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Jo BG, Park NJ, Kim SN, Jegal J, Choi S, Lee SW, Yi LW, Lee SR, Kim KH, Yang MH. Isolation of maltol derivatives from Stellera chamaejasme and the anti-atopic properties of maltol on skin lesions in DNCB-stimulated mice. RSC Adv 2019; 9:2125-2132. [PMID: 35516135 PMCID: PMC9059894 DOI: 10.1039/c8ra09743g] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 12/18/2018] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to isolate maltol derivatives from S. chamaejasme and to investigate the anti-atopic dermatitis (anti-AD) effect of maltol in a 2,4-dinitrochlorobenzene (DNCB)-sensitized mouse model of AD.
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Affiliation(s)
- Beom-Geun Jo
- College of Pharmacy
- Pusan National University
- Busan 46241
- South Korea
| | - No-June Park
- Natural Products Research Institute
- Korea Institute of Science and Technology
- Gangneung 25451
- South Korea
| | - Su-Nam Kim
- Natural Products Research Institute
- Korea Institute of Science and Technology
- Gangneung 25451
- South Korea
| | - Jonghwan Jegal
- College of Pharmacy
- Pusan National University
- Busan 46241
- South Korea
| | - Sangho Choi
- International Biological Material Research Center
- Korea Research Institute of Bioscience and Biotechnology
- Daejeon 34141
- South Korea
| | - Sang Woo Lee
- International Biological Material Research Center
- Korea Research Institute of Bioscience and Biotechnology
- Daejeon 34141
- South Korea
| | - Li Wan Yi
- Institute of Medicinal Plants
- Yunnan Academy of Agricultural Sciences
- Yunnan 650205
- China
| | - Seoung Rak Lee
- Natural Product Research Laboratory
- School of Pharmacy
- Sungkyunkwan University
- Suwon
- South Korea
| | - Ki Hyun Kim
- Natural Product Research Laboratory
- School of Pharmacy
- Sungkyunkwan University
- Suwon
- South Korea
| | - Min Hye Yang
- College of Pharmacy
- Pusan National University
- Busan 46241
- South Korea
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Hon KL, Leung AKC, Leung TNH, Lee VWY. Investigational drugs for atopic dermatitis. Expert Opin Investig Drugs 2018; 27:637-647. [PMID: 30058384 DOI: 10.1080/13543784.2018.1494723] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Many novel medications and herbal medicines have claimed efficacy on atopic dermatitis (AD). AREAS COVERED This review covers evidence on efficacy of topical and oral forms of novel and investigational drugs. Topical agents include emollients, phosphodiesterase E4 (PDE4) inhibitors, and topical herbs. There is little evidence that ceramides or natural moisturizing factors provide relief in AD. PDE4 inhibitors have shown promise as an effective topical treatment for mild-to-moderate AD with minimal adverse events, and dupilumab as an effective subcutaneous agent for the treatment of moderate-to-severe AD in adult patients with little adverse effects. However, only preliminary data are available for dupilumab in children with AD. The long-term effects of dupilumab are also not known. Potential new systemic treatments include a number of herbal concoctions. EXPERT OPINION Randomized, double-blind placebo-controlled trials (RCTs) have demonstrated topical PDE4 inhibitors are effective and safe in the treatment of both children and adults with AD but further evaluations are needed. RCTs have also shown that subcutaneous dupilumab is an effective and safe agent for the treatment of AD in adults. Long-term effects of these topical and systemic investigational drugs are currently unavailable. Regarding herbal medications, scientific methods are often flawed and objective evidence is lacking.
