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Cieślik M, Bagińska N, Górski A, Jończyk-Matysiak E. Human β-Defensin 2 and Its Postulated Role in Modulation of the Immune Response. Cells 2021; 10:cells10112991. [PMID: 34831214 PMCID: PMC8616480 DOI: 10.3390/cells10112991] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 12/17/2022] Open
Abstract
Studies described so far suggest that human β-defensin 2 is an important protein of innate immune response which provides protection for the human organism against invading pathogens of bacterial, viral, fungal, as well as parasitical origin. Its pivotal role in enhancing immunity was proved in infants. It may also be considered a marker of inflammation. Its therapeutic administration has been suggested for maintenance of the balance of systemic homeostasis based on the appropriate composition of the microbiota. It has been suggested that it may be an important therapeutic tool for modulating the response of the immune system in many inflammatory diseases, offering new treatment modalities. For this reason, its properties and role in the human body discussed in this review should be studied in more detail.
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Affiliation(s)
- Martyna Cieślik
- Bacteriophage Laboratory, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (M.C.); (N.B.); (E.J.-M.)
| | - Natalia Bagińska
- Bacteriophage Laboratory, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (M.C.); (N.B.); (E.J.-M.)
| | - Andrzej Górski
- Bacteriophage Laboratory, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (M.C.); (N.B.); (E.J.-M.)
- Phage Therapy Unit, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland
- Infant Jesus Hospital, The Medical University of Warsaw, 02-006 Warsaw, Poland
- Correspondence:
| | - Ewa Jończyk-Matysiak
- Bacteriophage Laboratory, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (M.C.); (N.B.); (E.J.-M.)
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2
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Patiño MI, Restrepo LM, Becerra NY, van der Mei HC, van Kooten TG, Sharma PK. Nonviral Expression of LL-37 in a Human Skin Equivalent to Prevent Infection in Skin Wounds. Hum Gene Ther 2021; 32:1147-1157. [PMID: 33980038 DOI: 10.1089/hum.2021.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Inefficient autologous tissue recovery in skin wounds increases the susceptibility of patients to infections caused by multidrug resistant microorganisms, resulting in a high mortality rate. Genetic modification of skin cells has become an important field of study because it could lead to the construction of more functional skin grafts, through the overexpression of antimicrobial peptides that would prevent early contamination and infection with bacteria. In this study, we produce and evaluate human skin equivalents (HSEs) containing transfected human primary fibroblasts and keratinocytes by polyplexes to express the antimicrobial peptide LL-37. The effect of LL-37 on the metabolic activity of normal HSEs was evaluated before the construction of the transfected HSEs, and the antimicrobial efficacy against Pseudomonas aeruginosa and Staphylococcus aureus was evaluated. Subsequently, the levels of LL-37 in the culture supernatants of transfected HSEs, as well as the local expression, were determined. It was found that LL-37 treatment significantly promoted the cellular proliferation of HSEs. Furthermore, HSEs that express elevated levels of LL-37 were shown to possess histological characteristics close to the normal skin and display enhanced antimicrobial activity against S. aureus in vitro. These findings demonstrate that HSEs expressing LL-37 through nonviral modification of skin cells are a promising approach for the prevention of bacterial colonization in wounds.
