Health Research (NIHR), Leeds Biomedical Research Centre (BRC), Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Andrew Wright
- Bradford Teaching Hospital Foundation Trust, Bradford, United Kingdom; Centre for Skin Sciences, University of Bradford, Bradford, United Kingdom
| | - Philip Helliwell
- National Institute of Health Research (NIHR), Leeds Biomedical Research Centre (BRC), Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Sara Edward
- St James's Institute of Oncology, St James's University Hospital, Leeds, Leeds, United Kingdom
| | - Gordon D Brown
- Medical Research Council Centre for Medical Mycology at the University of Aberdeen, Aberdeen Fungal Group, Institute of Medical Sciences, Aberdeen, United Kingdom
| | - Delyth M Reid
- Bradford Teaching Hospital Foundation Trust, Bradford, United Kingdom
| | - Joerg Wenzel
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
| | - Martin Stacey
- Faculty of Biological Sciences, School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Miriam Wittmann
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, United Kingdom; National Institute of Health Research (NIHR), Leeds Biomedical Research Centre (BRC), Leeds Teaching Hospitals, Leeds, United Kingdom; Centre for Skin Sciences, University of Bradford, Bradford, United Kingdom.
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39
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Garzorz-Stark N, Lauffer F, Krause L, Thomas J, Atenhan A, Franz R, Roenneberg S, Boehner A, Jargosch M, Batra R, Mueller NS, Haak S, Groß C, Groß O, Traidl-Hoffmann C, Theis FJ, Schmidt-Weber CB, Biedermann T, Eyerich S, Eyerich K. Toll-like receptor 7/8 agonists stimulate plasmacytoid dendritic cells to initiate TH17-deviated acute contact dermatitis in human subjects. J Allergy Clin Immunol 2018; 141:1320-1333.e11. [DOI: 10.1016/j.jaci.2017.07.045] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 06/08/2017] [Accepted: 07/24/2017] [Indexed: 10/18/2022]
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40
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Stoffel E, Maier H, Riedl E, Brüggen MC, Reininger B, Schaschinger M, Bangert C, Guenova E, Stingl G, Brunner PM. Analysis of anti-tumour necrosis factor-induced skin lesions reveals strong T helper 1 activation with some distinct immunological characteristics. Br J Dermatol 2018; 178:1151-1162. [PMID: 29143979 DOI: 10.1111/bjd.16126] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Psoriasiform and eczematous eruptions are the most common dermatological adverse reactions linked to anti-tumour necrosis factor (TNF)-α therapy. Yet, a detailed characterization of their immune phenotype is lacking. OBJECTIVES To characterize anti-TNF-α-induced inflammatory skin lesions at a histopathological, cellular and molecular level, compared with psoriasis, eczema (atopic dermatitis) and healthy control skin. METHODS Histopathological evaluation, gene expression (quantitative real-time polymerase chain reaction) and computer-assisted immunohistological studies (TissueFAXS) were performed on 19 skin biopsies from patients with inflammatory bowel disease (n = 17) and rheumatoid arthritis (n = 2) with new-onset inflammatory skin lesions during anti-TNF-α-therapy. RESULTS Although most biopsies showed a psoriasiform and/or spongiotic (eczematous) histopathological architecture, these lesions were inconsistent with either psoriasis or eczema on a molecular level using an established chemokine (C-C motif) ligand 27/inducible nitric oxide synthase classifier. Despite some differences in immune skewing depending on the specific histopathological reaction pattern, all anti-TNF-α-induced lesions showed strong interferon (IFN)-γ activation, at higher levels than in psoriasis or eczema. IFN-γ was most likely produced by CD3/CD4/Tbet-positive T helper 1 lymphocytes. CONCLUSIONS New-onset anti-TNF-α-induced eruptions previously classified as psoriasis or spongiotic dermatitis (eczema) exhibit a molecular profile that is different from either of these disorders.