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Affiliation(s)
- Kam Lun Hon
- a Department of Paediatrics , The Chinese University of Hong Kong, Prince of Wales Hospital , Shatin , Hong Kong
| | - Alexander K C Leung
- b Department of Pediatrics, The University of Calgary , Alberta Children's Hospital , Calgary , Canada
| | - Theresa N H Leung
- c Department of Paediatrics and Adolescent Medicine , The University of Hong Kong , Hong Kong
| | - Vivian W Y Lee
- d School of Pharmacy , The Chinese University of Hong Kong , Hong Kong
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3
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Serezani APM, Bozdogan G, Sehra S, Walsh D, Krishnamurthy P, Potchanant EAS, Nalepa G, Goenka S, Turner MJ, Spandau DF, Kaplan MH. IL-4 impairs wound healing potential in the skin by repressing fibronectin expression. J Allergy Clin Immunol 2017; 139:142-151.e5. [PMID: 27554818 PMCID: PMC5222746 DOI: 10.1016/j.jaci.2016.07.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 05/27/2016] [Accepted: 07/05/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is characterized by intense pruritis and is a common childhood inflammatory disease. Many factors are known to affect AD development, including the pleiotropic cytokine IL-4. Yet little is known regarding the direct effects of IL-4 on keratinocyte function. OBJECTIVE AND METHODS In this report RNA sequencing and functional assays were used to define the effect of the allergic environment on primary keratinocyte function and wound repair in mice. RESULTS Acute or chronic stimulation by IL-4 modified expression of more than 1000 genes expressed in human keratinocytes that are involved in a broad spectrum of nonoverlapping functions. Among the IL-4-induced changes, repression of fibronectin critically impaired the human keratinocyte wound response. Moreover, in mouse models of spontaneous and induced AD-like lesions, there was delayed re-epithelialization. Importantly, topical treatment with fibronectin restored the epidermal repair response. CONCLUSION Keratinocyte gene expression is critically shaped by IL-4, altering cell fate decisions, which are likely important for the clinical manifestations and pathology of allergic skin disease.
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Affiliation(s)
- Ana PM Serezani
- Department of Pediatrics, H.B. Wells Center for Pediatric Research and Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Gunseli Bozdogan
- Department of Pediatrics, H.B. Wells Center for Pediatric Research and Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Sarita Sehra
- Department of Pediatrics, H.B. Wells Center for Pediatric Research and Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Daniel Walsh
- Department of Pediatrics, H.B. Wells Center for Pediatric Research and Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Purna Krishnamurthy
- Department of Pediatrics, H.B. Wells Center for Pediatric Research and Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Elizabeth A Sierra Potchanant
- Department of Pediatrics, H.B. Wells Center for Pediatric Research and Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Division of Pediatric Hematology-Oncology Bone Marrow Failure Program, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Grzegorz Nalepa
- Department of Pediatrics, H.B. Wells Center for Pediatric Research and Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Division of Pediatric Hematology-Oncology Bone Marrow Failure Program, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Shreevrat Goenka
- Department of Pediatrics, H.B. Wells Center for Pediatric Research and Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Matthew J Turner
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Dan F Spandau
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Mark H Kaplan
- Department of Pediatrics, H.B. Wells Center for Pediatric Research and Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Sehra S, Serezani APM, Ocaña JA, Travers JB, Kaplan MH. Mast Cells Regulate Epidermal Barrier Function and the Development of Allergic Skin Inflammation. J Invest Dermatol 2016; 136:1429-1437. [PMID: 27021404 DOI: 10.1016/j.jid.2016.03.019] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 02/15/2016] [Accepted: 03/06/2016] [Indexed: 11/30/2022]
Abstract
Atopic dermatitis is a chronic inflammatory skin disease characterized by infiltration of eosinophils, T helper cells, and mast cells. The role of mast cells in atopic dermatitis is not completely understood. To define the effects of mast cells on skin biology, we observed that mast cells regulate the homeostatic expression of epidermal differentiation complex and other skin genes. Decreased epidermal differentiation complex gene expression in mice that genetically lack mast cells (Kit(W-sh/W-sh) mice) is associated with increased uptake of protein antigens painted on the skin by dendritic cells (DCs) compared with similarly treated wild-type mice, suggesting a protective role for mast cells in exposure to nominal environmental allergens. To test this further, we crossed Kit(W-sh/W-sh) mice with signal transducer and activator of transcription 6 (i.e., Stat6) VT transgenic mice that develop spontaneous atopic dermatitis-like disease that is dependent on T helper cell 2 cytokines and is associated with high serum concentrations of IgE. We observed that Stat6VT × Kit(W-sh/W-sh) mice developed more frequent and more severe allergic skin inflammation than Stat6VT transgenic mice that had mast cells. Together, these studies suggest that mast cells regulate epidermal barrier function and have a potential protective role in the development of atopic dermatitis-like disease.
