1
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Eyerich K, Garzorz-Stark N. Back to Broad? How Molecular Profiling Facilitates Targeted Therapies of Overlapping Phenotypes. J Invest Dermatol 2024; 144:3-4. [PMID: 37715751 DOI: 10.1016/j.jid.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 09/18/2023]
Affiliation(s)
- Kilian Eyerich
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Natalie Garzorz-Stark
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.
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2
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Roenneberg S, Braun SA, Garzorz-Stark N, Stark SP, Muresan AM, Schmidle P, Biedermann T, Guenova E, Eyerich K. Histology-based classifier to distinguish early mycosis fungoides from atopic dermatitis. J Eur Acad Dermatol Venereol 2023; 37:2284-2292. [PMID: 37422709 DOI: 10.1111/jdv.19325] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/30/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Histopathological differentiation of early mycosis fungoides (MF) from benign chronic inflammatory dermatoses remains difficult and often impossible, despite the inclusion of all available diagnostic parameters. OBJECTIVE To identify the most impactful histological criteria for a predictive diagnostic model to discriminate MF from atopic dermatitis (AD). METHODS In this multicentre study, two cohorts of patients with either unequivocal AD or MF were evaluated by two independent dermatopathologists. Based on 32 histological attributes, a hypothesis-free prediction model was developed and validated on an independent patient's cohort. RESULTS A reduced set of two histological features (presence of atypical lymphocytes in either epidermis or dermis) was trained. In an independent validation cohort, this model showed high predictive power (95% sensitivity and 100% specificity) to differentiate MF from AD and robustness against inter-individual investigator differences. LIMITATIONS The study investigated a limited number of cases and the classifier is based on subjectively evaluated histological criteria. CONCLUSION Aiming at distinguishing early MF from AD, the proposed binary classifier performed well in an independent cohort and across observers. Combining this histological classifier with immunohistochemical and/or molecular techniques (such as clonality analysis or molecular classifiers) could further promote differentiation of early MF and AD.
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Affiliation(s)
- Sophie Roenneberg
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Stephan Alexander Braun
- Department of Dermatology, University Hospital Muenster, Muenster, Germany
- Department of Dermatology, Medical Faculty, Heinrich-Heine University, Duesseldorf, Germany
| | - Natalie Garzorz-Stark
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Unit of Dermatology, Karolinska University Hospital, Stockholm, Sweden
| | - Sebastian Paul Stark
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Ana-Maria Muresan
- Department of Dermatology, University Hospital Muenster, Muenster, Germany
| | - Paul Schmidle
- Department of Dermatology, University Hospital Muenster, Muenster, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Emmanuella Guenova
- Dermatology Department, University Hospital Zurich and Medical Faculty, University of Zurich, Zurich, Switzerland
- Department of Dermatology, Lausanne University Hospital (CHUV) and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Kilian Eyerich
- Department of Dermatology and Venerology, Medical Center, University of Freiburg, Freiburg, Germany
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3
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Technau-Hafsi K, Garzorz-Stark N, Eyerich K. [Molecular diagnosis of hand eczema]. Dermatologie (Heidelb) 2023:10.1007/s00105-023-05148-z. [PMID: 37272967 DOI: 10.1007/s00105-023-05148-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Because hand eczema is a diagnostic challenge even for experienced dermatologists, a correct diagnosis is essential to ensure success of specific therapies. OBJECTIVES Prerequisites for successful molecular diagnostics in general and in hand eczema in particular are discussed. MATERIALS AND METHODS Basic research and opinion statement on new developments in molecular diagnostics are considered with a special focus on hand eczema. RESULTS The first molecular classifier to distinguish psoriasis from (hand) eczema signature has been introduced as CE-marked in vitro diagnostics (CE-IVD); many more biomarkers associated with diagnostics, theranostics, or natural course of the disease are currently being investigated. CONCLUSIONS Diagnosis of hand eczema will be supported by molecular diagnostics in the near future; we are at the beginning of the molecular era in dermatology.
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Affiliation(s)
- Kristin Technau-Hafsi
- Klinik für Dermatologie und Venerologie, Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland.
- Universitäts-Hautklinik Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland.
| | - Natalie Garzorz-Stark
- Division of Dermatology, Department of Medicine, Karolinska Insitutet, Stockholm, Schweden
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, München, Deutschland
- Dermagnostix GmbH, Hamburg, Deutschland
| | - Kilian Eyerich
- Klinik für Dermatologie und Venerologie, Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland
- Division of Dermatology, Department of Medicine, Karolinska Insitutet, Stockholm, Schweden
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4
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Böhner A, Jargosch M, Müller NS, Garzorz-Stark N, Pilz C, Lauffer F, Wang R, Roenneberg S, Zink A, Thomas J, Theis FJ, Biedermann T, Eyerich S, Eyerich K. The neglected twin: nummular eczema is a variant of atopic dermatitis with co-dominant Th2/Th17 immune response. J Allergy Clin Immunol 2023:S0091-6749(23)00514-6. [PMID: 37119871 DOI: 10.1016/j.jaci.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/23/2023] [Accepted: 04/07/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Nummular eczema (NE) is a common chronic inflammatory skin disease characterized by multiple, pruritic, discoid-shaped lesions. Since the underlying immune mechanisms are not fully understood, it is unclear whether NE should be regarded as variant of atopic dermatitis (AD) or a distinct disease. OBJECTIVE Here, we compared the clinical, histopathological, and molecular signature of NE with that of type 2 and type 3 skin diseases. METHODS We performed bulk RNAseq, histological and clinical studies in lesional and non-lesional skin biopsy specimens from NE (n=50), AD (n=47) and psoriasis (n=90) patients. RESULTS NE displayed typical hallmarks of AD such as an impaired epidermal barrier, microbial colonization, spongiosis and eosinophil infiltration, but also aspects of psoriasis including increased epidermal thickness, number of Ki67+ cells and neutrophilic infiltration. On gene expression level, neutrophil-attracting cytokines (IL19, CXCL8, CXCL5) were upregulated while Th2-related cytokines (IL13, CCL17, CCL18, CCL26, CCL27) were similar expressed in NE compared to AD. Principal component analysis of transcriptome data from lesional skin showed that AD and NE cluster together distinct of psoriasis. In line with this, an established molecular classifier identified NE as AD rather than psoriasis. Finally, we demonstrated clinical and molecular efficacy of Dupilumab treatment in NE. CONCLUSION In summary, NE shows overlapping type 2 and type 3 immune signatures, while type 2 immunity is dominating and should be the primary target of specific therapeutic interventions. This supports the view of NE as a variant of AD.
