1
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Jiang Y, Gruszka D, Zeng C, Swindell WR, Gaskill C, Sorensen C, Brown W, Gangwar RS, Tsoi LC, Webster J, Sigurðardóttir SL, Sarkar MK, Uppala R, Kidder A, Xing X, Plazyo O, Xing E, Billi AC, Maverakis E, Kahlenberg JM, Gudjonsson JE, Ward NL. Suppression of TCF4 promotes a ZC3H12A-mediated self-sustaining inflammatory feedback cycle involving IL-17RA/IL-17RE epidermal signaling. JCI Insight 2024; 9:e172764. [PMID: 38470486 DOI: 10.1172/jci.insight.172764] [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: 06/05/2023] [Accepted: 03/05/2024] [Indexed: 03/13/2024] Open
Abstract
IL-17C is an epithelial cell-derived proinflammatory cytokine whose transcriptional regulation remains unclear. Analysis of the IL17C promoter region identified TCF4 as putative regulator, and siRNA knockdown of TCF4 in human keratinocytes (KCs) increased IL17C. IL-17C stimulation of KCs (along with IL-17A and TNF-α stimulation) decreased TCF4 and increased NFKBIZ and ZC3H12A expression in an IL-17RA/RE-dependent manner, thus creating a feedback loop. ZC3H12A (MCPIP1/Regnase-1), a transcriptional immune-response regulator, also increased following TCF4 siRNA knockdown, and siRNA knockdown of ZC3H12A decreased NFKBIZ, IL1B, IL36G, CCL20, and CXCL1, revealing a proinflammatory role for ZC3H12A. Examination of lesional skin from the KC-Tie2 inflammatory dermatitis mouse model identified decreases in TCF4 protein concomitant with increases in IL-17C and Zc3h12a that reversed following the genetic elimination of Il17c, Il17ra, and Il17re and improvement in the skin phenotype. Conversely, interference with Tcf4 in KC-Tie2 mouse skin increased Il17c and exacerbated the inflammatory skin phenotype. Together, these findings identify a role for TCF4 in the negative regulation of IL-17C, which, alone and with TNF-α and IL-17A, feed back to decrease TCF4 in an IL-17RA/RE-dependent manner. This loop is further amplified by IL-17C-TCF4 autocrine regulation of ZC3H12A and IL-17C regulation of NFKBIZ to promote self-sustaining skin inflammation.
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Affiliation(s)
- Yanyun Jiang
- Department of Dermatology, Ann Arbor, Michigan, USA
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dennis Gruszka
- Departments of Nutrition and Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Chang Zeng
- Department of Dermatology, Ann Arbor, Michigan, USA
| | - William R Swindell
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Christa Gaskill
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christian Sorensen
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Whitney Brown
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Roopesh Singh Gangwar
- Departments of Nutrition and Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Lam C Tsoi
- Department of Dermatology, Ann Arbor, Michigan, USA
| | - Joshua Webster
- Departments of Nutrition and Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | | | | | | | | | | | | | - Enze Xing
- Department of Dermatology, Ann Arbor, Michigan, USA
| | | | - Emanual Maverakis
- Department of Dermatology, University of California Davis School of Medicine, Sacramento, California, USA
| | - J Michelle Kahlenberg
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Nicole L Ward
- Departments of Nutrition and Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Institute for Infection, Immunology, and Inflammation (VI4) and Vanderbilt Center for Immunobiology (VCI), Vanderbilt University Medical Center, Nashville, Tennessee, USA
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2
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Zhang H, Patrick MT, Tejasvi T, Sarkar MK, Wasikowski R, Stuart PE, Li Q, Xing X, Voorhees JJ, Ward NL, He K, Zhou X, Gudjonsson JE, Nair RP, Elder JT, Tsoi LC. Retrospective pharmacogenetic study of psoriasis highlights the role of KLK7 in tumour necrosis factor signalling. Br J Dermatol 2023; 190:70-79. [PMID: 37672660 PMCID: PMC10733628 DOI: 10.1093/bjd/ljad332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/29/2023] [Accepted: 09/01/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Multiple treatment options are available for the management of psoriasis, but clinical response varies among individual patients and no biomarkers are available to facilitate treatment selection for improved patient outcomes. OBJECTIVES To utilize retrospective data to conduct a pharmacogenetic study to explore the potential genetic pathways associated with drug response in the treatment of psoriasis. METHODS We conducted a retrospective pharmacogenetic study using self-evaluated treatment response from 1942 genotyped patients with psoriasis. We examined 6 502 658 genetic markers to model their associations with response to six treatment options using linear regression, adjusting for cohort variables and demographic features. We further utilized an integrative approach incorporating epigenomics, transcriptomics and a longitudinal clinical cohort to provide biological implications for the topmost signals associated with drug response. RESULTS Two novel markers were revealed to be associated with treatment response: rs1991820 (P = 1.30 × 10-6) for anti-tumour necrosis factor (TNF) biologics; and rs62264137 (P = 2.94 × 10-6) for methotrexate, which was also associated with cutaneous mRNA expression levels of two known psoriasis-related genes KLK7 (P = 1.0 × 10-12) and CD200 (P = 5.4 × 10-6). We demonstrated that KLK7 expression was increased in the psoriatic epidermis, as shown by immunohistochemistry, as well as single-cell RNA sequencing, and its responsiveness to anti-TNF treatment was highlighted. By inhibiting the expression of KLK7, we further illustrated that keratinocytes have decreased proinflammatory responses to TNF. CONCLUSIONS Our study implicates the genetic regulation of cytokine responses in predicting clinical drug response and supports the association between pharmacogenetic loci and anti-TNF response, as shown here for KLK7.
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Affiliation(s)
| | | | - Trilokraj Tejasvi
- Department of Dermatology
- Ann Arbor Veterans Affairs Hospital, Ann Arbor, MI, USA
| | | | | | | | | | | | | | - Nicole L Ward
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Johann E Gudjonsson
- Department of Dermatology
- Taubman Medical Research Institute, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - James T Elder
- Department of Dermatology
- Ann Arbor Veterans Affairs Hospital, Ann Arbor, MI, USA
| | - Lam C Tsoi
- Departments of Biostatistics
- Department of Dermatology
- Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
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3
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Ma F, Plazyo O, Billi AC, Tsoi LC, Xing X, Wasikowski R, Gharaee-Kermani M, Hile G, Jiang Y, Harms PW, Xing E, Kirma J, Xi J, Hsu JE, Sarkar MK, Chung Y, Di Domizio J, Gilliet M, Ward NL, Maverakis E, Klechevsky E, Voorhees JJ, Elder JT, Lee JH, Kahlenberg JM, Pellegrini M, Modlin RL, Gudjonsson JE. Single cell and spatial sequencing define processes by which keratinocytes and fibroblasts amplify inflammatory responses in psoriasis. Nat Commun 2023; 14:3455. [PMID: 37308489 PMCID: PMC10261041 DOI: 10.1038/s41467-023-39020-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [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: 01/11/2022] [Accepted: 05/26/2023] [Indexed: 06/14/2023] Open
Abstract
The immunopathogenesis of psoriasis, a common chronic inflammatory disease of the skin, is incompletely understood. Here we demonstrate, using a combination of single cell and spatial RNA sequencing, IL-36 dependent amplification of IL-17A and TNF inflammatory responses in the absence of neutrophil proteases, which primarily occur within the supraspinous layer of the psoriatic epidermis. We further show that a subset of SFRP2+ fibroblasts in psoriasis contribute to amplification of the immune network through transition to a pro-inflammatory state. The SFRP2+ fibroblast communication network involves production of CCL13, CCL19 and CXCL12, connected by ligand-receptor interactions to other spatially proximate cell types: CCR2+ myeloid cells, CCR7+ LAMP3+ dendritic cells, and CXCR4 expressed on both CD8+ Tc17 cells and keratinocytes, respectively. The SFRP2+ fibroblasts also express cathepsin S, further amplifying inflammatory responses by activating IL-36G in keratinocytes. These data provide an in-depth view of psoriasis pathogenesis, which expands our understanding of the critical cellular participants to include inflammatory fibroblasts and their cellular interactions.
