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Wu J, Li L, Zhang T, Lu J, Tai Z, Zhu Q, Chen Z. The epidermal lipid-microbiome loop and immunity: Important players in atopic dermatitis. J Adv Res 2024:S2090-1232(24)00088-2. [PMID: 38460775 DOI: 10.1016/j.jare.2024.03.001] [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: 05/27/2023] [Revised: 02/10/2024] [Accepted: 03/04/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND The promotion of epidermal barrier dysfunction is attributed to abnormalities in the lipid-microbiome positive feedback loop which significantly influences the imbalance of the epithelial immune microenvironment (EIME) in atopic dermatitis (AD). This imbalance encompasses impaired lamellar membrane integrity, heightened exposure to epidermal pathogens, and the regulation of innate and adaptive immunity. The lipid-microbiome loop is substantially influenced by intense adaptive immunity which is triggered by abnormal loop activity and affects the loop's integrity through the induction of atypical lipid composition and responses to dysregulated epidermal microbes. Immune responses participate in lipid abnormalities within the EIME by downregulating barrier gene expression and are further cascade-amplified by microbial dysregulation which is instigated by barrier impairment. AIM OF REVIEW This review examines the relationship between abnormal lipid composition, microbiome disturbances, and immune responses in AD while progressively substantiating the crosstalk mechanism among these factors. Based on this analysis, the "lipid-microbiome" positive feedback loop, regulated by immune responses, is proposed. KEY SCIENTIFIC CONCEPTS OF REVIEW The review delves into the impact of adaptive immune responses that regulate the EIME, driving AD, and investigates potential mechanisms by which lipid supplementation and probiotics may alleviate AD through the up-regulation of the epidermal barrier and modulation of immune signaling. This exploration offers support for targeting the EIME to attenuate AD.
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Affiliation(s)
- Junchao Wu
- School of Medicine, Shanghai University, Shanghai 200444, China; Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Lisha Li
- School of Medicine, Shanghai University, Shanghai 200444, China; Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Tingrui Zhang
- School of Medicine, Shanghai University, Shanghai 200444, China; Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Jiaye Lu
- School of Medicine, Shanghai University, Shanghai 200444, China; Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Zongguang Tai
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China; Shanghai Engineering Research Center for Topical Chinese Medicine, Shanghai, 200443, China.
| | - Quangang Zhu
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China; Shanghai Engineering Research Center for Topical Chinese Medicine, Shanghai, 200443, China.
| | - Zhongjian Chen
- School of Medicine, Shanghai University, Shanghai 200444, China; Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China; Shanghai Engineering Research Center for Topical Chinese Medicine, Shanghai, 200443, China.
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2
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Kim S, Song Y, Kim J, Jeong B, Park N, Park YM, Kim YT, Rho D, Lee SJ, Choi BG, Im SG, Lee KG. Nanotopology-Enabled On-Site Pathogen Detection for Managing Atopic Dermatitis. Adv Healthc Mater 2024:e2303272. [PMID: 38412280 DOI: 10.1002/adhm.202303272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/19/2024] [Indexed: 02/29/2024]
Abstract
Atopic dermatitis (AD), a prevalent skin condition often complicated by microbial infection, poses a significant challenge in identifying the responsible pathogen for its effective management. However, a reliable, safe tool for pinpointing the source of these infections remains elusive. In this study, a novel on-site pathogen detection that combines chemically functionalized nanotopology with genetic analysis is proposed to capture and analyze pathogens closely associated with severe atopic dermatitis. The chemically functionalized nanotopology features a 3D hierarchical nanopillar array (HNA) with a functional polymer coating, tailored to isolate target pathogens from infected skin. This innovative nanotopology demonstrates superior pathogenic capture efficiency, favorable entrapment patterns, and non-cytotoxicity. An HNA-assembled stick is utilized to directly retrieve bacteria from infected skin samples, followed by extraction-free quantitative loop-mediated isothermal amplification (direct qLAMP) for validation. To mimic human skin conditions, porcine skin is employed to successfully capture Staphylococcus aureus, a common bacterium exacerbating AD cases. The on-site detection method exhibits an impressive detection limit of 103 cells mL-1 . The HNA-assembled stick represents a promising tool for on-site detection of bacteria associated with atopic dermatitis. This innovative approach enables to deepen the understanding of AD pathogenesis and open avenues for more effective management strategies for chronic skin conditions.
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Affiliation(s)
- Seongeun Kim
- Department of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, 34141, Republic of Korea
| | - Younseong Song
- Department of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, 34141, Republic of Korea
| | - Jueun Kim
- Department of Chemical Engineering, Kangwon National University, Samcheok, 25913, Republic of Korea
| | - Booseok Jeong
- Department of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, 34141, Republic of Korea
| | - Nahyun Park
- Department of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, 34141, Republic of Korea
| | - Yoo Min Park
- Center for NanoBio Development, National NanoFab Center, Daejeon, 34141, Republic of Korea
| | - Yong Tae Kim
- Department of Chemical Engineering & Biotechnology, Tech University of Korea, Siheung-si, 15073, Republic of Korea
| | - Donggee Rho
- Center for NanoBio Development, National NanoFab Center, Daejeon, 34141, Republic of Korea
| | - Seok Jae Lee
- Center for NanoBio Development, National NanoFab Center, Daejeon, 34141, Republic of Korea
| | - Bong Gill Choi
- Department of Chemical Engineering, Kangwon National University, Samcheok, 25913, Republic of Korea
| | - Sung Gap Im
- Department of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, 34141, Republic of Korea
| | - Kyoung G Lee
- Center for NanoBio Development, National NanoFab Center, Daejeon, 34141, Republic of Korea
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Kaczmarska A, Kwiatkowska D, Skrzypek KK, Kowalewski ZT, Jaworecka K, Reich A. Pathomechanism of Pruritus in Psoriasis and Atopic Dermatitis: Novel Approaches, Similarities and Differences. Int J Mol Sci 2023; 24:14734. [PMID: 37834183 PMCID: PMC10573181 DOI: 10.3390/ijms241914734] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Pruritus is defined as an unpleasant sensation that elicits a desire to scratch. Nearly a third of the world's population may suffer from pruritus during their lifetime. This symptom is widely observed in numerous inflammatory skin diseases-e.g., approximately 70-90% of patients with psoriasis and almost every patient with atopic dermatitis suffer from pruritus. Although the pathogenesis of atopic dermatitis and psoriasis is different, the complex intricacies between several biochemical mediators, enzymes, and pathways seem to play a crucial role in both conditions. Despite the high prevalence of pruritus in the general population, the pathogenesis of this symptom in various conditions remains elusive. This review aims to summarize current knowledge about the pathogenesis of pruritus in psoriasis and atopic dermatitis. Each molecule involved in the pruritic pathway would merit a separate chapter or even an entire book, however, in the current review we have concentrated on some reports which we found crucial in the understanding of pruritus. However, the pathomechanism of pruritus is an extremely complex and intricate process. Moreover, many of these signaling pathways are currently undergoing detailed analysis or are still unexplained. As a result, it is currently difficult to take an objective view of how far we have come in elucidating the pathogenesis of pruritus in the described diseases. Nevertheless, considerable progress has been made in recent years.
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Affiliation(s)
- Agnieszka Kaczmarska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszów, Poland; (A.K.); (D.K.); (K.J.)
| | - Dominika Kwiatkowska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszów, Poland; (A.K.); (D.K.); (K.J.)
| | | | | | - Kamila Jaworecka
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszów, Poland; (A.K.); (D.K.); (K.J.)
| | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszów, Poland; (A.K.); (D.K.); (K.J.)
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4
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Tamai M, Yamazaki Y, Ito T, Nakagawa S, Nakamura Y. Pathogenic role of the staphylococcal accessory gene regulator quorum sensing system in atopic dermatitis. Front Cell Infect Microbiol 2023; 13:1178650. [PMID: 37124047 PMCID: PMC10140505 DOI: 10.3389/fcimb.2023.1178650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/03/2023] [Indexed: 05/02/2023] Open
Abstract
The skin is home to various bacteria, archaea, fungi, and viruses, collectively referred to as the skin microbiota. Patients with certain skin diseases reportedly have unique skin "dysbiosis," a condition involving imbalanced microbiota, suggesting that dysbiosis in the skin may be either causal or a consequence of specific skin diseases. Atopic dermatitis (AD) is the most common allergic skin disease that affects 15-20% of children and 2-10% of adults worldwide. Both intrinsic genetic factors, such as susceptibility to type 2 inflammation or skin barrier dysfunction, and extrinsic environmental factors, such as air pollen and skin microbiota, contribute to AD. Staphylococcus aureus, which does not often colonize the skin of healthy individuals, is commonly identified in the lesional skin of patients with AD and is correlated with the disease flare. However, the role of S. aureus in the pathogenesis of AD has not been elucidated. Here, we discuss the pathological behavior of S. aureus, focusing on accessory gene regulator (Agr) quorum sensing, which is a fundamental bacterial cell-to-cell interaction mechanism that affects the behavior of S. aureus and other members of the microbial community. Importantly, beyond bacteria-bacteria interactions, the Agr quorum sensing system also regulates various virulence factors, which induce type 2 and IL-17-dependent skin inflammation in the host. Furthermore, the colonization of Agr-positive S. aureus in early life accelerates the development of pediatric AD. Finally, we aim to highlight the current efforts to establish novel therapeutic methods to ameliorate or prevent AD through Agr-targeted intervention.
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Affiliation(s)
- Masakazu Tamai
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuriko Yamazaki
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
- Cutaneous Allergy and Host Defense, Immunology Frontier Research Center, Osaka University, Osaka, Japan
- *Correspondence: Yuumi Nakamura, ; Yuriko Yamazaki,
| | - Tomoka Ito
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Seitaro Nakagawa
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Pathology and Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Yuumi Nakamura
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
- Cutaneous Allergy and Host Defense, Immunology Frontier Research Center, Osaka University, Osaka, Japan
- *Correspondence: Yuumi Nakamura, ; Yuriko Yamazaki,
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5
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Hammond M, Gamal A, Mukherjee PK, Damiani G, McCormick TS, Ghannoum MA, Nedorost S. Cutaneous dysbiosis may amplify barrier dysfunction in patients with atopic dermatitis. Front Microbiol 2022; 13:944365. [PMID: 36452925 PMCID: PMC9701744 DOI: 10.3389/fmicb.2022.944365] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 10/13/2022] [Indexed: 09/12/2023] Open
Abstract
Atopic dermatitis (AD) is associated with cutaneous dysbiosis, barrier defects, and immune dysregulation, but the interplay between these factors needs further study. Early-onset barrier dysfunction may facilitate an innate immune response to commensal organisms and, consequently, the development of allergic sensitization. We aimed to compare the cutaneous microbiome in patients with active dermatitis with and without a history of childhood flexural dermatitis (atopic dermatitis). Next-gen Ion-Torrent deep-sequencing identified AD-associated changes in the skin bacterial microbiome ("bacteriome") and fungal microbiome ("mycobiome") of affected skin in swabs from areas of skin affected by dermatitis. Data were analyzed for diversity, abundance, and inter-kingdom correlations. Microbial interactions were assessed in biofilms using metabolic activity (XTT) assay and scanning electron microscopy (SEM), while host-pathogen interactions were determined in cultured primary keratinocytes exposed to biofilms. Increased richness and abundance of Staphylococcus, Lactococcus, and Alternaria were found in atopics. Staphylococcus and Alternaria formed robust mixed-species biofilms (based on XTT and SEM) that were resistant to antifungals/antimicrobials. Furthermore, their biofilm supernatant was capable of influencing keratinocytes biology (pro-inflammatory cytokines and structural proteins), suggesting an additive effect on AD-associated host response. In conclusion, microbial inter-kingdom and host-microbiome interactions may play a critical role in the modulation of atopic dermatitis to a greater extent than in non-atopic adults with allergic contact dermatitis.
