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Huang Y, Zhou W, Liu S, Zeng D, Zhou W. Association between polymorphisms and atopic dermatitis susceptibility: A systematic review and meta-analysis. Gene 2024; 913:148397. [PMID: 38513928 DOI: 10.1016/j.gene.2024.148397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 03/23/2024]
Abstract
AIM Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease that is closely linked to genetic factors. Previous studies have revealed numerous single nucleotide polymorphisms (SNPs) that been related to susceptibility to AD; however, the results are conflicting. Therefore, a meta-analysis was conducted to assess the associations of these polymorphisms and AD risk. MATERIAL AND METHODS PubMed, Web of Science, Embase, Cochrane Library, and China National Knowledge Infrastructure databases were retrieved to identify eligible studies, with selected polymorphisms being reported in a minimum of three separate studies. The Newcastle-Ottawa Scale (NOS) was used to evaluate study quality. Review Manager 5.3 and STATA 14.0 were used to perform the meta-analysis. RESULTS After screening, 64 studies involving 13 genes (24 SNPs) were selected for inclusion in the meta-analysis. Nine SNPs were positively correlated with AD susceptibility [filaggrin (FLG) R501X, FLG 2282del4, chromosome 11q13.5 rs7927894, interleukin (IL)-17A rs2275913, IL-18 -137 G/C, Toll-like receptor 2 (TLR2) rs5743708, TLR2 A-16934 T, serine protease inhibitor Kazal type-5 (SPINK5) Asn368Ser, interferon-γ (IFN-γ) T874A] and one was negatively associated with AD susceptibility (IL-4 -1098 T/G). The 14 remaining SNPs were not significantly associated with AD susceptibility. CONCLUSIONS Nine SNPs that may be risk factors and one SNP that may be a protective factor for AD were identified, providing a reference for AD prediction, prevention, and therapy.
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Affiliation(s)
- Yunxia Huang
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China; Department of Allergy, Chongqing General Hospital, Chongqing 400014, China
| | - Wei Zhou
- Department of Allergy, Chongqing General Hospital, Chongqing 400014, China
| | - Shunan Liu
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China; Department of Allergy, Chongqing General Hospital, Chongqing 400014, China
| | - Dan Zeng
- Department of Allergy, Chongqing General Hospital, Chongqing 400014, China
| | - Weikang Zhou
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China; Department of Allergy, Chongqing General Hospital, Chongqing 400014, China.
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2
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Tsiogka A, Paschou E, Koumaki D, Vakirlis E, Gregoriou S. Interleukin antagonists for atopic dermatitis: a new era of therapy. Expert Opin Investig Drugs 2024; 33:549-559. [PMID: 38656240 DOI: 10.1080/13543784.2024.2347294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/22/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Over the last decade, increasing understanding of the immunopathogenesis of atopic dermatitis (AD) enabled the recognition of multiple therapeutic targets and subsequently the development of novel, highly effective systemic treatments, including interleukin (IL)-antagonists. To date, the IL-4Ra-inhibitor dupilumab and the IL-13 inhibitor tralokinumab have gained regulatory approval in Europe for the treatment of moderate-to-severe AD, while more than 70 new therapeutics are currently in development. AREAS COVERED In this review, we address the role of ILs in the pathogenesis of AD and provide an overview of the novel and investigational IL-antagonists, as regards their efficacy and safety on moderate-to-severe AD. EXPERT OPINION Current data have established IL-4 and IL-13 inhibitors as effective and safe for the treatment of moderate-to-severe AD, as regards the rapid control of flares as well as the long-term remission of the disease. Data regarding the efficacy and safety of other IL-inhibitors, including those targeting IL-31, IL-22, IL-33, IL-36 and IL-18, are accumulating. There is still an unmet need for real-world-evidence studies and head-to-head studies for both currently available and future agents in AD treatment. Establishing predictive biomarkers of treatment response in a disorder of such considerable heterogenicity might help physicians pursue a patient-tailored therapeutic response.
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MESH Headings
- Dermatitis, Atopic/drug therapy
- Humans
- Antibodies, Monoclonal, Humanized/pharmacology
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/administration & dosage
- Drug Development
- Animals
- Interleukins/antagonists & inhibitors
- Severity of Illness Index
- Antibodies, Monoclonal/pharmacology
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/administration & dosage
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Affiliation(s)
- Aikaterini Tsiogka
- Faculty of Medicine, First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Eleni Paschou
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Koumaki
- Dermatology Department, University Hospital of Heraklion, Heraklion, Greece
| | - Efstratios Vakirlis
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stamatios Gregoriou
- Faculty of Medicine, First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
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3
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Pontikas A, Antonatos C, Evangelou E, Vasilopoulos Y. Candidate Gene Association Studies in Atopic Dermatitis in Participants of European and Asian Ancestry: A Systematic Review and Meta-Analysis. Genes (Basel) 2023; 14:1456. [PMID: 37510360 PMCID: PMC10379179 DOI: 10.3390/genes14071456] [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: 06/19/2023] [Revised: 07/12/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
Atopic dermatitis (AD) has been extensively investigated for genetic associations utilizing both candidate gene approaches and genome-wide scans. Here, we comprehensively evaluated the available literature to determine the association of candidate genes in AD to gain additional insight into the etiopathogenesis of the disease. We systematically screened all studies that explored the association between polymorphisms and AD risks in cases of European and Asian ancestry and synthesized the available evidence through a random-effects meta-analysis. We identified 99 studies that met our inclusion/exclusion criteria that examined 17 candidate loci in Europeans and 14 candidate genes in Asians. We confirmed the significant associations between FLG variants in both European and Asian populations and AD risk, while synthesis of the available data revealed novel loci mapped to IL18 and TGFB1 genes in Europeans and IL12RB1 and MIF in Asians that have not yet been identified by genome-wide association studies. Our findings provide comprehensive evidence for AD risk loci in cases of both European and Asian ancestries, validating previous associations as well as revealing novel loci that could imply previously unexplored biological pathways.
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Affiliation(s)
- Alexandros Pontikas
- Laboratory of Genetics, Section of Genetics, Cell Biology and Development, Department of Biology, University of Patras, 26504 Patras, Greece
| | - Charalabos Antonatos
- Laboratory of Genetics, Section of Genetics, Cell Biology and Development, Department of Biology, University of Patras, 26504 Patras, Greece
| | - Evangelos Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, 45110 Ioannina, Greece
- Biomedical Research Institute, Foundation for Research and Technology-Hellas, 45110 Ioannina, Greece
- Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK
| | - Yiannis Vasilopoulos
- Laboratory of Genetics, Section of Genetics, Cell Biology and Development, Department of Biology, University of Patras, 26504 Patras, Greece
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4
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Broderick C, Ziehfreund S, van Bart K, Arents B, Eyerich K, Weidinger S, Rastrick J, Zink A, Flohr C. Biomarkers associated with the development of comorbidities in patients with atopic dermatitis: A systematic review. Allergy 2023; 78:84-120. [PMID: 36366871 PMCID: PMC10107168 DOI: 10.1111/all.15578] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/06/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
Biomarkers associated with the development of comorbidities in atopic dermatitis (AD) patients have been reported, but have not yet been systematically reviewed. Seven electronic databases were searched, from database inception to September 2021. English language randomized controlled trials, prospective and retrospective cohort, and case-control studies that investigated the association between a biomarker and the development of comorbidities in AD patients were included. Two authors independently screened the records for eligibility, one extracted all data, and critically appraised the quality of studies and risk of bias. Fifty six articles met the inclusion criteria, evaluating 146 candidate biomarkers. The most frequently reported biomarkers were filaggrin mutations and allergen specific-IgE. Promising biomarkers include specific-IgE and/or skin prick tests predicting the development of asthma, and genetic polymorphisms predicting the occurrence of eczema herpeticum. The identified studies and biomarkers were highly heterogeneous, and associated with predominately moderate-to-high risk of bias across multiple domains. Overall, findings were inconsistent. High-quality studies assessing biomarkers associated with the development of comorbidities in people with AD are lacking. Harmonized datasets and independent validation studies are urgently needed.