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Affiliation(s)
- Alexander Böhner
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.
| | - Manja Jargosch
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany; ZAUM - Center of Allergy and Environment, Technical University and Helmholtz Center Munich, Munich, Germany.
| | - Nikola S Müller
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - Natalie Garzorz-Stark
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany; Division of Dermatology and Venerology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Caroline Pilz
- ZAUM - Center of Allergy and Environment, Technical University and Helmholtz Center Munich, Munich, Germany; Department of Dermatology and Venerology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Felix Lauffer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Rosi Wang
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Sophie Roenneberg
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Jenny Thomas
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany; Division of Dermatology and Venerology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Fabian J Theis
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany; Department of Mathematics, Technical University of Munich, Garching, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Stefanie Eyerich
- ZAUM - Center of Allergy and Environment, Technical University and Helmholtz Center Munich, Munich, Germany
| | - Kilian Eyerich
- Division of Dermatology and Venerology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Dermatology and Venerology, Medical Center, University of Freiburg, Freiburg, Germany
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5
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Gebhardt C, Eyerich K, Garzorz-Stark N. Status quo und Zukunftsperspektiven der molekularen Diagnostik in der Dermatologie. J Dtsch Dermatol Ges 2023; 21:415-419. [PMID: 37070508 DOI: 10.1111/ddg.15010_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 04/19/2023]
Affiliation(s)
- Christoffer Gebhardt
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland
| | - Kilian Eyerich
- Klinik für Dermatologie und Venerologie, Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for molecular medicine, Karolinska Institutet, Stockholm, Schweden
| | - Natalie Garzorz-Stark
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for molecular medicine, Karolinska Institutet, Stockholm, Schweden
- Technische Universität München, Medizinische Fakultät, Klinik und Poliklinik für Dermatologie und Allergologie, München, Deutschland
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6
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Gebhardt C, Eyerich K, Garzorz-Stark N. Status quo and future perspectives of molecular diagnostics in dermatology. J Dtsch Dermatol Ges 2023; 21:415-418. [PMID: 36892267 DOI: 10.1111/ddg.15010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 03/10/2023]
Abstract
Molecular diagnostics (MDx) has become an indispensable pillar of diagnostics in dermatology. Modern sequencing technologies allow for identification of rare genodermatoses, analysis of somatic mutations in melanoma are prerequisite for targeted therapies, and cutaneous infectious pathogens are quickly detected by PCR and other amplification methods. However, to push innovation in molecular diagnostics and tackle so far unmet clinical needs, research activities need to be bundled and the pipeline from idea to MDx product clearly rolled out. Only then, the requirements for technical validity and clinical utility of novel biomarkers can be fulfilled and the long-term vision of personalized medicine will be realized.
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Affiliation(s)
- Christoffer Gebhardt
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Kilian Eyerich
- Department of Dermatology and Venerology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Division of Dermatology and Venereology, Department of Medicine Solna, and Center for molecular medicine, Karolinska Institutet, Stockholm, Sweden
| | - Natalie Garzorz-Stark
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for molecular medicine, Karolinska Institutet, Stockholm, Sweden.,Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany
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7
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Fischer F, Doll A, Uereyener D, Roenneberg S, Hillig C, Weber L, Hackert V, Meinel M, Farnoud A, Seiringer P, Thomas J, Anand P, Graner L, Schlenker F, Zengerle R, Jonsson P, Jargosch M, Theis FJ, Schmidt-Weber CB, Biedermann T, Howell M, Reich K, Eyerich K, Menden M, Garzorz-Stark N, Lauffer F, Eyerich S. Gene expression based molecular test as diagnostic aid for the differential diagnosis of psoriasis and eczema in formalin fixed and paraffin embedded tissue, microbiopsies and tape strips. J Invest Dermatol 2023:S0022-202X(23)00156-2. [PMID: 36889660 DOI: 10.1016/j.jid.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/28/2023] [Accepted: 02/14/2023] [Indexed: 03/08/2023]
Abstract
Highly effective targeted therapies are available to treat non-communicable chronic inflammatory skin diseases (ncISD). In contrast, the exact diagnosis of ncISD is complicated by their complex pathogenesis and clinical and histological overlap. Particularly, differential diagnosis of psoriasis and eczema can be challenging in special cases and molecular diagnostic tools need to be developed to support gold standard diagnosis. Aim of this work was to develop a real-time PCR based molecular classifier to distinguish psoriasis from eczema in FFPE-fixed skin samples and to evaluate the use of minimally invasive microbiopsies and tape strips for molecular diagnosis. Here, we present a FFPE-based molecular classifier (MC) that determines the probability for psoriasis with a sensitivity/specificity of 92%/100%, respectively, and an AUC of 0.97 delivering comparable results to our previous published RNAprotect-based MC. The psoriasis probability, as well as levels of NOS2 expression positively correlated with disease hallmarks of psoriasis and negatively with eczema hallmarks. Furthermore, minimally invasive tape strips and microbiopsies were effectively used to differentiate psoriasis from eczema. In summary, the MC offers broad usage in pathology laboratories as well as outpatient settings and can support the differential diagnosis of ncISD on a molecular level FFPE tissue, microbiopsies and tape strips.
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Affiliation(s)
- Felix Fischer
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - Anais Doll
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Deniz Uereyener
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - Sophie Roenneberg
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Christina Hillig
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | | | | | - Martin Meinel
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - Ali Farnoud
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - Peter Seiringer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Jenny Thomas
- ZAUM-Center of Allergy and Environment, Technical University of Munich and Helmholtz Center Munich, Munich, Germany
| | - Philipp Anand
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | | | | | - Roland Zengerle
- Laboratory for MEMS Applications, Department of Microsystems Engineering - IMTEK, University of Freiburg, Freiburg, Germany; Hahn-Schickard, Freiburg, Germany
| | - Pontus Jonsson
- Karolinska Universitetssjukhuset - Hudkliniken Stockholm, Stockholm, Sweden
| | - Manja Jargosch
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany; ZAUM-Center of Allergy and Environment, Technical University of Munich and Helmholtz Center Munich, Munich, Germany
| | - Fabian J Theis
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany; Department of Mathematics, Technical University of Munich, Garching, Germany
| | - Carsten B Schmidt-Weber
- ZAUM-Center of Allergy and Environment, Technical University of Munich and Helmholtz Center Munich, Munich, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | | | - Kristian Reich
- Translational Research in Inflammatory Skin Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kilian Eyerich
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Michael Menden
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - Natalie Garzorz-Stark
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Felix Lauffer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Stefanie Eyerich
- ZAUM-Center of Allergy and Environment, Technical University of Munich and Helmholtz Center Munich, Munich, Germany.
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8
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Schäbitz A, Hillig C, Mubarak M, Jargosch M, Farnoud A, Scala E, Kurzen N, Pilz AC, Bhalla N, Thomas J, Stahle M, Biedermann T, Schmidt-Weber CB, Theis F, Garzorz-Stark N, Eyerich K, Menden MP, Eyerich S. Spatial transcriptomics landscape of lesions from non-communicable inflammatory skin diseases. Nat Commun 2022; 13:7729. [PMID: 36513651 PMCID: PMC9747967 DOI: 10.1038/s41467-022-35319-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Abundant heterogeneous immune cells infiltrate lesions in chronic inflammatory diseases and characterization of these cells is needed to distinguish disease-promoting from bystander immune cells. Here, we investigate the landscape of non-communicable inflammatory skin diseases (ncISD) by spatial transcriptomics resulting in a large repository of 62,000 spatially defined human cutaneous transcriptomes from 31 patients. Despite the expected immune cell infiltration, we observe rather low numbers of pathogenic disease promoting cytokine transcripts (IFNG, IL13 and IL17A), i.e. >125 times less compared to the mean expression of all other genes over lesional skin sections. Nevertheless, cytokine expression is limited to lesional skin and presented in a disease-specific pattern. Leveraging a density-based spatial clustering method, we identify specific responder gene signatures in direct proximity of cytokines, and confirm that detected cytokine transcripts initiate amplification cascades of up to thousands of specific responder transcripts forming localized epidermal clusters. Thus, within the abundant and heterogeneous infiltrates of ncISD, only a low number of cytokine transcripts and their translated proteins promote disease by initiating an inflammatory amplification cascade in their local microenvironment.
