1
|
Kommoss KS, Bieler T, Ringen J, Lehmann A, Mihalceanu S, Hobohm L, Keller K, Brand A, Fischer B, Kramer D, Wild J, Waisman A, Enk A, Schäkel K, Heikenwälder M, Karbach S. A simple tool for evaluation of inflammation in psoriasis: Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio as markers in psoriasis patients and related murine models of psoriasis-like skin disease. J Mol Med (Berl) 2024; 102:247-255. [PMID: 38127137 PMCID: PMC10857970 DOI: 10.1007/s00109-023-02406-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 11/04/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023]
Abstract
Objective parameters to quantify psoriatic inflammation are needed for interdisciplinary patient care, as well as preclinical experimental models. This study evaluates neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in psoriasis patients and five murine models of psoriasis-like skin disease based on topical imiquimod application and overexpression of IL-17A under different promotors. We performed a single-center prospective observational study in a German population, investigating psoriasis patients prior to, 4 weeks, and 16 weeks post begin of systemic anti-inflammatory therapy. Psoriasis area and severity index (PASI), blood count, and C-reactive protein (CRP) levels were attained at each timepoint. Additionally, five murine models of psoriasis-like skin disease involving five distinct experimental procedures differing in time of disease-onset and severity were investigated regarding PLR and NLR. Of 43 recruited psoriasis patients, 34 patients were followed up to 16 weeks. The cohort was 69.77% male, showing a median age of 32.0 years (range 19.0-67.0; IQR 26). The median PASI decreased from 16.35 (8.0-50.0; 10.20) to 1.6 (0-10.3; 2.56) after 16 weeks of systemic therapy. Spearman's correlation showed statistically significant positive correlation for NLR with PASI (rs = 0.27, p = 0.006), however not for PLR. NLR, but not PLR, was significantly associated with PASI in a multiple linear regression analysis including age, sex, psoriasis arthritis, and smoking. In the murine models of psoriasis-like skin disease, both NLR and PLR were significantly increased in the acute-severe models compared to controls (p < 0.001, p = 0.005, and p = 0.02, respectively), demonstrating gradually less increased values from severe-acute to mild-late-onset psoriatic phenotype. NLR was significantly associated with PASI in psoriatic patients as well as psoriatic phenotype in different murine psoriasis models. Our data warrants investigation of NLR in psoriasis patients and preclinical psoriasis models as an objective biomarker of psoriatic skin inflammation. KEY MESSAGES : NLR, but not PLR, showed a statistically significant positive correlation with Psoriasis Area and Severity Index (PASI) in our human psoriasis cohort. Both NLR and PLR were significantly increased in murine psoriasis models compared to matched controls, with gradually less increased values from severe-acute to mild-late-onset psoriatic phenotype. NLR may represent an easily available, cheap, and objective parameter to monitor psoriatic inflammation in both clinical patient routine, as well as preclinical experimental murine models.
Collapse
Affiliation(s)
- Katharina S Kommoss
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany.
