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Sardana K, Mathachan SR, Khurana A. Tofacitinib: A Treatment Option for Recalcitrant Polymorphic Light Eruption and Its Mechanistic Rationale. Dermatitis 2024. [PMID: 38265448 DOI: 10.1089/derm.2023.0360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Background: Polymorphous light eruption is largely characterized by a delayed-type (type IV) hypersensitivity reaction to 1 or more undefined endogenous ultraviolet-induced skin antigens. Objectives: To evaluate the efficacy of tofacitinib in refractory cases of polymorphous light eruption. Methods: Seven patients who had failed multiple systemic treatments or relapsed within 2 weeks of existing systemic agents with concomitant photoprotection were offered tofacitinib after written consent. Results: Initiation of tofacitinib led to a marked reduction of itching (mean ± SD 3.1 ± 1.12 days) followed by clinical resolution (mean ± SD 2.6 ± 1.1 weeks). The duration of therapy ranged from 1 to 3 months (mean ± SD 2 ± 0.63 months), and 4 of 7 patients had a recurrence in 5.5 weeks and were again initiated on tofacitinib with a prompt response. Conclusion: Tofacitinib inhibits Janus kinase (JAK)1 and JAK3 thus it can abrogate the effects of the predominant cytokine milieu of polymorphic light eruption (PMLE) and thus reduce the expression of aberrant inflammatory T lymphocyte expression in PMLE.
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Affiliation(s)
- Kabir Sardana
- From the Department of Dermatology, Venereology and Leprosy, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | | | - Ananta Khurana
- From the Department of Dermatology, Venereology and Leprosy, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India
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IL-31-generating network in atopic dermatitis comprising macrophages, basophils, thymic stromal lymphopoietin, and periostin. J Allergy Clin Immunol 2023; 151:737-746.e6. [PMID: 36410530 DOI: 10.1016/j.jaci.2022.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/22/2022] [Accepted: 11/11/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND IL-31 is a type 2 cytokine involved in the itch sensation in atopic dermatitis (AD). The cellular origins of IL-31 are generally considered to be TH2 cells. Macrophages have also been implicated as cellular sources of IL-31. OBJECTIVE We sought to determine the expression of IL-31 by macrophages and to elucidate the productive mechanisms and contributions to itch in AD skin lesions. METHODS Expression of IL-31 by macrophages, expressions of thymic stromal lymphopoietin (TSLP) and periostin, and presence of infiltrating basophils in human AD lesions were examined through immunofluorescent staining, and correlations were assessed. Furthermore, mechanisms of inducing IL-31-expressing macrophages were analyzed in an MC903-induced murine model for AD in vivo and in mouse peritoneal macrophages ex vivo. RESULTS A significant population of IL-31+ cells in human AD lesions was that of CD68+ cells expressing CD163, an M2 macrophage marker. The number of IL-31+/CD68+ cells correlated with epidermal TSLP, dermal periostin, and the number of dermal-infiltrating basophils. In the MC903-induced murine AD model, significant scratching behaviors with enhanced expressions of TSLP and periostin were observed, accompanied by massive infiltration of basophils and IL-31+/MOMA-2+/Arg-1+ cells. Blockade of IL-31 signaling with anti-IL-31RA antibody or direct depletion of macrophages by clodronate resulted in attenuation of scratching behaviors. To effectively reduce lesional IL-31+ macrophages and itch, basophil depletion was essential in combination with TSLP- and periostin-signal blocking. Murine peritoneal macrophages produced IL-31 when stimulated with TSLP, periostin, and basophils. CONCLUSIONS A network comprising IL-31-expressing macrophages, TSLP, periostin, and basophils plays a significant role in AD itch.