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Affiliation(s)
- A. Schäbitz
- grid.4714.60000 0004 1937 0626Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - C. Hillig
- grid.4567.00000 0004 0483 2525Institute of Computational Biology, Helmholtz Zentrum München—German Research Centre for Environmental Health, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
| | - M. Mubarak
- grid.6936.a0000000123222966Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - M. Jargosch
- grid.6936.a0000000123222966Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Biedersteinerstrasse 29, 80802 Munich, Germany ,grid.6936.a0000000123222966Department of Dermatology and Allergy, Technical University of Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - A. Farnoud
- grid.4567.00000 0004 0483 2525Institute of Computational Biology, Helmholtz Zentrum München—German Research Centre for Environmental Health, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
| | - E. Scala
- grid.4714.60000 0004 1937 0626Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden ,grid.5963.9Department of Dermatology and Venerology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - N. Kurzen
- grid.6936.a0000000123222966Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - A. C. Pilz
- grid.6936.a0000000123222966Department of Dermatology and Allergy, Technical University of Munich, Biedersteinerstrasse 29, 80802 Munich, Germany ,grid.5963.9Department of Dermatology and Venerology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - N. Bhalla
- grid.5037.10000000121581746Department of Gene Technology, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Stockholm, Sweden
| | - J. Thomas
- grid.6936.a0000000123222966Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - M. Stahle
- grid.4714.60000 0004 1937 0626Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - T. Biedermann
- grid.6936.a0000000123222966Department of Dermatology and Allergy, Technical University of Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - C. B. Schmidt-Weber
- grid.6936.a0000000123222966Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - F. Theis
- grid.4567.00000 0004 0483 2525Institute of Computational Biology, Helmholtz Zentrum München—German Research Centre for Environmental Health, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
| | - N. Garzorz-Stark
- grid.4714.60000 0004 1937 0626Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden ,grid.6936.a0000000123222966Department of Dermatology and Allergy, Technical University of Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - K. Eyerich
- grid.4714.60000 0004 1937 0626Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden ,grid.5963.9Department of Dermatology and Venerology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany ,grid.24381.3c0000 0000 9241 5705Department of Dermatology and Venereology, Unit of Dermatology, Karolinska University Hospital, Stockholm, Sweden
| | - M. P. Menden
- grid.4567.00000 0004 0483 2525Institute of Computational Biology, Helmholtz Zentrum München—German Research Centre for Environmental Health, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany ,grid.5252.00000 0004 1936 973XDepartment of Biology, Ludwig-Maximilians University, Goßhadernerstrasse 2, Martinsried, 82152 Germany ,grid.452622.5German Center for Diabetes Research (DZD e.V.), Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
| | - S. Eyerich
- grid.6936.a0000000123222966Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Biedersteinerstrasse 29, 80802 Munich, Germany
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9
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Scala E, Schäbitz A, Hillig C, Pilz A, Meinel M, Dietl T, Menden M, Eyerich K, Thomas J, Garzorz-Stark N. 033 A “two-strike” model for psoriasis: an in vivo human study. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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10
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Das Mahapatra K, Jargosch M, Hillig C, Buchholz B, Thomas J, Eyerich S, Eyerich K, Garzorz-Stark N. 002 The role of HIF-1α in the pathogenesis of psoriasis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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11
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Tizek L, Schuster B, Gebhardt C, Reich K, von Kiedrowski R, Biedermann T, Eyerich K, Zink A, Garzorz-Stark N. Molekulardiagnostik in der Dermatologie: Eine Online-Umfrage zur Untersuchung von Nutzung, Hürden und Anforderungen in Deutschland. J Dtsch Dermatol Ges 2022; 20:287-296. [PMID: 35304958 DOI: 10.1111/ddg.14659_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 09/20/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Linda Tizek
- Technische Universität München, Medizinische Fakultät, Klinik und Poliklinik für Dermatologie und Allergologie, München, Deutschland
| | - Barbara Schuster
- Technische Universität München, Medizinische Fakultät, Klinik und Poliklinik für Dermatologie und Allergologie, München, Deutschland.,Division of Dermatology and Venereology, Department of Medicine Solna, and Center for molecular medicine, Karolinska Institutet, Stockholm, Schweden
| | - Christoffer Gebhardt
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland
| | - Kristian Reich
- Competenzzentrum Translationale Forschung bei entzündlichen Hauterkrankungen, Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland
| | - Ralph von Kiedrowski
- Dermatologische Praxis und dermatologisches Studienzentrum (CMS3), Dr. Ralph von Kiedrowski, Selters/Westerwald, Deutschland
| | - Tilo Biedermann
- Technische Universität München, Medizinische Fakultät, Klinik und Poliklinik für Dermatologie und Allergologie, München, Deutschland
| | - Kilian Eyerich
- Technische Universität München, Medizinische Fakultät, Klinik und Poliklinik für Dermatologie und Allergologie, München, Deutschland.,Division of Dermatology and Venereology, Department of Medicine Solna, and Center for molecular medicine, Karolinska Institutet, Stockholm, Schweden
| | - Alexander Zink
- Technische Universität München, Medizinische Fakultät, Klinik und Poliklinik für Dermatologie und Allergologie, München, Deutschland.,Division of Dermatology and Venereology, Department of Medicine Solna, and Center for molecular medicine, Karolinska Institutet, Stockholm, Schweden
| | - Natalie Garzorz-Stark
- Technische Universität München, Medizinische Fakultät, Klinik und Poliklinik für Dermatologie und Allergologie, München, Deutschland.,Division of Dermatology and Venereology, Department of Medicine Solna, and Center for molecular medicine, Karolinska Institutet, Stockholm, Schweden
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12
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Tizek L, Schuster B, Gebhardt C, Reich K, von Kiedrowski R, Biedermann T, Eyerich K, Zink A, Garzorz-Stark N. Molecular diagnostics in dermatology: An online survey to study usage, obstacles and requirements in Germany. J Dtsch Dermatol Ges 2021; 20:287-295. [PMID: 34962069 DOI: 10.1111/ddg.14659] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 09/20/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Molecular diagnostics (MDx) increasingly gains importance in dermatology and its application is a prerequisite for personalized medicine. The goal of this cross-sectional study was to determine how MDx is implemented in dermatologists' offices in the three fields of oncology, inflammation and infectiology and which hurdles office-based dermatologists face in terms of MDx. METHODS Physician members of the Association of the German Dermatologists (Berufsverband der Deutschen Dermatologen e. V.; BVDD) were surveyed via an online questionnaire on MDx. RESULTS 39.6 % of the 192 participants reported using MDx. Of these, the vast majority used MDx for diagnosing infectious diseases (86.5 % and 44.3 % of users perform MDx for detection of funghi and sexually transmitted diseases, respectively). Only a small minority applied MDx to answer oncological or immunological questions. The major obstacles for non-users as compared to users were difficulties in implementation, lack of expertise as well as time, personnel, and technical availability. Reimbursement was a main issue in both groups. CONCLUSIONS Despite availability of specific therapies requiring precision medicine, MDx has not yet been broadly implemented in office-based dermatology. To advance MDx, more needs to be done in terms of continuous education, availability of reliable and valid tests, and reimbursability.