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Affiliation(s)
- Feiyang Ma
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Olesya Plazyo
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Allison C Billi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Xianying Xing
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Rachael Wasikowski
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | | | - Grace Hile
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Yanyun Jiang
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Paul W Harms
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Enze Xing
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Joseph Kirma
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Jingyue Xi
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Jer-En Hsu
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Mrinal K Sarkar
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Yutein Chung
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Jeremy Di Domizio
- Department of Dermatology, University Hospital of Lausanne, 1011, Lausanne, Switzerland
| | - Michel Gilliet
- Department of Dermatology, University Hospital of Lausanne, 1011, Lausanne, Switzerland
| | - Nicole L Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Emanual Maverakis
- Department of Dermatology, University of California Davis, Sacramento, CA, USA
| | - Eynav Klechevsky
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - John J Voorhees
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - James T Elder
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
- Ann Arbor Veterans Affairs Medical Center, Ann Arbor, MI, 48105, USA
| | - Jun Hee Lee
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - J Michelle Kahlenberg
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Matteo Pellegrini
- Department of Molecular, Cell and Developmental Biology, University of California, Los Angeles, CA, 90095, USA
| | - Robert L Modlin
- Division of Dermatology, Department of Medicine, University of California, Los Angeles, CA, 90095, USA
- Department of Microbiology, Immunology and Molecular Genetics, University of California, Los Angeles, CA, 90095, USA
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA.
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4
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Goepfert A, Barske C, Lehmann S, Wirth E, Willemsen J, Gudjonsson JE, Ward NL, Sarkar MK, Hemmig R, Kolbinger F, Rondeau JM. IL-17-induced dimerization of IL-17RA drives the formation of the IL-17 signalosome to potentiate signaling. Cell Rep 2022; 41:111489. [PMID: 36260993 PMCID: PMC9637376 DOI: 10.1016/j.celrep.2022.111489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/20/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022] Open
Abstract
Signaling through innate immune receptors such as the Toll-like receptor (TLR)/interleukin-1 receptor (IL-1R) superfamily proceeds via the assembly of large membrane-proximal complexes or “signalosomes.” Although structurally distinct, the IL-17 receptor family triggers cellular responses that are typical of innate immune receptors. The IL-17RA receptor subunit is shared by several members of the IL-17 family. Using a combination of crystallographic, biophysical, and mutational studies, we show that IL-17A, IL-17F, and IL-17A/F induce IL-17RA dimerization. X-ray analysis of the heteromeric IL-17A complex with the extracellular domains of the IL-17RA and IL-17RC receptors reveals that cytokine-induced IL-17RA dimerization leads to the formation of a 2:2:2 hexameric signaling assembly. Furthermore, we demonstrate that the formation of the IL-17 signalosome potentiates IL-17-induced IL-36γ and CXCL1 mRNA expression in human keratinocytes, compared with a dimerization-defective IL-17RA variant. IL-17RA is the shared co-receptor for several IL-17 family members. Goepfert et al. show that IL-17 induces IL-17RA dimerization, which then drives the formation of a 2:2:2 hexameric signaling assembly with IL-17RC. Furthermore, IL-17RA dimerization potentiates IL-17 signaling in immortalized primary human keratinocytes, compared with cells expressing a dimerization-defective IL-17RA variant.
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Affiliation(s)
- Arnaud Goepfert
- Novartis Institutes for BioMedical Research, Novartis Pharma AG, 4002 Basel, Switzerland
| | - Carmen Barske
- Novartis Institutes for BioMedical Research, Novartis Pharma AG, 4002 Basel, Switzerland
| | - Sylvie Lehmann
- Novartis Institutes for BioMedical Research, Novartis Pharma AG, 4002 Basel, Switzerland
| | - Emmanuelle Wirth
- Novartis Institutes for BioMedical Research, Novartis Pharma AG, 4002 Basel, Switzerland
| | - Joschka Willemsen
- Novartis Institutes for BioMedical Research, Novartis Pharma AG, 4002 Basel, Switzerland
| | | | - Nicole L Ward
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mrinal K Sarkar
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - René Hemmig
- Novartis Institutes for BioMedical Research, Novartis Pharma AG, 4002 Basel, Switzerland
| | - Frank Kolbinger
- Novartis Institutes for BioMedical Research, Novartis Pharma AG, 4002 Basel, Switzerland
| | - Jean-Michel Rondeau
- Novartis Institutes for BioMedical Research, Novartis Pharma AG, 4002 Basel, Switzerland.
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5
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Gharaee-Kermani M, Estadt SN, Tsoi LC, Wolf-Fortune SJ, Liu J, Xing X, Theros J, Reed TJ, Lowe L, Gruszka D, Ward NL, Gudjonsson JE, Kahlenberg JM. IFN-κ Is a Rheostat for Development of Psoriasiform Inflammation. J Invest Dermatol 2022; 142:155-165.e3. [PMID: 34364883 PMCID: PMC8688309 DOI: 10.1016/j.jid.2021.05.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/07/2021] [Accepted: 05/24/2021] [Indexed: 01/03/2023]
Abstract
Psoriasis is a common, inflammatory autoimmune skin disease. Early detection of an IFN-1 signature occurs in many psoriasis lesions, but the source of IFN production remains debated. IFN-κ is an important source of IFN-1 production in the epidermis. We identified a correlation between IFN-regulated and psoriasis-associated genes in human lesional skin. We thus wanted to explore the effects of IFN-κ in psoriasis using the well-characterized imiquimod psoriasis model. Three mouse strains aged 10 weeks were used: wild-type C57Bl/6, C57Bl/6 that overexpress Ifnk in the epidermis (i.e., transgenic), and total body Ifnk-/- (i.e., knockout) strain. Psoriasis was induced by topical application of imiquimod on both ears for 8 consecutive days. Notably, the severity of skin lesions and inflammatory cell infiltration was more significantly increased in transgenic than in wild-type than in knockout mice. Gene expression analysis identified greater upregulation of Mxa, Il1b, Tnfa, Il6, Il12, Il23, Il17, and Ifng in transgenic compared to wild-type compared to knockout mice after imiquimod treatment. Furthermore, imiquimod increased CD8+ and CD4+ T-cell infiltration more in transgenic than in wild-type than in knockout mice. In summary, we identified IFN-κ as a rheostat for initiation of psoriasiform inflammation. This suggests that targeting IFN-1s early in the disease may be an effective way of controlling psoriatic inflammation.
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Affiliation(s)
- Mehrnaz Gharaee-Kermani
- Division of Rheumatology, Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA,Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA,These authors contributed equally to this work
| | - Shannon N. Estadt
- Division of Rheumatology, Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA,Graduate Program in Immunology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA,These authors contributed equally to this work
| | - Lam C. Tsoi
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA,Department of Computational Medicine and Bioinformatics, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Sonya J. Wolf-Fortune
- Division of Rheumatology, Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA,Graduate Program in Immunology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Jianhua Liu
- Division of Rheumatology, Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Xianying Xing
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Jonathon Theros
- Division of Rheumatology, Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Tamra J. Reed
- Division of Rheumatology, Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Lori Lowe
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA,Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Dennis Gruszka
- Department of Nutrition, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA,Department of Dermatology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Nicole L. Ward
- Department of Nutrition, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA,Department of Dermatology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Johann E. Gudjonsson
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - J. Michelle Kahlenberg
- Division of Rheumatology, Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA,Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
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6
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Shao S, Chen J, Swindell WR, Tsoi LC, Xing X, Ma F, Uppala R, Sarkar MK, Plazyo O, Billi AC, Wasikowski R, Smith KM, Honore P, Scott VE, Maverakis E, Kahlenberg JM, Wang G, Ward NL, Harms PW, Gudjonsson JE. Phospholipase A2 enzymes represent a shared pathogenic pathway in psoriasis and pityriasis rubra pilaris. JCI Insight 2021; 6:e151911. [PMID: 34491907 PMCID: PMC8564909 DOI: 10.1172/jci.insight.151911] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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: 06/01/2021] [Accepted: 09/03/2021] [Indexed: 02/02/2023] Open
Abstract
Altered epidermal differentiation along with increased keratinocyte proliferation is a characteristic feature of psoriasis and pityriasis rubra pilaris (PRP). However, despite this large degree of overlapping clinical and histologic features, the molecular signatures these skin disorders share are unknown. Using global transcriptomic profiling, we demonstrate that plaque psoriasis and PRP skin lesions have high overlap, with all differentially expressed genes in PRP relative to normal skin having complete overlap with those in psoriasis. The major common pathway shared between psoriasis and PRP involves the phospholipases PLA2G2F, PLA2G4D, and PLA2G4E, which were found to be primarily expressed in the epidermis. Gene silencing each of the 3 PLA2s led to reduction in immune responses and epidermal thickness both in vitro and in vivo in a mouse model of psoriasis, establishing their proinflammatory roles. Lipidomic analyses demonstrated that PLA2s affect mobilization of a phospholipid-eicosanoid pool, which is altered in psoriatic lesions and functions to promote immune responses in keratinocytes. Taken together, our results highlight the important role of PLA2s as regulators of epidermal barrier homeostasis and inflammation, identify PLA2s as a shared pathogenic mechanism between PRP and psoriasis, and as potential therapeutic targets for both diseases.