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Affiliation(s)
- Margaret Hammond
- Department of Dermatology, University Hospitals Cleveland Medical Center/Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Ahmed Gamal
- Department of Dermatology, University Hospitals Cleveland Medical Center/Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Pranab K. Mukherjee
- Department of Dermatology, University Hospitals Cleveland Medical Center/Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Giovanni Damiani
- Department of Dermatology, University Hospitals Cleveland Medical Center/Case Western Reserve University School of Medicine, Cleveland, OH, United States
- Department of Biomedical, Surgical and Dental Sciences University of Milan, Milan, Italy
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Pharmaceutical and Pharmacological Sciences, PhD Degree Program in Pharmacological Sciences, University of Padua, Padua, Italy
| | - Thomas S. McCormick
- Department of Dermatology, University Hospitals Cleveland Medical Center/Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Mahmoud A. Ghannoum
- Department of Dermatology, University Hospitals Cleveland Medical Center/Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Susan Nedorost
- Department of Dermatology, University Hospitals Cleveland Medical Center/Case Western Reserve University School of Medicine, Cleveland, OH, United States
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6
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Bier K, Schittek B. Beneficial effects of coagulase-negative Staphylococci on Staphylococcus aureus skin colonization. Exp Dermatol 2021; 30:1442-1452. [PMID: 33960019 DOI: 10.1111/exd.14381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/15/2021] [Accepted: 04/29/2021] [Indexed: 12/11/2022]
Abstract
Our skin is constantly exposed to a large number of pathogens while at the same time undergoing selective colonization by commensal microorganisms such as coagulase-negative Staphylococci. Staphylococcus aureus, however, is a facultative pathogen that is usually absent from healthy skin but frequently colonizes the inflamed skin of atopic dermatitis patients, where it further promotes inflammation. Enhanced S. aureus skin colonization was shown to correlate with a loss of microbiome diversity indicating a role for skin commensals to shape pathogen colonization. Together, keratinocytes and immune cells in the skin need to discriminate commensals from pathogens and orchestrate subsequent immune reactions in response to colonizing microbes. However, the mechanisms how individual commensals cooperate with keratinocytes and the immune system of the skin to prevent pathogen colonization are barely understood. In this review, we discuss the current knowledge on the functional effects of coagulase-negative staphylococci, the most frequently isolated skin commensals, on S. aureus skin colonization.
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Affiliation(s)
- Katharina Bier
- Division of Dermatooncology, Department of Dermatology, University of Tübingen, Tübingen, Germany
| | - Birgit Schittek
- Division of Dermatooncology, Department of Dermatology, University of Tübingen, Tübingen, Germany
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7
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Brauweiler AM, Leung DYM, Goleva E. The Transcription Factor p63 Is a Direct Effector of IL-4- and IL-13-Mediated Repression of Keratinocyte Differentiation. J Invest Dermatol 2020; 141:770-778. [PMID: 33038352 DOI: 10.1016/j.jid.2020.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 09/01/2020] [Accepted: 09/02/2020] [Indexed: 12/20/2022]
Abstract
Atopic Dermatitis is an inflammatory skin disease associated with broad defects in skin barrier function caused by increased levels of type-2 cytokines (IL-4 and IL-13) that repress keratinocyte (KC) differentiation. Although crucial in mediating allergic disease, the mechanisms for gene repression induced by type-2 cytokines remain unclear. In this study, we determined that gene repression requires the master regulator of the epidermal differentiation program, p63. We found that type-2 cytokine-mediated inhibition of the expression of genes involved in early KC differentiation, including keratin 1, keratin 10, and DSC-1, is reversed by p63 blockade. Type-2 cytokines, through p63, also regulate additional genes involved in KC differentiation, including CHAC-1, STC2, and CALML5. The regulation of the expression of these genes is ablated by p63 small interfering RNA as well. In addition, we found that IL-4 and IL-13 and Staphylococcus aureus lipoteichoic acid work in combination through p63 to further suppress the early KC differentiation program. Finally, we found that IL-4 and IL-13 also inhibit the activity of Notch, a transcription factor required to induce early KC differentiation. In conclusion, type-2 cytokine-mediated gene repression and blockade of KC differentiation are multifactorial, involving pathways that converge on transcription factors critical for epidermal development, p63 and Notch.
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Affiliation(s)
- Anne M Brauweiler
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA
| | - Donald Y M Leung
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA; Department of Pediatrics, University of Colorado Denver, Aurora, Colorado, USA
| | - Elena Goleva
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA.
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8
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Panchatcharam BS, Cooksley CM, Ramezanpour M, Vediappan RS, Bassiouni A, Wormald PJ, Psaltis AJ, Vreugde S. Staphylococcus aureus
biofilm exoproteins are cytotoxic to human nasal epithelial barrier in chronic rhinosinusitis. Int Forum Allergy Rhinol 2020; 10:871-883. [DOI: 10.1002/alr.22566] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/22/2020] [Accepted: 03/26/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Beula Subashini Panchatcharam
- Department of Surgery‒Otorhinolaryngology Head and Neck SurgeryThe Queen Elizabeth Hospital, University of Adelaide Adelaide SA Australia
| | - Clare M. Cooksley
- Department of Surgery‒Otorhinolaryngology Head and Neck SurgeryThe Queen Elizabeth Hospital, University of Adelaide Adelaide SA Australia
| | - Mahnaz Ramezanpour
- Department of Surgery‒Otorhinolaryngology Head and Neck SurgeryThe Queen Elizabeth Hospital, University of Adelaide Adelaide SA Australia
| | - Rajan Sundaresan Vediappan
- Department of Surgery‒Otorhinolaryngology Head and Neck SurgeryThe Queen Elizabeth Hospital, University of Adelaide Adelaide SA Australia
| | - Ahmed Bassiouni
- Department of Surgery‒Otorhinolaryngology Head and Neck SurgeryThe Queen Elizabeth Hospital, University of Adelaide Adelaide SA Australia
| | - Peter J. Wormald
- Department of Surgery‒Otorhinolaryngology Head and Neck SurgeryThe Queen Elizabeth Hospital, University of Adelaide Adelaide SA Australia
| | - Alkis J. Psaltis
- Department of Surgery‒Otorhinolaryngology Head and Neck SurgeryThe Queen Elizabeth Hospital, University of Adelaide Adelaide SA Australia
| | - Sarah Vreugde
- Department of Surgery‒Otorhinolaryngology Head and Neck SurgeryThe Queen Elizabeth Hospital, University of Adelaide Adelaide SA Australia
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9
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Brauweiler AM, Goleva E, Leung DYM. Staphylococcus aureus Lipoteichoic Acid Initiates a TSLP-Basophil-IL4 Axis in the Skin. J Invest Dermatol 2019; 140:915-917.e2. [PMID: 31539531 DOI: 10.1016/j.jid.2019.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/12/2019] [Accepted: 09/04/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Anne M Brauweiler
- Department of Pediatrics, National Jewish Health, Denver, Colarado, USA
| | - Elena Goleva
- Department of Pediatrics, National Jewish Health, Denver, Colarado, USA
| | - Donald Y M Leung
- Department of Pediatrics, National Jewish Health, Denver, Colarado, USA; Department of Pediatrics, University of Colorado Denver, Aurora, Colarado, USA.
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10
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The Unique Immunoregulatory Function of Staphylococcus Aureus Lipoteichoic Acid in Dendritic Cells. J 2019. [DOI: 10.3390/j2030022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background and objectives: Lipoteichoic acid (LTA) is a structural component of Staphylococcus aureus (S. aureus) that induces severe infection disease and skin inflammation such as atopic dermatitis (AD); the biological function of LTA is still unclear. Dendritic cells (DC) are important regulators in the immune system, and the cells ectopically recognize agents that have an influence on the host immune response. We aimed to reveal the DC-based immune response against LTA to understand the novel mechanism in S. aureus related acute skin inflammation. Materials and Methods: Different doses of LTA were applied on the epidermal barrier dysfunction mice in order to evaluate the epidermal thickness, DC activation, and subsequent immunological response such as effector T-cell (Teff) activation. In addition, bone marrow-derived dendritic cells (BMDCs) were also treated with LTA, and the immunoregulatory mechanism was investigated. Results: A low dose of LTA did not induce skin inflammation at all; however, a high dose of LTA induced severe skin inflammation on epidermalba rrier dysfunction mice. Those symptoms were correlated with the DC and Teff activation status. The low-dose treatment of LTA showed a suppressive effect in pro-inflammatory cytokine production via a Toll-like receptor 2 (TLR2)-dominant manner, and the effect was significant regarding the co-treatment with another stimulatory signal such as TLR4 by lipopolysaccharide (LPS). Meanwhile, a high-dose treatment of LTA completely abolished the suppressive effect of a low-dose treatment. This phenomenon was based on C-type lectin receptors (CLRs), because the high dose of LTA greatly enhanced the expression of CLRs in the activated DCs. Conclusions: DCs sensed the dose difference of LTA, and the mechanism contributed to regulating immune responses such as effector T-cell activation, which was directly correlated with inflammatory response. This finding might provide an understanding for the novel immunological effect of LTA and S. aureus pathogenesis under inflammation, as well as the mechanism of symbiosis.
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11
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Iwamoto K, Moriwaki M, Miyake R, Hide M. Staphylococcus aureus in atopic dermatitis: Strain-specific cell wall proteins and skin immunity. Allergol Int 2019; 68:309-315. [PMID: 30878567 DOI: 10.1016/j.alit.2019.02.006] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/06/2019] [Accepted: 02/07/2019] [Indexed: 12/21/2022] Open
Abstract
Atopic dermatitis (AD) is a common chronic skin disease. The presence of the bacterium Staphylococcus aureus (S. aureus) is frequently detected on skin affected with AD. In this review, we focused on the characteristics of S. aureus strains isolated from AD skin, particularly the proteins on the cell surface that modulates the interactions between Langerhans cell, keratinocyte, and S. aureus. The skin microbiome plays an important role in maintaining homeostasis of the skin, and colonization of S. aureus in AD is considered to be deeply involved in the clinical manifestation and pathogenesis of skin flares. Colonizing S. aureus strains in AD harbor different surface proteins at the strain level, which are indicated as clonal complexes. Moreover, the cell wall proteins of S. aureus affect skin adhesion and induce altered immune responses. S. aureus from AD skin (AD strain) exhibits internalization into keratinocytes and induces imbalanced Th1/Th2 adaptive immune responses via Langerhans cells. AD strain-derived cell wall proteins and secreted virulence factors are expected to represent therapeutic targets. In addition, the microbiome on the AD skin surface is associated with skin immunity; thus, microbiome-based immunotherapy, whose mechanism of action completely differs from that of typical steroid ointments, are expected to be developed in the future.