- Division of Chronic Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Tabea Bieler
- Division of Chronic Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Interdisciplinary Center for Scientific Computing (IWR), Heidelberg University, Heidelberg, Germany
| | - Julia Ringen
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
| | - Annika Lehmann
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
| | - Silvia Mihalceanu
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Lukas Hobohm
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- Center for Cardiology-Cardiology I, University Medical Center Mainz, Mainz, Germany
| | - Karsten Keller
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- Center for Cardiology-Cardiology I, University Medical Center Mainz, Mainz, Germany
- Department of Sports Medicine, Medical Clinic VII, University Hospital Heidelberg, Heidelberg, Germany
| | - Anna Brand
- Institute of Molecular Medicine, University Medical Center Mainz, Mainz, Germany
| | - Berenice Fischer
- Department of Dermatology, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Daniela Kramer
- Department of Dermatology, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Johannes Wild
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- Center for Cardiology-Cardiology I, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK)-Partner Site RheinMain (Mainz), Mainz, Germany
| | - Ari Waisman
- Institute of Molecular Medicine, University Medical Center Mainz, Mainz, Germany
| | - Alexander Enk
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Knut Schäkel
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Mathias Heikenwälder
- Division of Chronic Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
- The M3 Research Center, Institute for Interdisciplinary Research On Cancer Metabolism and Chronic Inflammation, Medical Faculty, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Susanne Karbach
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- Center for Cardiology-Cardiology I, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK)-Partner Site RheinMain (Mainz), Mainz, Germany
| |
Collapse
|
2
|
Fischer B, Kübelbeck T, Kolb A, Ringen J, Waisman A, Wittmann M, Karbach S, Kölsch SM, Kramer D. IL-17A-driven psoriasis is critically dependent on IL-36 signaling. Front Immunol 2023; 14:1256133. [PMID: 38162658 PMCID: PMC10754973 DOI: 10.3389/fimmu.2023.1256133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Plaque psoriasis is an autoinflammatory and autoimmune skin disease, affecting 1-3% of the population worldwide. Previously, high levels of IL-36 family cytokines were found in psoriatic skin lesions, thereby contributing to keratinocyte hyperproliferation and infiltration of immune cells such as neutrophils. While treatment with anti-IL36 receptor (IL36R) antibodies was recently approved for generalized pustular psoriasis (GPP), it remains unclear, if targeting the IL36R might also inhibit plaque psoriasis. Here we show that antibody-mediated inhibition of IL36R is sufficient to suppress imiquimod-induced psoriasis-like skin inflammation and represses the disease's development in a model that depends on IL-17A overexpression in the skin. Importantly, treatment with anti-IL36R antibodies inhibited skin inflammation and attenuated psoriasis-associated, systemic inflammation. This is possibly due to a widespread effect of IL36R inhibition, which not only suppresses pro-inflammatory gene expression in keratinocytes, but also the activation of other immune cells such as T-cells or dendritic cells. In conclusion, we propose that inhibition of the IL-36 signaling pathway might constitute an attractive, alternative approach for treating IL-17A-driven psoriasis and psoriasis-linked comorbidities.
Collapse
Affiliation(s)
- Berenice Fischer
- Department of Dermatology, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Tanja Kübelbeck
- Department of Dermatology, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Antonia Kolb
- Department of Dermatology, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Julia Ringen
- Center for Cardiology- Cardiology I, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Ari Waisman
- Institute of Molecular Medicine, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
- Research Center for Immunotherapy, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Miriam Wittmann
- Department of Dermatology, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Susanne Karbach
- Center for Cardiology- Cardiology I, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK) – Partner Site Rhine-Main, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Stephan Marcus Kölsch
- Boehringer Ingelheim Pharma GmbH & Co. KG, Medical Affairs, Ingelheim am Rhein, Germany
| | - Daniela Kramer
- Department of Dermatology, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
- Research Center for Immunotherapy, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| |
Collapse
|
3
|
Schaller T, Ringen J, Fischer B, Bieler T, Perius K, Knopp T, Kommoss KS, Korn T, Heikenwälder M, Oelze M, Daiber A, Münzel T, Kramer D, Wenzel P, Wild J, Karbach S, Waisman A. Reactive oxygen species produced by myeloid cells in psoriasis as a potential biofactor contributing to the development of vascular inflammation. Biofactors 2023; 49:861-874. [PMID: 37139784 DOI: 10.1002/biof.1949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/04/2023] [Indexed: 05/05/2023]
Abstract
Psoriasis is an immune-mediated inflammatory skin disease driven by interleukin-17A (IL-17A) and associated with cardiovascular dysfunction. We used a severe psoriasis mouse model of keratinocyte IL-17A overexpression (K14-IL-17Aind/+ , IL-17Aind/+ control mice) to investigate the activity of neutrophils and a potential cellular interconnection between skin and vasculature. Levels of dermal reactive oxygen species (ROS) and their release by neutrophils were measured by lucigenin-/luminol-based assays, respectively. Quantitative RT-PCR determined neutrophilic activity and inflammation-related markers in skin and aorta. To track skin-derived immune cells, we used PhAM-K14-IL-17Aind/+ mice allowing us to mark all cells in the skin by photoconversion of a fluorescent protein to analyze their migration into spleen, aorta, and lymph nodes by flow cytometry. Compared to controls, K14-IL-17Aind/+ mice exhibited elevated ROS levels in the skin and a higher neutrophilic oxidative burst accompanied by the upregulation of several activation markers. In line with these results psoriatic mice displayed elevated expression of genes involved in neutrophil migration (e.g., Cxcl2 and S100a9) in skin and aorta. However, no direct immune cell migration from the psoriatic skin into the aortic vessel wall was observed. Neutrophils of psoriatic mice showed an activated phenotype, but no direct cellular migration from the skin to the vasculature was observed. This suggests that highly active vasculature-invading neutrophils must originate directly from the bone marrow. Hence, the skin-vasculature crosstalk in psoriasis is most likely based on the systemic effects of the autoimmune skin disease, emphasizing the importance of a systemic therapeutic approach for psoriasis patients.