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Affiliation(s)
- E Stoffel
- Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University of Vienna, Vienna, Austria.,Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - H Maier
- Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Vienna, Austria
| | - E Riedl
- Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Vienna, Austria
| | - M-C Brüggen
- Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University of Vienna, Vienna, Austria
| | - B Reininger
- Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University of Vienna, Vienna, Austria
| | - M Schaschinger
- Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University of Vienna, Vienna, Austria
| | - C Bangert
- Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University of Vienna, Vienna, Austria
| | - E Guenova
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - G Stingl
- Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University of Vienna, Vienna, Austria
| | - P M Brunner
- Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University of Vienna, Vienna, Austria.,Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, U.S.A
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41
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Yu LR, Cao Z, Makhoul I, Daniels JR, Klimberg S, Wei JY, Bai JP, Li J, Lathrop JT, Beger RD, Todorova VK. Immune response proteins as predictive biomarkers of doxorubicin-induced cardiotoxicity in breast cancer patients. Exp Biol Med (Maywood) 2017; 243:248-255. [PMID: 29224368 DOI: 10.1177/1535370217746383] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Cancer treatment with doxorubicin (DOX) can induce cumulative dose-dependent cardiotoxicity. Currently, there are no specific biomarkers that can identify patients at risk during the initial doses of chemotherapy. The aim of this study was to examine plasma cytokines/chemokines and potential cardiovascular biomarkers for the prediction of DOX-induced cardiotoxicity. Plasma samples were collected before (T0), and after the first (T1) and the second (T2) cycles of DOX-based chemotherapy of 27 breast cancer patients, including five patients who presented with >10% decline of left ventricular ejection fraction (LVEF), five patients with LVEF decline of 5-10%, and 17 patients who maintained normal LVEF at the end of chemotherapy (240 mg/m2 cumulative dose of DOX from four cycles of treatment). Multiplex immunoassays were used to screen plasma samples for 40 distinct chemokines, nine matrix metalloproteinases, 33 potential markers of cardiovascular diseases, and the fourth-generation cardiac troponin T assay. The results showed that the patients with abnormal decline of LVEF (>10%) had lower levels of CXCL6 and sICAM-1 and higher levels of CCL23 and CCL27 at T0; higher levels of CCL23 and lower levels of CXCL5, CCL26, CXCL6, GM-CSF, CXCL1, IFN-γ, IL-2, IL-8, CXCL11, CXCL9, CCL17, and CCL25 at T1; and higher levels of MIF and CCL23 at T2 than the patients who maintained normal LVEF. Patients with LVEF decline of 5-10% had lower plasma levels of CXCL1, CCL3, GDF-15, and haptoglobin at T0; lower levels of IL-16, FABP3, and myoglobin at T1; and lower levels of myoglobin and CCL23 at T2 as compared to the patients who maintained normal LVEF. This pilot study identified potential biomarkers that may help predict which patients are vulnerable to DOX-induced cardiotoxicity although further validation is needed in a larger cohort of patients. Impact statement Drug-induced cardiotoxicity is one of the major concerns in drug development and clinical practice. It is critical to detect potential cardiotoxicity early before onset of symptomatic cardiac dysfunction or heart failure. Currently there are no qualified clinical biomarkers for the prediction of cardiotoxicity caused by cancer treatment such as doxorubicin (DOX). By using multiplex immunoassays, we identified proteins with significantly changed plasma levels in a group of breast cancer patients who were treated with DOX-based chemotherapy and produced cardiotoxicity. These proteins were associated with immune response and were identified before DOX treatment or at early doses of treatment, thus they could be potential predictive biomarkers of cardiotoxicity although further validation is required to warrant their clinical values.
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Affiliation(s)
- Li-Rong Yu
- 1 Division of Systems Biology, 12215 National Center for Toxicological Research, FDA , Jefferson, AR 72079, USA
| | - Zhijun Cao
- 1 Division of Systems Biology, 12215 National Center for Toxicological Research, FDA , Jefferson, AR 72079, USA
| | - Issam Makhoul
- 2 12215 University of Arkansas for Medical Sciences , Little Rock, AR 72205, USA
| | - Jaclyn R Daniels
- 1 Division of Systems Biology, 12215 National Center for Toxicological Research, FDA , Jefferson, AR 72079, USA
| | - Suzanne Klimberg
- 2 12215 University of Arkansas for Medical Sciences , Little Rock, AR 72205, USA
| | - Jeanne Y Wei
- 2 12215 University of Arkansas for Medical Sciences , Little Rock, AR 72205, USA
