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Bier K, Senajova Z, Henrion F, Wang Y, Bruno S, Rauld C, Hörmann LC, Barske C, Delucis-Bronn C, Bergling S, Altorfer M, Hägele J, Knehr J, Junt T, Roediger B, Röhn TA, Kolbinger F. IL-26 Potentiates Type 2 Skin Inflammation in the Presence of IL-1β. J Invest Dermatol 2024; 144:1544-1556.e9. [PMID: 38237730 DOI: 10.1016/j.jid.2023.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/12/2023] [Accepted: 12/16/2023] [Indexed: 06/24/2024]
Abstract
Atopic dermatitis (AD) is a debilitating inflammatory skin disorder. Biologics targeting the IL-4/IL-13 axis are effective in AD, but there is still a large proportion of patients who do not respond to IL-4R blockade. Further exploration of potentially pathogenic T-cell-derived cytokines in AD may lead to new effective treatments. This study aimed to investigate the downstream effects of IL-26 on skin in the context of type 2 skin inflammation. We found that IL-26 alone exhibited limited inflammatory activity in the skin. However, in the presence of IL-1β, IL-26 potentiated the secretion of TSLP, CXCL1, and CCL20 from human epidermis through Jak/signal transducer and activator of transcription signaling. Moreover, in an in vivo AD-like skin inflammation model, IL-26 exacerbated skin pathology and locally increased type 2 cytokines, most notably of IL13 in skin T helper cells. Neutralization of IL-1β abrogated IL-26-mediated effects, indicating that the presence of IL-1β is required for full IL-26 downstream action in vivo. These findings suggest that the presence of IL-1β enables IL-26 to be a key amplifier of inflammation in the skin. As such, IL-26 may contribute to the development and pathogenesis of inflammatory skin disorders such as AD.
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Affiliation(s)
- Katharina Bier
- Immunology Disease Area, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland.
| | - Zuzana Senajova
- Immunology Disease Area, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Fanny Henrion
- Immunology Disease Area, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Yichen Wang
- Immunology Disease Area, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Sandro Bruno
- Immunology Disease Area, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Celine Rauld
- Immunology Disease Area, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Lisa C Hörmann
- Immunology Disease Area, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Carmen Barske
- Immunology Disease Area, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Corinne Delucis-Bronn
- Immunology Disease Area, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Sebastian Bergling
- Discovery Science, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Marc Altorfer
- Discovery Science, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Jasmin Hägele
- Discovery Science, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Judith Knehr
- Discovery Science, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Tobias Junt
- Immunology Disease Area, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Ben Roediger
- Immunology Disease Area, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Till A Röhn
- Immunology Disease Area, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Frank Kolbinger
- Immunology Disease Area, Novartis Biomedical Research, Novartis Pharma AG, Basel, Switzerland
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2
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Protano C, Vitali M, De Giorgi A, Marotta D, Crucianelli S, Fontana M. Balneotherapy using thermal mineral water baths and dermatological diseases: a systematic review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:1005-1013. [PMID: 38530467 PMCID: PMC11108950 DOI: 10.1007/s00484-024-02649-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/28/2024] [Accepted: 03/03/2024] [Indexed: 03/28/2024]
Abstract
Balneotherapy includes practices and methods using medically and legally recognized mineral-medicinal waters, muds and natural gases from natural springs for therapeutic purposes. One of the most widely used method in balneotherapy is bathing with thermal mineral water. In the course of the years, scientific community has produced an increasing number of evidences that this practice is an effective method for treating signs and symptoms of several pathologies such as rheumatic, cardiovascular and dermatological diseases. This systematic review is aimed at evaluating the effect of balneotherapy with thermal water baths as a treatment to manage signs and symptoms of patients affected by all types of dermatological diseases. The systematic review was conducted according to the PRISMA Statement, and its protocol was registered on PROSPERO platform (CRD42022295913). The research was performed on the databases Pubmed, Scopus, Web of Science and Cochrane. We included clinical trials evaluating the effects of balneotherapy using thermal mineral water baths for managing dermatological diseases in humans, published in English and Italian language. Eight studies were included, seven of them enrolled adults affected by psoriasis and one studied atopic dermatitis patients. The common result of all the articles included was a clear improvement of signs and symptoms of psoriasis and eczematous diseases after use of thermal mineral water baths. These effects seem to be strictly related to physical and chemical properties of thermal water used for balneotherapy. However, studies in this field are still limited to support robust evidence of the effectiveness of balneotherapy using thermal mineral water baths and often their quality is low. Thus, new clinical studies need to be carried out, using more correct methods for conducting the studies and for processing statistical data.
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Affiliation(s)
- Carmela Protano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, P.Le Aldo Moro 5, 00185, Rome, Italy.
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, P.Le Aldo Moro 5, 00185, Rome, Italy
| | - Andrea De Giorgi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, P.Le Aldo Moro 5, 00185, Rome, Italy
| | - Daniela Marotta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, P.Le Aldo Moro 5, 00185, Rome, Italy
| | - Serena Crucianelli
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, P.Le Aldo Moro 5, 00185, Rome, Italy
| | - Mario Fontana
- Department of Biochemical Sciences, Sapienza University of Rome, P.Le Aldo Moro 5, 00185, Rome, Italy
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3
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Gilliet M, Modlin RL. Immunobiology of IL-26. J Invest Dermatol 2024; 144:1217-1222. [PMID: 38206272 DOI: 10.1016/j.jid.2023.10.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/22/2023] [Accepted: 10/22/2023] [Indexed: 01/12/2024]
Abstract
T helper 17 (Th17) cells produce a set of cytokines that include IL-17 family members, IL-21, IL-22, and IL-26. These cytokines all contribute to the classic function of Th17 cells in combatting extracellular infection and promoting inflammation in autoimmune diseases. However, of the Th17 cytokines, only IL-26 has direct antimicrobial activity against microbes and can activate a broad range of immune cells through its ability to bind DNA and trigger pattern recognition receptors. It is noteworthy that IL-26 is produced by mammalian cells, including human Th17 cells, but is absent in rodents. As such, IL-26 is a potential therapeutic target to augment host immune responses against microbial pathogens but also to prevent inflammation and tissue damage in a variety of autoimmune diseases.
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Affiliation(s)
- Michel Gilliet
- Department of Dermatology, CHUV University Hospital and University of Lausanne (UNIL), Lausanne, Switzerland.
| | - Robert L Modlin
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
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4
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Kashyap MP, Mishra B, Sinha R, Jin L, Kumar N, Goliwas KF, Deshane J, Elewski BE, Elmets CA, Athar M, Shahid Mukhtar M, Raman C. NK and NKT cells in the pathogenesis of Hidradenitis suppurativa: Novel therapeutic strategy through targeting of CD2. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.31.565057. [PMID: 37961206 PMCID: PMC10634971 DOI: 10.1101/2023.10.31.565057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic debilitating inflammatory skin disease with poorly understood pathogenesis. Single-cell RNAseq analysis of HS lesional and healthy individual skins revealed that NKT and NK cell populations were greatly expanded in HS, and they expressed elevated CD2, an activation receptor. Immunohistochemistry analyses confirmed significantly expanded numbers of CD2+ cells distributed throughout HS lesional tissue, and many co-expressed the NK marker, CD56. While CD4+ T cells were expanded in HS, CD8 T cells were rare. CD20+ B cells in HS were localized within tertiary follicle like structures. Immunofluorescence microscopy showed that NK cells (CD2 + CD56 dim ) expressing perforin, granzymes A and B were enriched within the hyperplastic follicular epidermis and tunnels of HS and juxtaposed with apoptotic cells. In contrast, NKT cells (CD2 + CD3 + CD56 bright ) primarily expressed granzyme A and were associated with α-SMA expressing fibroblasts within the fibrotic regions of the hypodermis. Keratinocytes and fibroblasts expressed high levels of CD58 (CD2 ligand) and they interacted with CD2 expressing NKT and NK cells. The NKT/NK maturation and activating cytokines, IL-12, IL-15 and IL-18, were significantly elevated in HS. Inhibition of cognate CD2-CD58 interaction with blocking anti-CD2 mAb in HS skin organotypic cultures resulted in a profound reduction of the inflammatory gene signature and secretion of inflammatory cytokines and chemokines in the culture supernate. In summary, we show that a cellular network of heterogenous NKT and NK cell populations drives inflammation, tunnel formation and fibrosis in the pathogenesis of HS. Furthermore, CD2 blockade is a viable immunotherapeutic approach for the management of HS.