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Affiliation(s)
- Shuai Shao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi, China.,Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jiaoling Chen
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi, China
| | - William R Swindell
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.,Department of Internal Medicine, the Jewish Hospital, Cincinnati, Ohio, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Xianying Xing
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Feiyang Ma
- Department of Dermatology, Department of Medicine, UCLA, Los Angeles, California, USA
| | - Ranjitha Uppala
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mrinal K Sarkar
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Olesya Plazyo
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Allison C Billi
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rachael Wasikowski
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Prisca Honore
- AbbVie Dermatology Discovery, North Chicago, Illinois, USA
| | | | - Emanual Maverakis
- Department of Dermatology, UC Davis School of Medicine, Sacramento, California, USA
| | - J Michelle Kahlenberg
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Gang Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi, China
| | - Nicole L Ward
- Departments of Nutrition and Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Paul W Harms
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.,Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan, USA
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7
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Yan D, Gudjonsson JE, Le S, Maverakis E, Plazyo O, Ritchlin C, Scher JU, Singh R, Ward NL, Bell S, Liao W. New Frontiers in Psoriatic Disease Research, Part I: Genetics, Environmental Triggers, Immunology, Pathophysiology, and Precision Medicine. J Invest Dermatol 2021; 141:2112-2122.e3. [PMID: 34303522 PMCID: PMC8384663 DOI: 10.1016/j.jid.2021.02.764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 02/07/2023]
Abstract
Psoriasis is a chronic inflammatory condition characterized by systemic immune dysregulation. Over the past several years, advances in genetics, microbiology, immunology, and mouse models have revealed the complex interplay between the heritable and microenvironmental factors that drive the development of psoriatic inflammation. In the first of this two-part review series, the authors will discuss the newest insights into the pathogenesis of psoriatic disease and highlight how the evolution of these scientific fields has paved the way for a more personalized approach to psoriatic disease treatment.
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Affiliation(s)
- Di Yan
- Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York, New York, USA
| | | | - Stephanie Le
- Department of Dermatology, University of California, Davis, Sacramento, California, USA
| | - Emanual Maverakis
- Department of Dermatology, University of California, Davis, Sacramento, California, USA
| | - Olesya Plazyo
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Christopher Ritchlin
- Center for Musculoskeletal Research, Division of Allergy, Immunology and Rheumatology, University of Rochester School of Medicine & Dentistry, Rochester, New York, USA
| | - Jose U Scher
- Department of Medicine, NYU Grossman School of Medicine, NYU Langone Health, New York, New York, USA
| | - Roopesh Singh
- Department of Nutrition, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Nicole L Ward
- Department of Nutrition, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA; Department of Dermatology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Stacie Bell
- National Psoriasis Foundation, Portland, Oregon, USA
| | - Wilson Liao
- UCSF Department of Dermatology, University of California San Francisco, San Francisco, California, USA.
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8
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Shao S, Tsoi LC, Swindell WR, Chen J, Uppala R, Billi AC, Xing X, Zeng C, Sarkar MK, Wasikowski R, Jiang Y, Kirma J, Sun J, Plazyo O, Wang G, Harms PW, Voorhees JJ, Ward NL, Ma F, Pellegrini M, Merleev A, Perez White BE, Modlin RL, Andersen B, Maverakis E, Weidinger S, Kahlenberg JM, Gudjonsson JE. IRAK2 Has a Critical Role in Promoting Feed-Forward Amplification of Epidermal Inflammatory Responses. J Invest Dermatol 2021; 141:2436-2448. [PMID: 33864770 DOI: 10.1016/j.jid.2021.03.019] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/01/2021] [Accepted: 03/16/2021] [Indexed: 12/12/2022]
Abstract
Many inflammatory skin diseases are characterized by altered epidermal differentiation. Whether this altered differentiation promotes inflammatory responses has been unknown. Here, we show that IRAK2, a member of the signaling complex downstream of IL-1 and IL-36, correlates positively with disease severity in both atopic dermatitis and psoriasis. Inhibition of epidermal IRAK2 normalizes differentiation and inflammation in two mouse models of psoriasis- and atopic dermatitis-like inflammation. Specifically, we demonstrate that IRAK2 ties together proinflammatory and differentiation-dependent responses and show that this function of IRAK2 is specific to keratinocytes and acts through the differentiation-associated transcription factor ZNF750. Taken together, our findings suggest that IRAK2 has a critical role in promoting feed-forward amplification of inflammatory responses in skin through modulation of differentiation pathways and inflammatory responses.
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Affiliation(s)
- Shuai Shao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, China; Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - William R Swindell
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jiaoling Chen
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ranjitha Uppala
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Allison C Billi
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Xianying Xing
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Chang Zeng
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mrinal K Sarkar
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rachael Wasikowski
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yanyun Jiang
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Joseph Kirma
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jingru Sun
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Olesya Plazyo
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Gang Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Paul W Harms
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA; Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - John J Voorhees
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicole L Ward
- Departments of Nutrition and Dermatology, School of Medicine, Case Western University, Cleveland, Ohio, USA
| | - Feiyang Ma
- Department of UCLA Dermatology, UCLA Medical School, Los Angeles, California, USA
| | - Matteo Pellegrini
- Department of UCLA Dermatology, UCLA Medical School, Los Angeles, California, USA
| | - Alexander Merleev
- Department of Dermatology, University of California Davis School of Medicine, Sacramento, California, USA
| | - Bethany E Perez White
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Robert L Modlin
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Bogi Andersen
- Department of Biological Chemistry, School of Medicine, University of California, Irvine, Irvine, California, USA
| | - Emanual Maverakis
- Department of Dermatology, University of California Davis School of Medicine, Sacramento, California, USA
| | - Stephan Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - J Michelle Kahlenberg
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.
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9
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Garshick MS, Ward NL, Krueger JG, Berger JS. Cardiovascular Risk in Patients With Psoriasis: JACC Review Topic of the Week. J Am Coll Cardiol 2021; 77:1670-1680. [PMID: 33795041 DOI: 10.1016/j.jacc.2021.02.009] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [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] [Received: 10/22/2020] [Revised: 01/21/2021] [Accepted: 02/01/2021] [Indexed: 12/11/2022]
Abstract
Psoriasis is a chronic inflammatory skin disease that affects 2% to 3% of the U.S. population. The immune response in psoriasis includes enhanced activation of T cells and myeloid cells, platelet activation, and up-regulation of interferons, tumor necrosis factor-α, and interleukins (ILs) IL-23, IL-17, and IL-6, which are linked to vascular inflammation and atherosclerosis development. Patients with psoriasis are up to 50% more likely to develop cardiovascular disease (CV) disease, and this CV risk increases with skin severity. Major society guidelines now advocate incorporating a psoriasis diagnosis into CV risk prediction and prevention strategies. Although registry data suggest treatment targeting psoriasis skin disease reduces vascular inflammation and coronary plaque burden, and may reduce CV risk, randomized placebo-controlled trials are inconclusive to date. Further studies are required to define traditional CV risk factor goals, the optimal role of lipid-lowering and antiplatelet therapy, and targeted psoriasis therapies on CV risk.