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Affiliation(s)
- Conor Broderick
- Unit for Population-Based Dermatology Research, School of Basic and Medical Biosciences, St John's Institute of Dermatology, King's College London, London, UK
| | - Stefanie Ziehfreund
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Karin van Bart
- Royal College of Physicians, National Guideline Centre, London, UK
| | - Bernd Arents
- Dutch Association for People with Atopic Dermatitis, Nijkerk, The Netherlands
| | - Kilian Eyerich
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Division of Dermatology and Venerology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Stephan Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | | | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Division of Dermatology and Venerology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Carsten Flohr
- Unit for Population-Based Dermatology Research, School of Basic and Medical Biosciences, St John's Institute of Dermatology, King's College London, London, UK
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5
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Abstract
Atopic dermatitis is a common, chronic and recurrent inflammatory skin disease, which often appears in childhood but can last into adulthood. It negatively impacts patients, their families and society in general. There is a therapeutic unmet need, with patients requiring new drugs that are safe and effective. The increasing knowledge of the pathophysiology of AD and the role of the Janus kinase (JAK) and signal transducer and activator of transcription (STAT) pathway in the development and maintenance of AD, has led to the development of agents blocking this intracellular signaling pathway, the JAK inhibitors. Baricitinib shows high selectivity for JAK1 and JAK2, making it appealing for the treatment of this condition. Phase II and phase III trials evaluated the efficacy and safety of baricitinib in the treatment of AD, and the results have been encouraging, showing a good efficacy and a favorable safety and tolerability profile. At the end of 2020, EMA approved baricitinib for the treatment of adult patients with moderate-to-severe atopic dermatitis who are candidates for systemic therapy, increasing the therapeutic option for this debilitating disease.
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Affiliation(s)
- Amelia Melo
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - Jose Manuel Carrascosa
- Department of Dermatology, Germans Trias i Pujol University Hospital (HUGTP), Autonomous University of Barcelona (UAB), Badalona, Spain
| | - Tiago Torres
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal.,Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal
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6
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Cytokines and apoptosis in atopic dermatitis. Postepy Dermatol Alergol 2021; 38:1-13. [PMID: 34408560 PMCID: PMC8362769 DOI: 10.5114/ada.2019.88394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/29/2019] [Indexed: 02/06/2023] Open
Abstract
Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. AD affects 10-20% of children worldwide and persists into adulthood in a minority of cases, affecting approximately 2-3% of the adult population, with an increased prevalence over the past decades in developed countries. Atopy is a genetic tendency to overproduce IgE class antibodies in response to common antigens found in the environment. Concurrence of different atopy such as allergic rhinitis or asthma in children with AD is estimated at 80%. AD is characterized by a vicious cycle of an allergic immune response. The emerging picture of the AD is a complex disorder with barrier dysfunction, immunological, genetic and environmental factors all playing key roles. Patients with severe or persistent disease and their families experience significant impairment in their quality of life, and in addition, AD places a heavy economic burden on society as a whole. Pathogenesis, the role of the epidermal barrier, mechanisms of cells apoptosis, the role of T cells and cytokines in AD are discussed in this article.
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7
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Dubin C, Del Duca E, Guttman-Yassky E. The IL-4, IL-13 and IL-31 pathways in atopic dermatitis. Expert Rev Clin Immunol 2021; 17:835-852. [PMID: 34106037 DOI: 10.1080/1744666x.2021.1940962] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Atopic dermatitis (AD) is the most common inflammatory skin disease. It has a complex pathophysiology, with a combination of immune dysregulation and intrinsic barrier defects driving cutaneous inflammation and allergic symptomatology. The IL-4, IL-13 and IL-31 inflammatory pathways have been identified as hallmark features in the pathogenesis of the disease, contributing uniquely and synergistically to immune and barrier abnormalities as well as the key symptoms, such as pruritis. Novel therapeutics that target these pathways have been under development to find treatments for AD.Areas covered: This review discusses the IL-4, IL-13 and IL-31 pathways in AD. We will also detail novel targeted therapeutics that have recently been or are currently in clinical trials for AD. A literature search was conducted by querying Scopus, Google Scholar, PubMed, and Clinicaltrials.gov up to January 2021 using combinations of the search terms 'IL-4' 'IL-13' 'IL-31' 'atopic dermatitis' 'immune pathway' 'biologics' 'novel therapeutics' 'JAK/STAT inhibitors.'Expert opinion: The complex pathophysiology of AD advocates for innovation. Novel minimally invasive sampling modalities such as tape stripping will allow for a broader characterization of the immunomechanisms behind AD pathophysiology. This will allow for the continued development of a personalized medicine approach to treat AD.
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Affiliation(s)
- Celina Dubin
- Department of Dermatology, And Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Ester Del Duca
- Department of Dermatology, And Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, USA.,Department of Dermatology, Magna Graecia, Catanzaro, IT, Calabria
| | - Emma Guttman-Yassky
- Department of Dermatology, And Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, USA.,Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York USA
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8
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Cork MJ, Danby SG, Ogg GS. Atopic dermatitis epidemiology and unmet need in the United Kingdom. J DERMATOL TREAT 2020; 31:801-809. [PMID: 31631717 PMCID: PMC7573657 DOI: 10.1080/09546634.2019.1655137] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 07/31/2019] [Indexed: 01/17/2023]
Abstract
Atopic dermatitis (AD), also known as atopic eczema, is a chronic inflammatory skin condition associated with a significant health-related and socioeconomic burden, and is characterized by intense itch, disruption of the skin barrier, and upregulation of type 2-mediated immune responses. The United Kingdom (UK) has a high prevalence of AD, affecting 11-20% of children and 5-10% of adults. Approximately 2% of all cases of childhood AD in the UK are severe. Despite this, most AD treatments are performed at home, with little contact with healthcare providers or services. Here, we discuss the course of AD, treatment practices, and unmet need in the UK. Although the underlying etiology of the disease is still emerging, AD is currently attributed to skin barrier dysfunction and altered inflammatory responses. Management of AD focuses on avoiding triggers, improving skin hydration, managing exacerbating factors, and reducing inflammation through topical and systemic immunosuppressants. However, there is a significant unmet need to improve the overall management of AD and help patients gain control of their disease through safe and effective treatments. Approaches that target individual inflammatory pathways (e.g. dupilumab, anti-interleukin (IL)-4 receptor α) are emerging and likely to provide further therapeutic opportunities for patient benefit.
