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Rodríguez Baeza D, Bejarano Antonio L, González de Arriba M, Picó-Monllor JA, Cañueto J, Navarro-Lopez V. Cutaneous T-Cell Lymphoma and Microbiota: Etiopathogenesis and Potential New Therapeutic Targets. Dermatol Res Pract 2024; 2024:9919225. [PMID: 38435536 PMCID: PMC10904680 DOI: 10.1155/2024/9919225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/17/2023] [Accepted: 02/08/2024] [Indexed: 03/05/2024] Open
Abstract
Objective To review the scientific literature related to human microbiota and cutaneous T-cell lymphoma. Methodology. An exploratory and systematic review of the articles retrieved from the bibliographic databases MEDLINE (PubMed), Embase, The Cochrane Library, and Scopus, published in the last 10 years with the following descriptors: "lymphoma, T-cell, cutaneous," "microbiota," "Mycosis Fungoides," "Sézary Syndrome," "lymphoma, primary cutaneous anaplastic large cell," "Lymphomatoid Papulosis" and "Microbiota," "microbiota," "Microbial Community," and "Microbial Communities." Results Of the 87 references retrieved, after applying the inclusion and exclusion criteria, 21 articles were selected. Most studies linking cutaneous T-cell lymphoma and the microbiota focus on the cutaneous microbiome, with Staphylococcus aureus being the main related agent. Skin colonization by this bacterium could be involved in the hyperactivation of the STAT3 inflammatory pathway and in the overproduction of IL-17, both of which are widely related to the development of more aggressive and advanced forms of cutaneous T-cell lymphoma. We also found evidence of a possible relationship between intestinal dysbiosis and the development of cutaneous T-cell lymphoma, observing a decrease in taxonomic variability and an increase in certain genera such as Prevotella in the intestinal microbiome of patients with cutaneous T-cell lymphoma. The possible etiopathogenic mechanism underlying this relationship could be explained by an increase in systemic cytokine release, promoting the hyperactivation of STAT3 at the skin level. Conclusion There appears to be a relationship between cutaneous T-cell lymphoma and the cutaneous and intestinal microbiome, as well as a possible pathophysiological pathway involved. The possible modulation of the cutaneous and intestinal microbiome or the action on the signaling inflammatory pathway, using pharmacological tools such as JAK inhibitors or IL-17 inhibitors in the latter case, could open the possibility for future therapeutic studies for cutaneous T-cell lymphoma.
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Affiliation(s)
- Daniel Rodríguez Baeza
- Dermatology Service, Rio Hortega University Hospital, Calle Dulzaina, 2, Valladolid 47012, Spain
- MiBioPath Research Group, Medicine Faculty, Catholic University of Murcia (UCAM), Av. de los Jerónimos, 135, Murcia 30107, Spain
| | - Lía Bejarano Antonio
- Dermatology Service, Salamanca University Hospital, Paseo de la Transición Española, Salamanca 37007, Spain
| | - Marta González de Arriba
- Dermatology Service, Salamanca University Hospital, Paseo de la Transición Española, Salamanca 37007, Spain
| | - José Antonio Picó-Monllor
- Faculty of Pharmacy, Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University of Elche, Ctra. Alicante-Valencia N 332, 03550 Sant Joan Alacant, Alicante, Spain
| | - Javier Cañueto
- Dermatology Service, Salamanca University Hospital, Paseo de la Transición Española, Salamanca 37007, Spain
- IBSAL, Institute of Biomedical Research of Salamanca, P.º de San Vicente, 182, Salamanca 37007, Spain
| | - Vicente Navarro-Lopez
- MiBioPath Research Group, Medicine Faculty, Catholic University of Murcia (UCAM), Av. de los Jerónimos, 135, Murcia 30107, Spain
- Clinical Microbiology and Infectious Disease Unit, Vinalopó University Hospital, c/Tonico Sansano Mora, 14, Elche 03293, Spain
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The Skin Microbiome in Cutaneous T-Cell Lymphomas (CTCL)—A Narrative Review. Pathogens 2022; 11:pathogens11080935. [PMID: 36015055 PMCID: PMC9414712 DOI: 10.3390/pathogens11080935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 12/02/2022] Open
Abstract
In recent years, numerous studies have shown a significant role of the skin microbiome in the development and exacerbation of skin diseases. Cutaneous T-cell lymphomas (CTCL) are a group of malignancies primary involving skin, with unclear pathogenesis and etiology. As external triggers appear to contribute to chronic skin inflammation and the malignant transformation of T-cells, some microorganisms or dysbiosis may be involved in these processes. Recently, studies analyzing the skin microbiome composition and diversity have been willingly conducted in CTCL patients. In this review, we summarize currently available data on the skin microbiome in CTLC. We refer to a healthy skin microbiome and the contribution of microorganisms in the pathogenesis and progression of other skin diseases, focusing on atopic dermatitis and its similarities to CTCL. Moreover, we present information about the possible role of identified microorganisms in CTCL development and progression. Additionally, we summarize information about the involvement of Staphylococcus aureus in CTCL pathogenesis. This article also presents therapeutic options used in CTCL and discusses how they may influence the microbiome.
