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Leung DYM, Facheris P, Veverka KA, Cevikbas F, Guttman-Yassky E. Targeting type 2 immune activation beyond atopic dermatitis. Ann Allergy Asthma Immunol 2024; 132:121-123. [PMID: 37442541 DOI: 10.1016/j.anai.2023.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023]
Affiliation(s)
- Donald Y M Leung
- Pediatric Allergy and Clinical Immunology, Department of Pediatrics, National Jewish Health, Denver, Colorado.
| | - Paola Facheris
- Department of Dermatology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Rozzano, Milan, Italy
| | | | | | - Emma Guttman-Yassky
- Dermatology and Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, New York
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Cevikbas F, Ward A, Firth C, Veverka K. Eblasakimab, a novel IL-13 receptor alpha 1 monoclonal antibody, blocks STAT6 phosphorylation with low dose in human volunteers. Clin Immunol 2023:109677. [PMID: 37315681 DOI: 10.1016/j.clim.2023.109677] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/21/2023] [Accepted: 06/07/2023] [Indexed: 06/16/2023]
Abstract
Eblasakimab is a first-in-class monoclonal antibody under investigation for the treatment of atopic dermatitis (AD) which targets IL-13Rα1, a subunit of the Type 2 receptor complex. IL-13Rα1 stimulates phosphorylation of signal transducer and activator of transcription 6 (STAT6) to drive inflammation. This brief report investigates the mechanistic basis of eblasakimab and its effects on IL-13Rα1 signaling as part of a phase 1a, open-label, single ascending dose study. Single ascending doses of eblasakimab were administered by intravenous or subcutaneous injection to healthy male volunteers. The impact of eblasakimab on IL-13Rα1 receptor occupancy and STAT6 phosphorylation was assessed in participant blood monocytes. No serious treatment emergent adverse events were reported. Eblasakimab effectively blocked the IL-13Rα1 receptor and inhibited STAT6 phosphorylation with single doses of 3 mg/kg intravenously and 300 mg subcutaneously. Results support further clinical development of eblasakimab as a novel biologic for AD, with potential for 2- to 4-week dosing regimens.
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Affiliation(s)
- Ferda Cevikbas
- ASLAN Pharmaceuticals, 400 Concar Drive, San Mateo, CA, USA.
| | - Alison Ward
- ASLAN Pharmaceuticals, 400 Concar Drive, San Mateo, CA, USA
| | - Carl Firth
- ASLAN Pharmaceuticals, 400 Concar Drive, San Mateo, CA, USA
| | - Karen Veverka
- ASLAN Pharmaceuticals, 400 Concar Drive, San Mateo, CA, USA
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Miron Y, Miller P, Firth C, Cevikbas F. LB1039 New insights into neuronal itch mechanisms by targeting IL-13Rα1 with eblasakimab. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.1077] [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] [Indexed: 10/17/2022]
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Miron Y, Miller PE, Hughes C, Indersmitten T, Lerner EA, Cevikbas F. Mechanistic Insights into the Anti-Pruritic Effects of Lebrikizumab, an Anti-IL-13 Monoclonal Antibody. J Allergy Clin Immunol 2022; 150:690-700. [PMID: 35240144 DOI: 10.1016/j.jaci.2022.01.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/17/2021] [Accepted: 01/25/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic, inflammatory skin disease with persistent and severe itch among its hallmark features. Significant increases in type 2 cytokines (i.e., IL-4, IL-13, IL-31) have been documented in acute AD lesions and lead to multi-faceted downstream effects, including inflammation, epidermal barrier dysfunction, and itch. OBJECTIVE The primary objective of preclinical studies reported here was to test direct effects of IL-13 and the anti-IL-13 monoclonal antibody, lebrikizumab, in a human dorsal root ganglion (hDRG) model in itch amplification, neuronal excitability, and transcriptional downstream targets. METHODS Neuroactive effects were assessed via live cell calcium imaging, electric field stimulation, and RNA sequencing of hDRGs stimulated with IL-13 alone or in combination with lebrikizumab. RESULTS These preclinical findings suggest that IL-13 has a direct enhancer role in multiple itch and neuroactive pathways, as well as transcriptional downstream effects, and provide key insights into the mechanistic basis for lebrikizumab's anti-itch effects. CONCLUSION IL-13 is a potent enhancer of neuronal responses to different itch stimuli, consistent with the neuro-immune axis contributing to chronic itch-associated inflammatory skin disease, and that blockade of this cytokine pathway may provide a therapeutic approach.