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Affiliation(s)
- Kazumasa Iwamoto
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Masaya Moriwaki
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryu Miyake
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Michihiro Hide
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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12
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Goleva E, Berdyshev E, Leung DY. Epithelial barrier repair and prevention of allergy. J Clin Invest 2019; 129:1463-1474. [PMID: 30776025 DOI: 10.1172/jci124608] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Allergic diseases have in common a dysfunctional epithelial barrier, which allows the penetration of allergens and microbes, leading to the release of type 2 cytokines that drive allergic inflammation. The accessibility of skin, compared with lung or gastrointestinal tissue, has facilitated detailed investigations into mechanisms underlying epithelial barrier dysfunction in atopic dermatitis (AD). This Review describes the formation of the skin barrier and analyzes the link between altered skin barrier formation and the pathogenesis of AD. The keratinocyte differentiation process is under tight regulation. During epidermal differentiation, keratinocytes sequentially switch gene expression programs, resulting in terminal differentiation and the formation of a mature stratum corneum, which is essential for the skin to prevent allergen or microbial invasion. Abnormalities in keratinocyte differentiation in AD skin result in hyperproliferation of the basal layer of epidermis, inhibition of markers of terminal differentiation, and barrier lipid abnormalities, compromising skin barrier and antimicrobial function. There is also compelling evidence for epithelial dysregulation in asthma, food allergy, eosinophilic esophagitis, and allergic rhinosinusitis. This Review examines current epithelial barrier repair strategies as an approach for allergy prevention or intervention.
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Affiliation(s)
- Elena Goleva
- Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, and
| | - Evgeny Berdyshev
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, National Jewish Health, Denver, Colorado, USA
| | - Donald Ym Leung
- Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, and.,Department of Pediatrics, University of Colorado Denver, Aurora, Colorado, USA
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13
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Brauweiler AM, Goleva E, Leung DYM. Staphylococcus aureus Lipoteichoic Acid Damages the Skin Barrier through an IL-1-Mediated Pathway. J Invest Dermatol 2019; 139:1753-1761.e4. [PMID: 30779913 DOI: 10.1016/j.jid.2019.02.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/18/2019] [Accepted: 02/04/2019] [Indexed: 01/11/2023]
Abstract
Staphylococcus aureus is a significant bacterial pathogen that may penetrate through the barrier into the epidermis and dermis of the skin. We hypothesized that the S. aureus cell wall product lipoteichoic acid (LTA) may contribute to the development of inflammation and skin barrier defects; however, the effects of LTA in vivo are not well understood. In this study, we examined the effects induced by intradermal S. aureus LTA. We found that keratinocytes in LTA-treated skin were highly proliferative, expressing 10-fold increased levels of Ki67. Furthermore, we observed that LTA caused damage to the skin barrier with substantial loss of filaggrin and loricrin expression. In addition, levels of the IL-1 family of inflammatory cytokines, as well as the neutrophil-attracting chemokines Cxcl1 and Cxcl2, were increased. Concomitantly, we observed significant numbers of neutrophils infiltrating into the epidermis. Finally, we determined that LTA-induced signals were mediated in part through IL-1, because an IL-1 receptor type 1 antagonist ameliorated the effects of LTA, blocking neutrophil recruitment and increasing the expression of skin barrier proteins. In summary, we show that S. aureus LTA alone is sufficient to promote keratinocyte proliferation, inhibit expression of epidermal barrier proteins, induce IL-1 signaling, and recruit cells involved in skin inflammation.
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Affiliation(s)
- Anne M Brauweiler
- Department of Pediatrics, National Jewish Health, 1400 Jackson Street, Denver, Colorado, USA
| | - Elena Goleva
- Department of Pediatrics, National Jewish Health, 1400 Jackson Street, Denver, Colorado, USA
| | - Donald Y M Leung
- Department of Pediatrics, National Jewish Health, 1400 Jackson Street, Denver, Colorado, USA; Department of Pediatrics, University of Colorado Denver, 13065 East 17th Avenue, Aurora, Colorado, USA.
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14
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Iwamoto K, Nümm TJ, Koch S, Herrmann N, Leib N, Bieber T. Langerhans and inflammatory dendritic epidermal cells in atopic dermatitis are tolerized toward TLR2 activation. Allergy 2018; 73:2205-2213. [PMID: 29672867 DOI: 10.1111/all.13460] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND The skin of atopic dermatitis (AD) patients presents a significant dysbalance of the microbiome with a high colonization by Staphylococcus aureus (S. aureus), which positively correlates with the severity of the disease. OBJECTIVE Understanding the role of epidermal dendritic cells (DC) as link between the innate and the adaptive immune systems in AD. METHODS Comparative phenotypic and functional analysis of TLR2 on Langerhans cells (LC) and inflammatory dendritic epidermal cells (IDEC) in organotypic models as well as freshly isolated cells from healthy and AD skin. RESULTS In situ analysis of freshly isolated LC and IDEC from AD skin revealed decreased TLR2 expression compared to LC from healthy skin. In contrast to IDEC, LC from AD skin failed to display any evidence for in situ activation. Exposure to TLR2 ligand Pam3Cys resulted in maturation and increased migratory activity of LC from normal skin. LC and IDEC from AD were unresponsive to TLR2 ligand in that they failed to mature and displayed a high spontaneous migratory activity. Keratinocytes from both healthy and AD skin expressed similar levels of TLR2. The production of IL-6 and IL-10 was impaired by Pam3Cys in supernatants from AD skin. IL-18 was significantly higher in supernatants from AD skin and not influenced by TLR2 ligation, when compared to healthy skin. CONCLUSION Our results suggest that TLR2-mediated sensing of S. aureus-derived signals is strongly impaired in LC from AD skin. This phenomenon may partly contribute to the immune deviation in AD and the lack of S. aureus clearance.
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Affiliation(s)
- K. Iwamoto
- Department of Dermatology and Allergy, and Christine Kühne-Center for Allergy Research and Education (CK-CARE); University of Bonn; Bonn Germany
| | - T. J. Nümm
- Department of Dermatology and Allergy, and Christine Kühne-Center for Allergy Research and Education (CK-CARE); University of Bonn; Bonn Germany
| | - S. Koch
- Department of Dermatology and Allergy, and Christine Kühne-Center for Allergy Research and Education (CK-CARE); University of Bonn; Bonn Germany
| | - N. Herrmann
- Department of Dermatology and Allergy, and Christine Kühne-Center for Allergy Research and Education (CK-CARE); University of Bonn; Bonn Germany
| | - N. Leib
- Department of Dermatology and Allergy, and Christine Kühne-Center for Allergy Research and Education (CK-CARE); University of Bonn; Bonn Germany
| | - T. Bieber
- Department of Dermatology and Allergy, and Christine Kühne-Center for Allergy Research and Education (CK-CARE); University of Bonn; Bonn Germany
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15
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Kim J, Bin BH, Choi EJ, Lee HG, Lee TR, Cho EG. Staphylococcus aureus-derived extracellular vesicles induce monocyte recruitment by activating human dermal microvascular endothelial cells in vitro. Clin Exp Allergy 2018; 49:68-81. [PMID: 30288827 DOI: 10.1111/cea.13289] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 09/20/2018] [Accepted: 09/28/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) represents the most common inflammatory skin disorder in children showing massive infiltration of immune cells. The colonization of AD-afflicted skin by Staphylococcus aureus and S. aureus-derived extracellular vesicles (SEVs) has been associated with AD pathogenesis; however, the molecular mechanism underlying SEV-mediated inflammatory responses remains unclear. OBJECTIVE We investigated how SEVs can mediate inflammatory responses in AD pathogenesis by examining the effect of SEVs on human dermal microvascular endothelia cells (HDMECs). METHODS HDMECs were treated with SEVs, and the expression of cell adhesion molecules or cytokines was assessed using RT-qPCR, Western blot or cytokine array analyses. The receptor for SEVs and related signalling molecules in HDMECs were addressed and verified via gene knockdown or inhibitor experiments. The recruitment assay of human THP-1 monocytic cells on HDMECs was performed after SEV treatment in the presence or absence of the verified receptor or signalling molecule. RESULTS SEVs, but not other gram-positive bacteria-derived extracellular vesicles, directly activated HDMECs by increasing the expression of cell adhesion molecules (E-selectin, VCAM1 and ICAM1) and that of IL-6, the inflammatory cytokine; consequently, they enhanced the recruitment of THP-1 monocytic cells to HDMECs. The SEV-induced HDMEC activation was dependent on Toll-like receptor 4 and the NF-κB signalling pathway, which was rapidly activated within 1 hour post-treatment and followed by an upregulation of cell adhesion molecules and IL-6 at later time-points. Moreover, SEV-mediated HDMEC responses were more rapid and intense than those induced by the same protein concentrations of S. aureus extracts. CONCLUSIONS & CLINICAL RELEVANCE SEVs as proinflammatory factors could mediate immune cell infiltration in AD by efficiently inducing endothelial cell activation and monocyte recruitment, which may provide insights into alleviating the S. aureus-mediated onset or progression of AD and its phenotypes.