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Affiliation(s)
- Michael S Garshick
- Center for the Prevention of Cardiovascular Disease and Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York, USA.
| | - Nicole L Ward
- Departments of Nutrition and Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - James G Krueger
- Laboratory for Investigative Dermatology, Rockefeller University, New York, New York, USA
| | - Jeffrey S Berger
- Center for the Prevention of Cardiovascular Disease and Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York, USA; Division of Hematology, Department of Medicine, New York University School of Medicine, New York, New York, USA; Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, New York, New York, USA
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10
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Billi AC, Ludwig JE, Fritz Y, Rozic R, Swindell WR, Tsoi LC, Gruzska D, Abdollahi-Roodsaz S, Xing X, Diaconu D, Uppala R, Camhi MI, Klenotic PA, Sarkar MK, Husni ME, Scher JU, McDonald C, Kahlenberg JM, Midura RJ, Gudjonsson JE, Ward NL. KLK6 expression in skin induces PAR1-mediated psoriasiform dermatitis and inflammatory joint disease. J Clin Invest 2021; 130:3151-3157. [PMID: 32155135 DOI: 10.1172/jci133159] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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: 09/03/2019] [Accepted: 02/27/2020] [Indexed: 12/12/2022] Open
Abstract
Kallikrein-related peptidase 6 (KLK6) is a secreted serine protease hypothesized to promote inflammation via cleavage of protease-activated receptor 1 (PAR1) and PAR2. KLK6 levels are elevated in multiple inflammatory and autoimmune conditions, but no definitive role in pathogenesis has been established. Here, we show that skin-targeted overexpression of KLK6 causes generalized, severe psoriasiform dermatitis with spontaneous development of debilitating psoriatic arthritis-like joint disease. The psoriatic skin and joint phenotypes are reversed by normalization of skin KLK6 levels and attenuated following genetic elimination of PAR1 but not PAR2. Conservation of this regulatory pathway was confirmed in human psoriasis using vorapaxar, an FDA-approved PAR1 antagonist, on explanted lesional skin from patients with psoriasis. Beyond defining a critical role for KLK6/PAR1 signaling in promoting psoriasis, our results demonstrate that KLK6/PAR1-mediated inflammation in the skin alone is sufficient to drive inflammatory joint disease. Further, we identify PAR1 as a promising cytokine-independent target in therapy of psoriasis and psoriatic arthritis.
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Affiliation(s)
- Allison C Billi
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jessica E Ludwig
- Department of Dermatology and.,Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Richard Rozic
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - William R Swindell
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.,Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA.,Department of Internal Medicine, Jewish Hospital, Cincinnati, Ohio, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.,Center for Statistical Genetics, Department of Biostatistics, and.,Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA
| | - Dennis Gruzska
- Department of Dermatology and.,Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA
| | - Shahla Abdollahi-Roodsaz
- Inflammation and Immunology Thematic Center of Excellence, Celgene Corp., Cambridge, Massachusetts, USA
| | - Xianying Xing
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Ranjitha Uppala
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | | | | | - Mrinal K Sarkar
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - M Elaine Husni
- Department of Rheumatologic and Immunologic Disease, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jose U Scher
- Department of Medicine, New York University, New York, New York, USA
| | - Christine McDonald
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Ronald J Midura
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Nicole L Ward
- Department of Dermatology and.,Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA.,Murdough Family Center for Psoriasis, Cleveland, Ohio, USA
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11
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Jiang Y, Tsoi LC, Billi AC, Ward NL, Harms PW, Zeng C, Maverakis E, Kahlenberg JM, Gudjonsson JE. Cytokinocytes: the diverse contribution of keratinocytes to immune responses in skin. JCI Insight 2020; 5:142067. [PMID: 33055429 PMCID: PMC7605526 DOI: 10.1172/jci.insight.142067] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [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] [Indexed: 02/06/2023] Open
Abstract
The skin serves as the primary interface between our body and the external environment and acts as a barrier against entry of physical agents, chemicals, and microbes. Keratinocytes make up the main cellular constitute of the outermost layer of the skin, contributing to the formation of the epidermis, and they are crucial for maintaining the integrity of this barrier. Beyond serving as a physical barrier component, keratinocytes actively participate in maintaining tissue homeostasis, shaping, amplifying, and regulating immune responses in skin. Keratinocytes act as sentinels, continuously monitoring changes in the environment, and, through microbial sensing, stretch, or other physical stimuli, can initiate a broad range of inflammatory responses via secretion of various cytokines, chemokines, and growth factors. This diverse function of keratinocytes contributes to the highly variable clinical manifestation of skin immune responses. In this Review, we highlight the highly diverse functions of epidermal keratinocytes and their contribution to various immune-mediated skin diseases.
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Affiliation(s)
- Yanyun Jiang
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.,Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.,Department of Computational Medicine and Bioinformatics and Department of Biostatistics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Allison C Billi
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicole L Ward
- Department of Nutrition and Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Paul W Harms
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Chang Zeng
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Emanual Maverakis
- Department of Dermatology, University of California, Davis, Sacramento, California, USA
| | - J Michelle Kahlenberg
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Michigan, USA.,A. Alfred Taubman Medical Research Institute, Michigan, USA
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.,A. Alfred Taubman Medical Research Institute, Michigan, USA
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12
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Uppala R, Tsoi LC, Harms PW, Wang B, Billi AC, Maverakis E, Michelle Kahlenberg J, Ward NL, Gudjonsson JE. "Autoinflammatory psoriasis"-genetics and biology of pustular psoriasis. Cell Mol Immunol 2020; 18:307-317. [PMID: 32814870 DOI: 10.1038/s41423-020-0519-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [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: 05/30/2020] [Accepted: 07/20/2020] [Indexed: 02/08/2023] Open
Abstract
Psoriasis is a chronic inflammatory skin condition that has a fairly wide range of clinical presentations. Plaque psoriasis, which is the most common manifestation of psoriasis, is located on one end of the spectrum, dominated by adaptive immune responses, whereas the rarer pustular psoriasis lies on the opposite end, dominated by innate and autoinflammatory immune responses. In recent years, genetic studies have identified six genetic variants that predispose to pustular psoriasis, and these have highlighted the role of IL-36 cytokines as central to pustular psoriasis pathogenesis. In this review, we discuss the presentation and clinical subtypes of pustular psoriasis, contribution of genetic predisposing variants, critical role of the IL-36 family of cytokines in disease pathophysiology, and treatment perspectives for pustular psoriasis. We further outline the application of appropriate mouse models for the study of pustular psoriasis and address the outstanding questions and issues related to our understanding of the mechanisms involved in pustular psoriasis.
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Affiliation(s)
- Ranjitha Uppala
- Graduate Program in Immunology, University of Michigan, Ann Arbor, MI, USA.,Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Paul W Harms
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA.,Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Bo Wang
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Allison C Billi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Emanual Maverakis
- Department of Dermatology, University of California, Davis, Sacramento, CA, USA
| | - J Michelle Kahlenberg
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.,A. Alfred Taubman Medical Research Institute, Ann Arbor, MI, USA
| | - Nicole L Ward
- Departments of Nutrition and Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA. .,A. Alfred Taubman Medical Research Institute, Ann Arbor, MI, USA.