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Affiliation(s)
| | | | | | | | - Ethan A Lerner
- Massachusetts General Hospital/Harvard Medical School, Boston, MA
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Miron Y, Miller P, Hughes C, Lerner E, Cevikbas F. 682 Lebrikizumab directly reverses IL-13 driven neuronal gene regulation and neuronal excitability. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.712] [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] [Indexed: 11/30/2022]
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Buhl T, Ikoma A, Kempkes C, Cevikbas F, Sulk M, Buddenkotte J, Akiyama T, Crumrine D, Camerer E, Carstens E, Schön MP, Elias P, Coughlin SR, Steinhoff M. Protease-Activated Receptor-2 Regulates Neuro-Epidermal Communication in Atopic Dermatitis. Front Immunol 2020; 11:1740. [PMID: 32903402 PMCID: PMC7435019 DOI: 10.3389/fimmu.2020.01740] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 06/29/2020] [Indexed: 01/01/2023] Open
Abstract
Background: Activation of protease-activated receptor-2 (PAR2) has been implicated in inflammation, pruritus, and skin barrier regulation, all characteristics of atopic dermatitis (AD), as well as Netherton syndrome which has similar characteristics. However, understanding the precise role of PAR2 on neuro-immune communication in AD has been hampered by the lack of appropriate animal models. Methods: We used a recently established mouse model with epidermal overexpression of PAR2 (PAR2OE) and littermate WT mice to study the impact of increased PAR2 expression in epidermal cells on spontaneous and house dust mite (HDM)-induced skin inflammation, itch, and barrier dysfunction in AD, in vivo and ex vivo. Results: PAR2OE newborns displayed no overt abnormalities, but spontaneously developed dry skin, severe pruritus, and eczema. Dermatological, neurophysiological, and immunological analyses revealed the hallmarks of AD-like skin disease. Skin barrier defects were observed before onset of skin lesions. Application of HDM onto PAR2OE mice triggered pruritus and the skin phenotype. PAR2OE mice displayed an increased density of nerve fibers, increased nerve growth factor and endothelin-1 expression levels, alloknesis, enhanced scratching (hyperknesis), and responses of dorsal root ganglion cells to non-histaminergic pruritogens. Conclusion: PAR2 in keratinocytes, activated by exogenous and endogenous proteases, is sufficient to drive barrier dysfunction, inflammation, and pruritus and sensitize skin to the effects of HDM in a mouse model that mimics human AD. PAR2 signaling in keratinocytes appears to be sufficient to drive several levels of neuro-epidermal communication, another feature of human AD.
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Affiliation(s)
- Timo Buhl
- Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA, United States.,Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Akihiko Ikoma
- Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA, United States.,Department of Dermatology and UCD Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland
| | - Cordula Kempkes
- Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Ferda Cevikbas
- Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Mathias Sulk
- Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA, United States.,Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Joerg Buddenkotte
- Department of Dermatology and Venerology, Hamad Medical Corporation, Doha, Qatar.,Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Tasuku Akiyama
- Department of Dermatology, Anatomy and Cell Biology, Temple Itch Center, Temple University, Philadelphia, PA, United States.,Department of Neurobiology, Physiology and Behavior, University of California, Davis, Davis, CA, United States
| | - Debbie Crumrine
- Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Eric Camerer
- INSERM U970, Paris Cardiovascular Research Centre, Paris, France
| | - Earl Carstens
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, Davis, CA, United States
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Peter Elias
- Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Shaun R Coughlin
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, United States
| | - Martin Steinhoff
- Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA, United States.,Department of Dermatology and UCD Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland.,Department of Dermatology and Venerology, Hamad Medical Corporation, Doha, Qatar.,Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar.,Department of Dermatology, Medical School, University of Qatar, Doha, Qatar.,School of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar.,Department of Dermatology, Weill Cornell Medicine, New York, NY, United States
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Abstract
Itch is a topic to which everyone can relate. The physiological roles of itch are increasingly understood and appreciated. The pathophysiological consequences of itch impact quality of life as much as pain. These dynamics have led to increasingly deep dives into the mechanisms that underlie and contribute to the sensation of itch. When the prior review on the physiology of itching was published in this journal in 1941, itch was a black box of interest to a small number of neuroscientists and dermatologists. Itch is now appreciated as a complex and colorful Rubik's cube. Acute and chronic itch are being carefully scratched apart and reassembled by puzzle solvers across the biomedical spectrum. New mediators are being identified. Mechanisms blur boundaries of the circuitry that blend neuroscience and immunology. Measures involve psychophysics and behavioral psychology. The efforts associated with these approaches are positively impacting the care of itchy patients. There is now the potential to markedly alleviate chronic itch, a condition that does not end life, but often ruins it. We review the itch field and provide a current understanding of the pathophysiology of itch. Itch is a disease, not only a symptom of disease.
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Affiliation(s)
- Ferda Cevikbas
- Dermira, Inc., Menlo Park, California; and Harvard Medical School and the Cutaneous Biology Research Center at Massachusetts General Hospital, Charlestown, Massachusetts
| | - Ethan A Lerner
- Dermira, Inc., Menlo Park, California; and Harvard Medical School and the Cutaneous Biology Research Center at Massachusetts General Hospital, Charlestown, Massachusetts
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Moyle M, Cevikbas F, Harden JL, Guttman‐Yassky E. Understanding the immune landscape in atopic dermatitis: The era of biologics and emerging therapeutic approaches. Exp Dermatol 2019; 28:756-768. [PMID: 30825336 PMCID: PMC6850480 DOI: 10.1111/exd.13911] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/28/2019] [Accepted: 02/14/2019] [Indexed: 12/15/2022]
Abstract
Atopic dermatitis (AD) is a chronic, systemic, inflammatory disease that affects the skin and is characterized by persistent itch and marked redness. AD is associated with an increased risk of skin infections and a reduced quality of life. Most AD treatment options to date were not designed to selectively target disease-causing pathways that have been established for this indication. Topical therapies have limited efficacy in moderate-to-severe disease, and systemic agents such as corticosteroids and immunosuppressants present with tolerability issues. Advances in the understanding of AD pathobiology have made possible a new generation of more disease-specific AD therapies. AD is characterized by the inappropriate activation of type 2 T helper (Th2) cells and type 2 innate lymphoid (ILC2) cells, with a predominant increase in type 2 cytokines in the skin, including interleukin (IL)-13 and IL-4. Both cytokines are implicated in tissue inflammation and epidermal barrier dysfunction, and monoclonal antibodies targeting each of these interleukins or their receptors are in clinical development in AD. In March 2017, dupilumab, a human anti-IL-4Rα antibody, became the first biologic to receive approval in the United States for the treatment of moderate-to-severe AD. The anti-IL-13 monoclonal antibodies lebrikizumab and tralokinumab, which bind different IL-13 epitopes with potentially different effects, are currently in advanced-stage trials. Here, we briefly review the underlying pathobiology of AD, the scientific basis for current AD targets, and summarize current clinical studies of these agents, including new research to develop both predictive and response biomarkers to further advance AD therapy in the era of precision medicine.