Collapse
Affiliation(s)
- Theresa Schaller
- Institute for Molecular Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Julia Ringen
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center of Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Berenice Fischer
- Department of Dermatology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Tabea Bieler
- Division of Chronic Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Interdisciplinary Center for Scientific Computing (IWR), University of Heidelberg, Heidelberg, Germany
| | - Katharina Perius
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center of Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Tanja Knopp
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center of Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Hematology and Central Hematology Laboratory, Inselspital University Hospital Bern, Bern, Switzerland
- Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Katharina S Kommoss
- Division of Chronic Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Thomas Korn
- Institute for Experimental Neuroimmunology, Technical University of Munich School of Medicine, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy) Ludwig-Maximilians-University Munich, Munich, Germany
| | - Mathias Heikenwälder
- Division of Chronic Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
- The M3 Research Institute, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Matthias Oelze
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK) - Partner Site Rhine-Main, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK) - Partner Site Rhine-Main, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center of Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK) - Partner Site Rhine-Main, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Daniela Kramer
- Department of Dermatology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philip Wenzel
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center of Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK) - Partner Site Rhine-Main, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Johannes Wild
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center of Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK) - Partner Site Rhine-Main, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Susanne Karbach
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center of Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK) - Partner Site Rhine-Main, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Ari Waisman
- Institute for Molecular Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Research Center for Immunotherapy, Johannes Gutenberg-University Mainz, Mainz, Germany
| |
Collapse
|
4
|
Brandt M, Dörschmann H, Khraisat S, Knopp T, Ringen J, Kalinovic S, Garlapati V, Siemer S, Molitor M, Göbel S, Stauber R, Karbach SH, Münzel T, Daiber A, Wenzel P. Telomere Shortening in Hypertensive Heart Disease Depends on Oxidative DNA Damage and Predicts Impaired Recovery of Cardiac Function in Heart Failure. Hypertension 2022; 79:2173-2184. [PMID: 35862118 DOI: 10.1161/hypertensionaha.121.18935] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Heart failure (HF) coincides with cardiomyocyte telomere shortening. Arterial hypertension is the most prominent risk factor for HF. Both HF and arterial hypertension are associated with dysregulation of the neurohormonal axis. How neurohormonal activation is linked to telomere shortening in the pathogenesis of HF is incompletely understood. METHODS Cardiomyocyte telomere length was assessed in a mouse model of hypertensive HF induced by excess neurohormonal activation (AngII [angiotensin II] infusion, high salt diet, and uninephrectomy), in AngII-stimulated cardiomyocytes and in endomyocardial biopsies from patients with HF. Superoxide production, expression of NOX2 (NADPH oxidase 2) and PRDX1 (peroxiredoxin 1) and HDAC6 (histone deacetylase 6) activity were assessed. RESULTS Telomere shortening occurred in vitro and in vivo, correlating with both left ventricular (LV) dilatation and LV systolic function impairment. Telomere shortening coincided with increased superoxide production, increased NOX2 expression, increased HDAC6 activity, loss of the telomere-specific antioxidant PRDX1, and increased oxidative DNA-damage. NOX2 knockout prevented PRDX1 depletion, DNA-damage and telomere shortening confirming this enzyme as a critical source of reactive oxygen species. Cotreatment with the NOX inhibitor apocynin ameliorated hypertensive HF and telomere shortening. Similarly, treatment with the HDAC6 inhibitor tubastatin A, which increases PRDX1 bioavailability, prevented telomere shortening in adult cardiomyocytes. To explore the clinical relevance of our findings, we examined endomyocardial biopsies from an all-comer population of patients with HF with reduced ejection fraction. Here, cardiomyocyte telomere length predicted the recovery of cardiac function. CONCLUSIONS Cardiomyocyte telomere shortening and oxidative damage in heart failure with reduced ejection fraction induced by excess neurohormonal activation depends on NOX2-derived superoxide and may help to stratify HF therapy.