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Affiliation(s)
- Michael J. Cork
- Sheffield Dermatology Research, Department of Infection, Immunity & Cardiovascular Disease, Faculty of Medicine, Dentistry & Health, The University of Sheffield, Sheffield, UK
- Sheffield Children’s Hospital and Sheffield Teaching Hospitals Clinical Research Facilities, Sheffield, UK
| | - Simon G. Danby
- Sheffield Dermatology Research, Department of Infection, Immunity & Cardiovascular Disease, Faculty of Medicine, Dentistry & Health, The University of Sheffield, Sheffield, UK
- Sheffield Children’s Hospital and Sheffield Teaching Hospitals Clinical Research Facilities, Sheffield, UK
| | - Graham S. Ogg
- MRC Human Immunology Unit, NIHR Biomedical Research Centre, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
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9
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Nath S, Kumari N, Bandyopadhyay D, Sinha N, Majumder PP, Mitra R, Mukherjee S. Dysbiotic Lesional Microbiome With Filaggrin Missense Variants Associate With Atopic Dermatitis in India. Front Cell Infect Microbiol 2020; 10:570423. [PMID: 33282748 PMCID: PMC7705349 DOI: 10.3389/fcimb.2020.570423] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 09/22/2020] [Indexed: 12/26/2022] Open
Abstract
Background: Atopic Dermatitis (AD) has been associated with the loss of function (LoF) mutations in Filaggrin (FLG) gene and increase in relative abundance of specific microbes in the lesional skin, predominantly in Caucasians. Our study aims to determine, in Indian AD patients, (a) the prevalence of FLG LoF and missense mutations, and (b) the nature and extent of dysbiosis and altered microbial pathways with and without mutations in FLG. AD patients (n = 34) and healthy controls (n = 54) were recruited from India in this study and shotgun sequencing was carried out in a subset of samples with adequate microbiome DNA concentration. Host DNA from the same subset of samples was subjected to FLG coding region sequencing and host-microbiome association was estimated. Results: The prevalence of FLG LoFs that are associated with AD globally were significantly lesser in our cases and controls (8.6%, 0%) than those reported in Europeans (27%, 2.6%). Staphylococcus aureus was present only on AD skin [abundance in Pediatric AD: 32.86%; Adult AD: 22.17%], but not on healthy skin on which Staphylococcus hominis (Adult controls: 16.43%, Adult AD: 0.20%; p = 0.002), Cutibacterium acnes (Adult controls:10.84%, Adult AD: 0.90%; p = 0.02), and Malassezia globosa (Adult controls: 8.89%, Adult AD: 0.005%; p = 0.001) were significantly more abundant. Microbial pathways mostly associated with skin barrier permeability, ammonia production and inflammation (Arginine and Proline metabolism, Histidine Metabolism and Staphylococcus aureus infection) were significantly enriched on AD skin metagenome. These pathways are also reported to impair antimicrobial peptide activity. Among AD patients with missense single nucleotide polymorphisms harboring "potentially damaging" alleles in FLG gene, damaging allele dosage was significantly (p < 0.02) positively correlated with relative abundance of phylum_Proteobacteria up to order_Pseudomonadales and negatively correlated with phylum_Firmicutes up to species_Staphylococcus aureus. Conclusion: Our study has provided evidence that host DNA profile is significantly associated with microbiome composition in the development of AD. Species and strain level analysis showed that the microbial pathways enriched in AD cases were mostly found in MRSA strains. These evidences can be harnessed to control AD by modulating the microbiome using a personalized strategy. Our findings on the association of FLG genotypes with the microbiome dysbiosis may pave the way for a personalized strategy to provide a more effective control of AD.
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Affiliation(s)
- Shankha Nath
- National Institute of Biomedical Genomics, Kalyani, India
| | - Naina Kumari
- National Institute of Biomedical Genomics, Kalyani, India
| | | | - Neloy Sinha
- College of Medicine and JNM Hospital, Kalyani, India
| | - Partha P Majumder
- National Institute of Biomedical Genomics, Kalyani, India.,Indian Statistical Institute, Kolkata, India
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10
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Potaczek DP, Przytulska-Szczerbik A, Bazan-Socha S, Nastałek M, Wojas-Pelc A, Okumura K, Nishiyama C, Jurczyszyn A, Undas A, Wypasek E. Interaction between functional polymorphisms in FCER1A and TLR2 and the severity of atopic dermatitis. Hum Immunol 2020; 81:709-713. [PMID: 32883546 DOI: 10.1016/j.humimm.2020.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/12/2020] [Accepted: 08/12/2020] [Indexed: 11/20/2022]
Abstract
Dendritic cell toll-like receptors (TLRs) and the high-affinity immunoglobulin E (IgE) receptor (FcεRI) may biologically interact with regard to atopic dermatitis (AD) development and, especially, severity. Our aim here was to test if such interaction can be detected on the genetic level. The combined effect of the TLR2 gene (TLR2) rs4696480 and the FcεRI α-chain gene (FCER1A) rs2252226 and rs2251746 polymorphisms on the AD severity as measured by SCORAD was assessed. The FCER1A rs2252226 and TLR2 rs4696480 polymorphisms interacted with regard to SCORAD. Higher SCORAD was observed in patients being the TLR2 rs4696480 major homozygotes and carrying at the same time the FCER1A rs2252226 minor allele, compared to those characterized by (any other of) the remaining combined rs2252226 and rs4696480 genotypes. The observation of the epistatic effect of TLR2 and FCER1A genetic variants on SCORAD is in line with the involvement of the interaction TLRs-FcεRI in the pathophysiology of AD.
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Affiliation(s)
- Daniel P Potaczek
- Institute of Laboratory Medicine and Pathobiochemistry, Universities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Philipps University Marburg, Marburg, Germany; Krakow Center for Medical Research and Technology, John Paul II Hospital, Krakow, Poland
| | | | - Stanisława Bazan-Socha
- Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Nastałek
- Faculty of Rehabilitation, University of Physical Education in Krakow, Poland
| | - Anna Wojas-Pelc
- Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland
| | - Ko Okumura
- Atopy Research Center, Juntendo University School of Medicine, Tokyo, Japan
| | - Chiharu Nishiyama
- Laboratory of Molecular Biology and Immunology, Department of Biological Science and Technology, Tokyo University of Science, Tokyo, Japan
| | - Artur Jurczyszyn
- Department of Hematology, Jagiellonian University Medical College, Krakow, Poland
| | - Anetta Undas
- Krakow Center for Medical Research and Technology, John Paul II Hospital, Krakow, Poland; Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Ewa Wypasek
- Krakow Center for Medical Research and Technology, John Paul II Hospital, Krakow, Poland; Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland.
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11
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Affiliation(s)
- Hiraku Suga
- Department of Dermatology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinichi Sato
- Department of Dermatology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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12
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Qi Y, Kong J, He J. Genetic relationship between IL-10 gene polymorphisms and the risk of clinical atopic dermatitis. BMC MEDICAL GENETICS 2019; 20:83. [PMID: 31101031 PMCID: PMC6525399 DOI: 10.1186/s12881-019-0817-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 04/30/2019] [Indexed: 01/02/2023]
Abstract
Background We retrieved different reports containing different genetic effects of − 1082 A/G, − 819 T/C, and − 592 A/C polymorphisms within the IL-10 (interleukin-10) gene on the susceptibility to clinical atopic dermatitis. Methods Herein, we conducted a meta-analysis to comprehensively assess such a genetic relationship after collecting the available published evidence. STATA 12.0 software was used for the statistical analysis under the allelic, homozygotic, heterozygotic, dominant, recessive and carrier genetic models. Results By retrieving and screening database literature, a total of 16 eligible case-control studies were finally selected. For the IL-10 -1082 A/G polymorphism, we did not detect a significant difference between atopic dermatitis cases and population-based controls in the overall meta-analysis under the genetic models of allele G vs. A (P = 0.540), GG vs. AA (P = 0.853), AG vs AA (P = 0.265), AG + GG vs AA (P = 0.221), GG vs AA+AG (P = 0.540) and carrier G vs. A (P = 0.643). Moreover, a statistically non-significant association was observed in the most subgroup meta-analyses by the factors of ethnicity, country and Hardy-Weinberg equilibrium. Likewise, the negative results were detected for the synthetic analysis of IL-10 -819 T/C and − 592 C/A polymorphisms. Conclusion The current evidence does not support a strong genetic relationship between IL-10 -1082 A/G, − 819 T/C and − 592 A/C polymorphisms and the susceptibility to atopic dermatitis. Electronic supplementary material The online version of this article (10.1186/s12881-019-0817-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuqing Qi
- Department of Dermatology and Venereology, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, 300052, People's Republic of China
| | - Jie Kong
- Department of Dermatology and Venereology, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, 300052, People's Republic of China
| | - Jinyan He
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, People's Republic of China.