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Balić A, Marinović B, Bukvić Mokos Z. The genetic aspects of hidradenitis suppurativa. Clin Dermatol 2023; 41:551-563. [PMID: 37652193 DOI: 10.1016/j.clindermatol.2023.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Genetic aspects have a substantial role in hidradenitis suppurativa (HS) pathogenesis. A positive family history of HS occurs in about one-third of HS cases and is significantly higher in patients with early onset of the disease. Recent twin studies have shown a high heritability in HS, fortifying the importance of genetic factors in disease pathogenesis. Based on existing knowledge on the genomics of HS, the disease can be categorized as familial HS, sporadic, syndromic HS, and "HS plus" associated with other syndromes. In familial HS, autosomal dominant transmission is proposed, and monogenic inheritance is rare. This monogenic trait is related to mutations of γ-secretase component genes and Notch signaling or defects in inflammasome function. With newly discovered gene mutations, such as those related to innate and adaptive immunity, skin microbiome, inflammasome, epidermal homeostasis, and keratinization pathway, we can define HS as a polygenic, multifactorial, autoinflammatory disease. To fully elucidate the genetic aspects of HS, we need extensive, long-term global collaborations.
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Affiliation(s)
- Anamaria Balić
- Department of Dermatology and Venereology, University Hospital Centre Zagreb, European Reference Network (ERN) - Skin Reference Centre, Zagreb, Croatia
| | - Branka Marinović
- Department of Dermatology and Venereology, University Hospital Centre Zagreb, European Reference Network (ERN) - Skin Reference Centre, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Zrinka Bukvić Mokos
- Department of Dermatology and Venereology, University Hospital Centre Zagreb, European Reference Network (ERN) - Skin Reference Centre, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
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Witte K, Schneider-Burrus S, Salinas G, Mössner R, Ghoreschi K, Wolk K, Sabat R. Blood T Helper Memory Cells: A Tool for Studying Skin Inflammation in HS? Int J Mol Sci 2023; 24:ijms24108854. [PMID: 37240200 DOI: 10.3390/ijms24108854] [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: 03/15/2023] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Hidradenitis suppurativa (HS) is an inflammatory skin disease characterized by painful lesions on intertriginous body areas such as the axillary, inguinal, and perianal sites. Given the limited treatment options for HS, expanding our knowledge of its pathogenetic mechanisms is a prerequisite for novel therapeutic developments. T cells are assumed to play a crucial role in HS pathogenesis. However, it is currently unknown whether blood T cells show specific molecular alterations in HS. To address this, we studied the molecular profile of CD4+ memory T (Thmem) cells purified from the blood of patients with HS and matched healthy participants. About 2.0% and 1.9% of protein-coding transcripts were found to be up- and down-regulated in blood HS Thmem cells, respectively. These differentially expressed transcripts (DETs) are known to be involved in nucleoside triphosphate/nucleotide metabolic processes, mitochondrion organization, and oxidative phosphorylation. The detected down-regulation of transcripts involved in oxidative phosphorylation suggest a metabolic shift of HS Thmem cells towards glycolysis. The inclusion of transcriptome data from skin from HS patients and healthy participants in the analyses revealed that in HS skin lesions, the expression pattern of transcripts identified as DETs in blood HS Thmem cells was very similar to the expression pattern of the totality of protein-coding transcripts. Furthermore, there was no significant association between the extent of the expressional changes in the DETs of blood HS Thmem cells and the extent of the expressional changes in these transcripts in HS skin lesions compared to healthy donor skin. Additionally, a gene ontology enrichment analysis did not demonstrate any association of the DETs of blood HS Thmem cells with skin disorders. Instead, there were associations with different neurological diseases, non-alcoholic fatty liver disease, and thermogenesis. The levels of most DETs linked to neurological diseases showed a positive correlation to each other, suggesting common regulatory mechanisms. In summary, the transcriptomic changes in blood Thmem cells observed in patients with manifest cutaneous HS lesions do not appear to be characteristic of the molecular changes in the skin. Instead, they could be useful for studying comorbidities and identifying corresponding blood biomarkers in these patients.
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Affiliation(s)
- Katrin Witte
- Psoriasis Research and Treatment Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany
| | - Sylke Schneider-Burrus
- Psoriasis Research and Treatment Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Center for Dermatosurgery, Havelklinik Berlin, 13595 Berlin, Germany
| | - Gabriela Salinas
- NGS-Integrative Genomics Core Unit, Institute of Human Genetics, University Medical Center Göttingen, 37073 Göttingen, Germany
| | - Rotraut Mössner
- Department of Dermatology, Georg-August-University Goettingen, 37073 Goettingen, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Kerstin Wolk
- Psoriasis Research and Treatment Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany
| | - Robert Sabat
- Psoriasis Research and Treatment Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
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7
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Scala E, Zink A. Editorial: Updates on hidradenitis suppurativa - Pathogenesis, diagnosis and treatment. Front Med (Lausanne) 2023; 10:1209545. [PMID: 37234248 PMCID: PMC10206322 DOI: 10.3389/fmed.2023.1209545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 04/25/2023] [Indexed: 05/27/2023] Open
Affiliation(s)
- Emanuele Scala
- Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Davydova A, Kurochkina Y, Goncharova V, Vorobyeva M, Korolev M. The Interleukine-17 Cytokine Family: Role in Development and Progression of Spondyloarthritis, Current and Potential Therapeutic Inhibitors. Biomedicines 2023; 11:1328. [PMID: 37238999 PMCID: PMC10216275 DOI: 10.3390/biomedicines11051328] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Spondyloarthritis (SpA) encompasses a group of chronic inflammatory rheumatic diseases with a predilection for the spinal and sacroiliac joints, which include axial spondyloarthritis, psoriatic arthritis, reactive arthritis, arthritis associated with chronic inflammatory bowel disease, and undifferentiated spondyloarthritis. The prevalence of SpA in the population varies from 0.5 to 2%, most commonly affecting young people. Spondyloarthritis pathogenesis is related to the hyperproduction of proinflammatory cytokines (TNFα, IL-17A, IL-23, etc.). IL-17A plays a key role in the pathogenesis of spondyloarthritis (inflammation maintenance, syndesmophites formation and radiographic progression, enthesites and anterior uveitis development, etc.). Targeted anti-IL17 therapies have established themselves as the most efficient therapies in SpA treatment. The present review summarizes literature data on the role of the IL-17 family in the pathogenesis of SpA and analyzes existing therapeutic strategies for IL-17 suppression with monoclonal antibodies and Janus kinase inhibitors. We also consider alternative targeted strategies, such as the use of other small-molecule inhibitors, therapeutic nucleic acids, or affibodies. We discuss advantages and pitfalls of these approaches and the future prospects of each method.
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Affiliation(s)
- Anna Davydova
- Research Institute of Clinical and Experimental Lymphology, Affiliated Branch of Federal Research Center of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, 630060 Novosibirsk, Russia; (Y.K.); (V.G.); (M.K.)
- Institute of Chemical Biology and Fundamental Medicine, Siberian Division of the Russian Academy of Sciences, 630090 Novosibirsk, Russia;
| | - Yuliya Kurochkina
- Research Institute of Clinical and Experimental Lymphology, Affiliated Branch of Federal Research Center of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, 630060 Novosibirsk, Russia; (Y.K.); (V.G.); (M.K.)
| | - Veronika Goncharova
- Research Institute of Clinical and Experimental Lymphology, Affiliated Branch of Federal Research Center of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, 630060 Novosibirsk, Russia; (Y.K.); (V.G.); (M.K.)
| | - Mariya Vorobyeva
- Institute of Chemical Biology and Fundamental Medicine, Siberian Division of the Russian Academy of Sciences, 630090 Novosibirsk, Russia;
| | - Maksim Korolev
- Research Institute of Clinical and Experimental Lymphology, Affiliated Branch of Federal Research Center of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, 630060 Novosibirsk, Russia; (Y.K.); (V.G.); (M.K.)