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Affiliation(s)
- Maria Isabel Patiño
- Tissue Engineering and Cell Therapy Group, Faculty of Medicine, University of Antioquia, Medellín, Colombia.,Department of Biomedical Engineering, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Luz Marina Restrepo
- Tissue Engineering and Cell Therapy Group, Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - Natalia Yiset Becerra
- Tissue Engineering and Cell Therapy Group, Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - Henny C van der Mei
- Department of Biomedical Engineering, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Theo G van Kooten
- Department of Biomedical Engineering, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Prashant K Sharma
- Department of Biomedical Engineering, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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3
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Jiménez M, Muñoz FC, Cervantes-García D, Cervantes MM, Hernández-Mercado A, Barrón-García B, Moreno Hernández-Duque JL, Rodríguez-Carlos A, Rivas-Santiago B, Salinas E. Protective Effect of Glycomacropeptide on the Atopic Dermatitis-Like Dysfunctional Skin Barrier in Rats. J Med Food 2020; 23:1216-1224. [DOI: 10.1089/jmf.2019.0247] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Mariela Jiménez
- Department of Microbiology, Autonomous University of Aguascalientes, Aguascalientes, México
| | - Fabiola C. Muñoz
- Department of Microbiology, Autonomous University of Aguascalientes, Aguascalientes, México
| | - Daniel Cervantes-García
- Department of Microbiology, Autonomous University of Aguascalientes, Aguascalientes, México
- National Council of Science and Technology, Mexico City, México
| | - Maritza M. Cervantes
- Department of Microbiology, Autonomous University of Aguascalientes, Aguascalientes, México
| | | | - Berenice Barrón-García
- Department of Microbiology, Autonomous University of Aguascalientes, Aguascalientes, México
| | | | - Adrián Rodríguez-Carlos
- Medical Research Unit from Zacatecas, Mexican Institute of Social Security, Zacatecas, México
| | - Bruno Rivas-Santiago
- Medical Research Unit from Zacatecas, Mexican Institute of Social Security, Zacatecas, México
| | - Eva Salinas
- Department of Microbiology, Autonomous University of Aguascalientes, Aguascalientes, México
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Epidermal Growth Factor Relieves Inflammatory Signals in Staphylococcus aureus-Treated Human Epidermal Keratinocytes and Atopic Dermatitis-Like Skin Lesions in Nc/Nga Mice. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9439182. [PMID: 29862299 PMCID: PMC5976919 DOI: 10.1155/2018/9439182] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/04/2017] [Accepted: 12/24/2017] [Indexed: 01/13/2023]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a defective immunologic barrier, which is aggravated by Staphylococcus aureus (S. aureus). Epidermal growth factor (EGF) suppresses inflammation and EGF receptor inhibitors increased S. aureus colonization. Thus, we investigated the potential roles of EGF in AD, which is often aggravated by S. aureus. We determined how EGF affects the expression of inflammatory cytokines and antimicrobial peptides (AMPs) in human epidermal keratinocytes (HEKs) treated with heat-inactivated S. aureus (HKSA) in vitro and 2,4-dinitrochlorobenzene-induced AD-like skin lesions in Nc/Nga mice. HKSA increased IL-6 and NFκB expression; EGF treatment had the opposite effect. EGF increased human β defensin-2 expression in HEKs and murine β defensin-3 in mice. In mice, both EGF and pimecrolimus groups showed less erythema with significantly reduced inflammation and decreased expression of thymic stromal lymphopoietin. EGF relieved S. aureus-induced inflammation and AD-like skin lesions in Nc/Nga mice. Therefore, EGF could be a potential topical treatment for AD.
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5
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Clausen ML, Slotved HC, Krogfelt KA, Agner T. Measurements of AMPs in stratum corneum of atopic dermatitis and healthy skin-tape stripping technique. Sci Rep 2018; 8:1666. [PMID: 29374283 PMCID: PMC5786105 DOI: 10.1038/s41598-018-20204-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/16/2018] [Indexed: 12/16/2022] Open
Abstract
Decreased levels of antimicrobial peptides (AMPs) in atopic dermatitis (AD) have previously been reported and have been linked to the increased susceptibility to skin infections found in AD patients. This study intents to identify AMPs: hBD-2, hBD-3, RNase7, psoriasin and LL-37 in AD patients and healthy controls, and determine concentrations in consecutive depths of the outer most skin layers. Tape stripping was used on lesional and non-lesional skin. From each skin site, 35 consecutive tape strips were collected and pooled in groups of 5. Commercially available ELISA kits were used to determine AMP concentration in stratum corneum samples. hBD-2, hBD-3, RNase7 and psoriasin were identified in stratum corneum samples. hBD-3-level was markedly higher in AD non-lesional skin compared to healthy controls, and a similar trend was observed for RNase7. Most AMPs were distributed evenly through 35 tape strips, implying a homogeneous distribution of antimicrobial defense in the outer most skin layers. The findings indicate that AD patients may not suffer from a general baseline deficiency in AMPs, and that the innate immune defense is present throughout the stratum corneum, both insights of importance for understanding the role of AMPs in AD.