Collapse
Affiliation(s)
- Moritz Brandt
- Department of Cardiology' University Medical Center Mainz' Mainz' Germany (M.B., H.D., S.K., T.K., J.R., S.K., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.).,Center for Thrombosis and Hemostasis' University Medical Center Mainz' Mainz' Germany (M.B., H.D., T.K., J.R., V.G., M.M., S.H.K., T.M., A.D., P.W.).,German Center for Cardiovascular Research (DZHK) - Partner site Rhine-Main (M.B., T.K., J.R., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.)
| | - Hendrik Dörschmann
- Department of Cardiology' University Medical Center Mainz' Mainz' Germany (M.B., H.D., S.K., T.K., J.R., S.K., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.)
| | - Sana'a Khraisat
- Department of Cardiology' University Medical Center Mainz' Mainz' Germany (M.B., H.D., S.K., T.K., J.R., S.K., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.)
| | - Tanja Knopp
- Department of Cardiology' University Medical Center Mainz' Mainz' Germany (M.B., H.D., S.K., T.K., J.R., S.K., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.).,Center for Thrombosis and Hemostasis' University Medical Center Mainz' Mainz' Germany (M.B., H.D., T.K., J.R., V.G., M.M., S.H.K., T.M., A.D., P.W.).,German Center for Cardiovascular Research (DZHK) - Partner site Rhine-Main (M.B., T.K., J.R., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.)
| | - Julia Ringen
- Department of Cardiology' University Medical Center Mainz' Mainz' Germany (M.B., H.D., S.K., T.K., J.R., S.K., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.).,Center for Thrombosis and Hemostasis' University Medical Center Mainz' Mainz' Germany (M.B., H.D., T.K., J.R., V.G., M.M., S.H.K., T.M., A.D., P.W.).,German Center for Cardiovascular Research (DZHK) - Partner site Rhine-Main (M.B., T.K., J.R., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.)
| | - Sanela Kalinovic
- Department of Cardiology' University Medical Center Mainz' Mainz' Germany (M.B., H.D., S.K., T.K., J.R., S.K., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.)
| | - Venkata Garlapati
- Department of Cardiology' University Medical Center Mainz' Mainz' Germany (M.B., H.D., S.K., T.K., J.R., S.K., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.).,Center for Thrombosis and Hemostasis' University Medical Center Mainz' Mainz' Germany (M.B., H.D., T.K., J.R., V.G., M.M., S.H.K., T.M., A.D., P.W.).,German Center for Cardiovascular Research (DZHK) - Partner site Rhine-Main (M.B., T.K., J.R., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.)
| | - Svenja Siemer
- Department of Otolaryngology, Head and Neck Surgery, University Medical Center Mainz' Mainz' Germany (S.S., R.S.)
| | - Michael Molitor
- Department of Cardiology' University Medical Center Mainz' Mainz' Germany (M.B., H.D., S.K., T.K., J.R., S.K., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.).,Center for Thrombosis and Hemostasis' University Medical Center Mainz' Mainz' Germany (M.B., H.D., T.K., J.R., V.G., M.M., S.H.K., T.M., A.D., P.W.).,German Center for Cardiovascular Research (DZHK) - Partner site Rhine-Main (M.B., T.K., J.R., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.)
| | - Sebastian Göbel
- Department of Cardiology' University Medical Center Mainz' Mainz' Germany (M.B., H.D., S.K., T.K., J.R., S.K., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.)