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13
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Zhao J, Chen ZY, Li LF. Association Between theIL-10-1082G/A,IL-10-592A/C, andIL-10-819G/APolymorphisms and Atopic Dermatitis Susceptibility: A Meta-Analysis. Genet Test Mol Biomarkers 2019; 23:332-341. [PMID: 30932690 DOI: 10.1089/gtmb.2018.0276] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Jian Zhao
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ze-yu Chen
- Department of Dermatology, Changping Hospital, Beijing, China
| | - Lin-feng Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Guttman‐Yassky E, Hanifin JM, Boguniewicz M, Wollenberg A, Bissonnette R, Purohit V, Kilty I, Tallman AM, Zielinski MA. The role of phosphodiesterase 4 in the pathophysiology of atopic dermatitis and the perspective for its inhibition. Exp Dermatol 2018; 28:3-10. [DOI: 10.1111/exd.13808] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 10/12/2018] [Accepted: 10/12/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Emma Guttman‐Yassky
- Department of DermatologyIcahn School of Medicine at Mount Sinai New York New York
| | - Jon M. Hanifin
- Department of DermatologyOregon Health and Science University Portland Oregon
| | | | - Andreas Wollenberg
- Department of Dermatology and AllergyLudwig Maximilian University Munich Germany
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Bin Huraib G, Al Harthi F, Arfin M, Al-Sugheyr M, Rizvi S, Al-Asmari A. Cytokine Gene Polymorphisms in Saudi Patients With Atopic Dermatitis: A Case-Control Study. Biomark Insights 2018; 13:1177271918777760. [PMID: 29887728 PMCID: PMC5989047 DOI: 10.1177/1177271918777760] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 04/20/2018] [Indexed: 12/28/2022] Open
Abstract
The cause of atopic dermatitis (AD) is multifactorial and a number of genes including cytokines have been involved. We genotyped 315 subjects for polymorphisms in TNF-α and TNF-β and IL-10 genes. Patients had significantly higher frequency of GA genotype of TNF-α (−308 G/A) than healthy controls. Patients with AD and controls had similar distribution of A and G alleles. Genotype AA was found in 7.11% of controls while completely absent in cases. The frequencies of genotypes GG and AA of TNF-β (+252 A/G) polymorphism were higher whereas the frequency of genotype GA was significantly lower in patients than the controls. The frequencies of genotypes GG and AA of IL-10 (1082 G/A) polymorphism were significantly increased whereas genotype GA was decreased in patients than the controls. It is concluded that TNF-α (−308 G/A), TNF-β (+252 A/G), and IL-10 (−1082 G/A) polymorphisms are linked with the susceptibility of AD in Saudis and can be a risk factor.
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Affiliation(s)
- Ghaleb Bin Huraib
- Department of Dermatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Fahad Al Harthi
- Department of Dermatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Misbahul Arfin
- Scientific Research Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohammed Al-Sugheyr
- Department of Dentistry, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Sadaf Rizvi
- Scientific Research Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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The role of regulatory T cells and genes involved in their differentiation in pathogenesis of selected inflammatory and neoplastic skin diseases. Part III: Polymorphisms of genes involved in Tregs' activation and function. Postepy Dermatol Alergol 2017; 34:517-525. [PMID: 29422815 PMCID: PMC5799752 DOI: 10.5114/pdia.2017.67053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 01/10/2017] [Indexed: 12/29/2022] Open
Abstract
Regulatory T cells (Tregs) represent a cell type that promotes immune tolerance to autologous components and maintains immune system homeostasis. The abnormal function of Tregs is relevant to the pathogenesis of several skin diseases like psoriasis, atopic dermatitis, systemic lupus erythematosus, cutaneous T-cell lymphomas, and skin cancer and is also important in rheumatoid arthritis, diabetes and other autoimmune diseases. In this review, we will summarize the role of mutations and/or polymorphisms of genes involved in Tregs development, and functions in the pathogenesis of selected skin diseases.
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Brunner PM, Guttman-Yassky E, Leung DYM. The immunology of atopic dermatitis and its reversibility with broad-spectrum and targeted therapies. J Allergy Clin Immunol 2017; 139:S65-S76. [PMID: 28390479 DOI: 10.1016/j.jaci.2017.01.011] [Citation(s) in RCA: 406] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 01/25/2017] [Accepted: 01/27/2017] [Indexed: 02/08/2023]
Abstract
Atopic dermatitis (AD), the most common chronic inflammatory skin disease, is driven by both terminal keratinocyte differentiation defects and strong type 2 immune responses. In contrast to chronic plaque-type psoriasis, AD is now understood to be a much more heterogeneous disease, with additional activation of TH22, TH17/IL-23, and TH1 cytokine pathways depending on the subtype of the disease. In this review we discuss our current understanding of the AD immune map in both patients with early-onset and those with chronic disease. Clinical studies with broad and targeted therapeutics have helped to elucidate the contribution of various immune axes to the disease phenotype. Importantly, immune activation extends well beyond lesional AD because nonlesional skin and the blood component harbor AD-specific inflammatory changes. For this reason, future therapeutics will need to focus on a systemic treatment approach, especially in patients with moderate-to-severe disease.
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Affiliation(s)
- Patrick M Brunner
- Laboratory for Investigative Dermatology, Rockefeller University, New York, NY
| | - Emma Guttman-Yassky
- Department of Dermatology and Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY
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Gooderham M, Lynde CW, Papp K, Bourcier M, Guenther L, Gulliver W, Hong CH, Poulin Y, Sussman G, Vender R. Review of Systemic Treatment Options for Adult Atopic Dermatitis. J Cutan Med Surg 2016; 21:31-39. [DOI: 10.1177/1203475416670364] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease resulting from defects in skin barrier and aberrant immune responses. AD significantly affects the quality of life. Not all patients respond to topical therapies, and often systemic therapy is required to control the disease. Objective: To review the treatment options for adult AD patients including those options for patients who do not respond adequately or have contraindications to oral systemic therapy. Methods: A working group of clinicians with experience managing AD was convened to review the current literature on treatment options for adult AD patients. This review is based on the best available evidence from a published systematic review and an additional literature search. Results: Current treatments for AD are reviewed, including options for adult AD patients who do not respond or have contraindications to current systemic therapies. A new approach with targeted therapies is reviewed based on best available evidence. Conclusion: Many AD patients respond satisfactorily to topical or systemic treatments, but for those patients who do not respond or have contraindications, new biologic agents appear to be promising therapies.
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Affiliation(s)
- Melinda Gooderham
- Queen’s University, SKiN Centre for Dermatology, and Probity Medical Research, Peterborough, ON, Canada
| | - Charles W. Lynde
- Lynde Dermatology, Probity Medical Research, Markham Ontario, and Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kim Papp
- K Papp Clinical Research and Probity Medical Research, Waterloo, ON, Canada
| | | | - Lyn Guenther
- University of Western Ontario, London ON, Canada
| | - Wayne Gulliver
- Memorial University of Newfoundland St. John’s, NL, Canada
| | - Chih-ho Hong
- Department of Dermatology and Skin Science, University of British Columbia, and Probity Medical Research, Surrey, BC, Canada
| | - Yves Poulin
- Laval University and CDQM and CRDQ, Quebec, QC, Canada
| | - Gordon Sussman
- Division of Clinical Immunology and Allergy, University of Toronto, Toronto, ON, Canada
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Soltani S, Saghazadeh A, Movahedi M, Tavakol M, Sadr M, Farhadi E, Rezaei N. FLG single nucleotide polymorphisms in chronic idiopathic urticaria. Allergol Immunopathol (Madr) 2016; 44:341-5. [PMID: 26796858 DOI: 10.1016/j.aller.2015.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 08/11/2015] [Accepted: 09/30/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Filaggrin (FLG), which is formed from profilaggrin protein during epidermal terminal differentiation, is a prerequisite to squame biogenesis and thus for perfect formation of the skin barrier. Yet, the relationship between genetic polymorphisms of FLG and chronic idiopathic urticaria (CIU) has not been investigated. METHODS The study population consisted of 93 CIU patients and 93 healthy control subjects without a history of allergic, autoimmune or any other systemic disease. Five single nucleotide polymorphisms (SNPs) of FLG were investigated: rs2485518, rs3126065, rs2786680, rs3814300, and rs3814299. RESULTS For all the investigated polymorphisms, 100% of both CIU patients and control subjects exhibited one given allele and consequently one given genotype as following: A/A genotype for two SNPs, rs3126065 and rs2786680, C/C genotype for two SNPs, rs2485518 and rs3814300, and G/G genotype for one SNP rs3814299 of FLG, and hence no association was found between either allele frequencies or genotype distributions of FLG SNPs and CIU in an Iranian population. CONCLUSIONS The present study examined the possible relationship between SNPs of FLG and CIU for the first time, and demonstrated that none of five investigated SNPs (rs2485518, rs3126065, rs2786680, rs3814300, and rs3814299) are correlated with CIU in an Iranian population. Further investigations are required to address whether ethnicity/race impacts on relationship between SNPs of FLG and CIU.