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Affiliation(s)
- Maja-Lisa Clausen
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark.
| | - H-C Slotved
- Department of Bacteria, parasites and fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Karen A Krogfelt
- Department of Bacteria, parasites and fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Tove Agner
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
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Elentner A, Schmuth M, Yannoutsos N, Eichmann TO, Gruber R, Radner FPW, Hermann M, Del Frari B, Dubrac S. Epidermal Overexpression of Xenobiotic Receptor PXR Impairs the Epidermal Barrier and Triggers Th2 Immune Response. J Invest Dermatol 2017; 138:109-120. [PMID: 28927887 PMCID: PMC6217923 DOI: 10.1016/j.jid.2017.07.846] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/29/2017] [Accepted: 07/03/2017] [Indexed: 12/11/2022]
Abstract
The skin is in daily contact with environmental pollutants, but the long-term effects of such exposure remain underinvestigated. Many of these toxins bind and activate the pregnane X receptor (PXR), a ligand-activated transcription factor that regulates genes central to xenobiotic metabolism. The objective of this work was to investigate the effect of constitutive activation of PXR in the basal layer of the skin to mimic repeated skin exposure to noxious molecules. We designed a transgenic mouse model that overexpresses the human PXR gene linked to the herpes simplex VP16 domain under the control of the keratin 14 promoter. We show that transgenic mice display increased transepidermal water loss and elevated skin pH, abnormal stratum corneum lipids, focal epidermal hyperplasia, activated keratinocytes expressing more thymic stromal lymphopoietin, a T helper type 2/T helper type 17 skin immune response, and increased serum IgE. Furthermore, the cutaneous barrier dysfunction precedes development of the T helper type 2/T helper type 17 inflammation in transgenic mice, thereby mirroring the time course of atopic dermatitis development in humans. Moreover, further experiments suggest increased PXR signaling in the skin of patients with atopic dermatitis when compared with healthy skin. Thus, PXR activation by environmental pollutants may compromise epidermal barrier function and favor an immune response resembling atopic dermatitis.
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Affiliation(s)
- Andreas Elentner
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Matthias Schmuth
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Nikolaos Yannoutsos
- Gene Regulation and Immunology Laboratory, Department of Cell Biology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas O Eichmann
- Institute of Molecular Biosciences, University of Graz, Graz, Austria
| | - Robert Gruber
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Franz P W Radner
- Institute of Molecular Biosciences, University of Graz, Graz, Austria
| | - Martin Hermann
- KMT Laboratory, Department of Visceral, Transplant and Thoracic Surgery, Center for Operative Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Del Frari
- Department of Plastic, Reconstructive and Esthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Sandrine Dubrac
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria.