| | - Roland Stauber
- Department of Otolaryngology, Head and Neck Surgery, University Medical Center Mainz' Mainz' Germany (S.S., R.S.)
| | - Susanne Helena Karbach
- Department of Cardiology' University Medical Center Mainz' Mainz' Germany (M.B., H.D., S.K., T.K., J.R., S.K., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.).,Center for Thrombosis and Hemostasis' University Medical Center Mainz' Mainz' Germany (M.B., H.D., T.K., J.R., V.G., M.M., S.H.K., T.M., A.D., P.W.).,German Center for Cardiovascular Research (DZHK) - Partner site Rhine-Main (M.B., T.K., J.R., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.)
| | - Thomas Münzel
- Department of Cardiology' University Medical Center Mainz' Mainz' Germany (M.B., H.D., S.K., T.K., J.R., S.K., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.).,Center for Thrombosis and Hemostasis' University Medical Center Mainz' Mainz' Germany (M.B., H.D., T.K., J.R., V.G., M.M., S.H.K., T.M., A.D., P.W.).,German Center for Cardiovascular Research (DZHK) - Partner site Rhine-Main (M.B., T.K., J.R., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.)
| | - Andreas Daiber
- Department of Cardiology' University Medical Center Mainz' Mainz' Germany (M.B., H.D., S.K., T.K., J.R., S.K., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.).,Center for Thrombosis and Hemostasis' University Medical Center Mainz' Mainz' Germany (M.B., H.D., T.K., J.R., V.G., M.M., S.H.K., T.M., A.D., P.W.).,German Center for Cardiovascular Research (DZHK) - Partner site Rhine-Main (M.B., T.K., J.R., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.)
| | - Philip Wenzel
- Department of Cardiology' University Medical Center Mainz' Mainz' Germany (M.B., H.D., S.K., T.K., J.R., S.K., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.).,Center for Thrombosis and Hemostasis' University Medical Center Mainz' Mainz' Germany (M.B., H.D., T.K., J.R., V.G., M.M., S.H.K., T.M., A.D., P.W.).,German Center for Cardiovascular Research (DZHK) - Partner site Rhine-Main (M.B., T.K., J.R., V.G., M.M., S.G., S.H.K., T.M., A.D., P.W.).,Department of Biochemistry, Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands (P.W.)
| |
Collapse
|
5
|
Wild J, Ringen J, Bieler T, Knopp T, Lagrange J, Molitor M, Sies K, Kropp A, Keller K, Daiber A, Münzel T, Rauh M, Waisman A, Wenzel P, Titze J, Karbach S. Epicutaneous application of Imiquimod to model psoriasis-like skin disease induces water-saving aestivation motifs and vascular inflammation. J Invest Dermatol 2022; 142:3117-3120.e2. [DOI: 10.1016/j.jid.2022.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/29/2022] [Accepted: 04/05/2022] [Indexed: 11/27/2022]
|
6
|
Wild J, Ringen J, Knopp T, Bieler T, Molitor M, Muenzel T, Waisman A, Wenzel P, Karbach S. Acute induction of psoriasis-like skin inflammation disturbes vascular tone and provokes a rapid blood pressure response in mice. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Psoriasis is the most common chronic skin disease worldwide. Furthermore, it is an independent cardiovascular risk factor. Several genetic and inducible murine models reproduce specific aspects of the human disease. In mice genetically overexpressing IL-17A in keratinocytes or dendritic cells, we coulod show both aspects of the disease: cutaneous hallmarks and the vascular phenotype. The most popular inducible model consists of topical application of Imiquimod (IMQ), a Toll-like receptor 7/8 agonist. In this model, cardiovascular aspects have not been studied yet. Therefore, we examined vascular and hemodynamic effects in this most popular murine psoriasis model.
Methods
C57BL/6J mice were treated with 5% IMQ or sham cream. During treatment, we measured bodyweight, skin thickness and skin water loss. After 10 days, aortic relaxation studies were performed. For assessment of vascular inflammation, inflammatory cell infiltration into the aortic tissue was investigated by flow cytometric analysis. To record physical activity, blood pressure and heart rate, carotid catheters were implanted two weeks before treatment with IMQ. Blood pressure and heart rate were continuously recorded by receiver platforms.