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Affiliation(s)
- Jihye Kim
- Skincare Research Division, R&D Unit, AmorePacific Corporation, Yongin-si, Gyeonggi-do, Korea
| | - Bum-Ho Bin
- Basic Research & Innovation Division, R&D Unit, AmorePacific Corporation, Yongin-si, Gyeonggi-do, Korea
| | - Eun-Jeong Choi
- Basic Research & Innovation Division, R&D Unit, AmorePacific Corporation, Yongin-si, Gyeonggi-do, Korea
| | - Hyun Gee Lee
- Basic Research & Innovation Division, R&D Unit, AmorePacific Corporation, Yongin-si, Gyeonggi-do, Korea
| | - Tae Ryong Lee
- Basic Research & Innovation Division, R&D Unit, AmorePacific Corporation, Yongin-si, Gyeonggi-do, Korea
| | - Eun-Gyung Cho
- Basic Research & Innovation Division, R&D Unit, AmorePacific Corporation, Yongin-si, Gyeonggi-do, Korea
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16
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Rangel SM, Paller AS. Bacterial colonization, overgrowth, and superinfection in atopic dermatitis. Clin Dermatol 2018; 36:641-647. [DOI: 10.1016/j.clindermatol.2018.05.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Staphylococcus aureus and Atopic Dermatitis: A Complex and Evolving Relationship. Trends Microbiol 2018; 26:484-497. [DOI: 10.1016/j.tim.2017.11.008] [Citation(s) in RCA: 222] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/06/2017] [Accepted: 11/16/2017] [Indexed: 12/16/2022]
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18
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Harrison KA, Romer E, Weyerbacher J, Ocana JA, Sahu RP, Murphy RC, Kelly LE, Smith TA, Rapp CM, Borchers C, Cool DR, Li G, Simman R, Travers JB. Enhanced Platelet-Activating Factor Synthesis Facilitates Acute and Delayed Effects of Ethanol-Intoxicated Thermal Burn Injury. J Invest Dermatol 2018; 138:2461-2469. [PMID: 29857067 DOI: 10.1016/j.jid.2018.04.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 04/06/2018] [Accepted: 04/20/2018] [Indexed: 02/07/2023]
Abstract
Thermal burn injuries in patients who are alcohol-intoxicated result in greater morbidity and mortality. Murine models combining ethanol and localized thermal burn injury reproduce the systemic toxicity seen in human subjects, which consists of both acute systemic cytokine production with multiple organ dysfunction, as well as a delayed systemic immunosuppression. However, the exact mechanisms for these acute and delayed effects are unclear. These studies sought to define the role of the lipid mediator platelet-activating factor in the acute and delayed effects of intoxicated burn injury. Combining ethanol and thermal burn injury resulted in increased enzymatic platelet-activating factor generation in a keratinocyte cell line in vitro, human skin explants ex vivo, as well as in murine skin in vivo. Further, the acute increase in inflammatory cytokines, such as IL-6, and the systemic immunosuppressive effects of intoxicated thermal burn injury were suppressed in mice lacking platelet-activating factor receptors. Together, these studies provide a potential mechanism and treatment strategies for the augmented toxicity and immunosuppressive effects of thermal burn injury in the setting of acute ethanol exposure, which involves the pleotropic lipid mediator platelet-activating factor.
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Affiliation(s)
- Kathleen A Harrison
- Department of Pharmacology, University of Colorado Health Sciences Center, Aurora, Colorado, USA
| | - Eric Romer
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - Jonathan Weyerbacher
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jesus A Ocana
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ravi P Sahu
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - Robert C Murphy
- Department of Pharmacology, University of Colorado Health Sciences Center, Aurora, Colorado, USA
| | - Lisa E Kelly
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - Townsend A Smith
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - Christine M Rapp
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - Christina Borchers
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - David R Cool
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - Gengxin Li
- Department of Mathematics and Statistics, Wright State University, Dayton, Ohio, USA
| | - Richard Simman
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA; Department of Dermatology, Wright State University, Dayton, Ohio, USA
| | - Jeffrey B Travers
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA; Department of Dermatology, Wright State University, Dayton, Ohio, USA; The Dayton VA Medical Center, Dayton, OH.
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19
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Volz T, Kaesler S, Draing C, Hartung T, Röcken M, Skabytska Y, Biedermann T. Induction of IL-10-balanced immune profiles following exposure to LTA from Staphylococcus epidermidis. Exp Dermatol 2018; 27:318-326. [DOI: 10.1111/exd.13540] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Thomas Volz
- Department of Dermatology and Allergology; Technical University Munich; Munich Germany
- Department of Dermatology; Eberhard Karls University; Tübingen Germany
| | - Susanne Kaesler
- Department of Dermatology and Allergology; Technical University Munich; Munich Germany
- Department of Dermatology; Eberhard Karls University; Tübingen Germany
| | - Christian Draing
- Center for Alternatives to Animal Testing Europe; University of Konstanz; Konstanz Germany
| | - Thomas Hartung
- Center for Alternatives to Animal Testing Europe; University of Konstanz; Konstanz Germany
- Bloomberg School of Public Health; Johns Hopkins University; Baltimore MD USA
| | - Martin Röcken
- Department of Dermatology; Eberhard Karls University; Tübingen Germany
| | - Yuliya Skabytska
- Department of Dermatology and Allergology; Technical University Munich; Munich Germany
- Department of Dermatology; Eberhard Karls University; Tübingen Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergology; Technical University Munich; Munich Germany
- Clinical Unit Allergology; Helmholtz Zentrum München, German Research Center for Environmental Health GmbH; Neuherberg Germany
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20
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Kwon HI, Jeong NH, Jun SH, Son JH, Kim S, Jeon H, Kang SC, Kim SH, Lee JC. Thymol attenuates the worsening of atopic dermatitis induced by Staphylococcus aureus membrane vesicles. Int Immunopharmacol 2018; 59:301-309. [PMID: 29679854 DOI: 10.1016/j.intimp.2018.04.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/30/2018] [Accepted: 04/13/2018] [Indexed: 12/16/2022]
Abstract
Staphylococcus aureus membrane vesicles (MVs) aggravate atopic dermatitis (AD) through the delivery of bacterial effector molecules to host cells and the stimulation of inflammatory responses. This study investigated the inhibitory effect of thymol, a phenolic monoterpene found in essential oils derived from plants, on the worsening of AD induced by S. aureus MVs both in vitro and in vivo. The sub-minimal inhibitory concentrations of thymol disrupted S. aureus MVs. Intact S. aureus MVs induced the expression of pro-inflammatory cytokine (interleukin (IL)-1β, IL-6, and tumor necrosis factor-α) and chemokine (IL-8 and monocyte chemoattractant protein-1) genes in cultured keratinocytes, whereas thymol-treated S. aureus MVs did not stimulate the expression of these genes. Topical application of thymol-treated S. aureus MVs or treatment with thymol after intact S. aureus MVs to AD-like skin lesions diminished the pathology of AD. This included decreases in epidermal/dermal thickness and infiltration of eosinophils/mast cells, and inhibited expression of pro-inflammatory cytokine and chemokine genes in mouse AD model. Moreover, thymol significantly suppressed the Th1, Th2, and Th17-mediated inflammatory responses in AD-like skin lesions induced by S. aureus MVs, and reduced the serum levels of immunoglobulin (Ig) G2a, mite-specific IgE, and total IgE. In summary, thymol disrupts S. aureus MVs and suppresses inflammatory responses in AD-like skin lesions aggravated by S. aureus MVs. Our results suggest that thymol is a possible candidate for the management of AD aggravation induced by S. aureus colonization or infection in the lesions.
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Affiliation(s)
- Hyo Il Kwon
- Department of Microbiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Na Hee Jeong
- CMRI, Department of Pharmacology, School of Medicine, Kyungpook National University Daegu, Republic of Korea
| | - So Hyun Jun
- Department of Microbiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Joo Hee Son
- Department of Microbiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Shukho Kim
- Department of Microbiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hyejin Jeon
- Department of Microbiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Sun Chul Kang
- Department of Biotechnology, Daegu University, Gyungbuk, Republic of Korea
| | - Sang Hyun Kim
- CMRI, Department of Pharmacology, School of Medicine, Kyungpook National University Daegu, Republic of Korea.
| | - Je Chul Lee
- Department of Microbiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
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21
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Iwamoto K, Moriwaki M, Niitsu Y, Saino M, Takahagi S, Hisatsune J, Sugai M, Hide M. Staphylococcus aureus from atopic dermatitis skin alters cytokine production triggered by monocyte-derived Langerhans cell. J Dermatol Sci 2017; 88:271-279. [DOI: 10.1016/j.jdermsci.2017.08.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/20/2017] [Accepted: 08/02/2017] [Indexed: 01/06/2023]
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22
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Werfel T, Allam JP, Biedermann T, Eyerich K, Gilles S, Guttman-Yassky E, Hoetzenecker W, Knol E, Simon HU, Wollenberg A, Bieber T, Lauener R, Schmid-Grendelmeier P, Traidl-Hoffmann C, Akdis CA. Cellular and molecular immunologic mechanisms in patients with atopic dermatitis. J Allergy Clin Immunol 2017; 138:336-49. [PMID: 27497276 DOI: 10.1016/j.jaci.2016.06.010] [Citation(s) in RCA: 396] [Impact Index Per Article: 56.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 06/20/2016] [Accepted: 06/22/2016] [Indexed: 12/18/2022]
Abstract
Atopic dermatitis (AD) is a complex skin disease frequently associated with other diseases of the atopic diathesis. Recent evidence supports the concept that AD can also recognize other comorbidities, such as chronic inflammatory bowel or cardiovascular diseases. These comorbidities might result from chronic cutaneous inflammation or from a common, yet-to-be-defined immunologic background leading to immune deviations. The activation of immune cells and their migration to the skin play an essential role in the pathogenesis of AD. In patients with AD, an underlying immune deviation might result in higher susceptibility of the skin to environmental factors. There is a high unmet medical need to define immunologic endotypes of AD because it has significant implications on upcoming stratification of the phenotype of AD and the resulting targeted therapies in the development of precision medicine. This review article emphasizes studies on environmental factors affecting AD development and novel biological agents used in the treatment of AD. Best evidence of the clinical efficacy of novel immunologic approaches using biological agents in patients with AD is available for the anti-IL-4 receptor α-chain antibody dupilumab, but a number of studies are currently ongoing with other specific antagonists to immune system players. These targeted molecules can be expressed on or drive the cellular players infiltrating the skin (eg, T lymphocytes, dendritic cells, or eosinophils). Such approaches can have immunomodulatory and thereby beneficial clinical effects on the overall skin condition, as well as on the underlying immune deviation that might play a role in comorbidities. An effect of these immunologic treatments on pruritus and the disturbed microbiome in patients with AD has other potential consequences for treatment.
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Affiliation(s)
- Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
| | - Jean-Pierre Allam
- Department of Dermatology and Allergy, Rheinische Friedrich Wilhelm University, Bonn, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Kilian Eyerich
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Stefanie Gilles
- Institute of Environmental Medicine, UNIKA-T, Technical University Munich and Helmholtz Zentrum München, Augsburg, Germany
| | - Emma Guttman-Yassky
- Laboratory for Investigative Dermatology, Rockefeller University, and the Department of Dermatology and the Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Wolfram Hoetzenecker
- Department of Dermatology/Allergology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Edward Knol
- Departments of Immunology and Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hans-Uwe Simon
- Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - Andreas Wollenberg
- Department of Dermatology and Allergy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Thomas Bieber
- Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland; Department of Dermatology and Allergy, University of Bonn, Bonn, Germany
| | - Roger Lauener
- Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland; Children's Hospital of Eastern Switzerland, St Gallen, Switzerland
| | - Peter Schmid-Grendelmeier
- Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland; Allergy Unit, University of Zurich, Zurich, Switzerland
| | - Claudia Traidl-Hoffmann
- Institute of Environmental Medicine, UNIKA-T, Technical University Munich and Helmholtz Zentrum München, Augsburg, Germany; Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland
| | - Cezmi A Akdis
- Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland; Swiss Institute for Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
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23
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Brauweiler AM, Hall CF, Goleva E, Leung DYM. Staphylococcus aureus Lipoteichoic Acid Inhibits Keratinocyte Differentiation through a p63-Mediated Pathway. J Invest Dermatol 2017; 137:2030-2033. [PMID: 28528912 DOI: 10.1016/j.jid.2017.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/21/2017] [Accepted: 05/05/2017] [Indexed: 01/09/2023]
Affiliation(s)
- Anne M Brauweiler
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA
| | - Clifton F Hall
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA
| | - Elena Goleva
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA
| | - Donald Y M Leung
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA; Department of Pediatrics, University of Colorado-Denver, Aurora, Colorado, USA.