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Moosbrugger-Martinz V, Schmuth M, Dubrac S. A Mouse Model for Atopic Dermatitis Using Topical Application of Vitamin D3 or of Its Analog MC903. Methods Mol Biol 2017; 1559:91-106. [DOI: 10.1007/978-1-4939-6786-5_8] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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8
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Clausen ML, Slotved HC, Krogfelt KA, Andersen PS, Agner T. In vivoexpression of antimicrobial peptides in atopic dermatitis. Exp Dermatol 2015; 25:3-9. [DOI: 10.1111/exd.12831] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2015] [Indexed: 12/13/2022]
Affiliation(s)
- Maja-Lisa Clausen
- Department of Dermatology; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
| | - H-C Slotved
- Department of Microbiology and Infection Control; Statens Serum Institut; Copenhagen Denmark
| | - Karen A. Krogfelt
- Department of Microbiology and Infection Control; Statens Serum Institut; Copenhagen Denmark
| | - Paal Skytt Andersen
- Department of Microbiology and Infection Control; Statens Serum Institut; Copenhagen Denmark
- Veterinary Disease Biology; University of Copenhagen; Copenhagen Denmark
| | - Tove Agner
- Department of Dermatology; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
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9
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Santoro D, Marsella R, Pucheu-Haston CM, Eisenschenk MNC, Nuttall T, Bizikova P. Review: Pathogenesis of canine atopic dermatitis: skin barrier and host-micro-organism interaction. Vet Dermatol 2015; 26:84-e25. [DOI: 10.1111/vde.12197] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2014] [Indexed: 01/19/2023]
Affiliation(s)
- Domenico Santoro
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; 2015 SW 16th Avenue Gainesville FL 32610 USA
| | - Rosanna Marsella
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; 2015 SW 16th Avenue Gainesville FL 32610 USA
| | - Cherie M. Pucheu-Haston
- Department of Veterinary Clinical Sciences; School of Veterinary Medicine; Louisiana State University; 1909 Skip Bertman Drive Baton Rouge LA 70803 USA
| | | | - Tim Nuttall
- Royal (Dick) School of Veterinary Studies; Easter Bush Veterinary Centre; University of Edinburgh; Roslin EH25 9RG UK
| | - Petra Bizikova
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; 1060 William Moore Drive Raleigh NC 27606 USA
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10
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Park K, Lee S, Lee YM. Sphingolipids and antimicrobial peptides: function and roles in atopic dermatitis. Biomol Ther (Seoul) 2014; 21:251-7. [PMID: 24244808 PMCID: PMC3819896 DOI: 10.4062/biomolther.2013.058] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 07/24/2013] [Accepted: 07/25/2013] [Indexed: 12/14/2022] Open
Abstract
Inflammatory skin diseases such as atopic dermatitis (AD) and rosacea were complicated by barrier abrogation and deficiency in innate immunity. The first defender of epidermal innate immune response is the antimicrobial peptides (AMPs) that exhibit a broad-spectrum antimicrobial activity against multiple pathogens, including Gram-positive and Gram-negative bacteria, viruses, and fungi. The deficiency of these AMPs in the skin of AD fails to protect our body against virulent pathogen infections. In contrast to AD where there is a suppression of AMPs, rosacea is characterized by overexpression of cathelicidin antimicrobial peptide (CAMP), the products of which result in chronic epidermal inflammation. In this regard, AMP generation that is controlled by a key ceramide metabolite S1P-dependent mechanism could be considered as alternate therapeutic approaches to treat these skin disorders, i.e., Increased S1P levels strongly stimulated the CAMP expression which elevated the antimicrobial activity against multiple pathogens resulting the improved AD patient skin.
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Affiliation(s)
- Kyungho Park
- Department of Dermatology, School of Medicine, University of California, San Francisco, California CA94115, USA
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11
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Lee HJ, Lee SH. Epidermal permeability barrier defects and barrier repair therapy in atopic dermatitis. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2014; 6:276-87. [PMID: 24991450 PMCID: PMC4077953 DOI: 10.4168/aair.2014.6.4.276] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Accepted: 01/06/2014] [Indexed: 12/18/2022]
Abstract
Atopic dermatitis (AD) is a multifactorial inflammatory skin disease perpetuated by gene-environmental interactions and which is characterized by genetic barrier defects and allergic inflammation. Recent studies demonstrate an important role for the epidermal permeability barrier in AD that is closely related to chronic immune activation in the skin during systemic allergic reactions. Moreover, acquired stressors (e.g., Staphylococcus aureus infection) to the skin barrier may also initiate inflammation in AD. Many studies involving patients with AD revealed that defective skin barriers combined with abnormal immune responses might contribute to the pathophysiology of AD, supporting the outside-inside hypothesis. In this review, we discuss the recent advances in human and animal models, focusing on the defects of the epidermal permeability barrier, its immunologic role and barrier repair therapy in AD.