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Affiliation(s)
- Sarita Sehra
- Department of Pediatrics and Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ana P M Serezani
- Department of Pediatrics and Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jesus A Ocaña
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jeffrey B Travers
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, Indiana, USA; Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA; Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - Mark H Kaplan
- Department of Pediatrics and Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, Indiana, USA; Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
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Affiliation(s)
- Shelley Peacock
- Lecturer, Florence Nightingale Faculty of Nursing and Midwifery, King's College London, England
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Perdigoto CN, Valdes VJ, Bardot ES, Ezhkova E. Epigenetic regulation of epidermal differentiation. Cold Spring Harb Perspect Med 2014; 4:4/2/a015263. [PMID: 24492849 DOI: 10.1101/cshperspect.a015263] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In a cell, the chromatin state is controlled by the highly regulated interplay of epigenetic mechanisms ranging from DNA methylation and incorporation of different histone variants to posttranslational modification of histones and ATP-dependent chromatin remodeling. These changes alter the structure of the chromatin to either facilitate or restrict the access of transcription machinery to DNA. These epigenetic modifications function to exquisitely orchestrate the expression of different genes, and together constitute the epigenome of a cell. In the skin, different epigenetic regulators form a regulatory network that operates to guarantee skin stem cell maintenance while controlling differentiation to multiple skin structures. In this review, we will discuss recent findings on epigenetic mechanisms of skin control and their relationship to skin pathologies.
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Affiliation(s)
- Carolina N Perdigoto
- Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, New York 10029
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Hon KL, Leung AKC, Barankin B. Barrier repair therapy in atopic dermatitis: an overview. Am J Clin Dermatol 2013; 14:389-99. [PMID: 23757122 DOI: 10.1007/s40257-013-0033-9] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Atopic eczema or dermatitis (AD) is a chronically relapsing dermatitis associated with pruritus, sleep disturbance, psychosocial symptoms, and impaired quality of life. It affects 10-20 % of school-aged children, and there is evidence to suggest that this prevalence is increasing. Filaggrin (filament-aggregating protein) has an important function in epidermal differentiation and barrier function. Null mutations within the filaggrin gene cause ichthyosis vulgaris and appear to be a major risk factor for developing AD. The affected skin of atopic individuals is deficient in filaggrin degradation products or ceramides. Avoidance of triggering factors, optimal skin care, topical corticosteroids, and calcineurin inhibitors are the mainstays of therapy for AD. Proper moisturizer therapy can reduce the frequency and intensity of flares, as well as the need for topical corticosteroids or topical calcineurin inhibitors. Recent advances in the understanding of the pathophysiological process of AD involving filaggrin and ceramides has led to the concept of barrier therapy and the production of new moisturizers and topical skin products targeted to correct reduced amounts of ceramides and natural moisturizing factors in the skin with natural moisturizing factors, ceramides, and pseudoceramide products. Emollients, both creams and ointments, improve the barrier function of the stratum corneum by providing it with water and lipids. Studies on AD and barrier repair treatment show that adequate lipid replacement therapy reduces the inflammation and restores epidermal function. We reviewed 12 randomized trials and 11 cohort studies and found some evidence that certain products had therapeutic efficacy in improving clinical and/or biophysical parameters of patients with AD. Nevertheless, study methods were often flawed and sample sizes were small. Additional research is warranted to better understand the optimal formulary compositions. Also, long-term studies would be important to evaluate whether lipid barrier replacement therapy reduces bacterial colonization or prevents progression of the atopic march.