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13
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Horsley V, Glass D, Minnillo R, Gallo R, Cruz P, Ward NL. Diversity is Excellence: Initiatives in the Society for Investigative Dermatology to Broaden Participation. J Invest Dermatol 2019; 139:2217-2219. [PMID: 31381893 DOI: 10.1016/j.jid.2019.07.695] [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] [Received: 07/15/2019] [Accepted: 07/18/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Valerie Horsley
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, Connecticut; Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.
| | - Donald Glass
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Richard Gallo
- Department of Dermatology, University of California, San Diego, California
| | - Ponciano Cruz
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Nicole L Ward
- Departments of Nutrition and Dermatology, Case Western University, Cleveland, Ohio
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14
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Billi AC, Gharaee-Kermani M, Fullmer J, Tsoi LC, Hill BD, Gruszka D, Ludwig J, Xing X, Estadt S, Wolf SJ, Rizvi SM, Berthier CC, Hodgin JB, Beamer MA, Sarkar MK, Liang Y, Uppala R, Shao S, Zeng C, Harms PW, Verhaegen ME, Voorhees JJ, Wen F, Ward NL, Dlugosz AA, Kahlenberg JM, Gudjonsson JE. The female-biased factor VGLL3 drives cutaneous and systemic autoimmunity. JCI Insight 2019; 4:127291. [PMID: 30996136 PMCID: PMC6538382 DOI: 10.1172/jci.insight.127291] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [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: 01/08/2019] [Accepted: 03/12/2019] [Indexed: 01/18/2023] Open
Abstract
Autoimmune disease is 4 times more common in women than men. This bias is largely unexplained. Female skin is "autoimmunity prone," showing upregulation of many proinflammatory genes, even in healthy women. We previously identified VGLL3 as a putative transcription cofactor enriched in female skin. Here, we demonstrate that skin-directed overexpression of murine VGLL3 causes a severe lupus-like rash and systemic autoimmune disease that involves B cell expansion, autoantibody production, immune complex deposition, and end-organ damage. Excess epidermal VGLL3 drives a proinflammatory gene expression program that overlaps with both female skin and cutaneous lupus. This includes increased B cell-activating factor (BAFF), the only current biologic target in systemic lupus erythematosus (SLE); IFN-κ, a key inflammatory mediator in cutaneous lupus; and CXCL13, a biomarker of early-onset SLE and renal involvement. Our results demonstrate that skin-targeted overexpression of the female-biased factor VGLL3 is sufficient to drive cutaneous and systemic autoimmune disease that is strikingly similar to SLE. This work strongly implicates VGLL3 as a pivotal orchestrator of sex-biased autoimmunity.
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Affiliation(s)
| | | | | | - Lam C. Tsoi
- Department of Dermatology
- A. Alfred Taubman Medical Research Institute
- Department of Biostatistics, Center for Statistical Genetics
- Department of Computational Medicine and Bioinformatics, and
| | - Brett D. Hill
- Department of Chemical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Dennis Gruszka
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jessica Ludwig
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Shannon Estadt
- Division of Rheumatology, Department of Internal Medicine
- Immunology Program
| | - Sonya J. Wolf
- Division of Rheumatology, Department of Internal Medicine
- Immunology Program
| | - Syed Monem Rizvi
- Department of Chemical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Jeffrey B. Hodgin
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | | | | | | | | | - Shuai Shao
- Department of Dermatology
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | | | - Paul W. Harms
- Department of Dermatology
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | | | | | - Fei Wen
- Department of Chemical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicole L. Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Andrzej A. Dlugosz
- Department of Dermatology
- Department of Cell and Developmental Biology, University of Michigan, Ann Arbor, Michigan, USA
| | - J. Michelle Kahlenberg
- Division of Rheumatology, Department of Internal Medicine
- A. Alfred Taubman Medical Research Institute
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15
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Gilbert E, Zhu J, Peng T, Ward NL. Decreased Labial Herpes Simplex Virus Outbreaks Following Botulinum Neurotoxin Type A Injection: A Case Report. J Drugs Dermatol 2018; 17:1127-1129. [PMID: 30365595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Herpes Labialis results from reactivation of latent herpes simplex virus (HSV-1 or HSV-2) harbored in the trigeminal ganglion during times of psychological stress, cutaneous injury or photo exposure. Following reactivation, the virus is anterogradely transported through axonal termini to the skin where the virus is released and replicates causing a clinical outbreak. Botulinum neurotoxin A (BoNTA) is known to inhibit presynaptic neuropeptide and neurotransmitter release. Whether it has the capacity to interfere with viral shedding and delivery into the skin remains unclear. We were interested in determining whether BoNTA could serve as a potential therapeutic or prophylactic treatment approach for frequent and severe HSV recurrences. We describe a clinical case report in which a patient successfully maintained a sustained absence of HSV outbreaks in regions where BoNTA was intradermally administered. BoNTA may offer a novel therapeutic approach for preventing recurrent HSV disease. J Drugs Dermatol. 2018;17(10):1127-1129.
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16
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Wang Q, McCormick TS, Ward NL, Cooper KD, Conic R, Xu R. Combining mechanism-based prediction with patient-based profiling for psoriasis metabolomics biomarker discovery. AMIA Annu Symp Proc 2018; 2017:1734-1743. [PMID: 29854244 PMCID: PMC5977692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED Psoriasis is a chronic, debilitating skin condition that affects approximately 125 million individuals worldwide. The cause of psoriasis appears multifactorial, and no unified mitigating signal or single antigenic target has been identified to date. Metabolomic studies hold great potential for explaining disease mechanism, facilitating early diagnosis, and identifying potential therapeutic areas. Here, we present an integrated disease metabolomic biomarker discovery strategy that combines mechanism-based biomarker discovery with clinical sample-based metabolomic profiling. We applied this strategy in identifying and understanding metabolite biomarkers for psoriasis. The key innovation of our strategy is a novel mechanism-based metabolite prediction system, mmPredict, which assimilates vast amounts of existing knowledge of diseases and metabolites. mmPredict first constructed a psoriasis-specific mouse mutational phenotype profile. It then constructed phenotype profiles for a total of 259,170 chemicals/metabolites using known chemical genetics and human metabolomic data. Metabolites were then prioritized based on the phenotypic similarities between disease- and metabolites. We evaluated mmPredict using 150 metabolites identified using our in-house metabolome profiling study of psoriasis patient samples. mmPredict found 96 of the 150 metabolites and ranked them highly (recall: 0.64, mean ranking: 8.73%, median ranking: 2.33%, p-value: 4.75E-44). These results show that mmPredict is consistent with, as well as a complement to, traditional human metabolomic profiling studies. We then developed a strategy to combine outputs from both systems and found that the oxidative product of linoleic acid, 13(S)-hydroxy-9Z,11E-octadecadienoic acid (13- HODE), ranked highly by both mmPredict and our in-house experiments. Our integrated analysis indicates that 13- HODE may be a mechanistic link between psoriasis and cardiovascular comorbidities associated with psoriasis. In summary, we developed an integrated metabolomic prediction system that combines both human metabolomic studies and mechanism-based prediction and demonstrated its application in the skin disease psoriasis. Our system is highly general and can be applied to other diseases when patient-based metabolomic profiling data becomes more increasingly available. Data is publicly available at: http://nlp. CASE edu/public/data/mmPredict_PSO.
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Affiliation(s)
| | - Thomas S McCormick
- Department of Dermatology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Nicole L Ward
- Department of Dermatology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Kevin D Cooper
- Department of Dermatology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Ruzica Conic
- ThinTek, LLC, Palo Alto, CA, USA
- Department of Dermatology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Department of Epidemiology and Biostatistics, Institute of Computational Biology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Rong Xu
- Department of Epidemiology and Biostatistics, Institute of Computational Biology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
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17
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Swindell WR, Beamer MA, Sarkar MK, Loftus S, Fullmer J, Xing X, Ward NL, Tsoi LC, Kahlenberg MJ, Liang Y, Gudjonsson JE. RNA-Seq Analysis of IL-1B and IL-36 Responses in Epidermal Keratinocytes Identifies a Shared MyD88-Dependent Gene Signature. Front Immunol 2018; 9:80. [PMID: 29434599 PMCID: PMC5796909 DOI: 10.3389/fimmu.2018.00080] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [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: 10/28/2017] [Accepted: 01/11/2018] [Indexed: 12/14/2022] Open
Abstract
IL-36 cytokines have recently emerged as mediators of inflammation in autoimmune conditions including psoriasis vulgaris (PsV) and generalized pustular psoriasis (GPP). This study used RNA-seq to profile the transcriptome of primary epidermal keratinocytes (KCs) treated with IL-1B, IL-36A, IL-36B, or IL-36G. We identified some early IL-1B-specific responses (8 h posttreatment), but nearly all late IL-1B responses were replicated by IL-36 cytokines (24 h posttreatment). Type I and II interferon genes exhibited time-dependent response patterns, with early induction (8 h) followed by no response or repression (24 h). Altogether, we identified 225 differentially expressed genes (DEGs) with shared responses to all 4 cytokines at both time points (8 and 24 h). These involved upregulation of ligands (IL1A, IL1B, and IL36G) and activating proteases (CTSS) but also upregulation of inhibitors such as IL1RN and IL36RN. Shared IL-1B/IL-36 DEGs overlapped significantly with genes altered in PsV and GPP skin lesions, as well as genes near GWAS loci linked to autoimmune and autoinflammatory diseases (e.g., PsV, psoriatic arthritis, inflammatory bowel disease, and primary biliary cholangitis). Inactivation of MyD88 adapter protein using CRISPR/Cas9 completely abolished expression responses of such DEGs to IL-1B and IL-36G stimulation. These results provide a global view of IL-1B and IL-36 expression responses in epidermal KCs with fine-scale characterization of time-dependent and cytokine-specific response patterns. Our findings support an important role for IL-1B and IL-36 in autoimmune or autoinflammatory conditions and show that MyD88 adaptor protein mediates shared IL-1B/IL-36 responses.