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9
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Sabat R, Šimaitė D, Gudjonsson JE, Brembach TC, Witte K, Krause T, Kokolakis G, Bartnik E, Nikolaou C, Rill N, Coulibaly B, Levin C, Herrmann M, Salinas G, Leeuw T, Volk HD, Ghoreschi K, Wolk K. Neutrophilic granulocyte-derived B-cell activating factor supports B cells in skin lesions in hidradenitis suppurativa. J Allergy Clin Immunol 2023; 151:1015-1026. [PMID: 36481267 DOI: 10.1016/j.jaci.2022.10.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 09/17/2022] [Accepted: 10/20/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by painful inflamed nodules, abscesses, and pus-draining tunnels appearing in axillary, inguinal, and perianal skin areas. HS lesions contain various types of immigrated immune cells. OBJECTIVE This study aimed to characterize mediators that support lesional B/plasma cell persistence in HS. METHODS Skin samples from several cohorts of HS patients and control cohorts were assessed by mRNA sequencing, quantitative PCR on reverse-transcribed RNA, flow cytometry, and immunohistofluorescence. Blood plasma and cultured skin biopsy samples, keratinocytes, dermal fibroblasts, neutrophilic granulocytes (neutrophils), monocytes, and B cells were analyzed. Complex systems biology approaches were used to evaluate bulk and single-cell RNA sequencing data. RESULTS Proportions of B/plasma cells, neutrophils, CD8+ T cells, and M0 and M1 macrophages were elevated in HS lesions compared to skin of healthy and perilesional intertriginous areas. There was an association between B/plasma cells, neutrophils, and B-cell activating factor (BAFF, aka TNFSF13B). BAFF was abundant in HS lesions, particularly in nodules and abscesses. Among the cell types present in HS lesions, myeloid cells were the main BAFF producers. Mechanistically, granulocyte colony-stimulating factor in the presence of bacterial products was the major stimulus for neutrophils' BAFF secretion. Lesional upregulation of BAFF receptors was attributed to B cells (TNFRSF13C/BAFFR and TNFRSF13B/TACI) and plasma cells (TNFRSF17/BCMA). Characterization of the lesional BAFF pathway revealed molecules involved in migration/adhesion (eg, CXCR4, CD37, CD53, SELL), proliferation/survival (eg, BST2), activation (eg, KLF2, PRKCB), and reactive oxygen species production (eg, NCF1, CYBC1) of B/plasma cells. CONCLUSION Neutrophil-derived BAFF supports B/plasma cell persistence and function in HS lesions.
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Affiliation(s)
- Robert Sabat
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany; Interdisciplinary Group Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Deimantė Šimaitė
- Data and Data Sciences, Sanofi-Aventis Deutschland GmbH, Frankfurt, Germany
| | - Johann Eli Gudjonsson
- Department of Dermatology, University of Michigan, and Taubman Medical Research Institute, University of Michigan Medical School, Ann Arbor, Mich
| | - Theresa-Charlotte Brembach
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany; Interdisciplinary Group Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Food Chemistry, Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Katrin Witte
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany; Interdisciplinary Group Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Inflammation and Regeneration of the Skin, BIH Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Torben Krause
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Georgios Kokolakis
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Eckart Bartnik
- Immunology & Inflammation Research TA, Sanofi-Aventis Deutschland GmbH, Frankfurt, Germany
| | - Christos Nikolaou
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany; Interdisciplinary Group Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Natascha Rill
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany; Interdisciplinary Group Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Béma Coulibaly
- Molecular Histopathology & Bio-Imaging, R&D, Sanofi-Aventis, Vitry-sur-Seine, France
| | - Clément Levin
- Molecular Histopathology & Bio-Imaging, R&D, Sanofi-Aventis, Vitry-sur-Seine, France
| | - Matthias Herrmann
- Immunology & Inflammation Research TA, Sanofi-Aventis Deutschland GmbH, Frankfurt, Germany
| | - Gabriela Salinas
- NGS-Integrative Genomics Core Unit, Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Thomas Leeuw
- Immunology & Inflammation Research TA, Sanofi-Aventis Deutschland GmbH, Frankfurt, Germany
| | - Hans-Dieter Volk
- BIH Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany; Institute of Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Kerstin Wolk
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany; Interdisciplinary Group Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Inflammation and Regeneration of the Skin, BIH Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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10
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Balato A, Scala E, Eyerich K, Brembilla NC, Chiricozzi A, Sabat R, Ghoreschi K. Management of Infections in Psoriatic Patients Treated with Systemic Therapies: A Lesson from the Immunopathogenesis of Psoriasis. Dermatol Pract Concept 2023; 13:dpc.1301a16. [PMID: 36892377 PMCID: PMC9946081 DOI: 10.5826/dpc.1301a16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 02/04/2023] Open
Abstract
Modern treatments continue to be developed based on identifying targets within the innate and adaptive immune pathways associated with psoriasis. Whilst there is a sound biologic rationale for increased risk of infection following treatment with immunomodulators, the clinical evidence is confounded by these agents being used in patients affected with several comorbidities. In an era characterized by an ever greater and growing risk of infections, it is necessary to always be updated on this risk. In this mini-review, we will discuss recent updates in psoriasis immunopathogenesis as a rationale for systemic therapy, outline the risk of infections linked to the disease itself and systemic therapy as well, and provide an overview of the prevention and management of infections.
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Affiliation(s)
- Anna Balato
- Dermatology Unit, University of Campania, Naples, Italy
| | - Emanuele Scala
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kilian Eyerich
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Dermatology and Venereology, Unit of Dermatology, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Robert Sabat
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin, Berlin, Germany.,Psoriasis Research and Treatment Center, Department of Dermatology and Allergy and Institute of Medical Immunology, Charité-Universitätsmedizin, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin, Berlin, Germany
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11
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Sabat R, Tsaousi A, Ghoreschi K, Wolk K, Schneider-Burrus S. Sex-disaggregated population analysis in patients with hidradenitis suppurativa. Front Med (Lausanne) 2022; 9:1028943. [PMID: 36388895 PMCID: PMC9663462 DOI: 10.3389/fmed.2022.1028943] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/11/2022] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a common chronic inflammatory skin disease, which affects both sexes. OBJECTIVES Identification of sex-specific risk factors, comorbidity, clinical manifestations, and treatments in HS patients. METHODS A non-interventional, cross-sectional, mono-centric study with 500 HS patients. All patients were examined by dermatologists. Prospectively collected demographic, anamnestic, clinical data, and blood parameters were evaluated. RESULTS There were no significant differences in age at HS onset and in disease duration between female and male patients. Furthermore, no differences regarding the family history for HS were found between sexes. Regarding further risk factors for HS, central obesity was more frequent in women while extensive cigarette smoking and acne vulgaris were more commonly found among male patients. Regarding comorbidity, lower HDL-levels were significantly more frequent in men. Female patients were found to suffer significantly more often from back pain, especially in the neck/shoulder region and lower back. Analyzing the clinical manifestation of HS, the groin was more frequently involved in women and the axillae in men. Women showed a higher number of skin sites with inflammatory nodules, whereas fistulas were observed more frequently in men. Nevertheless, there was no difference in HS treatment applied to female vs. male patients. LIMITATIONS Data were obtained from a mono-centric study. CONCLUSION Significant differences in HS risk factors, comorbidity, and clinical manifestation exist between female and male patients. Thus, sex-specific differences should be taken into account in the prevention as well as medical and surgical treatment of HS patients.
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Affiliation(s)
- Robert Sabat
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
- Psoriasis Research and Treatment Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Athanasia Tsaousi
- Psoriasis Research and Treatment Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Kerstin Wolk
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
- Psoriasis Research and Treatment Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Sylke Schneider-Burrus
- Institute of Medical Immunology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
- Center for Dermatosurgery, Havelklinik Berlin, Berlin, Germany
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12
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The Role of Interleukins in the Pathogenesis of Dermatological Immune-Mediated Diseases. Adv Ther 2022; 39:4474-4508. [PMID: 35997892 PMCID: PMC9395905 DOI: 10.1007/s12325-022-02241-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/22/2022] [Indexed: 01/30/2023]
Abstract
Autoimmune inflammatory diseases are primarily characterized by deregulated expression of cytokines, which drive pathogenesis of these diseases. A number of approved and experimental therapies utilize monoclonal antibodies against cytokine proteins. Cytokines can be classified into different families including the interleukins, which are secreted and act on leukocytes, the tumor necrosis factor (TNF) family, as well as chemokine proteins. In this review article, we focus on the interleukin family of cytokines, of which 39 members have been identified to this date. We outline the role of each of these interleukins in the immune system, and various dermatological inflammatory diseases with a focused discussion on the pathogenesis of psoriasis and atopic dermatitis. In addition, we describe the roles of various interleukins in psychiatric, cardiovascular, and gastrointestinal comorbidities. Finally, we review clinical efficacy and safety data from emerging late-phase anti-interleukin therapies under development for psoriasis and atopic dermatitis. Collectively, additional fundamental and clinical research remains necessary to fully elucidate the roles of various interleukin proteins in the pathogenesis of inflammatory dermatologic diseases, and treatment outcomes in patients.