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Turner MJ, Dasilva-Arnold SC, Yi Q, Mehrotra P, Kaplan MH, Travers JB. Topical application of a vitamin D analogue exacerbates atopic dermatitis and induces the atopic dermatitis-like phenotype in Stat6VT mice. Pediatr Dermatol 2013; 30:574-8. [PMID: 23889122 PMCID: PMC3770906 DOI: 10.1111/pde.12187] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Calcipotriene is a topical vitamin D3 analogue approved for the treatment of plaque and scalp psoriasis. We report the case of a 2-year-old boy whose atopic dermatitis (AD) flared in response to application of calcipotriene 0.005% cream and solution for a mistaken diagnosis of plaque and scalp psoriasis. We investigated whether the patient's eruption was secondary to an allergic contact dermatitis. In the Stat6VT mouse model of AD we tested whether calcipotriene could induce the otherwise-spontaneous AD-like phenotype. Closed patch testing was done on the patient with calcipotriene solution and cream, moisturizing cream, and 51% isopropanol. Stat6VT and wild-type (WT) mice were treated for 7 days with calcipotriene solution or vehicle (isopropanol) applied to the right and left upper back skin, respectively, after which mice were followed longitudinally for 10 weeks. Biopsy specimens from prior treatment sites were then collected for histology and RNA isolation. RNA was analyzed for interleukin (IL-4) expression using quantitative polymerase chain reaction. Patch testing was negative. Stat6VT mice, in contrast to WT mice, developed a persistent eczematous dermatitis at sites of calcipotriene application. Clinical and histologic features and high IL-4 transcript levels were consistent with the spontaneous AD-like phenotype seen in Stat6VT mice. At sites of active disease, calcipotriene can worsen a flare of AD. In Stat6VT mice, calcipotriene can induce the AD-like phenotype.
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Affiliation(s)
- Matthew J Turner
- Department of Dermatology, Indiana University, Indianapolis, Indiana
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Hon KL, Lau CBS, Hui PCL, Leung PC. Anti-allergic drug discovery in China for eczema: current methods and future strategies. Expert Opin Drug Discov 2013; 8:753-67. [DOI: 10.1517/17460441.2013.795539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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10
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Marsella R, Sousa CA, Gonzales AJ, Fadok VA. Current understanding of the pathophysiologic mechanisms of canine atopic dermatitis. J Am Vet Med Assoc 2012; 241:194-207. [DOI: 10.2460/javma.241.2.194] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hon KLE, Yong V, Leung TF. Research statistics in atopic eczema: what disease is this? Ital J Pediatr 2012; 38:26. [PMID: 22682479 PMCID: PMC3413563 DOI: 10.1186/1824-7288-38-26] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Accepted: 06/09/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Atopic eczema is a common and distressing disease. This study aims to review PubMed indexed research statistics on atopic eczema over a-10 year period to investigate the clinical relevance and research interest about this disease. METHODS PubMed (a service of the U.S. National Library of Medicine) was searched for the terms "atopic dermatitis" and "eczema", with limits activated (Humans, Clinical Trial, Meta-Analysis, Randomized Controlled Trial, English, published in the last 10 years), and editorials, letters, practice guidelines, reviews, and animal studies excluded. Journal impact factor (IF) is in accordance with Journal Citation Report (JCR) 2009, a product of Thomson ISI (Institute for Scientific Information). RESULTS A total of 890 articles were retrieved. Taking out publications that were irrelevant and those without an impact factor, 729 articles were obtained. These articles were grouped into dermatology (n = 337, mean IF: 3.01), allergy/immunology (n = 215, mean IF: 4.89), pediatrics (n = 118, mean IF: 2.53) and miscellaneous subject categories (n = 142, mean IF: 5.10). The impact factors were highest in the miscellaneous category (p = 0.0001), which includes such prestigious journals as the New England journal of Medicine (n = 1, IF: 47.05), the Lancet (n = 4, IF: 30.76) and BMJ (n = 6, IF: 13.66). There was no publication in any family medicine or general practice journal. The British Journal of Dermatology (n = 78), Pediatric Allergy and Immunology (n = 49) and Journal of Allergy and Clinical Immunology (n = 46) had the highest number of publications on the subject. Atopic eczema ranked higher in impact factors in allergy/immunology although more publications appeared in the dermatology category. CONCLUSIONS Atopic eczema is a multidisciplinary disease. Its clinical relevance and research interests are definitely beyond that of a mere cutaneous disease. Investigators may consider allergy/immunology and miscellaneous journal categories for higher impact of their research.