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Miron Y, Miller P, Ghetti A, Ramos M, Hofland H, Cevikbas F. LB1511 Neuronal responses elicited by interleukin-13 in human neurons. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.06.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Akiyama T, Ivanov M, Nagamine M, Davoodi A, Carstens MI, Ikoma A, Cevikbas F, Kempkes C, Buddenkotte J, Steinhoff M, Carstens E. Involvement of TRPV4 in Serotonin-Evoked Scratching. J Invest Dermatol 2016; 136:154-160. [PMID: 26763435 PMCID: PMC4731048 DOI: 10.1038/jid.2015.388] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 08/26/2015] [Accepted: 09/05/2015] [Indexed: 01/13/2023]
Abstract
Several thermo-sensitive TRP channels (TRPV1, -3; TRPA1) have been implicated in itch. In contrast, the role of transient receptor potential vanilloid type-4 (TRPV4) in itch is unknown. Therefore, we investigated if TRPV4, a temperature-sensitive cation channel, plays an important role in acute itch in mice. Four different pruritogens including serotonin (5-hydroxytrytamine, 5-HT), histamine, SLIGRL (PAR2/MrgprC11 agonist) and chloroquine (MrgprA3 agonist) were intradermally injected and itch-related scratching behavior was assessed. TRPV4 knockout (TRPV4KO) mice exhibited significantly fewer 5-HT-evoked scratching bouts compared to wild-type (WT) mice. Notably, no differences between TRPV4KO and WT mice were observed in the number of scratch bouts elicited by SLIGRL and histamine. Pretreatment with a TRPV4 antagonist significantly attenuated 5-HT-evoked scratching in vivo. Using calcium imaging in cultured primary murine dorsal root ganglion (DRG) neurons, the response of neurons after 5-HT application, but not other pruritogens, was significantly lower in TRPV4KO compared to WT mice. A TRPV4 antagonist significantly suppressed 5-HT-evoked responses in DRG cells from WT mice. Approximately 90% of 5-HT-sensitive DRG neurons were immunoreactive for an antibody to TRPV4, as assessed by calcium imaging. These results indicate that serotonin-induced itch is linked to TRPV4.
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Affiliation(s)
- Tasuku Akiyama
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, California, USA; Department of Dermatology, Department of Anatomy & Cell Biology, Temple Itch Center, Temple University, Philadelphia, Pennsylvania, USA.
| | - Margaret Ivanov
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, California, USA
| | - Masaki Nagamine
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, California, USA
| | - Auva Davoodi
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, California, USA
| | - Mirela I Carstens
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, California, USA
| | - Akihiko Ikoma
- Departments of Dermatology and Surgery, University of California, San Francisco, USA
| | - Ferda Cevikbas
- Departments of Dermatology and Surgery, University of California, San Francisco, USA
| | - Cordula Kempkes
- Departments of Dermatology and Surgery, University of California, San Francisco, USA
| | - Joerg Buddenkotte
- Departments of Dermatology and Surgery, University of California, San Francisco, USA; U Dept. of Dermatology and UCD Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland
| | - Martin Steinhoff
- Departments of Dermatology and Surgery, University of California, San Francisco, USA; U Dept. of Dermatology and UCD Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland.
| | - E Carstens
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, California, USA.
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Akiyama T, Nagamine M, Davoodi A, Iodi Carstens M, Cevikbas F, Steinhoff M, Carstens E. Intradermal endothelin-1 excites bombesin-responsive superficial dorsal horn neurons in the mouse. J Neurophysiol 2015; 114:2528-34. [PMID: 26311187 DOI: 10.1152/jn.00723.2015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [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: 07/21/2015] [Accepted: 08/24/2015] [Indexed: 01/21/2023] Open
Abstract
Endothelin-1 (ET-1) has been implicated in nonhistaminergic itch. Here we used electrophysiological methods to investigate whether mouse superficial dorsal horn neurons respond to intradermal (id) injection of ET-1 and whether ET-1-sensitive neurons additionally respond to other pruritic and algesic stimuli or spinal superfusion of bombesin, a homolog of gastrin-releasing peptide (GRP) that excites spinal itch-signaling neurons. Single-unit recordings were made from lumbar dorsal horn neurons in pentobarbital-anesthetized C57BL/6 mice. We searched for units that exhibited elevated firing after id injection of ET-1 (1 μg/μl). Responsive units were further tested with mechanical stimuli, bombesin (spinal superfusion, 200 μg·ml(-1)·min(-1)), heating, cooling, and additional chemicals [histamine, chloroquine, allyl isothiocyanate (AITC), capsaicin]. Of 40 ET-1-responsive units, 48% responded to brush and pinch [wide dynamic range (WDR)] and 52% to pinch only [high threshold (HT)]. Ninety-three percent responded to noxious heat, 50% to cooling, and >70% to histamine, chloroquine, AITC, and capsaicin. Fifty-seven percent responded to bombesin, suggesting that they participate in spinal itch transmission. That most ET-1-sensitive spinal neurons also responded to pruritic and algesic stimuli is consistent with previous studies of pruritogen-responsive dorsal horn neurons. We previously hypothesized that pruritogen-sensitive neurons signal itch. The observation that ET-1 activates nociceptive neurons suggests that both itch and pain signals may be generated by ET-1 to result in simultaneous sensations of itch and pain, consistent with observations that ET-1 elicits both itch- and pain-related behaviors in animals and burning itch sensations in humans.