| | - Jane Pf Bai
- 3 Center for Drug Evaluation and Research, FDA, Silver Spring, MD 20903, USA
| | - Jinong Li
- 4 Center for Devices and Radiological Health, FDA, Silver Spring, MD 20903, USA
| | - Julia T Lathrop
- 5 Center for Biologics Evaluation and Research, FDA, Silver Spring, MD 20903, USA
| | - Richard D Beger
- 1 Division of Systems Biology, 12215 National Center for Toxicological Research, FDA , Jefferson, AR 72079, USA
| | - Valentina K Todorova
- 2 12215 University of Arkansas for Medical Sciences , Little Rock, AR 72205, USA
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42
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Koppes SA, Engebretsen KA, Agner T, Angelova-Fischer I, Berents T, Brandner J, Brans R, Clausen ML, Hummler E, Jakasa I, Jurakić-Tončic R, John SM, Khnykin D, Molin S, Holm JO, Suomela S, Thierse HJ, Kezic S, Martin SF, Thyssen JP. Current knowledge on biomarkers for contact sensitization and allergic contact dermatitis. Contact Dermatitis 2017; 77:1-16. [DOI: 10.1111/cod.12789] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 02/07/2017] [Accepted: 02/09/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Sjors A. Koppes
- Department of Coronel Institute of Occupational Health, Academic Medical Center; University of Amsterdam; 1105 AZ Amsterdam The Netherlands
- Department of Dermatology-Allergology; VU University Medical Centre; 081 HV Amsterdam The Netherlands
| | - Kristiane A. Engebretsen
- Department of Dermatology and Allergy, National Allergy Research Centre; Herlev and Gentofte Hospital, University of Copenhagen; 2900 Hellerup Denmark
| | - Tove Agner
- Department of Dermatology; Bispebjerg Hospital, University of Copenhagen; 2400 Copenhagen Denmark
| | | | - Teresa Berents
- Institute of Clinical Medicine; University of Oslo; 0318 Oslo Norway
- Department of Dermatology; Oslo University Hospital; 0424 Oslo Norway
| | - Johanna Brandner
- Department of Dermatology and Venerology; University Hospital Hamburg-Eppendorf; 20246 Hamburg Germany
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; 49076 Osnabrück Germany
| | - Maja-Lisa Clausen
- Department of Dermatology; Bispebjerg Hospital, University of Copenhagen; 2400 Copenhagen Denmark
| | - Edith Hummler
- Department of Pharmacology and Toxicology; University of Lausanne; 1011 Lausanne Switzerland
| | - Ivone Jakasa
- Faculty of Food Technology and Biotechnology, Department of Chemistry and Biochemistry, Laboratory for Analytical Chemistry; University of Zagreb; 10000 Zagreb Croatia
| | - Ružica Jurakić-Tončic
- University Department of Dermatovenereology; Clinical Hospital Zagreb and School of Medicine; 10000 Zagreb Croatia
| | - Swen M. John
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; 49076 Osnabrück Germany
| | - Denis Khnykin
- Department of Pathology; Oslo University Hospital - Rikshospitalet; 0424 Oslo Norway
- Centre for Immune Regulation; University of Oslo; 0424 Oslo Norway
| | - Sonja Molin
- Department of Dermatology and Allergology; Ludwig-Maximilians-University; 81377 München Germany
| | - Jan O. Holm
- Institute of Clinical Medicine; University of Oslo; 0318 Oslo Norway
- Department of Dermatology; Oslo University Hospital; 0424 Oslo Norway
| | - Sari Suomela
- Department of Dermatology; Finnish Institute of Occupational Health; 00251 Helsinki Finland
| | - Hermann-Josef Thierse
- Department of Chemicals and Product Safety; German Federal Institute for Risk Assessment; 10589 Berlin Germany
- Laboratory for Immunology & Proteomics, Department of Dermatology and University Medical Centre Mannheim; University of Heidelberg; 68167 Mannheim Germany
| | - Sanja Kezic
- Department of Coronel Institute of Occupational Health, Academic Medical Center; University of Amsterdam; 1105 AZ Amsterdam The Netherlands
| | - Stefan F. Martin
- Department of Dermatology, Allergy Research Group; Medical Centre - University of Freiburg; 79104 Freiburg Germany
| | - Jacob P. Thyssen
- Department of Dermatology and Allergy, National Allergy Research Centre; Herlev and Gentofte Hospital, University of Copenhagen; 2900 Hellerup Denmark
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43
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Garzorz-Stark N, Lauffer F. Molecular diagnostics of inflammatory disease: New tools and perspectives. Exp Dermatol 2017; 26:677-680. [PMID: 27714854 DOI: 10.1111/exd.13235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2016] [Indexed: 12/13/2022]
Abstract
This essay reviews current approaches to establish novel molecular diagnostic tools for inflammatory skin diseases. Moreover, it highlights the importance of stratifying patients according to molecular signatures and revising current outdated disease classification systems to eventually reach the goal of personalized medicine.
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Affiliation(s)
- Natalie Garzorz-Stark
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Felix Lauffer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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