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Affiliation(s)
- Kam-Lun Ellis Hon
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Clinical Science Building, 6/F, Shatin, Hong Kong.
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Marsella R. Are transepidermal water loss and clinical signs correlated in canine atopic dermatitis? A compilation of studies. Vet Dermatol 2012; 23:238-e49. [DOI: 10.1111/j.1365-3164.2012.01055.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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DaSilva SC, Sahu RP, Konger RL, Perkins SM, Kaplan MH, Travers JB. Increased skin barrier disruption by sodium lauryl sulfate in mice expressing a constitutively active STAT6 in T cells. Arch Dermatol Res 2011; 304:65-71. [PMID: 21959772 DOI: 10.1007/s00403-011-1168-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 07/20/2011] [Accepted: 08/05/2011] [Indexed: 10/17/2022]
Abstract
Atopic dermatitis (AD) is a pruritic, chronic inflammatory skin disease that affects 10-20% of children and 1-3% of adults worldwide. Recent studies have indicated that the ability of Th2 cytokines, such as interleukin-4 (IL-4) to regulate skin barrier function may be a predisposing factor for AD development. The present studies examined the ability of increased Th2 activity to affect cutaneous barrier function in vivo and epidermal thickening. Mice that express a constitutively active Signal Transducer and Activator of Transcription 6 (STAT6VT) have increased Th2 cells and a predisposition to allergic inflammation were used in these studies, they demonstrate that topical treatment with the irritant sodium lauryl sulfate (SLS) caused increased transepidermal water loss and epidermal thickening in STAT6VT mice over similarly treated wild-type mice. The proliferation marker Ki-67 was increased in the epidermis of STAT6VT compared to the wild-type mice. However, these differences do not appear to be linked to the addition of an irritant as control-treated STAT6VT skin also exhibited elevated Ki-67 levels, suggesting that the increased epidermal thickness in SLS-treated STAT6VT mice is primarily driven by epidermal cell hypertrophy rather than an increase in cellular proliferation. Our results suggest that an environment with increased Th2 cytokines results in abnormal responses to topical irritants.
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Affiliation(s)
- Sonia C DaSilva
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, 46202, USA
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Marsella R, Olivry T, Carlotti DN. Current evidence of skin barrier dysfunction in human and canine atopic dermatitis. Vet Dermatol 2011; 22:239-48. [DOI: 10.1111/j.1365-3164.2011.00967.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Contrasting pathogenesis of atopic dermatitis and psoriasis--part I: clinical and pathologic concepts. J Allergy Clin Immunol 2011; 127:1110-8. [PMID: 21388665 DOI: 10.1016/j.jaci.2011.01.053] [Citation(s) in RCA: 256] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2010] [Revised: 12/27/2010] [Accepted: 01/05/2011] [Indexed: 02/01/2023]
Abstract
Atopic dermatitis and psoriasis are 2 of the most common inflammatory skin diseases. They are similar in that they are complex inherited diseases involving genes that encode immune components and structural proteins that regulate differentiation of epidermal cells. Each disease is characterized by proliferation of epidermal keratinocytes and abnormal cornification or terminal differentiation in the epidermis; skin lesions contain immune infiltrates of T cells, dendritic cells, and other types of leukocytes. We review similarities between the diseases and differences in epidermal barrier defects and immune cells. We also propose mechanisms of pathogenesis based on differences in the balance of immune cell subsets that could cause the phenotypes that distinguish these diseases. The first part of this 2-part review focuses on the clinical and pathologic features of the diseases; the second part discusses differences in immune cell subsets between atopic dermatitis and psoriasis and recent therapeutic strategies.