Results
IMQ treatment resulted in severe skin inflammation and induced a skin barrier defect resulting in a 7-fold increase of transcutaneous water loss (from 11±6 ml/m2h to 77±30 ml/m2h). Physical activity decreased more than 50% after d1 of treatment and normalized at d7. Telemetric recording revealed a reflex tachycardia at 1d of IMQ-application (from 492±21 bpm to 524±20 bpm) followed by a significant reduction of heart rate for the next two days (456±18bpm). Systolic blood pressure showed a similar trend: after a fast increase (from 120±13 mmHg to 127±18 mmHg), blood pressure dropped below baseline at d2/3 with a subsequent recovery. We could display a highly significant positive correlation between blood pressure and heart rate during the treatment (R=0.6; p≤0.0001). Aortas from animals after 10d of IMQ-treatment showed an increased infiltration of CD45+ and CD11b+ inflammatory cells but no change of responsiveness to endothelium dependent and independent vasodilators in organ chamber studies.
Conclusion
Skin treatment with IMQ had severe implications on the hemodynamic system: After an initial peak of heart rate and blood pressure, mice showed significantly lower values for two days with a subsequent full recovery. Moreover, bodyweight and physical activity were significantly altered during treatment. Our data indicate that skin inflammation and inflammatory skin barrier disruption by IMQ forces a compensatory whole-body response. 10 days of IMQ-treatment resulted in vascular inflammation without mediating vascular dysfunction. In summary, we could reveal that IMQ-induced psoriasis, as the most popular murine psoriasis model worldwide, has extensive effects on the cardiovascular system.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Boehringer Ingelheim Foundation “Novel and neglected cardiovascular risk factors: molecular mechanisms and therapeutic implications”German Federal Ministry for Education and Research (BMBF EDU-V24)
Collapse
Affiliation(s)
- J Wild
- University Medical Center of Mainz, Center for Cardiology, Mainz, Germany
| | - J Ringen
- Center for Thrombosis and Hemostasis, Mainz, Germany
| | - T Knopp
- Center for Thrombosis and Hemostasis, Mainz, Germany
| | - T Bieler
- Center for Thrombosis and Hemostasis, Mainz, Germany
| | - M Molitor
- University Medical Center of Mainz, Center for Cardiology, Mainz, Germany
| | - T Muenzel
- University Medical Center of Mainz, Center for Cardiology, Mainz, Germany
| | - A Waisman
- University Medical Center of Mainz, Mainz, Germany
| | - P Wenzel
- University Medical Center of Mainz, Center for Cardiology, Mainz, Germany
| | - S Karbach
- University Medical Center of Mainz, Center for Cardiology, Mainz, Germany
| |
Collapse
|
7
|
Knopp T, Bieler T, Jung R, Ringen J, Molitor M, Jurda A, Münzel T, Waisman A, Wenzel P, Karbach SH, Wild J. Effects of Dietary Protein Intake on Cutaneous and Systemic Inflammation in Mice with Acute Experimental Psoriasis. Nutrients 2021; 13:nu13061897. [PMID: 34072973 PMCID: PMC8228490 DOI: 10.3390/nu13061897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/24/2021] [Accepted: 05/28/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Psoriasis is a systemic inflammatory disorder, primarily characterized by skin plaques. It is linked to co-morbidities including cardiovascular disease and metabolic syndrome. Several studies demonstrate that dietary habits can influence psoriasis development and severity. However, the effect of different dietary protein levels on psoriasis development and severity is poorly understood. In this study, we examine the influence of dietary protein on psoriasis-like skin disease in mice. Methods: We fed male C57BL/6J mice with regular, low protein and high protein chow for 4 weeks. Afterwards, we induced psoriasis-like skin disease by topical imiquimod (IMQ)-treatment on ear and back skin. The local cutaneous and systemic inflammatory response was investigated using flow cytometry analysis, histology and quantitative rt-PCR. Results: After 5 days of IMQ-treatment, both diets reduced bodyweight in mice, whereas only the high protein diet slightly aggravated IMQ-induced skin inflammation. IMQ-treatment induced infiltration of myeloid cells, neutrophils, and monocytes/macrophages into skin and spleen independently of diet. After IMQ-treatment, circulating neutrophils and reactive oxygen species were increased in mice on low and high protein diets. Conclusion: Different dietary protein levels had no striking effect on IMQ-induced psoriasis but aggravated the systemic pro-inflammatory phenotype.