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13
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Hidradenitis Suppurativa: Host-Microbe and Immune Pathogenesis Underlie Important Future Directions. JID INNOVATIONS 2021; 1:100001. [PMID: 34909706 PMCID: PMC8659377 DOI: 10.1016/j.xjidi.2021.100001] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/24/2020] [Accepted: 12/10/2020] [Indexed: 12/17/2022] Open
Abstract
Hidradenitis suppurativa (HS) is an inflammatory disease of the skin with a chronic, relapsing-remitting course. The pathogenesis of the disease is poorly understood and involves multiple factors, including genetics, environment, host-microbe interactions, and immune dysregulation. In particular, the composition of the cutaneous microbiome shifts as the disease progresses, although it is unclear whether this is a primary or secondary process. Trials with immunomodulatory therapy elucidate the role of specific immune pathways and cytokine signaling in disease mechanism, such as TNF-α, IL-1β, IL-12, IL-17, IL-23, and complement. Future studies should continue examining the causes of and contributing factors to microbial changes and immune dysregulation in HS pathogenesis.
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Key Words
- AMP, antimicrobial peptide
- BD, β-defensin
- BMI, body mass index
- DC, dendritic cell
- DCD, dermcidin
- GSC, γ-secretase complex
- HS, hidradenitis suppurativa
- HiSCR, hidradenitis suppurativa clinical response
- IBD, inflammatory bowel disease
- IHS4, International Hidradenitis Suppurativa Severity Score System
- KC, keratinocyte
- MMP, matrix metalloproteinase
- NET, neutrophil extracellular traps
- NMSC, nonmelanoma skin cancer
- PG, pyoderma gangrenosum
- RCT, randomized controlled trial
- SAPHO, synovitis, acne, pustulosis, hyperostosis, and osteitis
- TLR, toll-like receptor
- Th, T helper type
- iNOS, inducible nitric oxide synthase
- pDC, plasmacytoid dendritic cell
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14
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Increased Serum Levels of S100A4 and S100A15 in Individuals Suffering from Hidradenitis Suppurativa. J Clin Med 2021; 10:jcm10225320. [PMID: 34830597 PMCID: PMC8617841 DOI: 10.3390/jcm10225320] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/02/2021] [Accepted: 11/10/2021] [Indexed: 12/25/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Recently, some S100 proteins have been suggested to play an important role in the pathogenesis of chronic immune-mediated inflammatory diseases and they may constitute valuable biomarkers for these diseases’ diagnosis and monitoring. The objective of the current study was to investigate, for the first time, serum levels of S100A4 and S100A15 in individuals suffering from HS. Furthermore, we assessed the associations between S100A4 and S100A15 serum levels and the severity of disease, CRP serum concentration and some demographic and clinical data. Serum levels of S100A4 and S100A15 were evaluated with the commercially available ELISA kit according to the manufacturer’s instructions. The serum level of S100A4 in individuals with HS was significantly elevated as compared to controls, with the highest level found in the individuals in Hurley stage II. The S100A15 serum level was positively correlated with the CRP concentration and was associated with the severity of the disease. The serum level of S100A15 in the individuals in Hurley stage III was significantly elevated compared to that of the controls and the individuals with HS in Hurley stages I and II. S100A4 and S100A15 may be considered as new serum biomarkers for the monitoring of HS progression, and they may play a role in the pathogenesis of HS by promoting inflammatory process and fibrosis.
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15
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Hansen BT, Maschkowitz G, Podschun R, Fickenscher H. The Kinocidin Interleukin-26 Shows Immediate Antimicrobial Effects Even to Multi-resistant Isolates. Front Microbiol 2021; 12:757215. [PMID: 34733265 PMCID: PMC8558509 DOI: 10.3389/fmicb.2021.757215] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/28/2021] [Indexed: 11/24/2022] Open
Abstract
The cationic proinflammatory cytokine Interleukin 26 (IL-26) shows antibacterial activity and inhibits the replication of cytomegalovirus and hepatitis C virus. This study evaluates the early microbicidal activities of IL-26 against major bacterial species including multi-resistant variants and Candida albicans. Recombinant IL-26 was bacterially expressed and studied for its microbicidal effects in culture. We show that IL-26 has strong 90% bactericidal activities against Enterococcus faecalis, Enterococcus faecium, Staphylococcus aureus, and Acinetobacter baumannii. Similarly, IL-26 sensitivity was also detectable in vancomycin-resistant Enterococcus species, methicillin-resistant S. aureus, and carbapenem-resistant A. baumannii clinical isolates. Additionally, a significant, albeit weak fungicidal effect against Candida albicans was observed. Activities against Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa were not detectable. The proinflammatory cytokine and kinocidin IL-26 shows strong bactericidal activities against A. baumannii and, almost selectively, against Gram-positive bacteria.
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Affiliation(s)
- Bjoern-Thore Hansen
- Institute for Infection Medicine, Christian-Albrecht University of Kiel and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Gregor Maschkowitz
- Institute for Infection Medicine, Christian-Albrecht University of Kiel and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Rainer Podschun
- Institute for Infection Medicine, Christian-Albrecht University of Kiel and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Helmut Fickenscher
- Institute for Infection Medicine, Christian-Albrecht University of Kiel and University Hospital Schleswig-Holstein, Kiel, Germany
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16
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Gowhari Shabgah A, Abdelbasset WK, Sulaiman Rahman H, Bokov DO, Suksatan W, Thangavelu L, Ahmadi M, Malekahmadi M, Gheibihayat SM, Gholizadeh Navashenaq J. A comprehensive review of IL-26 to pave a new way for a profound understanding of the pathobiology of cancer, inflammatory diseases and infections. Immunology 2021; 165:44-60. [PMID: 34716913 DOI: 10.1111/imm.13424] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/24/2021] [Accepted: 10/21/2021] [Indexed: 11/29/2022] Open
Abstract
Cytokines are considered vital mediators of the immune system. Down- or upregulation of these mediators is linked to several inflammatory and pathologic situations. IL-26 is referred to as an identified member of the IL-10 family and IL-20 subfamily. Due to having a unique cationic structure, IL-26 exerts diverse functions in several diseases. Since IL-26 is mainly secreted from Th17, it is primarily considered a pro-inflammatory cytokine. Upon binding to its receptor complex (IL-10R1/IL-20R2), IL-26 activates multiple signalling mediators, especially STAT1/STAT3. In cancer, IL-26 induces IL-22-producing cells, which consequently decrease cytotoxic T-cell functions and promote tumour growth through activating anti-apoptotic proteins. In hypersensitivity conditions such as rheumatoid arthritis, multiple sclerosis, psoriasis and allergic disease, this cytokine functions primarily as the disease-promoting mediator and might be considered a biomarker for disease prognosis. Although IL-26 exerts antimicrobial function in infections such as hepatitis, tuberculosis and leprosy, it has also been shown that IL-26 might be involved in the pathogenesis and exacerbation of sepsis. Besides, the involvement of IL-26 has been confirmed in other conditions, including graft-versus-host disease and chronic obstructive pulmonary disease. Therefore, due to the multifarious function of this cytokine, it is proposed that the underlying mechanism regarding IL-26 function should be elucidated. Collectively, it is hoped that the examination of IL-26 in several contexts might be promising in predicting disease prognosis and might introduce novel approaches in the treatment of various diseases.