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Affiliation(s)
- William R Swindell
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, United States
| | - Maria A Beamer
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Mrinal K Sarkar
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Shannon Loftus
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Joseph Fullmer
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Xianying Xing
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Nicole L Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, United States
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Michelle J Kahlenberg
- Department of Internal Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, MI, United States
| | - Yun Liang
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
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18
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Swindell WR, Xing X, Fritz Y, Diaconu D, Simon DI, Ward NL, Gudjonsson JE. Deficiency of myeloid-related proteins 8 and 14 (Mrp8/Mrp14) does not block inflammaging but prevents steatosis. Oncotarget 2018; 7:35535-35551. [PMID: 27224926 PMCID: PMC5094943 DOI: 10.18632/oncotarget.9550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 03/19/2016] [Accepted: 05/13/2016] [Indexed: 12/24/2022] Open
Abstract
The Mrp8 and Mrp14 proteins (calprotectin) accumulate within tissues during aging and may contribute to chronic inflammation. To address this possibility, we evaluated female calprotectin-deficient Mrp14-KO and wild-type (WT) mice at 5 and 24 months of age. However, there was no evidence that age-related inflammation is blunted in KO mice. Inflammation markers were in fact elevated in livers from old KO mice, and microarray analysis revealed more consistent elevation of genes specifically expressed by B-cells and T-cells. Adipose-specific genes, however, were less consistently elevated in aged KO mice, suggesting an anti-steatosis effect of Mrp8/14 deficiency. Consistent with this, genes decreased by the anti-steatosis agent SRT1720 were decreased in old KO compared to old WT mice. Expression of lipid metabolism genes was altered in KO mice at 5 months of age, along with genes associated with development, biosynthesis and immunity. These early-age effects of Mrp8/14 deficiency, in the absence of any external stressor, were unexpected. Taken together, our findings demonstrate a pro-steatosis rather than pro-inflammatory role of calprotectin within the aging liver. This appears to reflect a developmental-metabolic phenotype of Mrp14-KO mice that is manifest at a young age in the absence of pro-inflammatory stimuli.
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Affiliation(s)
- William R Swindell
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA.,Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Xianying Xing
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Yi Fritz
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - Doina Diaconu
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - Daniel I Simon
- Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Nicole L Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA.,The Murdough Family Center for Psoriasis, Case Western Reserve University, Cleveland, OH, USA
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19
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Swindell WR, Sarkar MK, Liang Y, Xing X, Baliwag J, Elder JT, Johnston A, Ward NL, Gudjonsson JE. RNA-seq identifies a diminished differentiation gene signature in primary monolayer keratinocytes grown from lesional and uninvolved psoriatic skin. Sci Rep 2017; 7:18045. [PMID: 29273799 PMCID: PMC5741737 DOI: 10.1038/s41598-017-18404-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [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: 09/27/2017] [Accepted: 12/11/2017] [Indexed: 02/08/2023] Open
Abstract
Keratinocyte (KC) hyper-proliferation and epidermal thickening are characteristic features of psoriasis lesions, but the specific contributions of KCs to plaque formation are not fully understood. This study used RNA-seq to investigate the transcriptome of primary monolayer KC cultures grown from lesional (PP) and non-lesional (PN) biopsies of psoriasis patients and control subjects (NN). Whole skin biopsies from the same subjects were evaluated concurrently. RNA-seq analysis of whole skin identified a larger number of psoriasis-increased differentially expressed genes (DEGs), but analysis of KC cultures identified more PP- and PN-decreased DEGs. These latter DEG sets overlapped more strongly with genes near loci identified by psoriasis genome-wide association studies and were enriched for genes associated with epidermal differentiation. Consistent with this, the frequency of AP-1 motifs was elevated in regions upstream of PN-KC-decreased DEGs. A subset of these genes belonged to the same co-expression module, mapped to the epidermal differentiation complex, and exhibited differentiation-dependent expression. These findings demonstrate a decreased differentiation gene signature in PP/PN-KCs that had not been identified by pre-genomic studies of patient-derived monolayers. This may reflect intrinsic defects limiting psoriatic KC differentiation capacity, which may contribute to compromised barrier function in normal-appearing uninvolved psoriatic skin.
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Affiliation(s)
- William R Swindell
- Ohio University, Heritage College of Osteopathic Medicine, Athens, OH, 45701, USA. .,University of Michigan, Department of Dermatology, Ann Arbor, MI, 48109-2200, USA.
| | - Mrinal K Sarkar
- University of Michigan, Department of Dermatology, Ann Arbor, MI, 48109-2200, USA
| | - Yun Liang
- University of Michigan, Department of Dermatology, Ann Arbor, MI, 48109-2200, USA
| | - Xianying Xing
- University of Michigan, Department of Dermatology, Ann Arbor, MI, 48109-2200, USA
| | - Jaymie Baliwag
- University of Michigan, Department of Dermatology, Ann Arbor, MI, 48109-2200, USA
| | - James T Elder
- University of Michigan, Department of Dermatology, Ann Arbor, MI, 48109-2200, USA
| | - Andrew Johnston
- University of Michigan, Department of Dermatology, Ann Arbor, MI, 48109-2200, USA
| | - Nicole L Ward
- Department of Dermatology, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106, USA.,The Murdough Family Center for Psoriasis, Case Western Reserve University, Cleveland, OH, USA
| | - Johann E Gudjonsson
- University of Michigan, Department of Dermatology, Ann Arbor, MI, 48109-2200, USA
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20
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Mehta NN, Teague HL, Swindell WR, Baumer Y, Ward NL, Xing X, Baugous B, Johnston A, Joshi AA, Silverman J, Barnes DH, Wolterink L, Nair RP, Stuart PE, Playford M, Voorhees JJ, Sarkar MK, Elder JT, Gallagher K, Ganesh SK, Gudjonsson JE. IFN-γ and TNF-α synergism may provide a link between psoriasis and inflammatory atherogenesis. Sci Rep 2017; 7:13831. [PMID: 29062018 PMCID: PMC5653789 DOI: 10.1038/s41598-017-14365-1] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/10/2017] [Indexed: 12/14/2022] Open
Abstract
Chronic inflammation is a critical component of atherogenesis, however, reliable human translational models aimed at characterizing these mechanisms are lacking. Psoriasis, a chronic inflammatory skin disease associated with increased susceptibility to atherosclerosis, provides a clinical human model that can be utilized to investigate the links between chronic inflammation and atherosclerosis development. We sought to investigate key biological processes in psoriasis skin and human vascular tissue to identify biological components that may promote atherosclerosis in chronic inflammatory conditions. Using a bioinformatics approach of human skin and vascular tissue, we determined IFN-γ and TNF-α are the dominant pro-inflammatory signals linking atherosclerosis and psoriasis. We then stimulated primary aortic endothelial cells and ex-vivo atherosclerotic tissue with IFN-γ and TNF-α and found they synergistically increased monocyte and T-cell chemoattractants, expression of adhesion molecules on the endothelial cell surface, and decreased endothelial barrier integrity in vitro, therefore increasing permeability. Our data provide strong evidence of synergism between IFN-γ and TNF- α in inflammatory atherogenesis and provide rationale for dual cytokine antagonism in future studies.