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May RD, Fung M. Strategies targeting the IL-4/IL-13 axes in disease. Cytokine 2016; 75:89-116. [PMID: 26255210 DOI: 10.1016/j.cyto.2015.05.018] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 05/15/2015] [Indexed: 02/07/2023]
Abstract
IL-4 and IL-13 are pleiotropic Th2 cytokines produced by a wide variety of different cell types and responsible for a broad range of biology and functions. Physiologically, Th2 cytokines are known to mediate host defense against parasites but they can also trigger disease if their activities are dysregulated. In this review we discuss the rationale for targeting the IL-4/IL-13 axes in asthma, atopic dermatitis, allergic rhinitis, COPD, cancer, inflammatory bowel disease, autoimmune disease and fibrotic disease as well as evaluating the associated clinical data derived from blocking IL-4, IL-13 or IL-4 and IL-13 together.
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21
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Coexistence of 2282del4 FLG gene mutation and IL-18 -137G/C gene polymorphism enhances the risk of atopic dermatitis. Postepy Dermatol Alergol 2016; 33:57-62. [PMID: 26985181 PMCID: PMC4793056 DOI: 10.5114/pdia.2015.48050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 09/10/2014] [Indexed: 01/13/2023] Open
Abstract
Introduction Atopic dermatitis (AD) pathogenesis appears in the context of the correlation between cornified envelope proteins and immunological factors. Aim To estimate the association between FLG R501X and 2282del4 gene mutations, –137 G/C IL-18 and –1112 C/T IL-13 gene polymorphisms and their influence on AD course and the risk in the Polish population. Material and methods One hundred and fifty-two AD patients and 123 healthy volunteers were included into the study. Amplification refractory mutation system – polymerase chain reaction method was used. Results 2282del4 FLG mutation, predominant (p = 0.04) in Polish AD patients, enhanced the risk of AD (OR = 2.35; p = 0.01) and was associated with itch (p = 0.023). GG genotype of IL-18 was prevailing in AD (p < 0.0001), associated with elevated IgE levels (p = 0.00074) and pruritus (p < 0.0001). GG genotype and G-allele in –137 position of IL-18 increased AD risk (OR = 5.4; p = 0.0001, respectively, OR = 5.3; p = 0.000029). –1112 C/T polymorphism of IL-13 was associated with elevated IgE levels (p = 0.00049), pruritus (p = 0.0005), SCORAD score (p = 0.02), concomitant asthma (p = 0.0087) and AD risk (OR = 2.02; p = 0.012). Coexistence of 2282del4 or R501X FLG gene mutation with GG genotype of IL-18 was associated with a 6-fold higher risk of AD (OR = 5.8; p = 0.00013), contrary to combined occurrence of FLG mutations with T-allele in –1112 position of IL-13 gene (OR = 0.12; p = 0.1). Conclusions 2282del4 FLG mutation similarly to GG genotype and G-allele in –137 position of IL-18 gene enhance the risk of AD in the Polish population. Coexistence of FLG mutations with GG genotype of IL-18 may be helpful to estimate chances of AD development.
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Howell MD, Parker ML, Mustelin T, Ranade K. Past, present, and future for biologic intervention in atopic dermatitis. Allergy 2015; 70:887-96. [PMID: 25879391 DOI: 10.1111/all.12632] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2015] [Indexed: 12/31/2022]
Abstract
Atopic dermatitis (AD) is a debilitating disease that significantly alters the quality of life for one in four children and one in 10 adults. Current management of AD utilizes combinations of treatments to symptomatically alleviate disease by suppressing the inflammatory response and restoring barrier function in the skin, reducing disease exacerbation and flare, and preventing secondary skin infections. Resolution is temporary and long-term usage of these treatments can be associated with significant side-effects. Antibody therapies previously approved for inflammatory diseases have been opportunistically evaluated in patients with atopic dermatitis; however, they often failed to demonstrate a significant clinical benefit. Monoclonal antibodies currently in development offer hope to those individuals suffering from the disease by specifically targeting immune and molecular pathways important for the pathogenesis of atopic dermatitis. Here, we review the underlying biological pathways and the state of the art in therapeutics in AD.
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Affiliation(s)
| | | | | | - K Ranade
- MedImmune, LLC, Gaithersburg, MD, USA
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23
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Esposito S, Patria MF, Spena S, Codecà C, Tagliabue C, Zampiero A, Lelii M, Montinaro V, Pelucchi C, Principi N. Impact of genetic polymorphisms on paediatric atopic dermatitis. Int J Immunopathol Pharmacol 2015; 28:286-95. [DOI: 10.1177/0394632015591997] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In order to investigate whether polymorphisms of genes encoding some factors of innate and adaptive immunity play a role in the development of, or protection against atopic dermatitis (AD) and condition its severity, we genotyped 33 candidate genes and 47 single nucleotide polymorphisms (SNPs) using Custom TaqMan Array Microfluidic Cards and an ABI 7900HT analyser (Applied Biosystems, Foster City, CA, USA). The study involved 104 children with AD (29 with mild-to-moderate and 75 with severe disease; 42 girls; mean age ± SD, 5.8 ± 3.3 years) and 119 healthy controls (49 girls; mean age, 4.8 ± 3.0 years). IL10-rs1800872T, TG and MBL2-rs500737AG were all significantly more frequent among the children with AD ( P = 0.015, P = 0.004 and P = 0.030), whereas IL10-rs1800896C and TC were more frequent in those without AD ( P = 0.028 and P = 0.032). The VEGFA-rs2146326A and CTLA4-rs3087243AG SNPs were significantly more frequent in the children with mild/moderate AD than in those with severe AD ( P = 0.048 and P = 0.036). IL10-rs1800872T and TG were significantly more frequent in the children with AD and other allergic diseases than in the controls ( P = 0.014 and P = 0.007), whereas IL10-rs1800896TC and C were more frequent in the controls than in the children with AD and other allergic diseases ( P = 0.0055 and P = 0.0034). These findings show that some of the polymorphisms involved in the immune response are also involved in some aspects of the development and course of AD and, although not conclusive, support the immunological hypothesis of the origin of the inflammatory lesions.
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Affiliation(s)
- Susanna Esposito
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Francesca Patria
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Spena
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudio Codecà
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Tagliabue
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alberto Zampiero
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mara Lelii
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Montinaro
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudio Pelucchi
- Department of Epidemiology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Nicola Principi
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Gillespie RMC, Brown SJ. From the outside-in: Epidermal targeting as a paradigm for atopic disease therapy. World J Dermatol 2015; 4:16-32. [DOI: 10.5314/wjd.v4.i1.16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Revised: 11/29/2014] [Accepted: 12/17/2014] [Indexed: 02/06/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disorder which can precede asthma and allergic rhinitis in a disease trajectory known as the atopic march. The pathophysiology of AD includes cutaneous inflammation, disrupted epidermal barrier function, xerosis and propensity to secondary infections. AD had previously been thought to arise from the systemic atopic immune response and therapies are therefore directed towards ameliorating Th2-mediated inflammation. However in recent years the focus has shifted towards primary defects in the skin barrier as an initiating event in AD. Links between loss-of-function variants in the gene encoding filaggrin and disrupted activity of epidermal serine proteases and AD have been reported. Based on these observations, a mechanism has been described by which epidermal barrier dysfunction may lead to inflammation and allergic sensitization. Exogenous and endogenous stressors can further exacerbate inherited barrier abnormalities to promote disease activity. Pathways underlying progression of the atopic march remain unclear, but recent findings implicate thymic stromal lymphopoietin as a factor linking AD to subsequent airway inflammation in asthma. This new appreciation of the epidermis in the development of AD should lead to deployment of more specific strategies to restore barrier function in atopic patients and potentially halt the atopic march.