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Affiliation(s)
- T Akiyama
- Department of Neurobiology, Physiology, and Behavior, University of California, Davis, California
| | - M Nagamine
- Department of Neurobiology, Physiology, and Behavior, University of California, Davis, California
| | - A Davoodi
- Department of Neurobiology, Physiology, and Behavior, University of California, Davis, California
| | - M Iodi Carstens
- Department of Neurobiology, Physiology, and Behavior, University of California, Davis, California
| | - F Cevikbas
- Departments of Dermatology and Surgery, University of California, San Francisco, California; and
| | - M Steinhoff
- Department of Dermatology and Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland
| | - E Carstens
- Department of Neurobiology, Physiology, and Behavior, University of California, Davis, California;
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Kido-Nakahara M, Buddenkotte J, Kempkes C, Ikoma A, Cevikbas F, Akiyama T, Nunes F, Seeliger S, Hasdemir B, Mess C, Buhl T, Sulk M, Müller FU, Metze D, Bunnett NW, Bhargava A, Carstens E, Furue M, Steinhoff M. Neural peptidase endothelin-converting enzyme 1 regulates endothelin 1-induced pruritus. J Clin Invest 2014; 124:2683-95. [PMID: 24812665 DOI: 10.1172/jci67323] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
In humans, pruritus (itch) is a common but poorly understood symptom in numerous skin and systemic diseases. Endothelin 1 (ET-1) evokes histamine-independent pruritus in mammals through activation of its cognate G protein-coupled receptor endothelin A receptor (ETAR). Here, we have identified neural endothelin-converting enzyme 1 (ECE-1) as a key regulator of ET-1-induced pruritus and neural signaling of itch. We show here that ETAR, ET-1, and ECE-1 are expressed and colocalize in murine dorsal root ganglia (DRG) neurons and human skin nerves. In murine DRG neurons, ET-1 induced internalization of ETAR within ECE-1-containing endosomes. ECE-1 inhibition slowed ETAR recycling yet prolonged ET-1-induced activation of ERK1/2, but not p38. In a murine itch model, ET-1-induced scratching behavior was substantially augmented by pharmacological ECE-1 inhibition and abrogated by treatment with an ERK1/2 inhibitor. Using iontophoresis, we demonstrated that ET-1 is a potent, partially histamine-independent pruritogen in humans. Immunohistochemical evaluation of skin from prurigo nodularis patients confirmed an upregulation of the ET-1/ETAR/ECE-1/ERK1/2 axis in patients with chronic itch. Together, our data identify the neural peptidase ECE-1 as a negative regulator of itch on sensory nerves by directly regulating ET-1-induced pruritus in humans and mice. Furthermore, these results implicate the ET-1/ECE-1/ERK1/2 pathway as a therapeutic target to treat pruritus in humans.
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Eissa A, Cretu D, Soosaipillai A, Thavaneswaran A, Pellett F, Diamandis A, Cevikbas F, Steinhoff M, Diamandis EP, Gladman D, Chandran V. Serum kallikrein-8 correlates with skin activity, but not psoriatic arthritis, in patients with psoriatic disease. Clin Chem Lab Med 2014; 51:317-25. [PMID: 23096109 DOI: 10.1515/cclm-2012-0251] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 07/15/2012] [Indexed: 11/15/2022]
Abstract
BACKGROUND About 30% of cutaneous psoriasis (PsC) patients develop psoriatic arthritis (PsA) in the joint, which is under-recognized by dermatologists. Biomarkers for PsA are needed so that early referral to a rheumatologist is made. Kallikreins (KLKs) are secreted serine proteases implicated in skin desquamation and inflammation. This study examined KLK potential as serum biomarkers of PsA in cutaneous psoriasis patients. METHODS KLKs were measured by ELISAs in synovial fluids of three PsA patients and three control early osteoarthritis (OA) patients, as well as in a cohort of 152 serum samples collected from age- and sex-matched PsC patients, with (n=76) or without PsA (n=76). KLK expression in psoriatic plaques was examined by immunohistochemistry. Univariate and multivariate logistic regression analyses were conducted to analyze the association between serum KLK levels and disease class (PsC, PsA). Serum KLKs that associated with PsA were correlated with clinical parameters of skin and joint activity. RESULTS Among the seven KLKs tested, KLK6 and KLK8 were elevated in both PsA synovial fluids and psoriatic plaques, but only serum KLK8 levels were associated with psoriatic disease (odds ratio=2.56, p=0.03). Although significantly elevated in PsC and PsA sera compared to healthy controls, KLK8 did not discriminate PsA from PsC patients. KLK8 correlated positively with the psoriasis area and severity index (PASI) (r=0.43, p=0.001) independent of age, sex and psoriasis duration ( β=1.153, p=0.0003) and exhibited no correlations with tender or swollen joint counts. CONCLUSIONS Increased KLK8 serum level in PsA patients reflects disease activity in the skin but not in the joints. Serum KLK levels are not useful for screening psoriasis patients for PsA.