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Voorhees T, Chang J, Yao Y, Kaplan MH, Chang CH, Travers JB. Dendritic cells produce inflammatory cytokines in response to bacterial products from Staphylococcus aureus-infected atopic dermatitis lesions. Cell Immunol 2010; 267:17-22. [PMID: 21109237 DOI: 10.1016/j.cellimm.2010.10.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 10/15/2010] [Accepted: 10/26/2010] [Indexed: 11/18/2022]
Abstract
Atopic Dermatitis (AD) patients often acquire secondary skin infections resulting in increased inflammation. The increased inflammation occurs through the activation of multiple cell types including dendritic cells (DC). In this study, we investigated the activity of soluble products present in infected AD lesions by measuring the ability of patients' wash fluids from a quantitative culture of lesions to activate DC. We found that wash fluid derived from AD lesions induced cytokine production by murine bone marrow-derived DC, including IL-1β, IL-6, ΙL-10, and tumor necrosis factor-α. The lipoprotein lipoteichoic acid (LTA) from Staphylococcusaureus was implicated as a potent stimulus in the wash fluids as only wash fluid samples that contained LTA exerted this activity, and exogenous LTA triggered similar DC cytokine activation. Wash fluid- and LTA-stimulated DC cytokine production required MyD88, but not the platelet-activating factor receptor (PAF-R), despite the ability of LTA to function through this receptor in keratinocytes. Thus, our results support a role for DC in the worsening of AD inflammation due to secondary bacteria infections.
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Affiliation(s)
- Timothy Voorhees
- Department of Microbiology and Immunology, the University of Michigan Medical School, Ann Arbor, MI 48109, United States.
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Sehra S, Yao Y, Howell MD, Nguyen ET, Kansas GS, Leung DYM, Travers JB, Kaplan MH. IL-4 regulates skin homeostasis and the predisposition toward allergic skin inflammation. THE JOURNAL OF IMMUNOLOGY 2010; 184:3186-90. [PMID: 20147633 DOI: 10.4049/jimmunol.0901860] [Citation(s) in RCA: 143] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IL-4 promotes the development of Th2 cells and allergic inflammation. In atopic dermatitis lesions, IL-4 decreases the expression of multiple genes associated with innate defense, including genes in the epidermal differentiation complex (EDC) that regulate epidermal barrier function. However, it is not clear whether IL-4 also contributes to homeostatic control of EDC genes. In this report, we demonstrate that expression of EDC genes and barrier function is increased in the absence of endogenous IL-4. Mice that express a constitutively active Stat6 (Stat6VT) are prone to the development of allergic skin inflammation and have decreased expression of EDC genes. IL-4 deficiency protects Stat6VT transgenic mice from the development of allergic skin inflammation and decreased recovery time in barrier function following skin irritation, with a concomitant increase in EDC gene expression. These data suggest that IL-4 plays an important role in regulating epidermal homeostasis and innate barrier function.