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Ressler JM, Zila N, Korosec A, Yu J, Silmbrod R, Bachmayr V, Tittes J, Strobl J, Lichtenberger BM, Hoeller C, Petzelbauer P. Myofibroblast stroma differentiation in infiltrative basal cell carcinoma is accompanied by regulatory T-cells. J Cutan Pathol 2022; 50:544-551. [PMID: 36562598 DOI: 10.1111/cup.14381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The implications of infiltrative compared to non-infiltrative growth of cutaneous basal cell carcinoma (BCC) on the tumor stroma and immune cell landscape are unknown. This is of clinical importance, because infiltrative BCCs, in contrast to other BCC subtypes, are more likely to relapse after surgery and radiotherapy. MATERIALS AND METHODS This descriptive cross-sectional study analyzed 38 BCCs collected from 2018 to 2021. In the first cohort (n = 28), immune cells were characterized by immunohistochemistry and multiplex immunofluorescence staining for CD3, CD8, CD68, Foxp3, and α-SMA protein expression. In the second cohort (n = 10) with matched characteristics (age, sex, location, and BCC subtype), inflammatory parameters, including TGF-β1, TGF-β2, ACTA2, IL-10, IL-12A, and Foxp3, were quantified via RT-qPCR after isolating mRNA from BCC tissue samples and perilesional skin. RESULTS Infiltrative BCCs showed significantly increased levels of α-SMA expression in fibroblasts (p = 0.0001) and higher levels of Foxp3+ (p = 0.0023) and CD3+ (p = 0.0443) T-cells compared to non-infiltrative BCCs. CD3+ (p = 0.0171) and regulatory T-cells (p = 0.0026) were significantly increased in α-SMA-positive tumor stroma, whereas CD8+ T-cells (p = 0.1329) and CD68+ myeloid cells (p = 0.2337) were not affected. TGF-β1 and TGF-β2 correlated significantly with ACTA2/α-SMA mRNA expression (p = 0.020, p = 0.005). CONCLUSION Infiltrative growth of BCCs shows a myofibroblastic stroma differentiation and is accompanied by an immunosuppressive tumor microenvironment.
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Affiliation(s)
| | - Nina Zila
- Department of Dermatology, Medical University of Vienna, Austria
| | - Ana Korosec
- Department of Dermatology, Medical University of Vienna, Austria.,SERD Skin and Endothelium Research Division, Medical University of Vienna, Austria
| | - Josef Yu
- Department of Dermatology, Medical University of Vienna, Austria
| | - Rita Silmbrod
- Department of Dermatology, Medical University of Vienna, Austria
| | | | - Julia Tittes
- Department of Dermatology, Medical University of Vienna, Austria
| | - Johanna Strobl
- Department of Dermatology, Medical University of Vienna, Austria
| | - Beate Maria Lichtenberger
- Department of Dermatology, Medical University of Vienna, Austria.,SERD Skin and Endothelium Research Division, Medical University of Vienna, Austria
| | | | - Peter Petzelbauer
- Department of Dermatology, Medical University of Vienna, Austria.,SERD Skin and Endothelium Research Division, Medical University of Vienna, Austria
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Patra V, Strobl J, Atzmüller D, Reininger B, Kleissl L, Gruber-Wackernagel A, Nicolas JF, Stary G, Vocanson M, Wolf P. Accumulation of Cytotoxic Skin Resident Memory T Cells and Increased Expression of IL-15 in Lesional Skin of Polymorphic Light Eruption. Front Med (Lausanne) 2022; 9:908047. [PMID: 35755042 PMCID: PMC9226321 DOI: 10.3389/fmed.2022.908047] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
Patients with polymorphic light eruption (PLE) develop lesions upon the first exposure to sun in spring/summer, but lesions usually subside during season due to the natural (or medical) photohardening. However, these lesions tend to reappear the following year and continue to do so in most patients, suggesting the presence of a disease memory. To study the potential role of skin resident memory T cells (Trm), we investigated the functional phenotype of Trm and the expression of IL-15 in PLE. IL-15 is known to drive Trm proliferation and survival. Multiplex immunofluorescence was used to quantify the expression of CD3, CD4, CD8, CD69, CD103, CD49a, CD11b, CD11c, CD68, granzyme B (GzmB), interferon-gamma (IFN-γ), and IL-15 in formalin-fixed, paraffin-embedded lesional skin samples from PLE patients and healthy skin from control subjects. Unlike the constitutive T cell population in healthy skin, a massive infiltration of T cells in the dermis and epidermis was observed in PLE, and the majority of these belonged to CD8+ T cells which express Trm markers (CD69, CD103, CD49a) and produced cytotoxic effector molecules GzmB and IFN-γ. Higher numbers of CD3+ T cells and CD11b+CD68+ macrophages produced IL-15 in the dermis as compared to healthy skin. The dominant accumulation of cytotoxic Trm cells and increased expression of IL-15 in lesional skin of PLE patients strongly indicates the potential role of skin Trm cells in the disease manifestation and recurrence.