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24
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David Boothe W, Tarbox JA, Tarbox MB. Atopic Dermatitis: Pathophysiology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1027:21-37. [PMID: 29063428 DOI: 10.1007/978-3-319-64804-0_3] [Citation(s) in RCA: 231] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The pathophysiology of atopic dermatitis is complex and multifactorial, involving elements of barrier dysfunction, alterations in cell mediated immune responses, IgE mediated hypersensitivity, and environmental factors. Loss of function mutations in filaggrin have been implicated in severe atopic dermatitis due to a potential increase in trans-epidermal water loss, pH alterations, and dehydration. Other genetic changes have also been identified which may alter the skin's barrier function, resulting in an atopic dermatitis phenotype. The imbalance of Th2 to Th1 cytokines observed in atopic dermatitis can create alterations in the cell mediated immune responses and can promote IgE mediated hypersensitivity, both of which appear to play a role in the development of atopic dermatitis. One must additionally take into consideration the role of the environment on the causation of atopic dermatitis and the impact of chemicals such as airborne formaldehyde, harsh detergents, fragrances, and preservatives. Use of harsh alkaline detergents in skin care products may also unfavorably alter the skin's pH causing downstream changes in enzyme activity and triggering inflammation. Environmental pollutants can trigger responses from both the innate and adaptive immune pathways. This chapter will discuss the multifaceted etiology of atopic dermatitis which will help us to elucidate potential therapeutic targets. We will also review existing treatment options and their interaction with the complex inflammatory and molecular triggers of atopic dermatitis.
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Affiliation(s)
- W David Boothe
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - James A Tarbox
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Michelle B Tarbox
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
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25
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Jun SH, Lee JH, Kim SI, Choi CW, Park TI, Jung HR, Cho JW, Kim SH, Lee JC. Staphylococcus aureus-derived membrane vesicles exacerbate skin inflammation in atopic dermatitis. Clin Exp Allergy 2016; 47:85-96. [DOI: 10.1111/cea.12851] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 10/11/2016] [Accepted: 10/20/2016] [Indexed: 12/26/2022]
Affiliation(s)
- S. H. Jun
- Department of Microbiology; Kyungpook National University School of Medicine; Daegu Korea
| | - J. H. Lee
- Department of Microbiology; Kyungpook National University School of Medicine; Daegu Korea
| | - S. I. Kim
- Division of Life Science; Korea Basic Science Institute; Daejeon Korea
| | - C. W. Choi
- Division of Life Science; Korea Basic Science Institute; Daejeon Korea
| | - T. I. Park
- Department of Pathology; Kyungpook National University School of Medicine; Daegu Korea
| | - H. R. Jung
- Department of Pathology; Keimyung University College of Medicine; Daegu Korea
| | - J. W. Cho
- Department of Dermatology; Keimyung University College of Medicine; Daegu Korea
| | - S. H. Kim
- Department of Pharmacology; Kyungpook National University School of Medicine; Daegu Korea
| | - J. C. Lee
- Department of Microbiology; Kyungpook National University School of Medicine; Daegu Korea
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26
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Affiliation(s)
| | - Tilo Biedermann
- Department of Dermatology and Allergology, TUM School of Medicine, Technische Universität München, Germany
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27
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Kaesler S, Skabytska Y, Chen KM, Kempf WE, Volz T, Köberle M, Wölbing F, Hein U, Hartung T, Kirschning C, Röcken M, Biedermann T. Staphylococcus aureus-derived lipoteichoic acid induces temporary T-cell paralysis independent of Toll-like receptor 2. J Allergy Clin Immunol 2016; 138:780-790.e6. [PMID: 26949056 DOI: 10.1016/j.jaci.2015.11.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 11/09/2015] [Accepted: 11/20/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND The interplay between microbes and surface organs, such as the skin, shapes a complex immune system with several checks and balances. The first-line defense is mediated by innate immune pathways leading to inflammation. In the second phase specific T cells invade the infected organ, amplifying inflammation and defense. Consecutively, termination of inflammation is crucial to avoid chronic inflammation triggered by microbes, such as in patients with atopic dermatitis. OBJECTIVE We aimed to elucidate how the Staphylococcus aureus-derived cell-wall component lipoteichoic acid (LTA) governs the second phase of immune responses when high concentrations of LTA access T cells directly through disrupted skin. METHODS We analyzed the direct exposure of T cells to LTA in vitro. For in vivo analyses, we used fluorescein isothiocyanate contact hypersensitivity and ovalbumin-induced dermatitis as models for TH2-mediated cutaneous inflammation. RESULTS We observed that LTA potently suppressed T-lymphocyte activation in a Toll-like receptor 2-independent manner. LTA-exposed T cells did not proliferate and did not produce cytokines. Importantly, these T cells remained completely viable and were responsive to consecutive activation signals on subsequent removal of LTA. Thus LTA exposure resulted in temporary functional T-cell paralysis. In vivo experiments revealed that T-cell cytokine production and cutaneous recall responses were significantly suppressed by LTA. CONCLUSION We identified a new mechanism through which bacterial compounds directly but temporarily modulate adaptive immune responses.
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Affiliation(s)
- Susanne Kaesler
- Department of Dermatology, Eberhard Karls University, Liebermeisterstr, Tubingen, Germany; Department of Dermatology and Allergology, Technische Universität München, Munich, Germany
| | - Yuliya Skabytska
- Department of Dermatology, Eberhard Karls University, Liebermeisterstr, Tubingen, Germany
| | - Ko-Ming Chen
- Department of Dermatology, Eberhard Karls University, Liebermeisterstr, Tubingen, Germany; Derma Labor Düsseldorf, Dusseldorf, Germany
| | - Wolfgang E Kempf
- Department of Dermatology, Eberhard Karls University, Liebermeisterstr, Tubingen, Germany; Department of Dermatology and Allergology, Technische Universität München, Munich, Germany
| | - Thomas Volz
- Department of Dermatology, Eberhard Karls University, Liebermeisterstr, Tubingen, Germany; Department of Dermatology and Allergology, Technische Universität München, Munich, Germany
| | - Martin Köberle
- Department of Dermatology, Eberhard Karls University, Liebermeisterstr, Tubingen, Germany; Department of Dermatology and Allergology, Technische Universität München, Munich, Germany
| | - Florian Wölbing
- Department of Dermatology, Eberhard Karls University, Liebermeisterstr, Tubingen, Germany; Department of Dermatology and Allergology, Technische Universität München, Munich, Germany
| | - Ulrike Hein
- Department of Dermatology, Eberhard Karls University, Liebermeisterstr, Tubingen, Germany
| | - Thomas Hartung
- Center for Alternatives to Animal Testing Europe, University of Konstanz, Konstanz, Germany; Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Md
| | - Carsten Kirschning
- Institute of Medical Microbiology, University of Duisburg-Essen, Essen, Germany
| | - Martin Röcken
- Department of Dermatology, Eberhard Karls University, Liebermeisterstr, Tubingen, Germany
| | - Tilo Biedermann
- Department of Dermatology, Eberhard Karls University, Liebermeisterstr, Tubingen, Germany; Department of Dermatology and Allergology, Technische Universität München, Munich, Germany.
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Miyano K, Matsushita S, Tsuchida T, Nakamura K. Inhibitory effect of a histamine 4 receptor antagonist on CCL17 and CCL22 production by monocyte-derived Langerhans cells in patients with atopic dermatitis. J Dermatol 2016; 43:1024-9. [DOI: 10.1111/1346-8138.13294] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 12/07/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Kyohei Miyano
- Department of Dermatology; Saitama Medical University; Saitama Japan
- Allergology Center; Saitama Medical University; Saitama Japan
| | - Sho Matsushita
- Allergology Center; Saitama Medical University; Saitama Japan
- Department of Immunology; Saitama Medical University; Saitama Japan
| | - Tetsuya Tsuchida
- Department of Dermatology; Saitama Medical University; Saitama Japan
| | - Koichiro Nakamura
- Department of Dermatology; Saitama Medical University; Saitama Japan
- Allergology Center; Saitama Medical University; Saitama Japan
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29
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Siddique MI, Katas H, Amin MCIM, Ng SF, Zulfakar MH, Buang F, Jamil A. Minimization of Local and Systemic Adverse Effects of Topical Glucocorticoids by Nanoencapsulation: In Vivo Safety of Hydrocortisone–Hydroxytyrosol Loaded Chitosan Nanoparticles. J Pharm Sci 2015; 104:4276-4286. [DOI: 10.1002/jps.24666] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/05/2015] [Accepted: 09/09/2015] [Indexed: 12/20/2022]
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Jiao D, Wong CK, Qiu HN, Dong J, Cai Z, Chu M, Hon KL, Tsang MSM, Lam CWK. NOD2 and TLR2 ligands trigger the activation of basophils and eosinophils by interacting with dermal fibroblasts in atopic dermatitis-like skin inflammation. Cell Mol Immunol 2015; 13:535-50. [PMID: 26388234 DOI: 10.1038/cmi.2015.77] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 07/16/2015] [Accepted: 07/17/2015] [Indexed: 12/23/2022] Open
Abstract
The skin of patients with atopic dermatitis (AD) has a unique predisposition for colonization by Staphylococcus aureus (S. aureus), which contributes to the inflammation and grim prognosis of AD. Although the mechanism underlying the S. aureus-induced exacerbation of AD remains unclear, recent studies have found a pivotal role for pattern recognition receptors in regulating the inflammatory responses in S. aureus infection. In the present study, we used a typical mouse model of AD-like skin inflammation and found that S. aureus-associated nucleotide-binding oligomerization domain-containing protein 2 (NOD2) and toll-like receptor 2 (TLR2) ligands exacerbated AD-like symptoms, which were further deteriorated by the in vivo expansion of basophils and eosinophils. Subsequent histological analyses revealed that dermal fibroblasts were pervasive in the AD-like skin lesions. Co-culture of human dermal fibroblasts with basophils and eosinophils resulted in a vigorous cytokine/chemokine response to the NOD2/TLR2 ligands and the enhanced expression of intercellular adhesion molecule-1 on the dermal fibroblasts. Basophils and eosinophils were primarily responsible for the AD-related cytokine/chemokine expression in the co-cultures. Direct intercellular contact was necessary for the crosstalk between basophils and dermal fibroblasts, while soluble mediators were sufficient to mediate the eosinophil-fibroblast interactions. Moreover, the intracellular p38 mitogen-activated protein kinase, extracellular signal-regulated kinase, and nuclear factor-kappa B signaling pathways were essential for NOD2/TLR2 ligand-mediated activation of basophils, eosinophils, and dermal fibroblasts in AD-related inflammation. This study provides the evidence of NOD2/TLR2-mediated exacerbation of AD through activation of innate immune cells and therefore sheds light on a novel mechanistic pathway by which S. aureus contributes to the pathophysiology of AD.