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Affiliation(s)
- Linda Tizek
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany
| | - Barbara Schuster
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany.,Division of Dermatology and Venereology, Department of Medicine Solna, and Center for molecular medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christoffer Gebhardt
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Kristian Reich
- Centre for Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ralph von Kiedrowski
- Dermatology Office and Dermatology Study Center (CMS3) Dr. Ralph von Kiedrowski, Selters/Westerwald, Germany
| | - Tilo Biedermann
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany
| | - Kilian Eyerich
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany.,Division of Dermatology and Venereology, Department of Medicine Solna, and Center for molecular medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alexander Zink
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany.,Division of Dermatology and Venereology, Department of Medicine Solna, and Center for molecular medicine, Karolinska Institutet, Stockholm, Sweden
| | - Natalie Garzorz-Stark
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany.,Division of Dermatology and Venereology, Department of Medicine Solna, and Center for molecular medicine, Karolinska Institutet, Stockholm, Sweden
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13
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Garzorz-Stark N, Eyerich K. IFN-1s: Sentinels Shaping Distinct Immune Responses in Skin. J Invest Dermatol 2021; 142:14-15. [PMID: 34565563 DOI: 10.1016/j.jid.2021.07.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/08/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Abstract
IFN-1s are early sentinels of potential danger in skin. Two interconnected axes exist: plasmacytoid dendritic cells (DCs) secreting IFN-α in response to single strand RNA or DNA and keratinocytes secreting IFN-κ after stimulation with double strand RNA or other IFNs. Both IFN-α and IFN-κ induce macrophages and DC subpopulations to secrete master regulators of cytotoxicity or wound healing, the latter related to psoriasis pathogenesis.
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Affiliation(s)
- Natalie Garzorz-Stark
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany; Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; Unit of Dermatology, Karolinska University Hospital, Stockholm, Sweden
| | - Kilian Eyerich
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany; Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; Unit of Dermatology, Karolinska University Hospital, Stockholm, Sweden.
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14
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Seiringer P, Garzorz-Stark N, Eyerich K. T-Cell‒Mediated Autoimmunity: Mechanisms and Future Directions. J Invest Dermatol 2021; 142:804-810. [PMID: 34538423 DOI: 10.1016/j.jid.2021.04.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/12/2021] [Accepted: 04/18/2021] [Indexed: 12/28/2022]
Abstract
T cells are key drivers of autoimmunity in numerous noncommunicable inflammatory skin diseases by directly harming host tissue or through helping B cells in producing autoantibodies. Technological advances have contributed to identifying autoantigens, the Holy Grail of autoimmunity, in many inflammatory disorders of the skin. Novel therapeutic approaches such as chimeric (auto)antibody receptor T cells are a milestone on the way to finding individualized, well-tolerated, targeted therapies. This review summarizes the current knowledge on pathogenesis, immune response pattern‒related ontology, diagnostic approaches, and treatment options of autoimmune skin diseases.
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Affiliation(s)
- Peter Seiringer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany; Center of Allergy and Environment (ZAUM), Helmholtz Center and Technical University of Munich, Munich, Germany
| | - Natalie Garzorz-Stark
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany; Division of Dermatology and Venereology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Center for molecular medicine, Karolinska Institutet, Stockholm, Sweden; Unit of Dermatology, Karolinska University Hospital, Stockholm, Sweden
| | - Kilian Eyerich
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany; Division of Dermatology and Venereology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Center for molecular medicine, Karolinska Institutet, Stockholm, Sweden; Unit of Dermatology, Karolinska University Hospital, Stockholm, Sweden.
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15
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Speth P, Jargosch M, Seiringer P, Schwamborn K, Bauer T, Scheerer C, Protzer U, Schmidt-Weber C, Biedermann T, Eyerich S, Garzorz-Stark N. Immunocompromised Patients with Therapy-Refractory Chronic Skin Diseases Show Reactivation of Latent Epstein‒Barr Virus and Cytomegalovirus Infection. J Invest Dermatol 2021; 142:549-558.e6. [PMID: 34480891 DOI: 10.1016/j.jid.2021.07.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/24/2021] [Accepted: 07/05/2021] [Indexed: 11/30/2022]
Abstract
Reactivation of latent Epstein‒Barr virus (EBV) and/or Cytomegalovirus (CMV) infection is a dreaded complication in immunocompromised patients receiving hematopoietic stem cell transplantation. Evidence is sparse on whether subclinical reactivation of viral infection may also be of clinical relevance in dermatological patients. We screened patients (N = 206) suffering from chronic skin diseases for subclinical reactivation of EBV and CMV infection. We found that immunocompromised patients with therapy-refractory chronic skin diseases showed higher rates of subclinical reactivation of CMV and EBV infection (6.7% vs. 0% for EBV and 16.7% vs. 5.6% for CMV) and a higher prevalence of virus-specific DNA in skin tissue (30.8% vs. 0% for EBV and 21.4% vs. 0% for CMV) than nonimmunocompromised patients with chronic skin diseases. T cells isolated from lesional skin exhibited up to 14-fold increased proliferation with production of T helper type 1 and T helper type 17 cytokines on stimulation with viral proteins, providing evidence for possible aggravation of the underlying skin diseases by viral infection. Improvement of skin lesions in patients with reactivation of CMV infection (n = 4) was observed on antiviral treatment. Our data suggest that subclinical reactivation of EBV and/or CMV infection is an under-recognized condition in the dermatological patient population with chronic skin diseases.