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Affiliation(s)
- VijayKumar Patra
- Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale, U1111, Université Claude Bernard Lyon 1, Centre National de la Recherche Scientifique, UMR 5308, Ecole Normale Supérieure de Lyon, Université de Lyon, Lyon, France.,Research Unit for Photodermatology, Medical University of Graz, Graz, Austria
| | - Johanna Strobl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Denise Atzmüller
- Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria
| | - Bärbel Reininger
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Lisa Kleissl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria
| | | | - Jean-Francois Nicolas
- Allergy and Clinical Immunology Department, Lyon Sud University Hospital, Pierre-Bénite, France
| | - Georg Stary
- Department of Dermatology, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria.,CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Marc Vocanson
- Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale, U1111, Université Claude Bernard Lyon 1, Centre National de la Recherche Scientifique, UMR 5308, Ecole Normale Supérieure de Lyon, Université de Lyon, Lyon, France
| | - Peter Wolf
- Research Unit for Photodermatology, Medical University of Graz, Graz, Austria
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Kadurina M, Kazandjieva J, Bocheva G. Immunopathogenesis and management of polymorphic light eruption. Dermatol Ther 2021; 34:e15167. [PMID: 34676645 DOI: 10.1111/dth.15167] [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: 01/28/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 11/30/2022]
Abstract
Polymorphic light eruption (PLE) is the most common immunologically mediated photodermatosis, demonstrating many abnormalities caused by critical failure of ultraviolet (UV)-induced immunosuppression. The unique expression of antimicrobial peptides in PLE, which is most likely determined by alteration of microbiome components upon UV exposure, implicates their possible triggering role and pathogenic significance in the eruption. The review aims to clarify current knowledge regarding the immunological disturbances correlated with PLE that serve a base for better understanding of molecular pathogenesis of the disease and the development of new therapeutic strategies. Preventive treatment with broad-spectrum suncreens and sunscreens containing DNA repair enzymes, as well as natural photohardening with graduate exposure to sunlight in early spring could be sufficient in milder cases. Antioxidants and topical calcipotriol are promising approach for adjuvant prevention. Phototherapy, mainly with narrow band UVB rays, is more appropriate method in severe cases of the disease. The established treatment options for PLE include local and systemic glucocorticoids, systemic nonsedative antihistamines for itch relief, and rarely, immunosuppressive drugs in the refractory cases. Like medical photohardening, afamelanotide has the potential of photoprotection by inducing a melanization of the skin. Afamelanotide is believed to be a possible new treatment option for very severe and refractory cases of PLE. Targeting the main pruritogenic cytokine, IL-31, opens a new road for the development of novel therapeutic approaches to combat moderate and severe itching in cases of PLE with intense pruritus.