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Affiliation(s)
- Delong Jiao
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China
| | - Chun-Kwok Wong
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China.,Institute of Chinese Medicine and State Key Laboratory of Phytochemistry and Plant Resources in West China, The Chinese University of Hong Kong, Hong Kong, China
| | - Huai-Na Qiu
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China
| | - Jie Dong
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China
| | - Zhe Cai
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China
| | - Man Chu
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China
| | - Kam-Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China
| | - Miranda Sin-Man Tsang
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China.,Institute of Chinese Medicine and State Key Laboratory of Phytochemistry and Plant Resources in West China, The Chinese University of Hong Kong, Hong Kong, China
| | - Christopher Wai-Kei Lam
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China.,State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology, Taipa, Macau, People's Republic of China
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31
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Biedermann T, Skabytska Y, Kaesler S, Volz T. Regulation of T Cell Immunity in Atopic Dermatitis by Microbes: The Yin and Yang of Cutaneous Inflammation. Front Immunol 2015. [PMID: 26217343 PMCID: PMC4500098 DOI: 10.3389/fimmu.2015.00353] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease predominantly mediated by T helper cells. While numerous adaptive immune mechanisms in AD pathophysiology have been elucidated in detail, deciphering the impact of innate immunity in AD pathogenesis has made substantial progress in recent years and is currently a fast evolving field. As innate and adaptive immunity are intimately linked, cross-talks between these two branches of the immune system are critically influencing the resulting immune response and disease. Innate immune recognition of the cutaneous microbiota was identified to substantially contribute to immune homeostasis and shaping of protective adaptive immunity in the absence of inflammation. Disturbances in the composition of the skin microbiome with reduced microbial diversity and overabundance of Staphylococcus spp. have been shown to be associated with AD inflammation. Distinct Staphylococcus aureus associated microbial associated molecular patterns (MAMPs) binding to TLR2 heterodimers could be identified to initiate long-lasting cutaneous inflammation driven by T helper cells and consecutively local immune suppression by induction of myeloid-derived suppressor cells further favoring secondary skin infections as often seen in AD patients. Moreover dissecting cellular and molecular mechanisms in cutaneous innate immune sensing in AD pathogenesis paved the way for exploiting regulatory and anti-inflammatory pathways to attenuate skin inflammation. Activation of the innate immune system by MAMPs of non-pathogenic bacteria on AD skin alleviated cutaneous inflammation. The induction of tolerogenic dendritic cells, interleukin-10 expression and regulatory Tr1 cells were shown to mediate this beneficial effect. Thus, activation of innate immunity by MAMPs of non-pathogenic bacteria for induction of regulatory T cell phenotypes seems to be a promising strategy for treatment of inflammatory skin disorders such as AD. These new findings demonstrate how detailed analyses identify partly opposing consequences of microbe sensing by the innate immune system and how these mechanisms translate into AD pathogenesis as well as new therapeutic strategies.
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Affiliation(s)
- Tilo Biedermann
- Department of Dermatology and Allergy, Technische Universität München , Munich , Germany
| | - Yuliya Skabytska
- Department of Dermatology, University Hospital , Tübingen , Germany
| | - Susanne Kaesler
- Department of Dermatology, University Hospital , Tübingen , Germany
| | - Thomas Volz
- Department of Dermatology and Allergy, Technische Universität München , Munich , Germany
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32
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Staphlyococcus aureus phenol-soluble modulins stimulate the release of proinflammatory cytokines from keratinocytes and are required for induction of skin inflammation. Infect Immun 2015; 83:3428-37. [PMID: 26077761 DOI: 10.1128/iai.00401-15] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 06/10/2015] [Indexed: 12/22/2022] Open
Abstract
Staphylococcus aureus is a human commensal that colonizes the skin. While it is normally innocuous, it has strong associations with atopic dermatitis pathogenesis and has become the leading cause of skin and soft tissue infections in the United States. The factors that dictate the role of S. aureus in disease are still being determined. In this work, we utilized primary keratinocyte culture and an epidermal murine colonization model to investigate the role of S. aureus phenol-soluble modulins (PSMs) in proinflammatory cytokine release and inflammation induction. We demonstrated that many species of Staphylococcus are capable of causing release of interleukin 18 (IL-18) from keratinocytes and that S. aureus PSMs are necessary and sufficient to stimulate IL-18 release from keratinocytes independently of caspase 1. Further, after 7 days of epicutaneous exposure to wild-type S. aureus, but not S. aureus Δpsm, we saw dramatic changes in gross pathology, as well as systemic release of proinflammatory cytokines. This work demonstrates the importance of PSM peptides in S. aureus-mediated inflammatory cytokine release from keratinocytes in vitro and in vivo and further implicates PSMs as important contributors to pathogenesis.
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33
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Th2 Cytokines Suppress Lipoteichoic Acid-Induced Matrix Metalloproteinase Expression and Keratinocyte Migration in Response to Wounding. J Invest Dermatol 2015; 135:2550-2553. [PMID: 25950824 PMCID: PMC4567972 DOI: 10.1038/jid.2015.181] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Abstract
Interactions between potentially pathogenic commensal bacteria and cutaneous immunity are poorly understood. In this issue of Immunity, Skabytska et al. (2014) show that S. aureus-derived TLR2/6 heterodimer ligands can recruit myeloid-derived suppressor cells into the skin, countering rather than promoting inflammation.
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Affiliation(s)
- Tina L Sumpter
- Department of Dermatology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Louis D Falo
- Department of Dermatology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; Department of Bioengineering, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; Pittsburgh Clinical and Translational Science Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; The McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; The University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
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35
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Skabytska Y, Wölbing F, Günther C, Köberle M, Kaesler S, Chen KM, Guenova E, Demircioglu D, Kempf WE, Volz T, Rammensee HG, Schaller M, Röcken M, Götz F, Biedermann T. Cutaneous innate immune sensing of Toll-like receptor 2-6 ligands suppresses T cell immunity by inducing myeloid-derived suppressor cells. Immunity 2014; 41:762-75. [PMID: 25456159 DOI: 10.1016/j.immuni.2014.10.009] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 10/17/2014] [Indexed: 12/27/2022]
Abstract
Skin is constantly exposed to bacteria and antigens, and cutaneous innate immune sensing orchestrates adaptive immune responses. In its absence, skin pathogens can expand, entering deeper tissues and leading to life-threatening infectious diseases. To characterize skin-driven immunity better, we applied living bacteria, defined lipopeptides, and antigens cutaneously. We found suppression of immune responses due to cutaneous infection with Gram-positive S. aureus, which was based on bacterial lipopeptides. Skin exposure to Toll-like receptor (TLR)2-6-binding lipopeptides, but not TLR2-1-binding lipopeptides, potently suppressed immune responses through induction of Gr1(+)CD11b(+) myeloid-derived suppressor cells (MDSCs). Investigating human atopic dermatitis, in which Gram-positive bacteria accumulate, we detected high MDSC amounts in blood and skin. TLR2 activation in skin resident cells triggered interleukin-6 (IL-6), which induced suppressive MDSCs, which are then recruited to the skin suppressing T cell-mediated recall responses such as dermatitis. Thus, cutaneous bacteria can negatively regulate skin-driven immune responses by inducing MDSCs via TLR2-6 activation.
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Affiliation(s)
- Yuliya Skabytska
- Department of Dermatology, Eberhard Karls University, Liebermeisterstrasse 25, 72076 Tübingen, Germany
| | - Florian Wölbing
- Department of Dermatology, Eberhard Karls University, Liebermeisterstrasse 25, 72076 Tübingen, Germany
| | - Claudia Günther
- Department of Dermatology, Technical University Dresden, Mommsenstrasse 11, 01069 Dresden, Germany
| | - Martin Köberle
- Department of Dermatology, Eberhard Karls University, Liebermeisterstrasse 25, 72076 Tübingen, Germany; Department of Dermatology and Allergy, Technische Universität München, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - Susanne Kaesler
- Department of Dermatology, Eberhard Karls University, Liebermeisterstrasse 25, 72076 Tübingen, Germany
| | - Ko-Ming Chen
- Department of Dermatology, Eberhard Karls University, Liebermeisterstrasse 25, 72076 Tübingen, Germany
| | - Emmanuella Guenova
- Department of Dermatology, Eberhard Karls University, Liebermeisterstrasse 25, 72076 Tübingen, Germany; Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, CH-8091 Zurich, Switzerland
| | - Doruk Demircioglu
- Department of Microbial Genetics, Eberhard Karls University, Waldhäuser Straße 70/8, 72076 Tübingen, Germany
| | - Wolfgang E Kempf
- Department of Dermatology, Eberhard Karls University, Liebermeisterstrasse 25, 72076 Tübingen, Germany; Department of Dermatology and Allergy, Technische Universität München, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - Thomas Volz
- Department of Dermatology, Eberhard Karls University, Liebermeisterstrasse 25, 72076 Tübingen, Germany; Department of Dermatology and Allergy, Technische Universität München, Biedersteinerstrasse 29, 80802 Munich, Germany
| | - Hans-Georg Rammensee
- Department of Immunology, Institute of Cell Biology, and German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) Partner Site Tübingen, Eberhard Karls University, Auf der Morgenstelle 15, 72076 Tübingen, Germany
| | - Martin Schaller
- Department of Dermatology, Eberhard Karls University, Liebermeisterstrasse 25, 72076 Tübingen, Germany
| | - Martin Röcken
- Department of Dermatology, Eberhard Karls University, Liebermeisterstrasse 25, 72076 Tübingen, Germany
| | - Friedrich Götz
- Department of Microbial Genetics, Eberhard Karls University, Waldhäuser Straße 70/8, 72076 Tübingen, Germany
| | - Tilo Biedermann
- Department of Dermatology, Eberhard Karls University, Liebermeisterstrasse 25, 72076 Tübingen, Germany; Department of Dermatology and Allergy, Technische Universität München, Biedersteinerstrasse 29, 80802 Munich, Germany.
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36
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Toxic interaction between Th2 cytokines and Staphylococcus aureus in atopic dermatitis. J Invest Dermatol 2014; 134:2069-2071. [PMID: 25029320 PMCID: PMC4101911 DOI: 10.1038/jid.2014.122] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Patients with atopic dermatitis (AD) are commonly colonized/infected with Staphylococcus aureus, and this bacterium is known to worsen the dermatitis. In this issue, Brauweiler et al. demonstrate a newly discovered mechanism by which Th2 cytokines involved in AD augments the toxicity of the lytic staphylococcal protein alpha toxin. This review presents mechanisms by which Th2 cytokines may interact with S. aureus to the detriment of the dermatitis.