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Affiliation(s)
- Azza Eissa
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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14
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Cevikbas F, Wang X, Akiyama T, Kempkes C, Savinko T, Antal A, Kukova G, Buhl T, Ikoma A, Buddenkotte J, Soumelis V, Feld M, Alenius H, Dillon SR, Carstens E, Homey B, Basbaum A, Steinhoff M. A sensory neuron-expressed IL-31 receptor mediates T helper cell-dependent itch: Involvement of TRPV1 and TRPA1. J Allergy Clin Immunol 2013; 133:448-60. [PMID: 24373353 DOI: 10.1016/j.jaci.2013.10.048] [Citation(s) in RCA: 471] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 10/18/2013] [Accepted: 10/23/2013] [Indexed: 01/16/2023]
Abstract
BACKGROUND Although the cytokine IL-31 has been implicated in inflammatory and lymphoma-associated itch, the cellular basis for its pruritic action is yet unclear. OBJECTIVE We sought to determine whether immune cell-derived IL-31 directly stimulates sensory neurons and to identify the molecular basis of IL-31-induced itch. METHODS We used immunohistochemistry and quantitative real-time PCR to determine IL-31 expression levels in mice and human subjects. Immunohistochemistry, immunofluorescence, quantitative real-time PCR, in vivo pharmacology, Western blotting, single-cell calcium imaging, and electrophysiology were used to examine the distribution, functionality, and cellular basis of the neuronal IL-31 receptor α in mice and human subjects. RESULTS Among all immune and resident skin cells examined, IL-31 was predominantly produced by TH2 and, to a significantly lesser extent, mature dendritic cells. Cutaneous and intrathecal injections of IL-31 evoked intense itch, and its concentrations increased significantly in murine atopy-like dermatitis skin. Both human and mouse dorsal root ganglia neurons express IL-31RA, largely in neurons that coexpress transient receptor potential cation channel vanilloid subtype 1 (TRPV1). IL-31-induced itch was significantly reduced in TRPV1-deficient and transient receptor channel potential cation channel ankyrin subtype 1 (TRPA1)-deficient mice but not in c-kit or proteinase-activated receptor 2 mice. In cultured primary sensory neurons IL-31 triggered Ca(2+) release and extracellular signal-regulated kinase 1/2 phosphorylation, inhibition of which blocked IL-31 signaling in vitro and reduced IL-31-induced scratching in vivo. CONCLUSION IL-31RA is a functional receptor expressed by a small subpopulation of IL-31RA(+)/TRPV1(+)/TRPA1(+) neurons and is a critical neuroimmune link between TH2 cells and sensory nerves for the generation of T cell-mediated itch. Thus targeting neuronal IL-31RA might be effective in the management of TH2-mediated itch, including atopic dermatitis and cutaneous T-cell lymphoma.
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Affiliation(s)
- Ferda Cevikbas
- Departments of Dermatology and Surgery, University of California, San Francisco, San Francisco, Calif; Department of Dermatology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Xidao Wang
- Department of Anatomy and the W.M. Keck Foundation Center for Integrative Neuroscience, University of California, San Francisco, San Francisco, Calif
| | - Tasuku Akiyama
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, Calif
| | - Cordula Kempkes
- Departments of Dermatology and Surgery, University of California, San Francisco, San Francisco, Calif
| | - Terhi Savinko
- Unit of Toxicology, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Attila Antal
- Department of Dermatology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Gabriela Kukova
- Department of Dermatology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Timo Buhl
- Departments of Dermatology and Surgery, University of California, San Francisco, San Francisco, Calif
| | - Akihiko Ikoma
- Departments of Dermatology and Surgery, University of California, San Francisco, San Francisco, Calif
| | - Joerg Buddenkotte
- Department of Dermatology, University Hospital Münster, Muenster, Germany
| | | | - Micha Feld
- Department of Dermatology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Harri Alenius
- Unit of Toxicology, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Stacey R Dillon
- ZymoGenetics (a Bristol-Myers Squibb Company), Seattle, Wash
| | - Earl Carstens
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, Calif
| | - Bernhard Homey
- Department of Dermatology, University Hospital Düsseldorf, Düsseldorf, Germany.
| | - Allan Basbaum
- Department of Anatomy and the W.M. Keck Foundation Center for Integrative Neuroscience, University of California, San Francisco, San Francisco, Calif.
| | - Martin Steinhoff
- Departments of Dermatology and Surgery, University of California, San Francisco, San Francisco, Calif; Department of Dermatology, University Hospital Düsseldorf, Düsseldorf, Germany.