Collapse
Affiliation(s)
- Tanja Knopp
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, 55131 Mainz, Germany; (T.K.); (T.B.); (R.J.); (J.R.); (M.M.); (A.J.); (P.W.); (S.H.K.)
| | - Tabea Bieler
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, 55131 Mainz, Germany; (T.K.); (T.B.); (R.J.); (J.R.); (M.M.); (A.J.); (P.W.); (S.H.K.)
| | - Rebecca Jung
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, 55131 Mainz, Germany; (T.K.); (T.B.); (R.J.); (J.R.); (M.M.); (A.J.); (P.W.); (S.H.K.)
| | - Julia Ringen
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, 55131 Mainz, Germany; (T.K.); (T.B.); (R.J.); (J.R.); (M.M.); (A.J.); (P.W.); (S.H.K.)
| | - Michael Molitor
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, 55131 Mainz, Germany; (T.K.); (T.B.); (R.J.); (J.R.); (M.M.); (A.J.); (P.W.); (S.H.K.)
- Center for Cardiology—Cardiology I, University Medical Center Mainz, 55131 Mainz, Germany;
- German Center for Cardiovascular Research (DZHK)—Partner Site Rhine-Main, 55131 Mainz, Germany
| | - Annika Jurda
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, 55131 Mainz, Germany; (T.K.); (T.B.); (R.J.); (J.R.); (M.M.); (A.J.); (P.W.); (S.H.K.)
| | - Thomas Münzel
- Center for Cardiology—Cardiology I, University Medical Center Mainz, 55131 Mainz, Germany;
- German Center for Cardiovascular Research (DZHK)—Partner Site Rhine-Main, 55131 Mainz, Germany
| | - Ari Waisman
- Institute of Molecular Medicine, University Medical Center Mainz, 55131 Mainz, Germany;
- Focus Program Translational Neurosciences, University Medical Center Mainz, 55131 Mainz, Germany
- Research Center for Immunotherapy, University Medical Center Mainz, 55131 Mainz, Germany
| | - Philip Wenzel
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, 55131 Mainz, Germany; (T.K.); (T.B.); (R.J.); (J.R.); (M.M.); (A.J.); (P.W.); (S.H.K.)
- Center for Cardiology—Cardiology I, University Medical Center Mainz, 55131 Mainz, Germany;
- German Center for Cardiovascular Research (DZHK)—Partner Site Rhine-Main, 55131 Mainz, Germany
| | - Susanne Helena Karbach
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, 55131 Mainz, Germany; (T.K.); (T.B.); (R.J.); (J.R.); (M.M.); (A.J.); (P.W.); (S.H.K.)
- Center for Cardiology—Cardiology I, University Medical Center Mainz, 55131 Mainz, Germany;
- German Center for Cardiovascular Research (DZHK)—Partner Site Rhine-Main, 55131 Mainz, Germany
| | - Johannes Wild
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, 55131 Mainz, Germany; (T.K.); (T.B.); (R.J.); (J.R.); (M.M.); (A.J.); (P.W.); (S.H.K.)