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37
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Kaesler S, Volz T, Skabytska Y, Köberle M, Hein U, Chen KM, Guenova E, Wölbing F, Röcken M, Biedermann T. Toll-like receptor 2 ligands promote chronic atopic dermatitis through IL-4-mediated suppression of IL-10. J Allergy Clin Immunol 2014; 134:92-9. [PMID: 24698321 DOI: 10.1016/j.jaci.2014.02.017] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 02/14/2014] [Accepted: 02/17/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a T cell-mediated inflammatory skin disease, with TH2 cells initiating acute flares. This inflamed skin is immediately colonized with Staphylococcus aureus, which provides potent Toll-like receptor (TLR) 2 ligands. However, the effect of TLR2 ligands on the development of TH2-mediated AD inflammation remains unclear. OBJECTIVE We investigated the progression of TH2 cell-mediated dermatitis after TLR2 activation. METHODS Using models for acute AD with TH2 cells initiating cutaneous inflammation, we investigated the consequences of TLR2 activation. Dermatitis, as assessed by changes in ear skin thickness and histology, was analyzed in different BALB/c and C57BL/6 wild-type and knockout mouse strains, and immune profiling was carried out by using in vitro and ex vivo cytokine analyses. RESULTS We show that TH2 cell-mediated dermatitis is self-limiting and depends on IL-4. Activation of TLR2 converted the limited TH2 dermatitis to chronic cutaneous inflammation. We demonstrate that the concerted activation of TLR2 and IL-4 receptor on dendritic cells is sufficient for this conversion. As an underlying mechanism, we found that the combinatorial sensing of the innate TLR2 ligands and the adaptive TH2 cytokine IL-4 suppressed anti-inflammatory IL-10 and consequently led to the exacerbation and persistence of dermatitis. CONCLUSION Our data demonstrate that innate TLR2 signals convert transient TH2 cell-mediated dermatitis into persistent inflammation, as seen in chronic human AD, through IL-4-mediated suppression of IL-10. For the first time, these data show how initial AD lesions convert to chronic inflammation and provide another rationale for targeting IL-4 in patients with AD, a therapeutic approach that is currently under development.
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Affiliation(s)
- Susanne Kaesler
- Department of Dermatology, Eberhard Karls University, Tübingen, Germany
| | - Thomas Volz
- Department of Dermatology, Eberhard Karls University, Tübingen, Germany
| | - Yuliya Skabytska
- Department of Dermatology, Eberhard Karls University, Tübingen, Germany
| | - Martin Köberle
- Department of Dermatology, Eberhard Karls University, Tübingen, Germany
| | - Ulrike Hein
- Department of Dermatology, Eberhard Karls University, Tübingen, Germany
| | - Ko-Ming Chen
- Department of Dermatology, Eberhard Karls University, Tübingen, Germany
| | - Emmanuella Guenova
- Department of Dermatology, Eberhard Karls University, Tübingen, Germany; Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Florian Wölbing
- Department of Dermatology, Eberhard Karls University, Tübingen, Germany
| | - Martin Röcken
- Department of Dermatology, Eberhard Karls University, Tübingen, Germany
| | - Tilo Biedermann
- Department of Dermatology, Eberhard Karls University, Tübingen, Germany; Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany.
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38
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Hannigan GD, Grice EA. Microbial ecology of the skin in the era of metagenomics and molecular microbiology. Cold Spring Harb Perspect Med 2013; 3:a015362. [PMID: 24296350 DOI: 10.1101/cshperspect.a015362] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The skin is the primary physical barrier between the body and the external environment and is also a substrate for the colonization of numerous microbes. Previously, dermatological microbiology research was dominated by culture-based techniques, but significant advances in genomic technologies have enabled the development of less-biased, culture-independent approaches to characterize skin microbial communities. These molecular microbiology approaches illustrate the great diversity of microbiota colonizing the skin and highlight unique features such as site specificity, temporal dynamics, and interpersonal variation. Disruptions in skin commensal microbiota are associated with the progression of many dermatological diseases. A greater understanding of how skin microbes interact with each other and with their host, and how we can therapeutically manipulate those interactions, will provide powerful tools for treating and preventing dermatological disease.
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Affiliation(s)
- Geoffrey D Hannigan
- Department of Dermatology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania 19104
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39
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Nakamura Y, Oscherwitz J, Cease KB, Chan SM, Muñoz-Planillo R, Hasegawa M, Villaruz AE, Cheung GYC, McGavin MJ, Travers JB, Otto M, Inohara N, Núñez G. Staphylococcus δ-toxin induces allergic skin disease by activating mast cells. Nature 2013; 503:397-401. [PMID: 24172897 PMCID: PMC4090780 DOI: 10.1038/nature12655] [Citation(s) in RCA: 364] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 09/12/2013] [Indexed: 12/14/2022]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects 15 to 30% of children and ~5% of adults in industrialized countries1. Although the pathogenesis of AD is not fully understood, the disease is mediated by an abnormal immunoglobulin E (IgE) immune response in the setting of skin barrier dysfunction2. Mast cells (MCs) contribute to IgE-mediated allergic disorders including AD3. Upon activation, MCs release their membrane-bound cytosolic granules leading to the release of multiple molecules that are important in the pathogenesis of AD and host defense4. More than 90% of AD patients are colonized with Staphylococcus aureus in the lesional skin whereas most healthy individuals do not harbor the pathogen5. Several Staphylococcal exotoxins (SEs) can act as superantigens and/or antigens in models of AD6. However, the role of these SEs in disease pathogenesis remains unclear. Here, we report that culture supernatants of S. aureus contain potent MC degranulation activity. Biochemical analysis identified δ-toxin as the MC degranulation-inducing factor produced by S. aureus. MC degranulation induced by δ-toxin depended on phosphoinositide 3-kinase (PI3K) and calcium (Ca2+) influx, but unlike that mediated by IgE crosslinking, it did not require the spleen tyrosine kinase (Syk). In addition, IgE enhanced δ-toxin-induced MC degranulation in the absence of antigen. Furthermore, S. aureus isolates recovered from AD patients produced high levels of δ-toxin. Importantly, skin colonization with S. aureus, but not a mutant deficient in δ-toxin, promoted IgE and IL-4 production, as well as inflammatory skin disease. Furthermore, enhancement of IgE production and dermatitis by δ-toxin was abrogated in KitW-sh/W-sh MC-deficient mice and restored by MC reconstitution. These studies identify δ-toxin as a potent inducer of MC degranulation and suggest a mechanistic link between S. aureus colonization and allergic skin disease.
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Affiliation(s)
- Yuumi Nakamura
- Department of Pathology and Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA
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Waller AK, Sage T, Kumar C, Carr T, Gibbins JM, Clarke SR. Staphylococcus aureus lipoteichoic acid inhibits platelet activation and thrombus formation via the Paf receptor. J Infect Dis 2013; 208:2046-57. [PMID: 23911710 PMCID: PMC3836464 DOI: 10.1093/infdis/jit398] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Impaired healing is common in wounds infected with the major human pathogen Staphylococcus aureus, although the underlying mechanisms are poorly understood. Here, we show that S. aureus lipoteichoic acid (LTA) inhibits platelet aggregation caused by physiological agonists and S. aureus and reduced platelet thrombus formation in vitro. The presence of D-alanine on LTA is necessary for the full inhibitory effect. Inhibition of aggregation was blocked using a monoclonal anti-platelet activating factor receptor (PafR) antibody and Ginkgolide B, a well-defined PafR antagonist, demonstrating that the LTA inhibitory signal occurs via PafR. Using a cyclic AMP (cAMP) assay and a Western blot for phosphorylated VASP, we determined that cAMP levels increase upon platelet incubation with LTA, an effect which inhibits platelet activation. This was blocked when platelets were preincubated with Ginkgolide B. Furthermore, LTA reduced hemostasis in a mouse tail-bleed assay.
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41
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Role of macrophages in the pathogenesis of atopic dermatitis. Mediators Inflamm 2013; 2013:942375. [PMID: 23533313 PMCID: PMC3603294 DOI: 10.1155/2013/942375] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 01/17/2013] [Accepted: 01/18/2013] [Indexed: 01/22/2023] Open
Abstract
Atopic dermatitis (AD) is one of the most common and most intensively studied chronic inflammatory skin diseases. Several cofactors, such as an impaired skin barrier function, modifications of the immune system, and a complex genetic background, direct the course of AD. Within this complex network, macrophages play a pivotal role in enhanced susceptibility to cutaneous infections and act as central connecting components in the pathogenesis of AD on the cellular level. In AD, macrophages are known to accumulate in acutely and chronically inflamed skin. During the early and short inflammatory phase, macrophages exert proinflammatory functions like antigen-presenting phagocytosis and the production of inflammatory cytokines and growth factors that facilitate the resolution of inflammation. However, persistence of pro-inflammatory activity and altered function of macrophages result in the development of chronic inflammatory diseases such as AD. The exact mechanism of macrophages activation in these processes is not yet completely understood. Further studies should be performed to clarify the dysregulated mechanism of macrophages activation in AD, and this would allow us to target these cells with versatile functions for therapeutic purpose and improve and control the disease.
In this paper, we highlight the new findings on dysregulated function of macrophages and the importance of these cells in the pathogenesis of AD in general and the contribution of these cells in enhanced susceptibility against microbial infections in particular.
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Yu J, Oh MH, Park JU, Myers AC, Dong C, Zhu Z, Zheng T. Epicutaneous exposure to staphylococcal superantigen enterotoxin B enhances allergic lung inflammation via an IL-17A dependent mechanism. PLoS One 2012; 7:e39032. [PMID: 22848348 PMCID: PMC3407176 DOI: 10.1371/journal.pone.0039032] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 05/16/2012] [Indexed: 11/18/2022] Open
Abstract
Atopic dermatitis (AD) is the initial step of the atopic march: the progression from AD to allergic rhinitis and asthma. There is a close association between skin barrier abnormalities and the development of AD and the atopic march. One of cardinal features of AD is that the lesional skin of the majority of AD patients is chronically colonized with Staphylococcus aureus with half isolates producing superantigen enterotoxin B (SEB). Although diverse roles of SEB in the pathogenesis and severity of AD have been recognized, whether SEB contributes to the dermal inflammation that drives lung inflammation and airway hyperresponsiveness (AHR) has not been examined. Here we show a novel role of S. aureus superantigen SEB in augmenting allergen ovalbumin (Ova) induced atopic march through an IL-17A dependent mechanism. When mice epicutaneously (EC) sensitized with allergen Ova, addition of topical SEB led to not only augmented systemic Th2 responses but also a markedly exaggerated systemic Th17/IL-17 immune environment. The ability of SEB in enhancing Th17/IL-17 was mediated through stimulating lymphocytes in spleen and draining lymph nodes to promote IL-6 production. Epicutaneous sensitization of mice with a combination of Ova and SEB significantly enhanced Ova-induced AHR and granulocytic lung inflammation than Ova allergen alone. When IL-17A was deleted genetically, the effects of SEB on augmenting lung inflammation and AHR were markedly diminished. These findings suggest that chronic heavy colonization of enterotoxin producing S. aureus in the skin of patients with atopic dermatitis may have an important role in the development of atopic march via an IL-17A dependent mechanism.