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Affiliation(s)
- Hae-Jin Lee
- Medical Corps of Sangmudae Army Service Support Group, Republic of Korea Army Training and Doctrine Command, Jangsung, Korea
| | - Seung-Hun Lee
- Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
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12
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Sollid J, Furberg A, Hanssen A, Johannessen M. Staphylococcus aureus: Determinants of human carriage. INFECTION GENETICS AND EVOLUTION 2014; 21:531-41. [DOI: 10.1016/j.meegid.2013.03.020] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 03/15/2013] [Accepted: 03/16/2013] [Indexed: 02/02/2023]
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13
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Lancto CA, Torres SMF, Hendrickson JA, Martins KV, Rutherford MS. Altered expression of antimicrobial peptide genes in the skin of dogs with atopic dermatitis and other inflammatory skin conditions. Vet Dermatol 2013; 24:414-21, e90. [DOI: 10.1111/vde.12034] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Cheryl A. Lancto
- Department of Veterinary and Biomedical Sciences; University of Minnesota; 1971 Commonwealth Avenue, 205 VSB; St Paul; MN; 55108; USA
| | - Sheila M. F. Torres
- Department of Veterinary Clinical Sciences; University of Minnesota; 1365 Gortner Avenue, 337 VMC; St Paul; MN; 55108; USA
| | - Julie A. Hendrickson
- Department of Veterinary and Biomedical Sciences; University of Minnesota; 1971 Commonwealth Avenue, 205 VSB; St Paul; MN; 55108; USA
| | - Kyra V. Martins
- Department of Veterinary and Biomedical Sciences; University of Minnesota; 1971 Commonwealth Avenue, 205 VSB; St Paul; MN; 55108; USA
| | - Mark S. Rutherford
- Department of Veterinary and Biomedical Sciences; University of Minnesota; 1971 Commonwealth Avenue, 205 VSB; St Paul; MN; 55108; USA
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de Oca EPM. Antimicrobial peptide elicitors: New hope for the post-antibiotic era. Innate Immun 2012; 19:227-41. [DOI: 10.1177/1753425912460708] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Antimicrobial peptides or host defense peptides are fundamental components of human innate immunity. Recent and growing evidence suggests they have a role in a broad range of diseases, including cancer, allergies and susceptibility to infection, including HIV/AIDS. Antimicrobial peptide elicitors (APEs) are physical, biological or chemical agents that boost human antimicrobial peptide expression. The current knowledge of APEs and their potential use in the treatment of human infectious diseases are reviewed, and a classification system for APEs is proposed. The efficient use of APEs in clinical practice could mark the beginning of the urgently needed post-antibiotic era, but further trials assessing their efficacy and safety are required.