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Affiliation(s)
- Sarita Sehra
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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18
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Travers JB, Kozman A, Mousdicas N, Saha C, Landis M, Al-Hassani M, Yao W, Yao Y, Hyatt AM, Sheehan MP, Haggstrom AN, Kaplan MH. Infected atopic dermatitis lesions contain pharmacologic amounts of lipoteichoic acid. J Allergy Clin Immunol 2009; 125:146-52.e1-2. [PMID: 19962742 DOI: 10.1016/j.jaci.2009.09.052] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 09/19/2009] [Accepted: 09/23/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Bacterial infection with Staphylococcus aureus is a known trigger for worsening of atopic dermatitis (AD); the exact mechanisms by which bacterial infection worsens dermatitis are unknown. OBJECTIVE We sought to characterize the amounts of the biologically active bacterial lipoprotein lipoteichoic acid (LTA) in infected AD lesions. METHODS Eighty-nine children with clinically impetiginized lesions of AD were enrolled in this study. A lesion was graded clinically by using the Eczema Area and Severity Index (EASI), wash fluid obtained from the lesion for quantitative bacterial culture, and measurement of LTA and cytokines. The staphylococcal isolate was tested for antibiotic susceptibilities. The patients were treated with a regimen that included topical corticosteroids and systemic antibiotics, and the lesion was reanalyzed after 2 weeks. RESULTS S aureus was identified in 79 of 89 children enrolled in the study. The bacterial colony-forming unit (CFU) counts correlated with the EASI lesional score (P = .04). LTA levels as high as 9.8 mug/mL were measured in the wash fluid samples, and the amounts correlated with the lesional EASI scores (P = .01) and S aureus CFU (P < .001). Approximately 30% of clinically impetiginized AD lesions contained greater than 1 mug/mL LTA, amounts that exert effects on various cell types in vitro. Moreover, injection of skin tissue ex vivo with amounts of LTA found in AD lesions resulted in epidermal cytokine gene expression. CONCLUSION Pharmacologic levels of LTA are found in many infected atopic dermatitis lesions.
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Affiliation(s)
- Jeffrey B Travers
- Department of Dermatology, Indiana University School of Medicine, 702 Barnhill Drive, Indianapolis, IN 46202, USA.
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Abstract
OBJECTIVE To review and compile data from published studies that provide support for the existence of the atopic march. DATA SOURCES Relevant articles and references found via a PubMed search using the following keywords: atopic march, allergic march, atopic dermatitis, eczema, atopic eczema, atopy, rhinitis, wheeze, bronchiolitis, and asthma. STUDY SELECTION All articles were reviewed and the most relevant were selected for inclusion in this review and for the compilation and graphical presentation of disease trends. RESULTS Data on the prevalence of each phenotype of the atopic march confirm the temporal pattern of progression from eczema to allergic rhinitis and asthma. However, the atopic march as it is currently defined, is lacking precision, which affects its usefulness. Early events in the atopic march, such as eczema, may be more useful with more careful refinement of the phenotype into atopic and nonatopic eczema. CONCLUSION Evidence supports that the atopic march is a useful paradigm to describe the clinically observed progression of atopy in certain children. There may be more precise phenotypes of the early stages of the atopic march that may improve its utility in predicting the development of later atopic, comorbid chronic disease.