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The Skin Microbiome and Influencing Elements in Cutaneous T-Cell Lymphomas. Cancers (Basel) 2022; 14:cancers14051324. [PMID: 35267632 PMCID: PMC8909499 DOI: 10.3390/cancers14051324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/18/2022] [Accepted: 03/01/2022] [Indexed: 12/29/2022] Open
Abstract
Simple Summary Since the 1970s, a connection between microbes living on the skin and the rare cutaneous neoplasia, cutaneous T-cell lymphomas (CTCL), was suggested. New technologies, for instance, next-generation sequencing technologies, enable investigators to look closely at the interplay between microbes and the host. In the present review, we collected research regarding the role of skin microbiota and skin barrier elements in the most common CTCL. It is known that Staphylococcus aureus infections play a major role in morbidity and mortality in advanced stages of the disease. It is possible that the microbiota of the patient might be involved in disease progression or its origin. Some findings suggest that the skin barrier may be deficient in CTCL. Restoring the skin barrier in CTCL might be a promising therapeutical option. Further studies are needed to provide more insight and potentially contribute to the development of new treatment approaches. Abstract Since the 1970s, a connection between the skin’s microbiota and cutaneous T-cell lymphomas (CTCL) was suggested. New techniques such as next-generation sequencing technologies enable the examination of the nuanced interplay between microbes and their host. The purpose of this review is an updated description of the current knowledge on the composition of the microbiome, relevant bacteria, or other stimuli, and their potential role in CTCL with a focus on the most frequent subtype, mycosis fungoides. Some findings suggest that the skin barrier—or the deficiency hereof—and host-microbiota might be involved in disease progression or etiopathogenesis. In addition, information on the current knowledge of antimicrobial peptide expression in CTCL, as well as treatment considerations with antiseptics and antibiotics, are included. Further studies are needed to provide more insight and potentially contribute to the development of new treatment approaches.
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Lewis DJ, Rook AH. Mogamulizumab in the treatment of advanced mycosis fungoides and Sézary syndrome: safety and efficacy. Expert Rev Anticancer Ther 2020; 20:447-452. [PMID: 32320304 DOI: 10.1080/14737140.2020.1760096] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Advanced mycosis fungoides (MF) and Sézary syndrome (SS) are forms of cutaneous T-cell lymphoma characterized by a poor prognosis. Treatments are associated with high rates of relapse, and thus there exists an unmet medical need for new, improved therapies. Mogamulizumab is a novel defucosylated monoclonal antibody targeting C-C chemokine receptor 4 that eradicates malignant cells via antibody-dependent cellular cytotoxicity (ADCC). AREAS COVERED Phase I-III clinical trials involving mogamulizumab demonstrated its significant efficacy and tolerability. In the phase III MAVORIC study, mogamulizumab exhibited greater efficacy than vorinostat (response rate, 28% versus 5%; median progression-free survival, 7.7 versus 3.1 months, respectively) for advanced, relapsed/refractory MF/SS. Responses were durable (median, 14.1 months), and response rates were highest in SS (37%) and within the blood compartment (68%). Common adverse events include infusion reactions and drug eruptions. The drug also increases the risk of immune-mediated complications such as autoimmune disease and acute graft-versus-host disease following transplantation. EXPERT OPINION Mogamulizumab represents a valuable therapy for advanced MF/SS as it can produce prolonged responses, particularly within the peripheral blood. Since it eliminates malignant T cells via ADCC, combining mogamulizumab with immunotherapeutic agents such as interferons, interleukin-12, and Toll-like receptor agonists may further enhance its efficacy.
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Affiliation(s)
- Daniel J Lewis
- Cutaneous Oncology Fellow, Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, PA, USA
| | - Alain H Rook
- Professor of Dermatology and Director of Cutaneous Lymphoma Program, Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, PA, USA
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