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Affiliation(s)
- Ernesto Prado Montes de Oca
- Molecular Biology Laboratory, Biosecurity Area, CIATEJ – National Council of Science and Technology, Guadalajara, Jalisco, Mexico
- In silico Laboratory, Pharmaceutical and Medical Biotechnology Unit, CIATEJ – National Council of Science and Technology, Guadalajara, Jalisco, Mexico
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15
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Abstract
Despite the acknowledged contributions of a defective epidermal permeability barrier, dryness of the skin, and the propensity to develop secondary infections to the etiology and pathophysiology of atopic dermatitis (AD), these epidermal changes have, until recently, been assumed to reflect downstream consequences that are secondary phenomena of the primary immunologic abnormality--the historical "inside-outside" view that AD is basically an intrinsic inflammatory disease. In this review, we focused on the role of the epidermal barrier function in the pathophysiology of AD. Specifically, we presented data in support of a barrier-initiated pathogenesis of AD, ie, the "outside-inside" concept. First, we reviewed the evidence on the existence of inherited barrier abnormalities in AD. Reported studies on the possible association of mutations in the filaggrin gene (FLG) and data on human tissue kallikreins (KLKs) and AD have been addressed. We then dealt with the question of the causal link between impaired epidermal barrier and inflammation. Finally, the association between innate immune defense system and the increased avidity of Staphylococcus aureus for atopic skin was examined. Despite very convincing evidence to support the barrier-initiated pathogenesis of AD, the view that AD reflects the downstream consequences of a primary immunologic abnormality cannot be dismissed out of hand. Almost every line of evidence in support of the role of the epidermal barrier as the "driver" of the disease activity can be challenged and at least partially contradicted by opposing evidence. Until more data are available and until all the dust settles around this issue, we should take advantage of what we already know and use our knowledge for practical purposes. Deployment of specific strategies to restore the barrier function in AD means the use of moisturizers as first-line therapy.
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Affiliation(s)
- Ronni Wolf
- Dermatology Unit, Kaplan Medical Center, Rehovot 76100, Israel.
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Reinholz M, Ruzicka T, Schauber J. Cathelicidin LL-37: an antimicrobial peptide with a role in inflammatory skin disease. Ann Dermatol 2012; 24:126-35. [PMID: 22577261 PMCID: PMC3346901 DOI: 10.5021/ad.2012.24.2.126] [Citation(s) in RCA: 145] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Chronic inflammatory skin diseases such as atopic dermatitis, psoriasis or rosacea are very common. Although their exact pathogenesis is not completely understood all three diseases are characterized by dysregulation of cutaneous innate immunity. Cathelicidin LL-37 is an important effector molecule of innate immunity in the skin and atopic dermatitis, psoriasis or rosacea show defects in cathelicidin expression, function or processing. In atopic dermatitis, cathelicidin induction might be disturbed resulting in defective antimicrobial barrier function. In contrast, psoriasis is characterized by overexpression of cathelicidin. However to date it is unclear whether pro- or anti-inflammatory functions of cathelicidin predominate in lesional skin in psoriasis. In rosacea, cathelicidin processing is disturbed resulting in peptide fragments causing inflammation, erythema and telangiectasias. In this review, the current evidence on the role of cathelicidin LL-37 in the pathogenesis of inflammatory skin diseases will be outlined. As cathelicidin LL-37 might also serve as a future treatment target potential novel treatment strategies for those diseases will be discussed.
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Affiliation(s)
- Markus Reinholz
- Department of Dermatology and Allergy, Ludwig-Maximilian-University, Munich, Germany
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17
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Cholinergic regulation of keratinocyte innate immunity and permeability barrier integrity: new perspectives in epidermal immunity and disease. J Invest Dermatol 2011; 132:28-42. [PMID: 21918536 DOI: 10.1038/jid.2011.264] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Several cutaneous inflammatory diseases and their clinical phenotypes are recapitulated in animal models of skin disease. However, the identification of shared pathways for disease progression is limited by the ability to delineate the complex biochemical processes fundamental for development of the disease. Identifying common signaling pathways that contribute to cutaneous inflammation and immune function will facilitate better scientific and therapeutic strategies to span a variety of inflammatory skin diseases. Aberrant antimicrobial peptide (AMP) expression and activity is one mechanism behind the development and severity of several inflammatory skin diseases and directly influences the susceptibility of skin to microbial infections. Our studies have recently exposed a newly identified pathway for negative regulation of AMPs in the skin by the cholinergic anti-inflammatory pathway via acetylcholine (ACh). The role of ACh in AMP regulation of immune and permeability barrier function in keratinocytes is reviewed, and the importance for a better comprehension of cutaneous disease progression by cholinergic signaling is discussed.
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