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Affiliation(s)
- Philipp Speth
- Department of Dermatology and Allergology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Manja Jargosch
- Department of Dermatology and Allergology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Peter Seiringer
- Department of Dermatology and Allergology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Kristina Schwamborn
- Institute of Pathology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Tanja Bauer
- Institute of Virology, Technical University/Helmholtz Center Munich, Munich, Germany
| | - Cora Scheerer
- Department of Dermatology and Allergology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Ulrike Protzer
- Institute of Virology, Technical University/Helmholtz Center Munich, Munich, Germany
| | - Carsten Schmidt-Weber
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Stefanie Eyerich
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
| | - Natalie Garzorz-Stark
- Department of Dermatology and Allergology, School of Medicine, Technical University of Munich, Munich, Germany; Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
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16
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Schäbitz A, Eyerich K, Garzorz-Stark N. So close, and yet so far away: The dichotomy of the specific immune response and inflammation in psoriasis and atopic dermatitis. J Intern Med 2021; 290:27-39. [PMID: 33428274 DOI: 10.1111/joim.13235] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/13/2020] [Accepted: 12/09/2020] [Indexed: 12/11/2022]
Abstract
Characterization of the complex interplay between cytokines, chemokines and microorganisms has led to a better understanding of the pathogenesis of both psoriasis and AD and resulted in new therapeutics targeting distinct immune responses. Psoriasis and AD share many characteristics: they are highly prevalent, chronic, cause primarily skin inflammation, but are associated with comorbidities, and come with a devastating quality of life due to itch and stigmatization. However, the pathogenesis of psoriasis and AD is opposing - psoriasis is dominated by a Th17 immune response that causes neutrophil migration, induction of innate immunity and exaggerated epithelial metabolism. Leading cytokines of this Th17 immune response are IL-17A and F, IL-22 and TNF-a. AD is characterized by Th2 immunity characterized by the signature cytokines IL-4 and IL-13 leading to an impaired epidermal barrier, dampened innate immunity and eosinophil migration. This review compares genetics, microbiome and T-cell infiltrate and resulting epithelial response in psoriasis and AD. Whilst the antagonistic course of psoriasis and AD is confirmed by response to specific biologics targeting the key cytokines of inflammation in psoriasis and AD, respectively, clinically overlapping phenotypes are challenging in our daily clinical practice. We conclude this review by summarizing what is known about these mixed phenotypes and how the identification of clinically relevant endotypes and molecular-driven decision-making is the next step in the field of dermato-immunology.
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Affiliation(s)
- A Schäbitz
- From the, Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - K Eyerich
- From the, Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Dermatology and Venereology, Unit of Dermatology, Karolinska University Hospital, Stockholm, Sweden.,Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - N Garzorz-Stark
- From the, Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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17
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Garzorz-Stark N, Beicht S, Baghin V, Stark SP, Biedermann T, Lauffer F. IMPROVE 1.0: Individual Monitoring of Psoriasis Activity by Regular Online App Questionnaires and Outpatient Visits. Front Med (Lausanne) 2021; 8:648233. [PMID: 34239885 PMCID: PMC8257945 DOI: 10.3389/fmed.2021.648233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/29/2021] [Indexed: 12/24/2022] Open
Abstract
Smartphone apps gain more and more importance in supporting management of chronic diseases. Psoriasis is a highly prevalent, lifelong chronic inflammatory skin disease with a high impact on patient's quality of life. Disease management includes regular topical and systemic treatment of skin lesions as well as co-treatment of metabolic and psychologic disorders. In this study, we investigated the potential of a new smartphone app (IMPROVE 1.0) for individual monitoring of disease activity and disease influencing factors. Twelve out of 50 psoriasis patients asked for study participation performed self-assessment of psoriasis severity, life quality, and stress scores using the app over a period of 1 year. Every 2 months, study participants were carefully examined by a dermatologist in order to control the quality of app-reported data. We found that psoriasis severity and life quality values as entered in the app closely correlate to physician's examination. Furthermore, we detected strong correlations of disease activity with life quality and psoriasis serum biomarker. Temporal relations between psoriasis aggravation and previous changes of lifestyle factors, such as increased stress levels, were observed in individual patients, indicating a high potential for preventive interventions in future psoriasis apps. The vast majority of study participants evaluated IMPROVE 1.0 app positively and wish to include the app into their daily life. Hence, we demonstrate that smartphone apps are a useful tool to raise self-awareness for the dimensions of complex diseases and fully integrate psoriasis patients into individual disease management. These data are important to develop more advanced digital tools supporting the management of chronic diseases in the future.
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Affiliation(s)
- Natalie Garzorz-Stark
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.,Division of Dermatology and Venereology, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sarah Beicht
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Veronika Baghin
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Sebastian P Stark
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Felix Lauffer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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18
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Abstract
BACKGROUND Correct diagnosis of nail changes in childhood may be challenging. Knowing the anatomy of the nail apparatus and some pathophysiologic principles helps to categorize nail disorders correctly. OBJECTIVES This article gives a structured overview of nail disorders in childhood, thus, facilitating correct diagnosis of nail abnormalities in childhood. MATERIALS AND METHODS A review of literature and our own experience are presented. RESULTS In the first part we present fundamental anatomical characteristics of the nail apparatus based on embryonal development of the nails. In the main part we categorize nail disorders according to clinical presentation: transient nail changes, congenital nail abnormalities, infectious diseases of the nails, nail changes in the context of chronic inflammatory skin diseases, pigmented nail changes, tumors and nail changes due to trauma.
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Affiliation(s)
- K Gresset-Kaliebe
- Klinik für Dermatologie und Allergologie am Biederstein, Klinikum Rechts der Isar, Technische Universität München, Biedersteinerstr. 29, 80802, München, Deutschland
| | - N Garzorz-Stark
- Klinik für Dermatologie und Allergologie am Biederstein, Klinikum Rechts der Isar, Technische Universität München, Biedersteinerstr. 29, 80802, München, Deutschland.,Division of Dermatology and Venereology, Department of Medicine Solna and Center for Molecular Medicine, Karolinka Institutet, Stockholm, Schweden.,Unit of Dermatology, Karolinska University Hospital, Stockholm, Schweden
| | - C Schnopp
- Klinik für Dermatologie und Allergologie am Biederstein, Klinikum Rechts der Isar, Technische Universität München, Biedersteinerstr. 29, 80802, München, Deutschland.
| | - A Weins
- Kinderdermatologisches Zentrum, Mutter-Kind-Zentrum-Schwaben, Klinik für Dermatologie, Universitätsklinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland
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19
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Thomas J, Wang R, Batra R, Böhner A, Garzorz-Stark N, Eberlein B, Theis F, Biedermann T, Schmidt-Weber C, Zink A, Eyerich K, Eyerich S. CD23 Levels on B Cells Determine Long-Term Therapeutic Response in Patients with Atopic Eczema Treated with Selective IgE Immune Apheresis. J Invest Dermatol 2020; 141:681-685.e6. [PMID: 32949565 DOI: 10.1016/j.jid.2020.05.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 05/11/2020] [Accepted: 05/27/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Jenny Thomas
- ZAUM-Center of Allergy and Environment, Technical University and Helmholtz Center Munich, Munich, Germany
| | - Rosi Wang
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.