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Lesiak A, Zakrzewski M, Przybyłowska K, Rogowski-Tylman M, Wozniacka A, Narbutt J. Atopic dermatitis patients carrying G allele in -1082 G/A IL-10 polymorphism are predisposed to higher serum concentration of IL-10. Arch Med Sci 2014; 10:1239-43. [PMID: 25624864 PMCID: PMC4296079 DOI: 10.5114/aoms.2014.47833] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 11/20/2012] [Accepted: 02/26/2013] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Atopic dermatitis (AD) is a chronic skin inflammatory disease in which Th2-derived cytokines play an essential role. Aim of the study was to assess interleukin 4, 10 and 13 (IL-4, IL-10 and IL-13) serum concentrations in AD patients and to correlate the values with the occurrence of genotypes of selected polymorphisms in genes encoding these cytokines. MATERIAL AND METHODS Seventy-six AD patients (mean age 11.4 years) and 60 healthy controls were enrolled in the study. Blood samples were analyzed for IL-4, IL-10 and IL-13 concentrations with ELISA assay and genotyping for -590C/T IL-4, -1082A/G IL-10 and -1055C/T IL-13 polymorphisms with PCR-RFLP. RESULTS The obtained results revealed statistically higher serum concentration of IL-10 and IL-13 in AD patients when compared to healthy controls (10.30 pg/ml vs. 8.51 pg/ml for IL-10 and 5.67 pg/ml vs. 4.98 pg/ml for IL-13). There were no significant differences between AD patients and controls in regard to IL-4 serum level (5.10 pg/ml vs. 7.1 pg/ml). Analyzing the association between level of the examined cytokines and genotype polymorphisms -590 C/T for the IL-4 gene, -1082 A/G for the IL-10 gene and -1055 C/T for the IL-13 gene, we found a statistically higher IL-10 serum level among carriers of the G allele in the -1082 G/A IL-10 polymorphism both in AD and control groups. We did not find any significant differences between serum level of IL-4 and IL-13 in regard to genotype occurrence in examined polymorphisms: -590 C/T for the IL-4 gene and -1055 C/T for the IL-13 gene. CONCLUSIONS The obtained results confirm the genetic background of IL-10 synthesis in the Polish population.
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Affiliation(s)
| | | | - Karolina Przybyłowska
- Department of Chemistry and Clinical Biochemistry, Medical University of Lodz, Lodz, Poland
| | | | - Anna Wozniacka
- Department of Dermatology, Medical University of Lodz, Lodz, Poland
| | - Joanna Narbutt
- Department of Dermatology, Medical University of Lodz, Lodz, Poland
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Narbutt J, Wojtczak M, Zalińska A, Salinski A, Przybylowska-Sygut K, Kuna P, Majak P, Sysa-Jedrzejowska A, Lesiak A. The A/A genotype of an interleukin-17A polymorphism predisposes to increased severity of atopic dermatitis and coexistence with asthma. Clin Exp Dermatol 2014; 40:11-6. [PMID: 25223230 DOI: 10.1111/ced.12438] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2014] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Studies have found that the interleukin-23/T helper 17 (IL-23/Th17) pathway plays an important role in the pathogenesis of atopic dermatitis (AD). Inhibition of the IL-23/Th17 pathway with monoclonal antibodies reduces skin inflammation in animal models. AIM To investigate the association between IL-17A and IL-23R gene single nucleotide polymorphisms (SNPs) and the development of AD in a Polish population. METHODS Blood samples were collected from 166 patients with AD and 160 controls. We analyzed two SNPs, -152 G/A IL-17A and 1142 G/A IL-23R, using PCR and restriction fragment length polymorphism (RFLP) analysis. RESULTS There was no statistically significant difference between the examined IL-17A SNP and the incidence of AD (P > 0.05 for all comparisons). Analysis of the IL-23R gene SNP showed no relationship between AD and the G/A genotype or presence of the A allele. The study did not establish any links between the IL-23R and IL-17A gene SNPs and the likelihood of developing AD resulting from gene-gene interaction. However, there was a significant relationship between the A/A genotype in the -152 G/A IL1-7A SNP and the coexistence of AD and asthma (P < 0.04). Analyzing the association between AD severity and the occurrence of IL-17A SNP, we found that subjects with the A/A genotype were at higher risk of developing moderate or severe AD (P = 0.02). CONCLUSIONS We found no evidence of any effect of IL-17A or IL-23R SNPs on the occurrence of AD in our Polish population. However, the A/A genotype in IL-17A was found to predispose to increased AD severity and coexistence of AD and asthma.
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Affiliation(s)
- J Narbutt
- Department of Dermatology and Venereology, Medical University of Lodz, Lodz, Poland
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Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin condition with complex etiology that is dependent upon interactions between the host and the environment. Acute skin lesions exhibit the features of a Th2-driven inflammatory disorder, and many patients are highly atopic. The skin barrier plays key roles in immune surveillance and homeostasis, and in preventing penetration of microbial products and allergens. Defects that compromise the structural integrity or else the immune function of the skin barrier play a pivotal role in the pathogenesis of AD. This article provides an overview of the array of molecular building blocks that are essential to maintaining healthy skin. The basis for structural defects in the skin is discussed in relation to AD, with an emphasis on filaggrin and its genetic underpinnings. Aspects of innate immunity, including the role of antimicrobial peptides and proteases, are also discussed.
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Affiliation(s)
- Rachana Agrawal
- Department of Medicine, University of Virginia Health System, Allergy Division, PO Box 801355, Charlottesville, VA, 22908-1355, USA,
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Lepre T, Cascella R, Ragazzo M, Galli E, Novelli G, Giardina E. Association of KIF3A, but not OVOL1 and ACTL9, with atopic eczema in Italian patients. Br J Dermatol 2013; 168:1106-8. [PMID: 23278845 DOI: 10.1111/bjd.12178] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Atopic eczema (AE) (OMIM %603165) is the most common chronic inflammatory skin disease characterized by xerosis, pruritus, and erythematous lesions with increased transepidermal water loss. It's a complex disease due to the interaction between environmental and genetics factors. To date, different loci have been related to the disease. OBJECTIVES To verify the association, between AE and rs479844, rs2164983, and rs2897442, target for OVOLI (11q13), ACTL9 (19p13.2), and in KIF3A (5q31) genes in the Italian population. Recently, these SNPs have been validated as associated to the disease. METHODS A case-control study testing a cohort of 359 AE cases and 778 controls. RESULTS We confirmed the association between rs2897442 in KIF3A gene and the disease at both allele and genotype level (P-value: 4.8 × 10(-4) and P-value: 6.3 × 10(-4), respectively). The C allele of the SNP showed an Odds Ratio (OR) of 1.46 (95% CI 1.18-1.82), moreover the CC genotype achieved an OR of 2.77 (95% CI 1.66-4.61). We failed to reveal association between AE and the other two SNPs tested. CONCLUSIONS Our study indicated KIF3A as a novel gene implicated in the development of AE in the Italian population.