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Affiliation(s)
- Nehal N Mehta
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Heather L Teague
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Yvonne Baumer
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nicole L Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - Xianying Xing
- Department of Dermatology, Univ. of Michigan, Ann Arbor, MI, USA
| | - Brooke Baugous
- Department of Dermatology, Univ. of Michigan, Ann Arbor, MI, USA
| | - Andrew Johnston
- Department of Dermatology, Univ. of Michigan, Ann Arbor, MI, USA
| | - Aditya A Joshi
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Joanna Silverman
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Drew H Barnes
- Department of Dermatology, Univ. of Michigan, Ann Arbor, MI, USA
| | - Liza Wolterink
- Department of Dermatology, Univ. of Michigan, Ann Arbor, MI, USA
| | - Rajan P Nair
- Department of Dermatology, Univ. of Michigan, Ann Arbor, MI, USA
| | - Philip E Stuart
- Department of Dermatology, Univ. of Michigan, Ann Arbor, MI, USA
| | - Martin Playford
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - John J Voorhees
- Department of Dermatology, Univ. of Michigan, Ann Arbor, MI, USA
| | - Mrinal K Sarkar
- Department of Dermatology, Univ. of Michigan, Ann Arbor, MI, USA
| | - James T Elder
- Department of Dermatology, Univ. of Michigan, Ann Arbor, MI, USA
| | - Katherine Gallagher
- Department of Surgery, Division of Vascular Surgery, Univ. of Michigan, Ann Arbor, MI, USA
| | - Santhi K Ganesh
- Department of Internal Medicine, Division of Cardiovascular Medicine, and Department of Human Genetics, Univ. of Michigan, Ann Arbor, MI, USA
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21
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Li Y, Golden JB, Camhi MI, Zhang X, Fritz Y, Diaconu D, Ivanco TL, Simon DI, Kikly K, McCormick TS, Wang Y, Ward NL. Protection from Psoriasis-Related Thrombosis after Inhibition of IL-23 or IL-17A. J Invest Dermatol 2017; 138:310-315. [PMID: 28951241 DOI: 10.1016/j.jid.2017.09.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 08/29/2017] [Accepted: 09/12/2017] [Indexed: 12/19/2022]
Abstract
Psoriasis patients experience chronic systemic skin inflammation and develop cardiovascular comorbidities that shorten their lifespan. Whether cardiovascular disease is improved by treatment with current biologics that target disease-specific pathways is unclear. KC-Tie2 mice develop psoriasiform skin inflammation with increases in IL-23 and IL-17A and proinflammatory monocytosis and neutrophilia that precedes development of carotid artery thrombus formation. To examine whether targeted blockade of IL-23 or IL-17A in KC-Tie2 psoriasis mice improves cardiovascular outcomes, mice were treated systemically for 6 weeks with antibodies targeting IL-17A, IL-17RA, IL-12/23p40, or IL-23p19. Skin inflammation; thrombosis clotting times; and percentage of splenic monocytes, neutrophils, and CD4 T cells were examined. Skin inflammation significantly improved in KC-Tie2 mice treated with each of the antibodies targeting IL-23, IL-17A, or IL-17RA, consistent with clinical efficacy observed in psoriasis patients. The time to occlusive thrombus formation lengthened in these mice and correlated with attenuated acanthosis. This decrease in skin inflammation paralleled decreases in splenic neutrophils (CD11b+Ly6G+) but not monocytes (CD11b+Ly6Chigh) or T cells (CD4+). Our data show that targeted inhibition of IL-23 or IL-17A improves psoriasis-like skin disease and also improves cardiovascular disease in mice.
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Affiliation(s)
- Yumeng Li
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jackelyn B Golden
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Maya I Camhi
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Xiufen Zhang
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Yi Fritz
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Doina Diaconu
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Tammy L Ivanco
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Daniel I Simon
- Department of Medicine, Division of Cardiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA; Cardiovascular Research Institute, Department of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Thomas S McCormick
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA; Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Yunmei Wang
- Department of Medicine, Division of Cardiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA; Cardiovascular Research Institute, Department of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Nicole L Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA; Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
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22
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Zhang LJ, Sen GL, Ward NL, Johnston A, Chun K, Chen Y, Adase C, Sanford JA, Gao N, Chensee M, Sato E, Fritz Y, Baliwag J, Williams MR, Hata T, Gallo RL. Antimicrobial Peptide LL37 and MAVS Signaling Drive Interferon-β Production by Epidermal Keratinocytes during Skin Injury. Immunity 2017; 45:119-30. [PMID: 27438769 DOI: 10.1016/j.immuni.2016.06.021] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 03/30/2016] [Accepted: 05/02/2016] [Indexed: 02/02/2023]
Abstract
Type 1 interferons (IFNs) promote inflammation in the skin but the mechanisms responsible for inducing these cytokines are not well understood. We found that IFN-β was abundantly produced by epidermal keratinocytes (KCs) in psoriasis and during wound repair. KC IFN-β production depended on stimulation of mitochondrial antiviral-signaling protein (MAVS) by the antimicrobial peptide LL37 and double stranded-RNA released from necrotic cells. MAVS activated downstream TBK1 (TANK-Binding Kinase 1)-AKT (AKT serine/threonine kinase 1)-IRF3 (interferon regulatory factor 3) signaling cascade leading to IFN-β production and then promoted maturation of dendritic cells. In mice, the production of epidermal IFN-β by LL37 required MAVS, and human wounded and/or psoriatic skin showed activation of MAVS-associated IRF3 and induction of MAVS and IFN-β gene signatures. These findings show that KCs are an important source of IFN-β and MAVS is critical to this function, and demonstrates how the epidermis triggers unwanted skin inflammation under disease conditions.
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Affiliation(s)
- Ling-Juan Zhang
- Department of Dermatology, University of California, San Diego, La Jolla, CA 92093, USA
| | - George L Sen
- Department of Dermatology, University of California, San Diego, La Jolla, CA 92093, USA; Department of Cellular and Molecular Medicine, San Diego, La Jolla, CA 92093, USA
| | - Nicole L Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Andrew Johnston
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Kimberly Chun
- Department of Dermatology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Yifang Chen
- Department of Dermatology, University of California, San Diego, La Jolla, CA 92093, USA; Department of Cellular and Molecular Medicine, San Diego, La Jolla, CA 92093, USA
| | - Christopher Adase
- Department of Dermatology, University of California, San Diego, La Jolla, CA 92093, USA
| | - James A Sanford
- Department of Dermatology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Nina Gao
- Department of Dermatology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Melanie Chensee
- Department of Dermatology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Emi Sato
- Department of Dermatology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Yi Fritz
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Jaymie Baliwag
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Michael R Williams
- Department of Dermatology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Tissa Hata
- Department of Dermatology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Richard L Gallo
- Department of Dermatology, University of California, San Diego, La Jolla, CA 92093, USA.