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Cattaruzza F, Johnson C, Leggit A, Grady E, Schenk AK, Cevikbas F, Cedron W, Bondada S, Kirkwood R, Malone B, Steinhoff M, Bunnett N, Kirkwood KS. Transient receptor potential ankyrin 1 mediates chronic pancreatitis pain in mice. Am J Physiol Gastrointest Liver Physiol 2013; 304:G1002-12. [PMID: 23558009 PMCID: PMC3680686 DOI: 10.1152/ajpgi.00005.2013] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Chronic pancreatitis (CP) is a devastating disease characterized by persistent and uncontrolled abdominal pain. Our lack of understanding is partially due to the lack of experimental models that mimic the human disease and also to the lack of validated behavioral measures of visceral pain. The ligand-gated cation channel transient receptor potential ankyrin 1 (TRPA1) mediates inflammation and pain in early experimental pancreatitis. It is unknown if TRPA1 causes fibrosis and sustained pancreatic pain. We induced CP by injecting the chemical agent trinitrobenzene sulfonic acid (TNBS), which causes severe acute pancreatitis, into the pancreatic duct of C57BL/6 trpa1(+/+) and trpa1(-/-) mice. Chronic inflammatory changes and pain behaviors were assessed after 2-3 wk. TNBS injection caused marked pancreatic fibrosis with increased collagen-staining intensity, atrophy, fatty replacement, monocyte infiltration, and pancreatic stellate cell activation, and these changes were reflected by increased histological damage scores. TNBS-injected animals showed mechanical hypersensitivity during von Frey filament probing of the abdomen, decreased daily voluntary wheel-running activity, and increased immobility scores during open-field testing. Pancreatic TNBS also reduced the threshold to hindpaw withdrawal to von Frey filament probing, suggesting central sensitization. Inflammatory changes and pain indexes were significantly reduced in trpa1(-/-) mice. In conclusion, we have characterized in mice a model of CP that resembles the human condition, with marked histological changes and behavioral measures of pain. We have demonstrated, using novel and objective pain measurements, that TRPA1 mediates inflammation and visceral hypersensitivity in CP and could be a therapeutic target for the treatment of sustained inflammatory abdominal pain.
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Affiliation(s)
- Fiore Cattaruzza
- 1Department of Surgery, University of California, San Francisco, California;
| | - Cali Johnson
- 1Department of Surgery, University of California, San Francisco, California;
| | - Alan Leggit
- 2Department of Neuroscience, University of California, San Francisco, California;
| | - Eileen Grady
- 1Department of Surgery, University of California, San Francisco, California;
| | - A. Katrin Schenk
- 5Department of Physics, Randolph College, Lynchburg, Virginia; and
| | - Ferda Cevikbas
- 3Department of Dermatology, University of California, San Francisco, California;
| | - Wendy Cedron
- 3Department of Dermatology, University of California, San Francisco, California;
| | - Sandhya Bondada
- 1Department of Surgery, University of California, San Francisco, California;
| | - Rebekah Kirkwood
- 1Department of Surgery, University of California, San Francisco, California;
| | - Brian Malone
- 4Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California;
| | - Martin Steinhoff
- 1Department of Surgery, University of California, San Francisco, California; ,3Department of Dermatology, University of California, San Francisco, California;
| | - Nigel Bunnett
- 6Monash Institute of Pharmaceutical Sciences, Parkville, Victoria, Australia
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Alemi F, Kwon E, Poole DP, Lieu T, Lyo V, Cattaruzza F, Cevikbas F, Steinhoff M, Nassini R, Materazzi S, Guerrero-Alba R, Valdez-Morales E, Cottrell GS, Schoonjans K, Geppetti P, Vanner SJ, Bunnett NW, Corvera CU. The TGR5 receptor mediates bile acid-induced itch and analgesia. J Clin Invest 2013; 123:1513-30. [PMID: 23524965 DOI: 10.1172/jci64551] [Citation(s) in RCA: 263] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 01/17/2013] [Indexed: 12/23/2022] Open
Abstract
Patients with cholestatic disease exhibit pruritus and analgesia, but the mechanisms underlying these symptoms are unknown. We report that bile acids, which are elevated in the circulation and tissues during cholestasis, cause itch and analgesia by activating the GPCR TGR5. TGR5 was detected in peptidergic neurons of mouse dorsal root ganglia and spinal cord that transmit itch and pain, and in dermal macrophages that contain opioids. Bile acids and a TGR5-selective agonist induced hyperexcitability of dorsal root ganglia neurons and stimulated the release of the itch and analgesia transmitters gastrin-releasing peptide and leucine-enkephalin. Intradermal injection of bile acids and a TGR5-selective agonist stimulated scratching behavior by gastrin-releasing peptide- and opioid-dependent mechanisms in mice. Scratching was attenuated in Tgr5-KO mice but exacerbated in Tgr5-Tg mice (overexpressing mouse TGR5), which exhibited spontaneous pruritus. Intraplantar and intrathecal injection of bile acids caused analgesia to mechanical stimulation of the paw by an opioid-dependent mechanism. Both peripheral and central mechanisms of analgesia were absent from Tgr5-KO mice. Thus, bile acids activate TGR5 on sensory nerves, stimulating the release of neuropeptides in the spinal cord that transmit itch and analgesia. These mechanisms could contribute to pruritus and painless jaundice that occur during cholestatic liver diseases.