- Center for Cardiology—Cardiology I, University Medical Center Mainz, 55131 Mainz, Germany;
- German Center for Cardiovascular Research (DZHK)—Partner Site Rhine-Main, 55131 Mainz, Germany
- Correspondence:
| |
Collapse
|
8
|
Jung R, Wild J, Ringen J, Karbach S, Wenzel P. Innate Immune Mechanisms of Arterial Hypertension and Autoimmune Disease. Am J Hypertens 2021; 34:143-153. [PMID: 32930786 DOI: 10.1093/ajh/hpaa145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/15/2020] [Accepted: 09/14/2020] [Indexed: 12/16/2022] Open
Abstract
The immune system is indispensable in the development of vascular dysfunction and hypertension. The interplay between immune cells and the vasculature, kidneys, heart, and blood pressure regulating nuclei in the central nervous system results in a complex and closely interwoven relationship of the immune system with arterial hypertension. A better understanding of this interplay is necessary for optimized and individualized antihypertensive therapy. Our review article focuses on innate cells in hypertension and to what extent they impact on development and preservation of elevated blood pressure. Moreover, we address the association of hypertension with chronic autoimmune diseases. The latter are ideally suited to learn about immune-mediated mechanisms in cardiovascular disease leading to high blood pressure.
Collapse
Affiliation(s)
- Rebecca Jung
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
| | - Johannes Wild
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- Department of Cardiology, University Medical Center Mainz, Mainz, Germany
| | - Julia Ringen
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
| | - Susanne Karbach
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- Department of Cardiology, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Germany
| | - Philip Wenzel
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
- Department of Cardiology, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Germany
| |
Collapse
|
9
|
Rohne P, Wolf S, Dörr C, Ringen J, Holtz A, Gollan R, Renner B, Prochnow H, Baiersdörfer M, Koch-Brandt C. Exposure of vital cells to necrotic cell lysates induce the IRE1α branch of the unfolded protein response and cell proliferation. Cell Stress Chaperones 2018; 23:77-88. [PMID: 28687980 PMCID: PMC5741583 DOI: 10.1007/s12192-017-0825-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/15/2017] [Accepted: 06/16/2017] [Indexed: 10/19/2022] Open
Abstract
Necrosis is a form of cell death that is detrimental to the affected tissue because the cell ruptures and releases its content (reactive oxygen species among others) into the extracellular space. Clusterin (CLU), a cytoprotective extracellular chaperone has been shown to be upregulated in the face of necrosis. We here show that in addition to CLU upregulation, necrotic cell lysates induce JNK/SAPK signaling, the IRE1α branch of the unfolded protein response (UPR), the MAPK/ERK1/2, and the mTOR signaling pathways and results in an enhanced proliferation of the vital surrounding cells. We name this novel response mechanism: Necrosis-induced Proliferation (NiP).
Collapse
Affiliation(s)
- Philipp Rohne
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
| | - Steven Wolf
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
- Department of Pathology, The University of Chicago, Chicago, IL USA
| | - Carolin Dörr
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
| | - Julia Ringen
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
| | - Andrew Holtz
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
| | - René Gollan
- Department of Neurology, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Benjamin Renner
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
| | - Hans Prochnow
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
- Department of Chemical Biology, Helmholtz Centre for Infection Research GmbH, Braunschweig, Germany
| | - Markus Baiersdörfer
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
| | - Claudia Koch-Brandt
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
| |
Collapse
|
10
|
Rohne P, Wolf S, Dörr C, Ringen J, Holtz A, Gollan R, Renner B, Prochnow H, Baiersdörfer M, Koch-Brandt C. Erratum to: exposure of vital cells to necrotic cell lysates induce the IRE1α branch of the unfolded protein response and cell proliferation. Cell Stress Chaperones 2018; 23:89. [PMID: 28741046 PMCID: PMC5741588 DOI: 10.1007/s12192-017-0831-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Philipp Rohne
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
| | - Steven Wolf
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
- Department of Pathology, The University of Chicago, Chicago, IL USA
| | - Carolin Dörr
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
| | - Julia Ringen
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
| | - Andrew Holtz
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
| | - René Gollan
- Department of Neurology, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Benjamin Renner
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
| | - Hans Prochnow
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
- Department of Chemical Biology, Helmholtz Centre for Infection Research GmbH, Braunschweig, Germany
| | - Markus Baiersdörfer
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
| | - Claudia Koch-Brandt
- Institute of Pharmacy and Biochemistry - Therapeutical Life Sciences, Johannes Gutenberg University of Mainz, Johann-Joachim Becherweg 30, 55128 Mainz, Germany
| |
Collapse
|