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Affiliation(s)
- Arezoo Gowhari Shabgah
- School of Medicine, Bam University of Medical Sciences, Bam, Iran.,Student Research Committee, Bam University of Medical Sciences, Bam, Iran
| | - Walid Kamal Abdelbasset
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia.,Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Heshu Sulaiman Rahman
- Department of Physiology, College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq.,Department of Medical Laboratory Sciences, Komar University of Science and Technology, Sulaymaniyah, Iraq
| | - Dmitry O Bokov
- Institute of Pharmacy, Sechenov First Moscow State Medical University, Moscow, Russia.,Laboratory of Food Chemistry, Federal Research Center of Nutrition, Biotechnology and Food Safety, Moscow, Russia
| | - Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Lakshmi Thangavelu
- Department of Pharmacology, Saveetha institute of medical and Technical Sciences, Saveetha Dental College and Hospital, Saveetha University, Chennai, India
| | - Majid Ahmadi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahsa Malekahmadi
- Research Center for Gastroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Gheibihayat
- Department of Biotechnology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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17
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Mintoff D, Borg I, Pace NP. The Clinical Relevance of the Microbiome in Hidradenitis Suppurativa: A Systematic Review. Vaccines (Basel) 2021; 9:1076. [PMID: 34696185 PMCID: PMC8537933 DOI: 10.3390/vaccines9101076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/18/2021] [Accepted: 09/20/2021] [Indexed: 12/21/2022] Open
Abstract
Hidradenitis suppurativa is a chronic disease of the pilosebaceous unit. The name of the condition is a testament to the presumed relationship between the disease and the microbiome. The pathophysiology of hidradenitis suppurativa is, however, complex and believed to be the product of a multifactorial interplay between the interfollicular epithelium, pilosebaceous unit, microbiome, as well as genetic and environmental factors. In this review we assimilate the existing literature regarding the role played by the human microbiome in HS in various contexts of the disease, including the pathophysiologic, therapeutic, and potentially, diagnostic as well prognostic. In conclusion, the role played by the microbiome in HS is extensive and relevant and can have bench-to-bedside applications.
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Affiliation(s)
- Dillon Mintoff
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta;
- Department of Dermatology, Mater Dei Hospital, Triq Id-Donaturi tad-Demm, MSD 2090 Msida, Malta
| | - Isabella Borg
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta;
- Centre for Molecular Medicine and Biobanking, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta;
- Medical Genetics Unit, Department of Pathology, Mater Dei Hospital, MSD 2090 Msida, Malta
| | - Nikolai Paul Pace
- Centre for Molecular Medicine and Biobanking, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta;
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18
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Rosi E, Fastame MT, Scandagli I, Di Cesare A, Ricceri F, Pimpinelli N, Prignano F. Insights into the Pathogenesis of HS and Therapeutical Approaches. Biomedicines 2021; 9:1168. [PMID: 34572354 PMCID: PMC8467309 DOI: 10.3390/biomedicines9091168] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 12/13/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a debilitating, chronic, (auto)inflammatory disease primarily affecting apocrine gland-rich areas of the body. Although pathogenic mechanisms responsible for HS have not yet been fully elucidated, it is a multifactorial process whose main target is the terminal follicle. The role of the inflammatory process (and consequently of cytokine milieu) and of several other factors (genetics, lifestyle, hormonal status, microbiome, innate and adaptive immune systems) involved in HS pathogenesis has been investigated (and often defined) over the years with a view to transferring research results from bench to bedside and describing a unique and universally accepted pathogenetic model. This review will update readers on recent advances in our understanding of HS pathogenesis and novel (potential) medical therapies for patients with moderate-to-severe HS.
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Affiliation(s)
| | | | | | | | | | | | - Francesca Prignano
- Department of Health Sciences, Section of Dermatology, University of Florence, 50125 Florence, Italy; (E.R.); (M.T.F.); (I.S.); (A.D.C.); (F.R.); (N.P.)
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19
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Hidradenitis Suppurativa: Where We Are and Where We Are Going. Cells 2021; 10:cells10082094. [PMID: 34440863 PMCID: PMC8392140 DOI: 10.3390/cells10082094] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 12/19/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease primarily affecting apocrine gland-rich areas of the body. It is a multifactorial disease in which genetic and environmental factors play a key role. The primary defect in HS pathophysiology involves follicular occlusion of the folliculopilosebaceous unit, followed by follicular rupture and immune responses. Innate pro-inflammatory cytokines (e.g., IL-1β, and TNF-α); mediators of activated T helper (Th)1 and Th17 cells (e.g., IFN-γ, and IL-17); and effector mechanisms of neutrophilic granulocytes, macrophages, and plasma cells are involved. On the other hand, HS lesions contain anti-inflammatory mediators (e.g., IL-10) and show limited activity of Th22 cells. The inflammatory vicious circle finally results in pain, purulence, tissue destruction, and scarring. HS pathogenesis is still enigmatic, and a valid animal model for HS is currently not available. All these aspects represent a challenge for the development of therapeutic approaches, which are urgently needed for this debilitating disease. Available treatments are limited, mostly off-label, and surgical interventions are often required to achieve remission. In this paper, we provide an overview of the current knowledge surrounding HS, including the diagnosis, pathogenesis, treatments, and existing translational studies.
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20
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Schell SL, Schneider AM, Nelson AM. Yin and Yang: A disrupted skin microbiome and an aberrant host immune response in hidradenitis suppurativa. Exp Dermatol 2021; 30:1453-1470. [PMID: 34018644 DOI: 10.1111/exd.14398] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/03/2021] [Accepted: 05/13/2021] [Indexed: 12/13/2022]
Abstract
The skin microbiome plays an important role in maintaining skin homeostasis by controlling inflammation, providing immune education and maintaining host defense. However, in many inflammatory skin disorders the skin microbiome is disrupted. This dysbiotic community may contribute to disease initiation or exacerbation through the induction of aberrant immune responses in the absence of infection. Hidradenitis suppurativa (HS) is a complex, multifaceted disease involving the skin, innate and adaptive immunity, microbiota and environmental stimuli. Herein, we discuss the current state of HS skin microbiome research and how microbiome components may activate pattern recognition receptor (PRR) pathways, metabolite sensing pathways and antigenic receptors to drive antimicrobial peptide, cytokine, miRNA and adaptive immune cell responses in HS. We highlight the major open questions that remain to be addressed and how antibiotic therapies for HS likely influence both microbial burden and inflammation. Ultimately, we hypothesize that the two-way communication between the skin microbiome and host immune response in HS skin generates a chronic positive feed-forward loop that perpetuates chronic inflammation, tissue destruction and disease exacerbation.
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Affiliation(s)
- Stephanie L Schell
- Department of Dermatology, Penn State Health Hershey Medical Center, Hershey, PA, USA
| | - Andrea M Schneider
- Department of Dermatology, Penn State Health Hershey Medical Center, Hershey, PA, USA
| | - Amanda M Nelson
- Department of Dermatology, Penn State Health Hershey Medical Center, Hershey, PA, USA
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21
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Schneider-Burrus S, Tsaousi A, Barbus S, Huss-Marp J, Witte K, Wolk K, Fritz B, Sabat R. Features Associated With Quality of Life Impairment in Hidradenitis Suppurativa Patients. Front Med (Lausanne) 2021; 8:676241. [PMID: 33987196 PMCID: PMC8112201 DOI: 10.3389/fmed.2021.676241] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 03/30/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with an adverse impact on patients' quality of life (QoL). Objectives: To quantify QoL impairment in patients in Germany suffering from HS and to identify the parameters associated with QoL impairment. Methods: A non-interventional, cross-sectional, mono-centric study with 500 HS patients. QoL data (measured using the Dermatology Life Quality Index; DLQI) and demographic, anamnestic, clinical, and blood parameters were collected. All patients were examined by dermatologists that documented the skin alterations. QoL data from 462 HS patients were available and evaluated. Results: The mean (± standard deviation) DLQI score of HS patients was 13.18 ± 7.99. Approximately 40% and 20% of HS patients declared very large and extremely large QoL impairment, respectively. The degree of QoL disturbance correlated with the severity of skin alterations, blood leucocyte count and, in particular, with anogenital localization and the presence of nodules and fistulas. Furthermore, QoL impairment was associated with specific comorbidities, such as adiposity and back pain, but not with HS family history. QoL impairment was not influenced by whether or not the patients had undergone resection surgery or antibiotic treatment but was more severe in HS patients that had undergone abscess lancing compared to patients without such treatment in the past. Limitations: It was a mono-centric study and most data were obtained from self-administered patient questionnaires. The association of QoL with type of treatment was analyzed for abscess lancing, resection surgery, and antibiotic treatment. Further therapeutic modalities recommended in the guidelines were not investigated. Conclusion: A profound impairment in QoL was present in patients with HS, and this was higher than that observed in other studied dermatoses. The degree of impairment correlated with the extent of cutaneous and some extra-cutaneous alterations. Surgical and conventional medicamentous therapies of HS were not associated with long-lasting reduction of QoL impairment. Our data support the implementation of patient-reported outcome measures for the assessment of therapy responses.