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Affiliation(s)
- Farzad Alemi
- Department of Surgery, UCSF, San Francisco, California 94121, USA
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Johnson C, Cattaruzza F, Bondada S, Cevikbas F, Cedron W, Grady EF, Kirkwood KS. Spinal microglia are activated in a painful model of murine chronic pancreatitis. J Am Coll Surg 2012. [DOI: 10.1016/j.jamcollsurg.2012.06.084] [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] [Indexed: 10/28/2022]
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Abstract
Itch has been described for many years as an unpleasant sensation that evokes the urgent desire to scratch. Studies of the neurobiology, neurophysiology, and cellular biology of itch have gradually been clarifying the mechanism of itch both peripherally and centrally. The discussion has been focused on which nerves and neuroreceptors play major roles in itch induction. The "intensity theory" hypothesizes that signal transduction on the same nerves leads to either pain (high intensity) or itch (low intensity), depending on the signal intensity. The "labeled-line coding theory" hypothesizes the complete separation of pain and itch pathways. Itch sensitization must also be considered in discussions of itch. This review highlights anatomical and functional properties of itch pathways and their relation to understanding itch perception and pruritic diseases.
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Affiliation(s)
- Akihiko Ikoma
- Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA, USA.
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19
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Abstract
Pruritus (itch) is a major symptom in many dermatologic as well as systemic diseases and has a dramatic impact on the quality of life in these patients. The symptom of itch has to be treated on the basis of its pathophysiology and its underlying disease. In daily practice, a "quick" diagnosis of the underlying disease is often difficult, although a rapid relief of the itch is desired. We often treat patients on the basis of the symptomatology. A rational therapeutic ladder for a symptomatic therapy is useful until the final diagnosis has been confirmed. There are probably many subtypes of pruritus, just as there are many diseases that cause itch. The pathophysiology in many subtypes of pruritus is still poorly understood, hindering a rapid and targeted treatment strategy. An extensive diagnostic workup is often required to determine the final cause(s) of the itch. Thus, in daily life, physicians often start with a more or less rational therapeutic strategy to combat the debilitating itch. We present possible therapeutic ladders that form the basis for effective therapeutic itch strategies in various diseases. On the basis of our current knowledge about the different pathophysiologies of itch, on clinical trials or case reports, and our own clinical experience, we aim to present therapeutic ladders for the rapid as well as long-term management of itch. Finally, we summarize current exciting developments of experimental strategies in itch research and in clinical development for itch therapy.
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Affiliation(s)
- Martin Steinhoff
- Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA.
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20
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Cevikbas F, Seeliger S, Fastrich M, Hinte H, Metze D, Kempkes C, Homey B, Steinhoff M. Role of protease-activated receptors in human skin fibrosis and scleroderma. Exp Dermatol 2010; 20:69-71. [DOI: 10.1111/j.1600-0625.2010.01184.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Targets for antipruritic therapies are now expanding from the skin to the central nervous system. Recent studies demonstrate that various neuronal receptors in the spinal cord are involved in pruritus. The spinal opioid receptor is one of the best-known examples. Spinal administration of morphine is frequently accompanied by segmental pruritus. In addition to μ-opioid receptor antagonists, κ-opioid receptor agonists have recently come into usage as novel antipruritic drugs, and are expected to suppress certain subtypes of itch such as hemodialysis- and cholestasis-associated itch that are difficult to treat with antihistamines. The gastrin-releasing peptide receptor in the superficial dorsal horn of the spinal cord has also received recent attention as a novel pathway of itch-selective neural transmission. The NMDA glutamate receptor appears to be another potential target for the treatment of itch, especially in terms of central sensitization. The development of NMDA receptor antagonists with less undesirable side effects on the central nervous system might be beneficial for antipruritic therapies. Drugs suppressing presynaptic glutamate-release such as gabapentin and pregabalin also reportedly inhibit certain subtypes of itch such as brachioradial pruritus. Spinal receptors of other neuromediators such as bradykinin, substance P, serotonin, and histamine may also be potential targets for antipruritic therapies, given that most of these molecules interfere not only with pain, but also with itch transmission or regulation. Thus, the identification of itch-specific receptors and understanding itch-related circuits in the spinal cord may be innovative strategies for the development of novel antipruritic drugs.
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Affiliation(s)
- Ferda Cevikbas
- Department of Dermatology, University of California, San Francisco, CA 94143-0660, USA
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22
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Feld M, Shpacovitch VM, Fastrich M, Cevikbas F, Steinhoff M. Interferon-γ induces upregulation and activation of the interleukin-31 receptor in human dermal microvascular endothelial cells. Exp Dermatol 2010; 19:921-3. [DOI: 10.1111/j.1600-0625.2010.01147.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Alemi F, Godfrey C, Cevikbas F, Poole D, Kwon E, Spreadbury I, Vanner S, Steinhoff M, Bunnett N, Corvera C. A novel cell surface receptor responsive to bile acids mediates itch. J Am Coll Surg 2010. [DOI: 10.1016/j.jamcollsurg.2010.06.023] [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] [Indexed: 11/16/2022]
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Gerber PA, Buhren BA, Cevikbas F, Bölke E, Steinhoff M, Homey B. Preliminary evidence for a role of mast cells in epidermal growth factor receptor inhibitor–induced pruritus. J Am Acad Dermatol 2010; 63:163-5. [DOI: 10.1016/j.jaad.2009.09.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 09/10/2009] [Accepted: 09/14/2009] [Indexed: 10/19/2022]
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Abstract
PURPOSE OF REVIEW Recent studies have advanced our understanding that allergic inflammation triggers neuronal dysfunction, thereby modulating inflammation-related changes in affected tissues including the skin. Vice versa, evidence has emerged that inflammatory responses are controlled by neurons. Moreover, structural cells and invading immune cells express neuronal receptors and release mediators which directly communicate with nerve endings in the skin. RECENT FINDINGS During the allergic response, skin cells do not only represent a significant source of neuromediators but also represent targets for neuropeptides or neurotrophins as well as neurotransmitters in the inflamed tissue. During the last decade, it has become obvious that a large variety of molecules influence the adaptive as well as the innate immune response. Beside neuropeptide receptors, proteinase-activated receptors, novel histamine receptors, different cytokine or chemokine receptors play a role in the pathophysiology of atopic and allergic diseases. SUMMARY Peripheral sensory and autonomic nerves are critically involved in many pathways of the innate and adoptive immune system during allergic and atopic skin diseases. Further dissection of receptor-mediated and intracellular signal pathways will help to develop more effective therapeutic approaches for allergic and inflammatory skin diseases.