| | - Richa Batra
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - Alexander Böhner
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Natalie Garzorz-Stark
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Bernadette Eberlein
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Fabian Theis
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany; Department of Mathematics, Technical University of Munich, Garching, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Carsten Schmidt-Weber
- ZAUM-Center of Allergy and Environment, Technical University and Helmholtz Center Munich, Munich, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Kilian Eyerich
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany; Unit of Dermatology and Venerology, Department of Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Stefanie Eyerich
- ZAUM-Center of Allergy and Environment, Technical University and Helmholtz Center Munich, Munich, Germany
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20
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Matthias J, Maul J, Noster R, Meinl H, Chao YY, Gerstenberg H, Jeschke F, Gasparoni G, Welle A, Walter J, Nordström K, Eberhardt K, Renisch D, Donakonda S, Knolle P, Soll D, Grabbe S, Garzorz-Stark N, Eyerich K, Biedermann T, Baumjohann D, Zielinski CE. Sodium chloride is an ionic checkpoint for human T H2 cells and shapes the atopic skin microenvironment. Sci Transl Med 2020; 11:11/480/eaau0683. [PMID: 30787167 DOI: 10.1126/scitranslmed.aau0683] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 08/14/2018] [Accepted: 01/25/2019] [Indexed: 12/21/2022]
Abstract
The incidence of allergic diseases has increased over the past 50 years, likely due to environmental factors. However, the nature of these factors and the mode of action by which they induce the type 2 immune deviation characteristic of atopic diseases remain unclear. It has previously been reported that dietary sodium chloride promotes the polarization of T helper 17 (TH17) cells with implications for autoimmune diseases such as multiple sclerosis. Here, we demonstrate that sodium chloride also potently promotes TH2 cell responses on multiple regulatory levels. Sodium chloride enhanced interleukin-4 (IL-4) and IL-13 production while suppressing interferon-γ (IFN-γ) production in memory T cells. It diverted alternative T cell fates into the TH2 cell phenotype and also induced de novo TH2 cell polarization from naïve T cell precursors. Mechanistically, sodium chloride exerted its effects via the osmosensitive transcription factor NFAT5 and the kinase SGK-1, which regulated TH2 signature cytokines and master transcription factors in hyperosmolar salt conditions. The skin of patients suffering from atopic dermatitis contained elevated sodium compared to nonlesional atopic and healthy skin. These results suggest that sodium chloride represents a so far overlooked cutaneous microenvironmental checkpoint in atopic dermatitis that can induce TH2 cell responses, the orchestrators of atopic diseases.
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Affiliation(s)
- Julia Matthias
- Institute of Virology, Technical University of Munich, 81675 Munich, Germany.,German Center for Infection Research, Partner Site Munich, Munich, Germany.,Department of Dermatology, Unit Cellular Immunoregulation, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Julia Maul
- Institute for Immunology, Biomedical Center, Ludwig-Maximilians-Universität München, 82152 Planegg-Martinsried, Germany
| | - Rebecca Noster
- Department of Dermatology, Unit Cellular Immunoregulation, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Hanna Meinl
- Institute of Virology, Technical University of Munich, 81675 Munich, Germany.,German Center for Infection Research, Partner Site Munich, Munich, Germany.,TranslaTUM, Technical University of Munich, 81675 Munich, Germany
| | - Ying-Yin Chao
- Institute of Virology, Technical University of Munich, 81675 Munich, Germany.,German Center for Infection Research, Partner Site Munich, Munich, Germany.,TranslaTUM, Technical University of Munich, 81675 Munich, Germany
| | | | - Florian Jeschke
- ZWE FRM II, Technical University of Munich, 85748 Garching, Germany
| | - Gilles Gasparoni
- Department of Genetics, University of Saarland, 66123 Saarbrücken, Germany
| | - Anna Welle
- Department of Genetics, University of Saarland, 66123 Saarbrücken, Germany
| | - Jörn Walter
- Department of Genetics, University of Saarland, 66123 Saarbrücken, Germany
| | - Karl Nordström
- Department of Genetics, University of Saarland, 66123 Saarbrücken, Germany
| | - Klaus Eberhardt
- Institute for Nuclear Chemistry, Johannes Gutenberg-Universität Mainz and Helmholtz Institute Mainz, 55252 Mainz, Germany
| | - Dennis Renisch
- Institute for Nuclear Chemistry, Johannes Gutenberg-Universität Mainz and Helmholtz Institute Mainz, 55252 Mainz, Germany
| | - Sainitin Donakonda
- German Center for Infection Research, Partner Site Munich, Munich, Germany.,Institute of Molecular Immunology and Experimental Oncology, Technical University of Munich, 81675 Munich, Germany
| | - Percy Knolle
- German Center for Infection Research, Partner Site Munich, Munich, Germany.,Institute of Molecular Immunology and Experimental Oncology, Technical University of Munich, 81675 Munich, Germany
| | - Dominik Soll
- Institute of Virology, Technical University of Munich, 81675 Munich, Germany.,German Center for Infection Research, Partner Site Munich, Munich, Germany
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Natalie Garzorz-Stark
- Department of Dermatology and Allergology, Technical University of Munich; Clinical Unit Allergology (EKA), Helmholtz Zentrum München; German Research Centre for Environmental Health GmbH, 80802 Munich, Germany
| | - Kilian Eyerich
- Department of Dermatology and Allergology, Technical University of Munich; Clinical Unit Allergology (EKA), Helmholtz Zentrum München; German Research Centre for Environmental Health GmbH, 80802 Munich, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergology, Technical University of Munich; Clinical Unit Allergology (EKA), Helmholtz Zentrum München; German Research Centre for Environmental Health GmbH, 80802 Munich, Germany
| | - Dirk Baumjohann
- Institute for Immunology, Biomedical Center, Ludwig-Maximilians-Universität München, 82152 Planegg-Martinsried, Germany
| | - Christina E Zielinski
- Institute of Virology, Technical University of Munich, 81675 Munich, Germany. .,German Center for Infection Research, Partner Site Munich, Munich, Germany.,Department of Dermatology, Unit Cellular Immunoregulation, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany.,TranslaTUM, Technical University of Munich, 81675 Munich, Germany
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21
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Thomas J, Küpper M, Batra R, Jargosch M, Atenhan A, Baghin V, Krause L, Lauffer F, Biedermann T, Theis FJ, Eyerich K, Schmidt-Weber CB, Eyerich S, Garzorz-Stark N. Corrigendum: Is the humoral immunity dispensable for the pathogenesis of psoriasis? J Eur Acad Dermatol Venereol 2019; 33:2380. [PMID: 31779039 DOI: 10.1111/jdv.16019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J Thomas
- ZAUM-Center of Allergy and Environment, Technical University and Helmholtz Munich, Munich, Germany
| | - M Küpper
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - R Batra
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.,Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - M Jargosch
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - A Atenhan
- ZAUM-Center of Allergy and Environment, Technical University and Helmholtz Munich, Munich, Germany
| | - V Baghin
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - L Krause
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - F Lauffer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - F J Theis
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany.,Institute of Mathematics, Technical University of Munich, Garching, Germany
| | - K Eyerich
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - C B Schmidt-Weber
- ZAUM-Center of Allergy and Environment, Technical University and Helmholtz Munich, Munich, Germany
| | - S Eyerich
- ZAUM-Center of Allergy and Environment, Technical University and Helmholtz Munich, Munich, Germany
| | - N Garzorz-Stark
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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Beicht S, Garzorz-Stark N, Lauffer F, Baghin V. 105 IMPROVE 1.0 – Individual monitoring of psoriasis activity via regular online-app surveys in combination with clinical expertise. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Berezhnoi A, Aguirre J, Hindelang B, Garzorz-Stark N, Omar M, Darsow U, Eyerich K, Ntziachristos V. Optical features of human skin revealed by optoacoustic mesoscopy in the visible and short-wave infrared regions. Opt Lett 2019; 44:4119-4122. [PMID: 31465343 DOI: 10.1364/ol.44.004119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 07/15/2019] [Indexed: 06/10/2023]
Abstract
Detailed assessment of skin conditions or the efficacy of skin treatments could greatly benefit from noninvasively assessing the distribution of cutaneous and subcutaneous structures and biomolecules. We considered ultrawideband raster scan optoacoustic mesoscopy with an extended wavelength range from visible to short-wave infrared and observed previously unseen high-resolution images of lipids colocalized with water, melanin, and hemoglobin distribution in human skin. Based on this contrast, the technique resolves subcutaneous fat, the pilosebaceous unit with complete hair strand and bulb, dermal microvasculature, and epidermal structures. We further visualize melanoidins that form via the Maillard reaction in the ultrathin stratum corneum layer, analyze their absorption spectrum, and separate them from the melanin layer. The suggested method may allow novel interrogation of skin conditions, possibly impacting diagnostics and medical and cosmetic treatments.