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Affiliation(s)
- Miroslava Kadurina
- Department of Dermatology, University Acibadem City Clinic, Sofia, Bulgaria
| | - Jana Kazandjieva
- Department of Dermatology, Medical University of Sofia, Sofia, Bulgaria
| | - Georgeta Bocheva
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
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Gruber-Wackernagel A, Schug T, Graier T, Legat FJ, Rinner H, Hofer A, Quehenberger F, Wolf P. Long-Term Course of Polymorphic Light Eruption: A Registry Analysis. Front Med (Lausanne) 2021; 8:694281. [PMID: 34336899 PMCID: PMC8323194 DOI: 10.3389/fmed.2021.694281] [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: 04/12/2021] [Accepted: 06/11/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Little is known about the long-term course of polymorphic light eruption (PLE). Objective: To predict disease course, a questionnaire was sent to patients whose PLE had been diagnosed between March 1990 and December 2018 and documented in the Austrian Cooperative Registry for Photodermatoses. Methods: In January 2019, 205 PLE patients were contacted by mail and asked to complete a questionnaire on their disease course, including whether the skin's sun sensitivity had normalized (i.e., PLE symptoms had disappeared), improved, stayed the same, or worsened over time. Patients who reported normalization of sun sensitivity were asked to report when it had occurred. Results: Ninety-seven patients (79 females, 18 males) returned a completed questionnaire. The mean (range) duration of follow-up from PLE onset was 29.6 (17–54) years for females and 29.4 (16–47) years for males. The disease disappeared in 32 (41%) females after 17.4 (2–41) years and in 4 (24%) males after 11.8 (5–26) years. Twenty-nine (37%) females and 6 (35%) males reported improvement of symptoms over time; 15 females (19%) and 7 males (41%) reported no change; and 3 females (4%) and no males reported worsening of symptoms. Kaplan-Meier analysis revealed that after 20 years 74% (95%CI, 64–82%) of patients still suffered from PLE. PLE lesion persistence (>1 week) tended to predict a prolonged course of PLE. Conclusions: PLE usually takes a long-term course over many years though in most patients its symptoms improve or disappear over time. How improvement relates to the pathophysiology of the disease remains to be determined.
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Affiliation(s)
| | - Tanja Schug
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Thomas Graier
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Franz J Legat
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Hanna Rinner
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Angelika Hofer
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Franz Quehenberger
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Peter Wolf
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
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Hashimoto T, Nattkemper LA, Kim HS, Kursewicz CD, Fowler E, Shah SM, Nanda S, Fayne RA, Paolini JF, Romanelli P, Yosipovitch G. Itch intensity in prurigo nodularis is closely related to dermal interleukin-31, oncostatin M, IL-31 receptor alpha and oncostatin M receptor beta. Exp Dermatol 2021; 30:804-810. [PMID: 33428793 DOI: 10.1111/exd.14279] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/10/2020] [Accepted: 01/08/2021] [Indexed: 12/14/2022]
Abstract
Prurigo nodularis (PN) is a chronic skin dermatosis with hyperkeratotic and intensely pruritic nodules. Managing PN-associated itch is difficult because its aetiology is still unknown. This study aimed to investigate the correlation between itch intensity in PN and the expression of a pruritogenic cytokine interleukin (IL)-31, its receptor complex components IL-31 receptor α (IL-31RA) and oncostatin M receptor β (OSMRβ), and oncostatin M (OSM), which is a ligand of OSMR β, through immunofluorescence staining examination. Itch intensity in PN was closely correlated with the number of dermal IL-31(+) cells (Spearman's r = 0.551, p < 0.05), dermal IL-31RA(+) cells (r = 0.475, p < 0.05) and dermal OSM(+) cells (r = 0.505, p < 0.05). In addition, the number of dermal OSMRβ (+) cells was increased in PN (t test, p < 0.05), despite not being correlated with itch intensity (Spearman's r = 0.375, p > 0.05). Major cellular sources of dermal IL-31 were T cells (27.0% of total IL-31-expressing cells) and macrophages (35.0%), while those of OSM were mainly T cells (49.8%) and mast cells (26.8%). IL-31RA-expressing dermal cells were mostly mast cells (49.3%) and macrophages (36.6%), and OSMRβ was mainly expressed by macrophages (51.8%) in the dermis. These findings indicate that IL-31 (mainly from macrophages and T cells) and OSM (principally from T cells and mast cells) stimulate dermal cells expressing IL-31RA and OSMRβ (e.g. macrophages), which may further promote itch and inflammation in PN. This complex dermal milieu of cell/cytokine/receptor network can be a therapeutic target for PN-associated itch.