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Affiliation(s)
- Ferda Cevikbas
- Department of Dermatology, IZKF Moenster and Boltzmann-Institute for Cell and Immunobiology of the Skin, University of Münster, Germany
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Rops AL, Götte M, Baselmans MH, van den Hoven MJ, Steenbergen EJ, Lensen JF, Wijnhoven TJ, Cevikbas F, van den Heuvel LP, van Kuppevelt TH, Berden JH, van der Vlag J. Syndecan-1 deficiency aggravates anti-glomerular basement membrane nephritis. Kidney Int 2007; 72:1204-15. [PMID: 17805240 DOI: 10.1038/sj.ki.5002514] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
During the heterologous phase of experimental anti-glomerular basement membrane (anti-GBM) nephritis, leukocyte influx peaks within hours, whereas albuminuria occurs within 1 day. In the subsequent autologous phase, endogenous anti-GBM IgG develops and albuminuria persists. Heparan sulfate (HS) proteoglycans like syndecan-1 play multiple roles during inflammation and we evaluate its role in experimental anti-GBM disease using syndecan-1 knockout (sdc-1-/-) mice. During the heterologous phase, glomerular leukocyte/macrophage influx was significantly higher in the sdc-1-/- mice and this was associated with higher glomerular endothelial expression of specific HS domains. In the autologous phase, glomerular influx of CD4+/CD8+ T cells was higher in the sdc-1-/- mice and these mice had persistently higher albuminuria and serum creatinine levels than wild-type mice. This resulted in a more sever glomerular injury and increased expression of extracellular matrix proteins. The sdc-1-/- mice developed higher plasma levels and glomerular deposits of total mouse Ig and IgG1 anti-rabbit IgG, whereas the levels of mouse IgG2a anti-rabbit IgG were lower. Furthermore, decreased Th1 and higher Th2 renal cytokine/chemokine expression were found in the sdc-1-/- mice. Our studies show that syndecan-1 deficiency exacerbates anti-GBM nephritis shifting the Th1/Th2 balance towards a Th2 response.
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Affiliation(s)
- A L Rops
- Nephrology Research Laboratory, Division of Nephrology, Nijmegen Centre for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Cevikbas F, Schaefer L, Uhlig P, Robenek H, Theilmeier G, Echtermeyer F, Bruckner P. Unilateral nephrectomy leads to up-regulation of syndecan-2- and TGF-beta-mediated glomerulosclerosis in syndecan-4 deficient male mice. Matrix Biol 2007; 27:42-52. [PMID: 17681770 DOI: 10.1016/j.matbio.2007.07.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2007] [Revised: 07/03/2007] [Accepted: 07/03/2007] [Indexed: 10/23/2022]
Abstract
Syndecan-4 is an ubiquitous, plasma membrane-spanning heparan sulfate proteoglycan involved in proliferation, differentiation, adhesion and migration of cells in vitro. Syndecan-4 knockout (KO) mice show no obvious defects but respond abnormally to experimental stress conditions. In the adult, syndecan-4 is the most abundant syndecan of renal tissue. We therefore investigated the consequences of syndecan-4 deficiency during progression of kidney disease using unilaterally nephrectomized mice, a model of glomerular hyperfiltration and renal hypertrophy. 60 days after unilateral nephrectomy (UNX), mesangial expansion, enhanced matrix production (collagens I and IV, fibronectin) and focal segmental glomerulosclerosis, resembling early stages of diabetic nephropathy, was apparent in male but not female syndecan-4 KO mice. No defect was detected in wild type UNX males. Syndecan-2 mRNA and protein were not detectable in renal glomeruli of wild type mice, but were induced specifically in the glomeruli of the syndecan-4 deficient kidneys after unilateral nephrectomy. Due to the structural similarities of syndecans-2 and -4 we hypothesize that de novo-production of syndecan-2 in kidneys after unilateral nephrectomy reflects a compensatory response. However, this response is counterproductive since syndecan-2 supports the pro-sclerotic activity of TGF-beta1 which is increased in parallel with syndecan-2 synthesis. By contrast, signaling through syndecan-4 negatively controls the production of pro-sclerotic TGF-beta1.
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Affiliation(s)
- Ferda Cevikbas
- University Hospital of Münster, Institute of Physiological Chemistry and Pathobiochemistry, Waldeyerstrasse 15, D-48149 Münster, Germany
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