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Seiringer P, Pohl B, Schmidle P, Eyerich K, Biedermann T, Lauffer F, Garzorz-Stark N. 142 Assessing patient satisfaction with topical anti-pruritic agents in routine in-patient care. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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25
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Garzorz-Stark N, Eyerich K. Psoriasis Pathogenesis: Keratinocytes Are Back in the Spotlight. J Invest Dermatol 2019; 139:995-996. [PMID: 31010530 DOI: 10.1016/j.jid.2019.01.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 01/06/2023]
Abstract
Psoriasis is a T helper type 17-mediated immune disease. Initial triggers that lead to T helper type 17 production and inflammatory cell recruitment into skin are being delineated. Autoantigens that stimulate T helper type 17 cells are also being identified. A new and important piece of the puzzle indicates that keratinocytes not only amplify inflammation, but that they are essential for a full-blown IL-17-mediated psoriatic phenotype in mice.
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Affiliation(s)
- Natalie Garzorz-Stark
- Department of Dermatology and Allergy, Technical University of Munich, Biedersteiner Munich, Germany
| | - Kilian Eyerich
- Department of Dermatology and Allergy, Technical University of Munich, Biedersteiner Munich, Germany.
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Thomas J, Küpper M, Batra R, Jargosch M, Atenhan A, Baghin V, Krause L, Lauffer F, Biedermann T, Theis FJ, Eyerich K, Schmidt-Weber CB, Eyerich S, Garzorz-Stark N. Is the humoral immunity dispensable for the pathogenesis of psoriasis? J Eur Acad Dermatol Venereol 2018; 33:115-122. [PMID: 29856508 DOI: 10.1111/jdv.15101] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/23/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Imbalances of T-cell subsets are hallmarks of disease-specific inflammation in psoriasis. However, the relevance of B cells for psoriasis remains poorly investigated. OBJECTIVE To analyse the role of B cells and immunoglobulins for the disease-specific immunology of psoriasis. METHODS We characterized B-cell subsets and immunoglobulin levels in untreated psoriasis patients (n = 37) and compared them to healthy controls (n = 20) as well as to psoriasis patients under disease-controlling systemic treatment (n = 28). B-cell subsets were analysed following the flow cytometric gating strategy based on the surface markers CD24, CD38 and CD138. Moreover, immunofluorescence stainings were used to detect IgA in psoriatic skin. RESULTS We found significantly increased levels of IgA in the serum of treatment-naïve psoriasis patients correlating with disease score. However, IgA was only observed in dermal vessels of skin sections. Concerning B-cell subsets, we only found a moderately positive correlation of CD138+ plasma cells with IgA levels and disease score in treatment-naïve psoriasis patients. Confirming our hypothesis that psoriasis can develop in the absence of functional humoral immunity, we investigated a patient who suffered concomitantly from both psoriasis and a hereditary common variable immune defect (CVID) characterized by a lack of B cells and immunoglobulins. We detected variants in three of the 13 described genes of CVID and a so far undescribed variant in the ligand of the TNFRSF13B receptor leading to disturbed B-cell maturation and antibody production. However, this patient showed typical psoriasis regarding clinical presentation, histology or T-cell infiltrate. Finally, in a group of psoriasis patients under systemic treatment, neither did IgA levels drop nor did plasma cells correlate with IgA levels and disease score. CONCLUSION B-cell alterations might rather be an epiphenomenal finding in psoriasis with a clear dominance of T cells over shifts in B-cell subsets.
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Affiliation(s)
- J Thomas
- ZAUM - Center of Allergy and Environment, Technical University and Helmholtz Munich, Munich, Germany
| | - M Küpper
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - R Batra
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.,Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - M Jargosch
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - A Atenhan
- ZAUM - Center of Allergy and Environment, Technical University and Helmholtz Munich, Munich, Germany
| | - V Baghin
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - L Krause
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany
| | - F Lauffer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - F J Theis
- Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany.,Institute of Mathematics, Technical University of Munich, Garching, Germany
| | - K Eyerich
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | | | - S Eyerich
- ZAUM - Center of Allergy and Environment, Technical University and Helmholtz Munich, Munich, Germany
| | - N Garzorz-Stark
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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Jargosch M, Lauffer F, Pätzold K, Krause L, Garzorz-Stark N, Biedermann T, Eyerich S, Eyerich K. 685 Necroptosis as special type of cell death in inflammatory skin diseases. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Garzorz-Stark N, Lauffer F, Krause L, Thomas J, Atenhan A, Franz R, Roenneberg S, Boehner A, Jargosch M, Batra R, Mueller NS, Haak S, Groß C, Groß O, Traidl-Hoffmann C, Theis FJ, Schmidt-Weber CB, Biedermann T, Eyerich S, Eyerich K. Toll-like receptor 7/8 agonists stimulate plasmacytoid dendritic cells to initiate TH17-deviated acute contact dermatitis in human subjects. J Allergy Clin Immunol 2018; 141:1320-1333.e11. [DOI: 10.1016/j.jaci.2017.07.045] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 06/08/2017] [Accepted: 07/24/2017] [Indexed: 10/18/2022]
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29
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Reiger M, Altunbulakli C, Neumann A, Garzorz-Stark N, Fleming M, Giner FC, Eyerich K, Akdis C, Traidl-Hoffmann C. 406 Skin barrier function genes differentially correlated to resident Staphylococci in lesional and non-lesional skin in atopic eczema. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Garzorz-Stark N, Lauffer F, Krause L, Groß O, Traidl-Hoffmann C, Theis F, Schmidt-Weber C, Biedermann T, Eyerich S, Eyerich K. 489 TLR7/8 agonists stimulate plasmacytoid dendritic cells to initiate a Th17-deviated acute contact dermatitis in humans. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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31
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Zink A, Herrmann M, Fischer T, Lauffer F, Garzorz-Stark N, Böhner A, Spinner CD, Biedermann T, Eyerich K. Addiction: an underestimated problem in psoriasis health care. J Eur Acad Dermatol Venereol 2017; 31:1308-1315. [PMID: 28281329 DOI: 10.1111/jdv.14204] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 01/16/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Psoriasis is a disease of enormous socio-economic impact. Despite approval of numerous highly efficient and costly therapies, a minor proportion of severely affected patients actually receives sufficient treatment. OBJECTIVE To investigate whether addictions are associated with psoriasis and to develop evidence-based recommendations for dermatologists in their daily clinical practice in order to improve medical assessment of psoriasis and patients' quality of life. PATIENTS AND METHODS Psoriasis patients at the University Department of Dermatology were asked to fill out a paper-based self-reported anonymous questionnaire with 92 questions of validated screening tests for the six most common addictions in Germany (alcohol, nicotine, drugs and illegal drugs, gambling, food). Body weight and height as well as current Psoriasis Area and Severity Index (PASI) were documented as well. RESULTS Between October 2015 and February 2016, 102 patients (65 males, 37 females; mean age 49.7 years (SD 13.4), range 18-83 years) participated in the study. Fifty-seven of the 102 patients showed addictive behaviour. Of these, 23.8% were high-risk drinkers, 41% regular smokers, 11% at risk of drug abuse, 4.1% at risk of food dependency and 19% compulsive gamblers. Compared with the general population, these results are significantly higher for alcohol abuse (P < 0.005), nicotine (P < 0.001) and gambling (P < 0.001). Body mass index was significantly higher in the study population (P < 0.001). CONCLUSION Addictions and gambling are more prevalent in patients with psoriasis compared with the general population. Respective screening measures are recommended in daily practice for doctors treating psoriasis patients, and PeakPASI is suggested as a score to document patients' lifetime highest PASI. Parallel to new drug approvals and even more detailed insights into the pathomechanism of psoriasis, public health strategies and interdisciplinary approaches are essential for a general sustained psoriasis treatment.