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Affiliation(s)
- T Lepre
- Department of Biopathology, University of Rome Tor Vergata, Rome, Italy
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Wilkowska A, Gleń J, Zabłotna M, Trzeciak M, Ryduchowska M, Sobjanek M, Nedoszytko B, Nowicki R, Sokołowska-Wojdyło M. The association ofGM-CSF-677A/C promoter gene polymorphism with the occurrence and severity of atopic dermatitis in a Polish population. Int J Dermatol 2013; 53:e172-4. [DOI: 10.1111/ijd.12245] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Aleksandra Wilkowska
- Department of Dermatology, Venereology and Allergology; Medical University of Gdansk; Gdansk Poland
| | - Jolanta Gleń
- Department of Dermatology, Venereology and Allergology; Medical University of Gdansk; Gdansk Poland
| | - Monika Zabłotna
- Department of Dermatology, Venereology and Allergology; Medical University of Gdansk; Gdansk Poland
| | - Magdalena Trzeciak
- Department of Dermatology, Venereology and Allergology; Medical University of Gdansk; Gdansk Poland
| | - Monika Ryduchowska
- Department of Dermatology, Venereology and Allergology; Medical University of Gdansk; Gdansk Poland
| | - Michal Sobjanek
- Department of Dermatology, Venereology and Allergology; Medical University of Gdansk; Gdansk Poland
| | - Boguslaw Nedoszytko
- Department of Dermatology, Venereology and Allergology; Medical University of Gdansk; Gdansk Poland
| | - Roman Nowicki
- Department of Dermatology, Venereology and Allergology; Medical University of Gdansk; Gdansk Poland
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Association Between the IL10 −1082A>G (rs1800896) Single-Nucleotide Polymorphism and Atopic Dermatitis. Dermatitis 2013; 24:161-5. [DOI: 10.1097/der.0b013e31829cb0e4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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31
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Leung DYM. New insights into atopic dermatitis: role of skin barrier and immune dysregulation. Allergol Int 2013; 62:151-61. [PMID: 23712284 DOI: 10.2332/allergolint.13-rai-0564] [Citation(s) in RCA: 209] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Indexed: 12/22/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease that is often associated with the development of food allergy and asthma. New insights into AD reveals an important role for structural abnormalities in the epidermis resulting in a leaky epithelial barrier as well as chronic immune activation that contribute to the pathophysiology of this common skin disease. Patients with AD have a predisposition to colonization or infection by microbial organisms, most notably Staphylococcus aureus and herpes simplex virus (HSV). Measures directed at healing and protecting the skin barrier and controlling the immune activation are needed for effective management of AD. Early intervention may improve outcomes for AD as well as reduce the systemic allergen sensitization that may lead to associated allergic diseases in other organs.
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Affiliation(s)
- Donald Y M Leung
- Division of Pediatric Allergy-Immunology, Department of Pediatrics, National Jewish Health, Denver, CO 80206, USA.
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Santoro D, Marsella R, Ahrens K, Graves TK, Bunick D. Altered mRNA and protein expression of filaggrin in the skin of a canine animal model for atopic dermatitis. Vet Dermatol 2013; 24:329-36, e73. [DOI: 10.1111/vde.12031] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2013] [Indexed: 12/20/2022]
Affiliation(s)
- Domenico Santoro
- Department of Veterinary Clinical Medicine; University of Illinois at Urbana-Champaign; 1008 W Hazelwood Drive; Urbana; IL; 61802; USA
| | - Rosanna Marsella
- Department of Small Animal Clinical Sciences; University of Florida; 2015 SW 16th Avenue; Gainesville; FL 32615; USA
| | - Kim Ahrens
- Department of Small Animal Clinical Sciences; University of Florida; 2015 SW 16th Avenue; Gainesville; FL 32615; USA
| | - Thomas K. Graves
- Department of Veterinary Clinical Medicine; University of Illinois at Urbana-Champaign; 1008 W Hazelwood Drive; Urbana; IL; 61802; USA
| | - David Bunick
- Department of Veterinary Biosciences; University of Illinois at Urbana-Champaign; 2001 South Lincoln Avenue; Urbana; IL 60802; USA
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Abstract
INTRODUCTION Atopic dermatitis (AD) is a common inflammatory skin disease regulated by genetic and environmental factors. Both skin barrier defects and aberrant immune responses are believed to drive cutaneous inflammation in AD. Existing therapies rely largely on allergen avoidance, emollients and topical and systemic immune-suppressants, some with significant toxicity and transient efficacy; no specific targeted therapies are in clinical use today. As our specific understanding of the immune and molecular pathways that cause different subsets of AD increases, a variety of experimental agents, particularly biologic agents that target pathogenic molecules bring the promise of safe and effective therapeutics for long-term use. AREAS COVERED This paper discusses the molecular pathways characterizing AD, the contributions of barrier and immune abnormalities to its pathogenesis, and development of new treatments that target key molecules in these pathways. In this review, we will discuss a variety of biologic therapies that are in development or in clinical trials for AD, perhaps revolutionizing treatment of this disease. EXPERT OPINION Biologic agents in moderate to severe AD offer promise for controlling a disease that currently lacks good and safe therapeutics posing a large unmet need. Unfortunately, existing treatments for AD aim to decrease cutaneous inflammation, but are not specific for the pathways driving this disease. An increasing understanding of the immune mechanisms underlying AD brings the promise of narrow targeted therapies as has occurred for psoriasis, another inflammatory skin disease, for which specific biologic agents have been demonstrated to both control the disease and prevent occurrence of new skin lesions. Although no biologic is yet approved for AD, these are exciting times for active therapeutic development in AD that might lead to revolutionary therapeutics for this disease.
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Affiliation(s)
- Emma Guttman-Yassky
- The Rockefeller University, Laboratory for Investigative Dermatology, New York, NY, USA
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Yu HS, Kang MJ, Jung YH, Kim HY, Seo JH, Kim YJ, Lee SH, Kim HJ, Kwon JW, Kim BJ, Yu J, Hong SJ. Mutations in the Filaggrin are Predisposing Factor in Korean Children With Atopic Dermatitis. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2013; 5:211-5. [PMID: 23814674 PMCID: PMC3695235 DOI: 10.4168/aair.2013.5.4.211] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 09/28/2012] [Accepted: 10/23/2012] [Indexed: 12/12/2022]
Abstract
Purpose Filaggrin (FLG) is a key protein that facilitates the terminal differentiation of the epidermis and the formation of the skin barrier. Recent studies showed that atopic dermatitis (AD) associates closely with loss-of-function mutations in the FLG gene. Asian and European populations differ in the frequencies of FLG mutations. Several FLG mutations, including 3321delA, E2422X, K4671X, S2554X, and R501X, occur frequently in Chinese and Japanese populations. The association between three FLG null mutations and AD in Korean children was investigated. Methods The FLG mutations in 1,430 children (aged 0-18 years) with AD and 862 control subjects were genotyped by using the TaqMan assay. Results The FLG null mutation E2422X was not detected in any patients with AD or control subjects. The R501X null mutation was detected in only one child with AD (0.1%). Children with AD had the 3321delA deletion significantly more frequently (2.4%) than the control subjects (0.0%, P<0.001). Children with AD also had a significantly higher combined allele frequency of the three FLG null mutations (2.6%) than the controls (0.0%, P<0.001). The 3321delA null mutation did not associate significantly with AD severity (P=0.842). When the patients with AD were divided into allergic AD and non-allergic AD patient groups, these two groups did not differ in terms of the frequency of 3321delA. Conclusions The Korean children had a lower frequency of FLG mutations than European populations. FLG null mutations may be associated with the development of AD in Korean children.
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Affiliation(s)
- Ho-Sung Yu
- Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Visser MJ, Landeck L, Campbell LE, McLean WHI, Weidinger S, Calkoen F, John SM, Kezic S. Impact of atopic dermatitis and loss-of-function mutations in the filaggrin gene on the development of occupational irritant contact dermatitis. Br J Dermatol 2013; 168:326-332. [PMID: 23039796 PMCID: PMC3974545 DOI: 10.1111/bjd.12083] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) and loss-of-function mutations in the filaggrin gene (FLG) are both associated with chronic irritant contact dermatitis (ICD). As FLG mutations also are a major risk factor for AD, it is not clear whether FLG mutations are an independent risk factor for ICD or whether the risk is mediated by AD. OBJECTIVES To investigate the relative contribution and interaction of FLG mutations and AD in German patients with occupational ICD and controls (vocational school apprentices). METHODS A total of 634 patients and 393 controls were genotyped for R501X, 2282del4, R2447X and S3247X. Current or past flexural eczema was used as an indicator of AD. RESULTS FLG mutations were found in 15·9% of the patients with ICD and 8·3% of the controls, with a crude odds ratio (OR) of 2·09 [95% confidence interval (CI) 1·33-3·28] for the combined genotype. The adjusted OR for FLG mutations, corrected for AD, was 1·62 (95% CI 1·01-2·58). Subjects with AD were at approximately three times higher risk of developing ICD than controls (OR 2·89; 95% CI 2·09-3·99). There was no evidence of an interaction between these two risk factors. CONCLUSIONS Our results indicate that both FLG mutations and AD increase the risk of ICD. Individuals with concurrent FLG mutations and AD are at the highest risk of developing ICD.