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Affiliation(s)
- Takashi Hashimoto
- Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA.,Department of Dermatology, National Defense Medical College, Tokorozawa, Japan
| | - Leigh A Nattkemper
- Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Hei Sung Kim
- Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Christina D Kursewicz
- Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Emilie Fowler
- Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Serena M Shah
- Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Sonali Nanda
- Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Rachel A Fayne
- Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - John F Paolini
- Kiniksa Pharmaceuticals Corp, Lexington, Massachusetts, USA
| | - Paolo Romanelli
- Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Gil Yosipovitch
- Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
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Vieyra-Garcia PA, Wolf P. A deep dive into UV-based phototherapy: Mechanisms of action and emerging molecular targets in inflammation and cancer. Pharmacol Ther 2020; 222:107784. [PMID: 33316286 DOI: 10.1016/j.pharmthera.2020.107784] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/25/2020] [Indexed: 02/07/2023]
Abstract
UV-based phototherapy (including psoralen plus UVA (PUVA), UVB and UVA1) has a long, successful history in the management of numerous cutaneous disorders. Photoresponsive diseases are etiologically diverse, but most involve disturbances in local (and occasionally systemic) inflammatory cells and/or abnormalities in keratinocytes that trigger inflammation. UV-based phototherapy works by regulating the inflammatory component and inducing apoptosis of pathogenic cells. This results in a fascinating and complex network of simultaneous events-immediate transcriptional changes in keratinocytes, immune cells, and pigment cells; the emergence of apoptotic bodies; and the trafficking of antigen-presenting cells in skin-that quickly transform the microenvironment of UV-exposed skin. Molecular elements in this system of UV recognition and response include chromophores, metabolic byproducts, innate immune receptors, neurotransmitters and mediators such as chemokines and cytokines, antimicrobial peptides, and platelet activating factor (PAF) and PAF-like molecules that simultaneously shape the immunomodulatory effects of UV and their interplay with the microbiota of the skin and beyond. Phototherapy's key effects-proapoptotic, immunomodulatory, antipruritic, antifibrotic, propigmentary, and pro-prebiotic-promote clinical improvement in various skin diseases such as psoriasis, atopic dermatitis (AD), graft-versus-host disease (GvHD), vitiligo, scleroderma, and cutaneous T-cell lymphoma (CTCL) as well as prevention of polymorphic light eruption (PLE). As understanding of phototherapy improves, new therapies (UV- and non-UV-based) are being developed that will modify regulatory T-cells (Treg), interact with (resident) memory T-cells and /or utilize agonists and antagonists as well as antibodies targeting soluble molecules such as cytokines and chemokines, transcription factors, and a variety of membrane-associated receptors.
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Affiliation(s)
- Pablo A Vieyra-Garcia
- Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, Graz A-8036, Austria.
| | - Peter Wolf
- Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, Graz A-8036, Austria.
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Abstract
Phototherapeutic modalities induce apoptosis of keratinocytes and immune cells, impact cytokine production, downregulate the IL-23/Th17 axis, and induce regulatory T cells. As in anti-IL-17 or anti-IL-23 antibody treatment, the dual action of phototherapy on skin and the immune system is likely responsible for sustained resolution of lesions in diseases such as psoriasis. In cutaneous T cell lymphoma, phototherapy may function by causing tumor cell apoptosis and eliminating the neoplastic and inflammatory infiltrate. Further research on phototherapeutic mechanisms will help advance, optimize, and refine dermatologic treatments and may open up novel avenues for treatment strategies in dermatology and beyond.
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Affiliation(s)
- Zizi Yu
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Peter Wolf
- Department of Dermatology, Research Unit for Photodermatology, Medical University of Graz, Auenbruggerplatz 8, Graz A-8036, Austria.
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Hashimoto T, Kursewicz CD, Fayne RA, Nanda S, Shah SM, Nattkemper L, Yokozeki H, Yosipovitch G. Mechanisms of Itch in Stasis Dermatitis: Significant Role of IL-31 from Macrophages. J Invest Dermatol 2020; 140:850-859.e3. [DOI: 10.1016/j.jid.2019.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 09/24/2019] [Accepted: 09/30/2019] [Indexed: 12/22/2022]
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