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Affiliation(s)
- Jinho Yu
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Min Hee Oh
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Ju-Un Park
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Allen C. Myers
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Chen Dong
- Department of Immunology, Center for Inflammation and Cancer, MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Zhou Zhu
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Tao Zheng
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- * E-mail:
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Travers JB, Kozman A, Yao Y, Ming W, Yao W, Turner MJ, Kaplan MH, Mousdicas N, Haggstrom AN, Saha C. Treatment outcomes of secondarily impetiginized pediatric atopic dermatitis lesions and the role of oral antibiotics. Pediatr Dermatol 2012; 29:289-96. [PMID: 22150395 PMCID: PMC3310266 DOI: 10.1111/j.1525-1470.2011.01661.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Patients with atopic dermatitis (AD) are predisposed to infection with Staphylococcus aureus, which worsens their skin disease; it has been postulated that the lack of antimicrobial peptides due to aberrant allergic inflammation in skin with AD could mediate this enhanced bacterial susceptibility. We sought to characterize the amounts of S. aureus and biological products found in infected AD lesions and whether treatment with topical corticosteroids and oral cephalexin as the only antimicrobial improved outcomes. Fifty-nine children with clinically and S. aureus-positive impetiginized lesions of AD were enrolled in this study. A lesion was graded clinically using the Eczema Area and Severity Index, and wash fluid was obtained from the lesion for quantitative bacterial culture and antibiotic sensitivities and measurement of bacterial products and cytokines. Subjects were re-evaluated 2 weeks after treatment. Improvement in the clinical and inflammatory characteristics of impetiginized lesions were noted, even in the 15% of lesions infected with Methicillin-resistant S. aureus (MRSA). In a subgroup of subjects whose lesions did not contain S. aureus 2 weeks after initiating treatment, beta-defensin levels were higher at both visits than in normal skin. Treatment of uncomplicated impetiginized pediatric AD with topical corticosteroids and cephalexin results in significant clinical improvement, even in subjects infected with MRSA. We propose that the inhibition of abnormal inflammation by the treatment regimen, resulting in the high levels of defensins, is involved in the improvement of AD and that systemic antibiotics do not appear to be necessary in secondary impetiginized AD.
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Affiliation(s)
- Jeffrey B Travers
- Department of Dermatology, Indiana University School of Medicine, 550 N. University Blvd., suite 3240, Indianapolis, IN 46202, Indiana, USA.
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Abstract
Atopic dermatitis (AD) is an important chronic or relapsing inflammatory skin disease that often precedes asthma and allergic disorders. New insights into the genetics and pathophysiology of AD point to an important role of structural abnormalities in the epidermis as well as immune dysregulation not only for this skin disease but also for the development of asthma and allergies. Patients with AD have a unique predisposition to colonization or infection by microbial organisms, most notably Staphylococcus aureus and herpes simplex virus. Measures directed at healing and protecting the skin barrier and addressing the immune dysregulation are essential in the treatment of patients with AD, and early intervention may improve outcomes for both the skin disease as well as other target organs.
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MESH Headings
- Adaptive Immunity
- Animals
- Anti-Inflammatory Agents/therapeutic use
- Asthma/complications
- Asthma/immunology
- Cytokines/immunology
- Dermatitis, Atopic/complications
- Dermatitis, Atopic/genetics
- Dermatitis, Atopic/immunology
- Dermatitis, Atopic/metabolism
- Dermatitis, Atopic/physiopathology
- Dermatitis, Atopic/therapy
- Disease Models, Animal
- Epidermis/immunology
- Epidermis/metabolism
- Epidermis/physiopathology
- Filaggrin Proteins
- Gene Expression Regulation
- Herpes Simplex/immunology
- Herpes Simplex/virology
- Humans
- Immunity, Innate
- Intermediate Filament Proteins/genetics
- Intermediate Filament Proteins/metabolism
- Keratinocytes/metabolism
- Keratinocytes/pathology
- Mice
- Mice, Transgenic
- Polymorphism, Genetic
- Pruritus/complications
- Pruritus/immunology
- Simplexvirus/immunology
- Staphylococcal Skin Infections/immunology
- Staphylococcal Skin Infections/microbiology
- Staphylococcus aureus/immunology
- T-Lymphocyte Subsets/immunology
- Tight Junctions/metabolism
- Tight Junctions/pathology
- Vitamin D/metabolism
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Affiliation(s)
- Mark Boguniewicz
- Division of Pediatric Allergy-Immunology, Department of Pediatrics, National Jewish Health, Denver, CO 80206, USA
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Kozman A, Yao Y, Bina P, Saha C, Yao W, Kaplan MH, Travers JB. Encoding a superantigen by Staphylococcus aureus does not affect clinical characteristics of infected atopic dermatitis lesions. Br J Dermatol 2011; 163:1308-11. [PMID: 20698850 DOI: 10.1111/j.1365-2133.2010.09966.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Bacterial infection with Staphylococcus aureus is a known trigger for the worsening of atopic dermatitis (AD). Staphylococcal superantigens have been theorized to make a potential contribution to this worsening of AD seen with infection. OBJECTIVES We sought to assess whether encoding a superantigen by S. aureus affects the inflammatory characteristics of impetiginized AD skin lesions. METHODS Fifty-two children with clinically impetiginized lesions of AD which were positive for S. aureus were enrolled in this study. A lesion was graded clinically using the Eczema Area and Severity Index (EASI), and then wash fluid was obtained from the lesion for quantitative bacterial culture, and measurement of bacterial products lipoteichoic acid and staphylococcal protein A and cytokines. The staphylococcal isolate was tested for antibiotic susceptibilities and the presence of a superantigen. RESULTS Fifty-four per cent (28 of 52) of the staphylococcal isolates encoded a superantigen. The presence of a superantigen had no significant effect on EASI score, amounts of bacterial products or inflammatory cytokines in the AD lesion. CONCLUSIONS These studies suggest that the expression of a superantigen by S. aureus alone does not play an important role in the increased skin inflammation associated with staphylococcal infection in childhood AD.
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Affiliation(s)
- A Kozman
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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Hong SW, Kim MR, Lee EY, Kim JH, Kim YS, Jeon SG, Yang JM, Lee BJ, Pyun BY, Gho YS, Kim YK. Extracellular vesicles derived from Staphylococcus aureus induce atopic dermatitis-like skin inflammation. Allergy 2011; 66:351-9. [PMID: 20831718 PMCID: PMC3052535 DOI: 10.1111/j.1398-9995.2010.02483.x] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Recently, we found that Staphylococcus aureus produces extracellular vesicles (EV) that contain pathogenic proteins. Although S. aureus infection has been linked with atopic dermatitis (AD), the identities of the causative agents from S. aureus are controversial. We evaluated whether S. aureus-derived EV are causally related to the pathogenesis of AD. Methods Extracellular vesicles were isolated by the ultracentrifugation of S. aureus culture media. The EV were applied three times per week to tape-stripped mouse skin. Inflammation and immune dysfunction were evaluated 48 h after the final application in hairless mice. Extracellular vesicles-specific IgE levels were measured by ELISA in AD patients and healthy subjects. Results The in vitro application of S. aureus EV increased the production of pro-inflammatory mediators (IL-6, thymic stromal lymphopoietin, macrophage inflammatory protein-1α, and eotaxin) by dermal fibroblasts. The in vivo application of S. aureus EV after tape stripping caused epidermal thickening with infiltration of the dermis by mast cells and eosinophils in mice. These changes were associated with the enhanced cutaneous production of IL-4, IL-5, IFN-γ, and IL-17. Interestingly, the serum levels of S. aureus EV-specific IgE were significantly increased in AD patients relative to healthy subjects. Conclusion These results indicate that S. aureus EV induce AD-like inflammation in the skin and that S. aureus-derived EV are a novel diagnostic and therapeutic target for the control of AD.
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Affiliation(s)
- S-W Hong
- Department of Life Science, Pohang University of Science and Technology (POSTECH), Pohang, Seoul, Korea
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Sicherer SH, Leung DY. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2010. J Allergy Clin Immunol 2011; 127:326-35. [DOI: 10.1016/j.jaci.2010.11.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 11/16/2010] [Indexed: 10/18/2022]
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Vu AT, Baba T, Chen X, Le TA, Kinoshita H, Xie Y, Kamijo S, Hiramatsu K, Ikeda S, Ogawa H, Okumura K, Takai T. Staphylococcus aureus membrane and diacylated lipopeptide induce thymic stromal lymphopoietin in keratinocytes through the Toll-like receptor 2–Toll-like receptor 6 pathway. J Allergy Clin Immunol 2010; 126:985-93, 993.e1-3. [DOI: 10.1016/j.jaci.2010.09.002] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Revised: 07/29/2010] [Accepted: 09/02/2010] [Indexed: 12/30/2022]
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Voorhees T, Chang J, Yao Y, Kaplan MH, Chang CH, Travers JB. Dendritic cells produce inflammatory cytokines in response to bacterial products from Staphylococcus aureus-infected atopic dermatitis lesions. Cell Immunol 2010; 267:17-22. [PMID: 21109237 DOI: 10.1016/j.cellimm.2010.10.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 10/15/2010] [Accepted: 10/26/2010] [Indexed: 11/18/2022]
Abstract
Atopic Dermatitis (AD) patients often acquire secondary skin infections resulting in increased inflammation. The increased inflammation occurs through the activation of multiple cell types including dendritic cells (DC). In this study, we investigated the activity of soluble products present in infected AD lesions by measuring the ability of patients' wash fluids from a quantitative culture of lesions to activate DC. We found that wash fluid derived from AD lesions induced cytokine production by murine bone marrow-derived DC, including IL-1β, IL-6, ΙL-10, and tumor necrosis factor-α. The lipoprotein lipoteichoic acid (LTA) from Staphylococcusaureus was implicated as a potent stimulus in the wash fluids as only wash fluid samples that contained LTA exerted this activity, and exogenous LTA triggered similar DC cytokine activation. Wash fluid- and LTA-stimulated DC cytokine production required MyD88, but not the platelet-activating factor receptor (PAF-R), despite the ability of LTA to function through this receptor in keratinocytes. Thus, our results support a role for DC in the worsening of AD inflammation due to secondary bacteria infections.
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Affiliation(s)
- Timothy Voorhees
- Department of Microbiology and Immunology, the University of Michigan Medical School, Ann Arbor, MI 48109, United States.
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Claßen A, Kalali BN, Schnopp C, Andres C, Aguilar-Pimentel JA, Ring J, Ollert M, Mempel M. TNF receptor I on human keratinocytes is a binding partner for staphylococcal protein A resulting in the activation of NF kappa B, AP-1, and downstream gene transcription. Exp Dermatol 2010; 20:48-52. [DOI: 10.1111/j.1600-0625.2010.01174.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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