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Affiliation(s)
- M J Visser
- Coronel Institute for Occupational Health, Academic Medical Centre, Amsterdam, The Netherlands
| | - L Landeck
- Dept. of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Germany
| | - L E Campbell
- Dermatology and Genetic Medicine, Colleges of Life Sciences and Medicine, Dentistry & Nursing, Medical Sciences Institute, University of Dundee, Dundee DD1 5EH, UK
| | - W H I McLean
- Dermatology and Genetic Medicine, Colleges of Life Sciences and Medicine, Dentistry & Nursing, Medical Sciences Institute, University of Dundee, Dundee DD1 5EH, UK
| | - S Weidinger
- Department of Dermatology, Allergology, and Venerology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - F Calkoen
- Coronel Institute for Occupational Health, Academic Medical Centre, Amsterdam, The Netherlands
| | - S M John
- Dept. of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Germany
| | - S Kezic
- Coronel Institute for Occupational Health, Academic Medical Centre, Amsterdam, The Netherlands
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Bieber T. Atopic dermatitis 2.0: from the clinical phenotype to the molecular taxonomy and stratified medicine. Allergy 2012; 67:1475-82. [PMID: 23106343 DOI: 10.1111/all.12049] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2012] [Indexed: 11/29/2022]
Abstract
Atopic dermatitis (AD) is a paradigmatic inflammatory chronic skin disease. As for other chronic skin diseases, (i) the spectrum of the clinical phenotype and severity as well as (ii) the genetic background and (iii) the underlying mechanisms strongly suggest a high degree of pathophysiological heterogeneity yet leading to a similar clinical pattern, that is, the eczematous skin lesion, but showing distinct progression patterns. This review suggests to exploit the recent knowledge about AD for a novel approach proposing a tentative first molecular taxonomy of this disease based on the genotype and endophenotype. The consequences in terms of personalized prevention and management are delineated.
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Affiliation(s)
- Th. Bieber
- Department of Dermatology and Allergy; University of Bonn; Bonn; Germany
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Lesiak A, Smolewski P, Sobolewska-Sztychny D, Sysa-Jedrzejowska A, Narbutt J. The role of T-regulatory cells and Toll-like receptors 2 and 4 in atopic dermatitis. Scand J Immunol 2012; 76:405-10. [PMID: 22686584 DOI: 10.1111/j.1365-3083.2012.02739.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Regulatory T cells (Tregs), toll-like receptors (TLRs) and interleukin-17 (IL-17) play important role in inflammatory diseases; however, their relevance in atopic dermatitis (AD) pathogenesis is not clear. The aim of study was to evaluate the number of circulating Tregs and peripheral blood mononuclear cells (PBMC) expressing TLR2 and TLR4 receptors in patients with AD. PBMC and CD4+/CD25(high) + Tregs were isolated from the whole blood of 32 AD patients and 36 healthy volunteers. Expression of CD4+CD25+, TLR2 and TLR4 receptors and IL 17+ was assessed with the flow cytometry. In the peripheral blood of AD patients, the percentage of Tregs was significantly higher when compared with the controls (P=0.0003). The number of TLR2+PBMC and TLR4+ PBMC in AD patients was significantly lower than in the controls (P=0.035; P=0.001, respectively). Also the percentages of Tregs with expression of both TLR2+ and TLR4+ in AD patients were significantly lower than in the control (3.85 versus 21.6, P<0.0001; 2.2 versus 17.6, P<0.0001, simultaneously). The percentage of CD4+/CD25high+/FOXP3+ Treg lymphocytes with expression of IL-17 was significantly higher in AD group than in healthy subjects (0.3% versus 0.06%; P=0.011). Distinct number of Tregs and various distribution of TLR2 and TLR4 expression on PBMC in AD patients suggest their contribution in the pathogenesis of AD.
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Affiliation(s)
- A Lesiak
- Department of Dermatology, Medical University of Lodz, Lodz, Poland.
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Abstract
The discovery, in 2006, that loss-of-function mutations in the filaggrin (FLG) gene are the cause of ichthyosis vulgaris-the most common disorder of keratinization-and also a strong genetic risk factor for atopic eczema, marked a significant breakthrough in the understanding of eczema pathogenesis. Subsequent investigations of the role of FLG-null mutations have identified a series of significant associations with atopic disease phenotypes, including atopic asthma, allergic rhinitis, and peanut allergy. However, many questions remain to be answered in relation to the precise mechanisms by which deficiency of an intracellular protein expressed primarily in the differentiating epidermis may contribute to the development of cutaneous and systemic pathology. This review aims to highlight the key milestones in filaggrin research over the past 25 years, to discuss the mechanistic, clinical, and therapeutic implications, and to consider possible future directions for ongoing investigation.
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Affiliation(s)
- Sara J Brown
- Dermatology and Genetic Medicine, Division of Molecular Medicine, University of Dundee, Dundee, UK
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39
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Belderbos M, Bont L. Response to Bullens et al. by Mirjam Belderbos on behalf of the authors. Clin Exp Allergy 2012. [DOI: 10.1111/j.1365-2222.2011.03916.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Belderbos
- Department of Pediatrics; University Medical Center Utrecht; Utrecht; The Netherlands
| | - L. Bont
- Department of Pediatrics; University Medical Center Utrecht; Utrecht; The Netherlands
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40
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Kubo A, Nagao K, Amagai M. Epidermal barrier dysfunction and cutaneous sensitization in atopic diseases. J Clin Invest 2012; 122:440-7. [PMID: 22293182 DOI: 10.1172/jci57416] [Citation(s) in RCA: 248] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Classic atopic dermatitis is complicated by asthma, allergic rhinitis, and food allergies, cumulatively referred to as atopic diseases. Recent discoveries of mutations in the filaggrin gene as predisposing factors for atopic diseases have refocused investigators' attention on epidermal barrier dysfunction as a causative mechanism. The skin's barrier function has three elements: the stratum corneum (air-liquid barrier), tight junctions (liquid-liquid barrier), and the Langerhans cell network (immunological barrier). Clarification of the molecular events underpinning epidermal barrier function and dysfunction should lead to a better understanding of the pathophysiological mechanisms of atopic diseases.
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Affiliation(s)
- Akiharu Kubo
- Department of Dermatology, Keio University School of Medicine, Shinanomachi 35, Shinjuku, Tokyo 160-8582, Japan
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Brandt EB, Sivaprasad U. Th2 Cytokines and Atopic Dermatitis. JOURNAL OF CLINICAL & CELLULAR IMMUNOLOGY 2011; 2:110. [PMID: 21994899 PMCID: PMC3189506 DOI: 10.4172/2155-9899.1000110] [Citation(s) in RCA: 425] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Atopic dermatitis (AD), a chronic relapsing inflammatory skin disease, is increasing in prevalence around the world. Intensive research is ongoing to understand the mechanisms involved in the development of AD and offer new treatment options for patients suffering from AD. In this review, we highlight the importance of allergic Th2 responses in the development of the disease and summarize relevant literature, including genetic studies, studies of human skin and mechanistic studies on keratinocytes and mouse models of AD. We discuss the importance of the skin barrier and review recent findings on the pro-Th2 cytokines TSLP, IL-25, and IL-33, notably their ability to polarize dendritic cells and promote Th2 responses. After a brief update on the contribution of different T-cell subsets to AD, we focus on Th2 cells and the respective contributions of each of the Th2 cytokines (IL-4, IL-13, IL-5, IL-31, and IL-10) to AD. We conclude with a brief discussion of the current gaps in our knowledge and technical limitations.
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Affiliation(s)
- Eric B. Brandt
- Division of Asthma Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, 45229, USA
| | - Umasundari Sivaprasad
- Division of Asthma Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, 45229, USA
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