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Affiliation(s)
- Sylke Schneider-Burrus
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Center for Dermatosurgery, Havelklinik, Berlin, Germany
| | - Athanasia Tsaousi
- Psoriasis Research and Treatment Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Katrin Witte
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Psoriasis Research and Treatment Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH) Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Kerstin Wolk
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Psoriasis Research and Treatment Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH) Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Department of Dermatology, Venereology, and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Björn Fritz
- AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany
| | - Robert Sabat
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Psoriasis Research and Treatment Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
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22
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Hydrogen Sulfide in Skin Diseases: A Novel Mediator and Therapeutic Target. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6652086. [PMID: 33986916 PMCID: PMC8079204 DOI: 10.1155/2021/6652086] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/25/2021] [Accepted: 04/07/2021] [Indexed: 02/05/2023]
Abstract
Together with nitric oxide (NO) and carbon monoxide (CO), hydrogen sulfide (H2S) is now recognized as a vital gaseous transmitter. The ubiquitous distributions of H2S-producing enzymes and potent chemical reactivities of H2S in biological systems make H2S unique in its ability to regulate cellular and organ functions in both health and disease. Acting as an antioxidant, H2S can combat oxidative species such as reactive oxygen species (ROS) and reactive nitrogen species (RNS) and protect the skin from oxidative stress. The aberrant metabolism of H2S is involved in the pathogenesis of several skin diseases, such as vascular disorders, psoriasis, ulcers, pigment disorders, and melanoma. Furthermore, H2S donors and some H2S hybrids have been evaluated in many experimental models of human disease and have shown promising therapeutic results. In this review, we discuss recent advances in understanding H2S and its antioxidant effects on skin pathology, the roles of altered H2S metabolism in skin disorders, and the potential value of H2S as a therapeutic intervention in skin diseases.
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23
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Wolk K, Brembach T, Šimaitė D, Bartnik E, Cucinotta S, Pokrywka A, Irmer M, Triebus J, Witte‐Händel E, Salinas G, Leeuw T, Volk H, Ghoreschi K, Sabat R. Activity and components of the granulocyte colony‐stimulating factor pathway in hidradenitis suppurativa*. Br J Dermatol 2021; 185:164-176. [DOI: 10.1111/bjd.19795] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2020] [Indexed: 12/12/2022]
Affiliation(s)
- K. Wolk
- Psoriasis Research and Treatment Centre Charité – Universitätsmedizin Berlin Berlin Germany
- Inflammation and Regeneration of Skin BIH Center for Regenerative Therapies Charité – Universitätsmedizin Berlin Berlin Germany
| | - T.‐C. Brembach
- Psoriasis Research and Treatment Centre Charité – Universitätsmedizin Berlin Berlin Germany
- University of PotsdamInstitute of Nutritional ScienceDepartment of Food Chemistry Potsdam Germany
| | - D. Šimaitė
- Data and Data Sciences Sanofi‐Aventis Deutschland GmbH FrankfurtGermany
| | - E. Bartnik
- Immunology and Inflammation Research Sanofi‐Aventis Deutschland GmbH Frankfurt Germany
| | - S. Cucinotta
- Psoriasis Research and Treatment Centre Charité – Universitätsmedizin Berlin Berlin Germany
| | - A. Pokrywka
- Department of Dermatology, Venereology and Allergology Charité – Universitätsmedizin Berlin Germany
| | - M.L. Irmer
- Psoriasis Research and Treatment Centre Charité – Universitätsmedizin Berlin Berlin Germany
| | - J. Triebus
- Psoriasis Research and Treatment Centre Charité – Universitätsmedizin Berlin Berlin Germany
| | - E. Witte‐Händel
- Psoriasis Research and Treatment Centre Charité – Universitätsmedizin Berlin Berlin Germany
| | - G. Salinas
- Transcriptome and Genome Core Unit University Medical Center Göttingen Göttingen Germany
| | - T. Leeuw
- Immunology and Inflammation Research Sanofi‐Aventis Deutschland GmbH Frankfurt Germany
| | - H.‐D. Volk
- BIH Center for Regenerative Therapies Charité – Universitätsmedizin Berlin Berlin Germany
- Institute of Medical Immunology Charité – Universitätsmedizin Berlin Germany
| | - K. Ghoreschi
- Department of Dermatology, Venereology and Allergology Charité – Universitätsmedizin Berlin Germany
| | - R. Sabat
- Psoriasis Research and Treatment Centre Charité – Universitätsmedizin Berlin Berlin Germany
- Interdisciplinary group Molecular Immunopathology Dermatology/Medical Immunology Charité – Universitätsmedizin Berlin Berlin Germany
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González-Manso A, Agut-Busquet E, Romaní J, Vilarrasa E, Bittencourt F, Mensa A, Cantó E, Aróstegui JI, Vidal S. Hidradenitis Suppurativa: Proposal of Classification in Two Endotypes with Two-Step Cluster Analysis. Dermatology 2020; 237:365-371. [PMID: 33171462 DOI: 10.1159/000511045] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/19/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Hidradenitis suppurativa (HS) is a chronic, inflammatory, recurrent disorder of the pilosebaceous unit. Currently, several attempts have been made to classify this disease according to its pathogenesis and clinical manifestations. We attempted at classifying 103 patients using two-step cluster analysis. METHODS The final model included body mass index, C-reactive protein (CRP), and serum concentrations of IL-1, IL-6, IL-17, and IL-10 as continuous variables, and sex, later/early onset, anterior/posterior lesion sites, presence/absence of sinus tracts, nodules and abscesses, positive/negative history of pilonidal sinus, and presence/absence of mutations in gamma-secretase subunits (APH1A, APH1B, MEFV, NCSTN, PSEN1, PSEN2, PSENEN, PSTPIP1) as qualitative variables. RESULTS The resultant model defined two groupings or clusters: cluster 1 (64.9% of patients) characterized by nonobese males, with nodular lesions in posterior sites, early-onset HS, higher IL-10, presence of gamma-secretase mutations, and history of pilonidal sinus; and cluster 2 (35.1% of patients) characterized by obese females or males, with lesions in anterior sites, more presence of sinus tracts and abscesses and less nodules, later-onset HS, and higher concentrations of IL-1, CRP, IL-17, and IL-6. Severity measures (Hurley, HS-PGA, and IHS4) and tobacco use were discarded because the analysis found them to be less relevant for clustering. CONCLUSION Our resultant model confirms the clinical impression that HS is a disease spectrum with two pathogenic poles defining two clusters or endotypes. The probability of having severe disease was equally distributed in the two clusters. The variable with the highest predictive value for clustering was involvement of typical anterior sites (axillae, submammary) or atypical posterior sites (back, gluteal). Serum concentrations of interleukins, tobacco use, and sex had a lower predictive power for clustering.
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Affiliation(s)
- Anxo González-Manso
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Eugènia Agut-Busquet
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.,Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jorge Romaní
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain, .,Department of Dermatology, Consorci Sanitari Parc Taulí, Sabadell, Spain,
| | - Eva Vilarrasa
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.,Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Flavia Bittencourt
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.,Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Anna Mensa
- Department of Immunology, Hospital Clínic i Provincial, Barcelona, Spain
| | - Elisabeth Cantó
- Department of Immunology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Juan I Aróstegui
- Department of Immunology, Hospital Clínic i Provincial, Barcelona, Spain
| | - Silvia Vidal
- Department of Immunology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Wolk K, Join-Lambert O, Sabat R. Aetiology and pathogenesis of hidradenitis suppurativa. Br J Dermatol 2020; 183:999-1010. [PMID: 33048349 DOI: 10.1111/bjd.19556] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2020] [Indexed: 02/06/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory disorder. Patients develop inflamed nodules and abscesses and, at later stages of disease, epithelialized tunnels and scars in skinfolds of axillary, inguinal, gluteal and perianal areas. Quality of life is affected due to severe pain, purulent secretion, restricted mobility and systemic involvement. Genetics and lifestyle factors including smoking and obesity contribute to the development of HS. These factors lead to microbiome alteration, subclinical inflammation around the terminal hair follicles, and infundibular hyperkeratosis, resulting in plugging and rupture of the follicles. Cell-damage-associated molecules and propagating bacteria trigger inflammation and lead to massive immune cell infiltration that clinically manifests as inflamed nodules and abscesses. The immune system plays a key role also in the progression and chronification of skin alterations. Innate proinflammatory cytokines (e.g. interleukin-1β and tumour necrosis factor-α), mediators of activated T helper (Th)1 and Th17 cells (e.g. interleukin-17 and interferon-γ), and effector mechanisms of neutrophilic granulocytes, macrophages and plasma cells are involved. Simultaneously, skin lesions contain anti-inflammatory mediators (e.g. interleukin-10) and show limited activity of Th22 and regulatory T cells. The inflammatory vicious circle finally results in pain, purulence, tissue destruction and scarring. Chronic inflammation in patients with HS is also frequently detected in organs other than the skin, as indicated by their comorbidities. All these aspects represent a challenge for the development of therapeutic approaches, which are urgently needed for this debilitating disease. This scholarly review focuses on the causes and pathogenetic mechanisms of HS and the potential therapeutic value of this knowledge.