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Affiliation(s)
- A Zink
- Department of Dermatology and Allergy, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - M Herrmann
- Department of Dermatology and Allergy, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - T Fischer
- Department of Dermatology and Allergy, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - F Lauffer
- Department of Dermatology and Allergy, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - N Garzorz-Stark
- Department of Dermatology and Allergy, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - A Böhner
- Department of Dermatology and Allergy, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - C D Spinner
- Department of Medicine II, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - K Eyerich
- Department of Dermatology and Allergy, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Abstract
This essay reviews current approaches to establish novel molecular diagnostic tools for inflammatory skin diseases. Moreover, it highlights the importance of stratifying patients according to molecular signatures and revising current outdated disease classification systems to eventually reach the goal of personalized medicine.
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Affiliation(s)
- Natalie Garzorz-Stark
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Felix Lauffer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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Garzorz-Stark N, Krause L, Lauffer F, Atenhan A, Thomas J, Stark SP, Franz R, Weidinger S, Balato A, Mueller NS, Theis FJ, Ring J, Schmidt-Weber CB, Biedermann T, Eyerich S, Eyerich K. A novel molecular disease classifier for psoriasis and eczema. Exp Dermatol 2016; 25:767-74. [DOI: 10.1111/exd.13077] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Natalie Garzorz-Stark
- Department of Dermatology and Allergy; Technical University of Munich; Munich Germany
| | - Linda Krause
- Institute of Computational Biology; Helmholtz Center Munich; Neuherberg Germany
| | - Felix Lauffer
- Department of Dermatology and Allergy; Technical University of Munich; Munich Germany
| | - Anne Atenhan
- ZAUM - Center of Allergy and Environment; Technical University of Munich and Helmholtz Center Munich; Member of the German Center for Lung Research (DZL); Munich Germany
| | - Jenny Thomas
- ZAUM - Center of Allergy and Environment; Technical University of Munich and Helmholtz Center Munich; Member of the German Center for Lung Research (DZL); Munich Germany
| | - Sebastian P. Stark
- ZAUM - Center of Allergy and Environment; Technical University of Munich and Helmholtz Center Munich; Member of the German Center for Lung Research (DZL); Munich Germany
| | - Regina Franz
- Department of Dermatology and Allergy; Technical University of Munich; Munich Germany
| | - Stephan Weidinger
- Department of Dermatology, Allergology, and Venereology; University Hospital Schleswig-Holstein; Kiel Germany
| | - Anna Balato
- Dipartimento di Scienze biomediche avanzate; Università degli Studi di Napoli Federico II; Naples Italy
| | - Nikola S. Mueller
- Institute of Computational Biology; Helmholtz Center Munich; Neuherberg Germany
| | - Fabian J. Theis
- Institute of Computational Biology; Helmholtz Center Munich; Neuherberg Germany
- Department of Mathematics; Technical University of Munich; Garching Germany
| | - Johannes Ring
- Department of Dermatology and Allergy; Technical University of Munich; Munich Germany
| | - Carsten B. Schmidt-Weber
- ZAUM - Center of Allergy and Environment; Technical University of Munich and Helmholtz Center Munich; Member of the German Center for Lung Research (DZL); Munich Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy; Technical University of Munich; Munich Germany
| | - Stefanie Eyerich
- ZAUM - Center of Allergy and Environment; Technical University of Munich and Helmholtz Center Munich; Member of the German Center for Lung Research (DZL); Munich Germany
| | - Kilian Eyerich
- Department of Dermatology and Allergy; Technical University of Munich; Munich Germany
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Ritter N, Franz R, Hein R, Biedermann T, Eyerich K, Garzorz-Stark N, Andres C. 482 Toll-like receptor 7: A new marker for differentaiation of nonmelanoma skin cancer? J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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35
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Mattii M, Lovászi M, Garzorz-Stark N, Atenhan A, Zouboulis C, Biedermann T, Eyerich K, Schmidt-Weber C, Torocsik D, Eyerich S. 433 Sebocytes contribute to skin inflammation by promoting the differentiation of Th17 cells. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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36
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Zink A, Herrmann M, Fischer T, Böhner A, Lauffer F, Garzorz-Stark N, Biedermann T, Eyerich K. 045 Psoriasis and addictions: a neglected challenge. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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37
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Reiger M, Garzorz-Stark N, Neumann A, Altunbulakli C, Akdis C, Traidl-Hoffmann C. 438 Differences between the microbiome of lesional and non-lesional skin in atopic dermatitis. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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38
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Aguirre J, Schwarz M, Garzorz-Stark N, Lauffer F, Soliman D, Buehler A, Eyerich K, Ntziachristos V. 328 Assessment of psoriasis using label-free ultra-broadband optoacoustic mesoscopy. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Altunbulakli C, Neumann A, Castro Giner F, Garzorz-Stark N, Reiger M, Akdis M, Traidl-Hoffmann C, Akdis C. 096 Transcriptomic analysis of epidermal barrier molecules, cytokines and growth factors in atopic dermatitis lesions. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Küpper M, Thomas J, Garzorz-Stark N, Krause L, Müller N, Biedermann T, Theis F, Schmidt-Weber C, Eyerich K, Eyerich S. 330 Characterization of multiple B cell subsets in peripheral blood of psoriasis patients identifies a correlation of regulatory B cells and disease severity. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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