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Affiliation(s)
- Jennifer Ker
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennesse 37232-8300, USA
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Zeller S, Rhyner C, Meyer N, Schmid-Grendelmeier P, Akdis CA, Crameri R. Exploring the repertoire of IgE-binding self-antigens associated with atopic eczema. J Allergy Clin Immunol 2009; 124:278-85, 285.e1-7. [PMID: 19541355 DOI: 10.1016/j.jaci.2009.05.015] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Revised: 05/11/2009] [Accepted: 05/13/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Atopic eczema (AE) is the most common chronic inflammatory skin disease. Recent data demonstrate the presence of autoreactive serum IgE antibodies correlating with the severity of the disease. OBJECTIVE Although several IgE-binding self-antigens have been reported, the whole repertoire of IgE-binding self-antigens is unknown. We aimed to estimate the repertoire size of autoreactive proteins related to AE and clone, produce, and characterize humoral and T-cell responses against novel self-antigens. METHODS Phage surface-displayed human cDNA libraries were enriched for clones binding to serum IgE from patients with AE and screened by using high-throughput technology. Selected clones were used to produce the encoded proteins, to test their IgE-binding ability in Western blots and ELISAs, and their ability to induce mediator release from basophils of sensitized individuals. RESULTS One hundred forty sequences encoding potential IgE-binding self-antigens associated with AE were identified. Sixteen sequences encoded already described self-antigens. Three new sequences showed homology with environmental allergens, 86 encoded known human proteins, 7 predicted proteins, and 28 showed sequence identity with genomic contigs. Immunoblotting and ELISA experiments demonstrated the presence of IgE antibodies in sera from patients with AE to 5 selected recombinant self-antigens and their ability to induce mediator release from basophils of patients with AE who have self-antigen-specific IgE antibodies. CONCLUSION These data demonstrate a broad spectrum of at least 140 IgE-binding self-antigens associated with AE. By binding IgE antibodies or activating specific T cells, they might promote, perpetuate, or both existing skin inflammation.
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Affiliation(s)
- Sabine Zeller
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
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Kawakami Y, Tomimori Y, Yumoto K, Hasegawa S, Ando T, Tagaya Y, Crotty S, Kawakami T. Inhibition of NK cell activity by IL-17 allows vaccinia virus to induce severe skin lesions in a mouse model of eczema vaccinatum. ACTA ACUST UNITED AC 2009; 206:1219-25. [PMID: 19468065 PMCID: PMC2715052 DOI: 10.1084/jem.20082835] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Threats of bioterrorism have renewed efforts to better understand poxvirus pathogenesis and to develop a safer vaccine against smallpox. Individuals with atopic dermatitis are excluded from smallpox vaccination because of their propensity to develop eczema vaccinatum, a disseminated vaccinia virus (VACV) infection. To study the underlying mechanism of the vulnerability of atopic dermatitis patients to VACV infection, we developed a mouse model of eczema vaccinatum. Virus infection of eczematous skin induced severe primary erosive skin lesions, but not in the skin of healthy mice. Eczematous mice exhibited lower natural killer (NK) cell activity but similar cytotoxic T lymphocyte activity and humoral immune responses. The role of NK cells in controlling VACV-induced skin lesions was demonstrated by experiments depleting or transferring NK cells. The proinflammatory cytokine interleukin (IL)-17 reduced NK cell activity in mice with preexisting dermatitis. Given low NK cell activities and increased IL-17 expression in atopic dermatitis patients, these results can explain the increased susceptibility of atopic dermatitis patients to eczema vaccinatum.
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Affiliation(s)
- Yuko Kawakami
- Division of Cell Biology, La Jolla Institute for Allergy and Immunology, La Jolla, CA 92037, USA.
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Current World Literature. Curr Opin Allergy Clin Immunol 2009; 9:177-84. [DOI: 10.1097/aci.0b013e328329f9ca] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Epigenetics is the study of differences in phenotype, in the absence of variation in the genetic code. Epigenetics is relevant in the pathogenesis of many skin diseases. In the case of the common skin cancers, aberrant methylation of tumor suppressor gene promoters is associated with their transcriptional inactivation. Environmental carcinogens such as ultraviolet radiation and arsenic may act through epigenetic mechanisms. Hypomethylation is associated with activation of systemic autoimmune diseases, such as systemic lupus erythematosus, subacute cutaneous lupus erythematosus and scleroderma. This may be through a mechanism of immunological cross-reactivity with hypomethylated DNA from pathogenic bacteria. Epigenetic factors may also be relevant in the pathogenesis of psoriasis and other inflammatory skin diseases, as well as in the pathogenesis of the disorders of genomic imprinting with cutaneous features.
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Affiliation(s)
- George W M Millington
- Dermatology Department, Norfolk & Norwich University Hospitals, NHS Foundation Trust, Colney Lane, Norwich, NR4 7UZ, UK.
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