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Affiliation(s)
- K Wolk
- Berlin-Brandenburg Centre for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - O Join-Lambert
- Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0, EA 2656), Normandie University, UNICAEN, UNIROUEN, Caen, France.,Department of Microbiology, CHU de Caen Normandie, Caen, France
| | - R Sabat
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany
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26
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The Role of Thermal Water in Chronic Skin Diseases Management: A Review of the Literature. J Clin Med 2020; 9:jcm9093047. [PMID: 32971735 PMCID: PMC7563194 DOI: 10.3390/jcm9093047] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/08/2020] [Accepted: 09/14/2020] [Indexed: 01/06/2023] Open
Abstract
The benefits of thermal water in different diseases have been known since ancient times. Over the past decades, a re-assessment of the use of mineral water for the treatment of several pathologic conditions has taken place around the world. Today, water therapy is being practiced in many countries that have a variety of mineral springs considerably different in their hydrogeologic origin, temperature, and chemical composition. Thermal water and balneotherapy offer several advantages: this approach needs no chemicals or potentially harmful drugs; there are almost no side effects during and after treatment, and there is a low risk to the patient’s general health and well-being. However, it is difficult to evaluate the efficacy of this therapeutic approach in clinical practice due to the complexity of molecular mechanisms underlying its efficacy. Here we review the current knowledge of the chemical, immunological, and microbiological basis for therapeutic effects of thermal water with a specific focus on chronic inflammatory skin diseases. We also describe recent evidence of the major dermatologic diseases that are frequently treated by balneotherapy with a remarkable rate of success. Moreover, we discuss the potential role of balneotherapy either alone or as a complement to conventional medical treatments.
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Broux B, Zandee S, Gowing E, Charabati M, Lécuyer MA, Tastet O, Hachehouche L, Bourbonnière L, Ouimet JP, Lemaitre F, Larouche S, Cayrol R, Bouthillier A, Moumdjian R, Lahav B, Poirier J, Duquette P, Arbour N, Peelen E, Prat A. Interleukin-26, preferentially produced by T H17 lymphocytes, regulates CNS barrier function. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2020; 7:7/6/e870. [PMID: 32788322 PMCID: PMC7428369 DOI: 10.1212/nxi.0000000000000870] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/13/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate the involvement of interleukin (IL)-26 in neuroinflammatory processes in multiple sclerosis (MS), in particular in blood-brain barrier (BBB) integrity. METHODS Expression of IL-26 was measured in serum, CSF, in vitro differentiated T helper (TH) cell subsets, and postmortem brain tissue of patients with MS and controls by ELISA, quantitative PCR, and immunohistochemistry. Primary human and mouse BBB endothelial cells (ECs) were treated with IL-26 in vitro and assessed for BBB integrity. RNA sequencing was performed on IL-26-treated human BBB ECs. Myelin oligodendrocyte glycoprotein35-55 experimental autoimmune encephalomyelitis (EAE) mice were injected IP with IL-26. BBB leakage and immune cell infiltration were assessed in the CNS of these mice using immunohistochemistry and flow cytometry. RESULTS IL-26 expression was induced in TH lymphocytes by TH17-inducing cytokines and was upregulated in the blood and CSF of patients with MS. CD4+IL-26+ T lymphocytes were found in perivascular infiltrates in MS brain lesions, and both receptor chains for IL-26 (IL-10R2 and IL-20R1) were detected on BBB ECs in vitro and in situ. In contrast to IL-17 and IL-22, IL-26 promoted integrity and reduced permeability of BBB ECs in vitro and in vivo. In EAE, IL-26 reduced disease severity and proinflammatory lymphocyte infiltration into the CNS, while increasing infiltration of Tregs. CONCLUSIONS Our study demonstrates that although IL-26 is preferentially expressed by TH17 lymphocytes, it promotes BBB integrity in vitro and in vivo and is protective in chronic EAE, highlighting the functional diversity of cytokines produced by TH17 lymphocytes.
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Affiliation(s)
- Bieke Broux
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Stephanie Zandee
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Elizabeth Gowing
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Marc Charabati
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Marc-André Lécuyer
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Olivier Tastet
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Lamia Hachehouche
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Lyne Bourbonnière
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Jean-Philippe Ouimet
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Florent Lemaitre
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Sandra Larouche
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Romain Cayrol
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Alain Bouthillier
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Robert Moumdjian
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Boaz Lahav
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Josée Poirier
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Pierre Duquette
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Nathalie Arbour
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Evelyn Peelen
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Alexandre Prat
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada.
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Fletcher JM, Moran B, Petrasca A, Smith CM. IL-17 in inflammatory skin diseases psoriasis and hidradenitis suppurativa. Clin Exp Immunol 2020; 201:121-134. [PMID: 32379344 DOI: 10.1111/cei.13449] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 12/14/2022] Open
Abstract
The skin is one of the most important organs in the body, providing integrity and acting as a barrier to exclude microbes, allergens and chemicals. However, chronic skin inflammation can result when barrier function is defective and immune responses are dysregulated or misdirected against harmless or self-antigens. During the last 15 years interleukin (IL)-17 cytokines have emerged as key players in multiple inflammatory disorders, and they appear to be especially prominent in skin inflammation. IL-17 cytokines produced by T cells and other cell types potently activate keratinocytes to promote inflammation in a feed-forward loop. Given this key pathogenic role of the IL-17 pathway in autoimmune and inflammatory disease, it has been the focus of intense efforts to target therapeutically. The inflammatory effects of IL-17 can be targeted directly by blocking the cytokine or its receptor, or indirectly by blocking cytokines upstream of IL-17-producing cells. Psoriasis has been the major success story for anti-IL-17 drugs, where they have proven more effective than in other indications. Hidradenitis suppurativa (HS) is another inflammatory skin disease which, despite carrying a higher burden than psoriasis, is poorly recognized and under-diagnosed, and current treatment options are inadequate. Recently, a key role for the IL-17 pathway in the pathogenesis of HS has emerged, prompting clinical trials with a variety of IL-17 inhibitors. In this review, we discuss the roles of IL-17A, IL-17F and IL-17C in psoriasis and HS and the strategies taken to target the IL-17 pathway therapeutically.
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Affiliation(s)
- J M Fletcher
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.,School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - B Moran
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - A Petrasca
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - C M Smith
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
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Hirsh J, Kositangool P, Shah A, Radwan Y, Padilla D, Barragan J, Cervantes J. IL-26 mediated human cell activation and antimicrobial activity against Borrelia burgdorferi. CURRENT RESEARCH IN MICROBIAL SCIENCES 2020; 1:30-36. [PMID: 34841299 PMCID: PMC8610320 DOI: 10.1016/j.crmicr.2020.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/25/2020] [Accepted: 05/27/2020] [Indexed: 12/31/2022] Open
Abstract
Lyme disease is an inflammatory disease caused by infection with Borrelia burgdorferi (Bb). Inflammatory sequelae of Bb infection appear to be refractory to antibiotics. An antimicrobial peptide with the ability to bind the DNA in the tissue could serve as a viable option of treatment for chronic complications of Lyme borreliosis. DNA of Bb can remain in tissues causing a prolonged inflammatory response that lead to chronic joint pain. Here we examined the effect of IL-26, a newly reported antimicrobial protein, against Bb DNA. An antimicrobial effect of IL-26 on the spirochete was observed. In human macrophages, IL-26 treated cells showed an increase in IRF activation upon Bb stimulation. Moreover, IL-26 treated macrophages showed an increased in phagocytic activity compared to untreated cells. Although no Bb DNA degradation was observed using a TUNEL assay run in an agarose gel, a Comet assay on whole bacteria showed cellular and Bb DNA degradation by IL-26. Our results showed that IL-26 (monomer and dimer) has not only the potential to control Bb growth in vitro, but it also enhances the anti-borrelial response of human macrophages. Further research aiming to characterize the role of IL-26 in controlling other aspects of the inflammatory response that could provide insight of its potential therapeutic applications are needed.
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Affiliation(s)
- Joshua Hirsh
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, Texas, U.S.A
| | - Piya Kositangool
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, Texas, U.S.A
| | - Aayush Shah
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, Texas, U.S.A
| | - Yousf Radwan
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, Texas, U.S.A
| | - Diana Padilla
- Laboratory for Education in Molecular Medicine, Texas Tech University Health Sciences Center at El Paso, TX, U.S.A
| | - Jose Barragan
- Laboratory for Education in Molecular Medicine, Texas Tech University Health Sciences Center at El Paso, TX, U.S.A
| | - Jorge Cervantes
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, Texas, U.S.A.,Laboratory for Education in Molecular Medicine, Texas Tech University Health Sciences Center at El Paso, TX, U.S.A
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30
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Emerging medical treatments for hidradenitis suppurativa. J Am Acad Dermatol 2020; 83:554-562. [PMID: 32289386 DOI: 10.1016/j.jaad.2020.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 03/27/2020] [Accepted: 04/02/2020] [Indexed: 02/07/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory disease affecting intertriginous skin areas, and it is characterized by recurrent painful episodes of inflammatory drainage. Although the pathophysiology of HS is not fully understood, recent research points to an imbalance of cytokines as a contributing factor to the associated symptoms of purulent drainage and sinus tract formation. HS lesions are often characterized by a superimposed pathogenic/commensal bacterial infection that can improve with targeted antibiotic therapy. New medical treatments have emerged in recent years, many of which specifically work against a variety of proinflammatory mediators associated with HS. These newer, specified treatment options, in conjunction with surgery and lasers, are thought to provide positive outcomes and an overall improvement in quality of life in patients with HS.
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Abstract
Hidradenitis suppurativa (HS; also designated as acne inversa) is a chronic inflammatory disorder, which affects the intertriginous skin and is associated with numerous systemic comorbidities. The estimated prevalence of HS is ~1% in most studied countries. Typically starting in early adulthood, cutaneous inflamed nodules, abscesses and pus-discharging tunnels develop in axillary, inguinal, gluteal and perianal body sites. The comorbidities of HS include metabolic and cardiovascular disorders, which contribute to reduced life expectancy. A genetic predisposition, smoking, obesity and hormonal factors are established aetiological factors for HS. Cutaneous changes seem to start around hair follicles and involve activation of cells of the innate and adaptive immune systems, with pivotal roles for pro-inflammatory cytokines such as tumour necrosis factor, IL-1β and IL-17. The unrestricted and chronic immune response eventually leads to severe pain, pus discharge, irreversible tissue destruction and scar development. HS has profound negative effects on patients' quality of life, which often culminate in social withdrawal, unemployment, depression and suicidal thoughts. The therapeutic options for HS comprise antibiotic treatment, neutralization of tumour necrosis factor and surgical intervention together with lifestyle modification. Nevertheless, there is an enormous need for awareness of HS, understanding of its pathogenesis and novel treatments.
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32
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Constantinou CA, Fragoulis GE, Nikiphorou E. Hidradenitis suppurativa: infection, autoimmunity, or both? Ther Adv Musculoskelet Dis 2019; 11:1759720X19895488. [PMID: 31908656 PMCID: PMC6937531 DOI: 10.1177/1759720x19895488] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 11/26/2019] [Indexed: 12/13/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease mainly affecting areas rich in apocrine glands. Clinically, is characterized by painful subcutaneous nodules and if left untreated to pus secretion, abscess and fistula formation. Its frequency is estimated to be 0.5-4% of the general population, affecting women more often. Pathogenesis of HS is still not clearly defined. It seems to be a combination of genetic factors with alterations in the skin microbiome. Furthermore, at tissue (i.e. skin) as well as at serum level, several inflammatory cytokines are upregulated. The most important of the latter are tumor necrosis factor (TNF), interleukin (IL)-1, IL-17, and IL-23. Adding another level of complexity, it has been suggested that keratinocytes might be intrinsically activated, contributing also to the observed inflammation. Interestingly, it has been noted that frequency of HS is increased in some autoimmune rheumatic diseases, such as spondyloarthropathies (SpA). Of note, both HS and SpA have relatively strong association with metabolic diseases and obesity implying that there are indeed some common underlying pathophysiological pathways. Although no specific microbe has been identified, alterations in the microbiome of the skin of these patients have been reported. Of note, microbes with a capability for biofilm formation are abundant. Treatment of HS among others, include antibiotics as well as biologic drugs targeting TNF and other cytokines and used for autoimmune rheumatic diseases. Herein, we review the current evidence on links between HS and autoimmune diseases and infectious diseases with a focus on epidemiology and pathophysiology.
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Affiliation(s)
- Costas A Constantinou
- Internal Medicine Department and Tuberculosis Unit, Kyperounta Rural Hospital, Kyperounta, Cyprus
- Communicable Diseases Surveillance and Control Unit, Medical and Public Health Services, Cyprus Ministry of Heath, Nicosia, Cyprus
| | - George E Fragoulis
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
- First Department of Propaedeutic and Internal Medicine, “Laiko” General Hospital, Athens, Greece
| | - Elena Nikiphorou
- Academic Rheumatology Department, King’s College London, Cutcombe Road, London, SE5 9RJ, UK
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33
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Giamarellos‐Bourboulis E. Staphylococcus aureus
and host interaction in the flare‐ups of hidradenitis suppurativa. Br J Dermatol 2019; 181:892-893. [DOI: 10.1111/bjd.18320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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34
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Hatano R, Itoh T, Otsuka H, Okamoto S, Komiya E, Iwata S, Aune TM, Dang NH, Kuwahara-Arai K, Ohnuma K, Morimoto C. Characterization of novel anti-IL-26 neutralizing monoclonal antibodies for the treatment of inflammatory diseases including psoriasis. MAbs 2019; 11:1428-1442. [PMID: 31397631 DOI: 10.1080/19420862.2019.1654305] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Interleukin (IL)-26, known as a Th17 cytokine, acts on various cell types and has multiple biological functions. Although its precise role still remains to be elucidated, IL-26 is suggested to be associated with the pathology of diverse chronic inflammatory diseases such as psoriasis, inflammatory bowel diseases and rheumatoid arthritis. To develop novel neutralizing anti-human IL-26 monoclonal antibodies (mAbs) for therapeutic use in the clinical setting, we immunized mice with human IL-26 protein. Hybridomas producing anti-IL-26 mAbs were screened for various in vitro functional assays, STAT3 phosphorylation and antibiotic assays. Although the IL-20RA/IL-10RB heterodimer is generally believed to be the IL-26 receptor, our data strongly suggest that both IL-20RA-dependent and -independent pathways are involved in IL-26-mediated stimulation. We also investigated the potential therapeutic effect of anti-IL-26 mAbs in the imiquimod-induced psoriasis-like murine model using human IL-26 transgenic mice. These screening methods enabled us to develop novel neutralizing anti-human IL-26 mAbs. Importantly, administration of IL-26-neutralizing mAb did not have an effect on the antimicrobial activity of IL-26. Taken together, our data strongly suggest that our newly developed anti-human IL-26 mAb is a potential therapeutic agent for the treatment of diverse chronic inflammatory diseases including psoriasis.
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Affiliation(s)
- Ryo Hatano
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Takumi Itoh
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Haruna Otsuka
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Sayo Okamoto
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Eriko Komiya
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan.,Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine , Urayasu , Japan
| | - Satoshi Iwata
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Thomas M Aune
- Department of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center , Nashville , TN , USA
| | - Nam H Dang
- Division of Hematology/Oncology, University of Florida , Gainesville , FL , USA
| | - Kyoko Kuwahara-Arai
- Department of Microbiology, Juntendo University School of Medicine , Tokyo , Japan
| | - Kei Ohnuma
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Chikao Morimoto
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan
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