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23
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Sigurdardottir SL, Fritz Y, Klenotic PA, Zhang X, Diaconu D, Zhang L, Ward NL. IL-17RA and not IL-17RE is required for IL-17C-mediated psoriasiform inflammation. The Journal of Immunology 2017. [DOI: 10.4049/jimmunol.198.supp.61.2] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
IL-17C is highly expressed in psoriasis skin and is thought to promote inflammation by binding IL-17RA and IL-17RE. Keratinocyte-overexpressing IL-17C (IL-17C+) mice develop a psoriasiform skin phenotype. To investigate IL-17C-mediated inflammation, IL-17C+ mice were mated with IL-17RE-deficient (KO) mice and skin examined. IL-17C+IL-17REKO mice had similar acanthosis and T cell numbers as IL-17C+ mice (n=8/grp; P>0.1), as did IL-17C+ mice transplanted with bone marrow from CD4-IL-17RE vs. WT mice (n=6–9; P>0.1). These results suggest that IL-17C signaling is IL-17RE independent. Next, IL-17C+IL-17REKO mice were treated with anti-IL-17RA antibodies and a 54% reduction in acanthosis was observed (n=3; P=0.006), suggesting that IL-17C-IL-17RA signaling is critical for skin inflammation. In KC-Tie2 psoriasis mice, skin IL-17A and IL-17C increase ~15-fold (P<0.05) and anti-IL-17A and anti-IL-17RA antibody treatment improves acanthosis and decreases CD4+ T cells (P<0.05 vs. IgG, n=5–11/grp), with anti-IL-17RA having greater efficacy than anti-IL-17A (P=0.02). This suggests that both IL-17C and IL-17A signaling through IL-17RA are critical. Indeed, genetic deletion of IL-17C from KC-Tie2 mice led to a 67% and 58% decrease in acanthosis and CD4+ T cells, respectively (n=8/grp; P<0.001 vs. KC-Tie2 mice). Finally, IL-17A modulation in IL-17C+ mice using anti-IL-17A antibodies, transplanting IL-17AKO bone marrow or introducing intradermal IL-17A, each had no effect on IL-17C+ skin inflammation. Our results demonstrate that IL-17C-mediated skin inflammation occurs in an IL-17RE independent, IL-17RA dependent manner and that a tiered balance between IL-17C-IL-17A-IL-17RA signaling may dictate levels of inflammation.
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24
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Swindell WR, Michaels KA, Sutter AJ, Diaconu D, Fritz Y, Xing X, Sarkar MK, Liang Y, Tsoi A, Gudjonsson JE, Ward NL. Imiquimod has strain-dependent effects in mice and does not uniquely model human psoriasis. Genome Med 2017; 9:24. [PMID: 28279190 PMCID: PMC5345243 DOI: 10.1186/s13073-017-0415-3] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [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: 08/11/2016] [Accepted: 02/22/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Imiquimod (IMQ) produces a cutaneous phenotype in mice frequently studied as an acute model of human psoriasis. Whether this phenotype depends on strain or sex has never been systematically investigated on a large scale. Such effects, however, could lead to conflicts among studies, while further impacting study outcomes and efforts to translate research findings. METHODS RNA-seq was used to evaluate the psoriasiform phenotype elicited by 6 days of Aldara (5% IMQ) treatment in both sexes of seven mouse strains (C57BL/6 J (B6), BALB/cJ, CD1, DBA/1 J, FVB/NJ, 129X1/SvJ, and MOLF/EiJ). RESULTS In most strains, IMQ altered gene expression in a manner consistent with human psoriasis, partly due to innate immune activation and decreased homeostatic gene expression. The response of MOLF males was aberrant, however, with decreased expression of differentiation-associated genes (elevated in other strains). Key aspects of the IMQ response differed between the two most commonly studied strains (BALB/c and B6). Compared with BALB/c, the B6 phenotype showed increased expression of genes associated with DNA replication, IL-17A stimulation, and activated CD8+ T cells, but decreased expression of genes associated with interferon signaling and CD4+ T cells. Although IMQ-induced expression shifts mirrored psoriasis, responses in BALB/c, 129/SvJ, DBA, and MOLF mice were more consistent with other human skin conditions (e.g., wounds or infections). IMQ responses in B6 mice were most consistent with human psoriasis and best replicated expression patterns specific to psoriasis lesions. CONCLUSIONS These findings demonstrate strain-dependent aspects of IMQ dermatitis in mice. We have shown that IMQ does not uniquely model psoriasis but in fact triggers a core set of pathways active in diverse skin diseases. Nonetheless, our findings suggest that B6 mice provide a better background than other strains for modeling psoriasis disease mechanisms.
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Affiliation(s)
- William R. Swindell
- Ohio University, Heritage College of Osteopathic Medicine, Athens, OH 45701-2979 USA
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109-2200 USA
| | - Kellie A. Michaels
- Department of Dermatology, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106 USA
| | - Andrew J. Sutter
- Department of Dermatology, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106 USA
| | - Doina Diaconu
- Department of Dermatology, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106 USA
| | - Yi Fritz
- Department of Dermatology, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106 USA
| | - Xianying Xing
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109-2200 USA
| | - Mrinal K. Sarkar
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109-2200 USA
| | - Yun Liang
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109-2200 USA
| | - Alex Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109-2200 USA
| | | | - Nicole L. Ward
- Department of Dermatology, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106 USA
- The Murdough Family Center for Psoriasis, Case Western Reserve University, Cleveland, OH USA
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25
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Fritz Y, Klenotic PA, Swindell WR, Yin ZQ, Groft SG, Zhang L, Baliwag J, Camhi MI, Diaconu D, Young AB, Foster AM, Johnston A, Gudjonsson JE, McCormick TS, Ward NL. Induction of Alternative Proinflammatory Cytokines Accounts for Sustained Psoriasiform Skin Inflammation in IL-17C+IL-6KO Mice. J Invest Dermatol 2017; 137:696-705. [PMID: 27984037 PMCID: PMC5326585 DOI: 10.1016/j.jid.2016.10.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 05/01/2016] [Revised: 09/19/2016] [Accepted: 10/11/2016] [Indexed: 12/30/2022]
Abstract
IL-6 inhibition has been unsuccessful in treating psoriasis, despite high levels of tissue and serum IL-6 in patients. In addition, de novo psoriasis onset has been reported after IL-6 blockade in patients with rheumatoid arthritis. To explore mechanisms underlying these clinical observations, we backcrossed an established psoriasiform mouse model (IL-17C+ mice) with IL-6-deficient mice (IL-17C+KO) and examined the cutaneous phenotype. IL-17C+KO mice initially exhibited decreased skin inflammation; however, this decrease was transient and reversed rapidly, concomitant with increases in skin Tnf, Il36α/β/γ, Il24, Epgn, and S100a8/a9 to levels higher than those found in IL-17C+ mice. A comparison of IL-17C+ and IL-17C+KO mouse skin transcriptomes with that of human psoriasis skin revealed significant correlation among transcripts of skin of patients with psoriasis and IL-17C+KO mouse skin, and confirmed an exacerbation of the inflammatory signature in IL-17C+KO mice that aligns closely with human psoriasis. Transcriptional analyses of IL-17C+ and IL-17C+KO primary keratinocytes confirmed increased expression of proinflammatory molecules, suggesting that in the absence of IL-6, keratinocytes increase production of numerous additional proinflammatory cytokines. These preclinical findings may provide insight into why patients with arthritis being treated with IL-6 inhibitors develop new onset psoriasis and why IL-6 blockade for the treatment of psoriasis has not been clinically effective.
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Affiliation(s)
- Yi Fritz
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Philip A Klenotic
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - William R Swindell
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA; Ohio University, Heritage College of Osteopathic Medicine, Athens, Ohio, USA
| | - Zhi Qiang Yin
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA; Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Sarah G Groft
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Li Zhang
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jaymie Baliwag
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Maya I Camhi
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Doina Diaconu
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Andrew B Young
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Alexander M Foster
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Andrew Johnston
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Thomas S McCormick
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA; Murdough Family Center for Psoriasis, Cleveland, Ohio, USA
| | - Nicole L Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA; Murdough Family Center for Psoriasis, Cleveland, Ohio, USA.
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26
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Wang Y, Golden JB, Fritz Y, Zhang X, Diaconu D, Camhi MI, Gao H, Dawes SM, Xing X, Ganesh SK, Gudjonsson JE, Simon DI, McCormick TS, Ward NL. Interleukin 6 regulates psoriasiform inflammation-associated thrombosis. JCI Insight 2016; 1:e89384. [PMID: 27942589 DOI: 10.1172/jci.insight.89384] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Psoriasis patients are at increased risk of heart attack and stroke and have elevated MRP8/14 levels that predict heart attack. The KC-Tie2 psoriasiform mouse model exhibits elevated MRP8/14 and is prothrombotic. Mrp14-/- mice, in contrast, are protected from thrombosis, but, surprisingly, KC-Tie2xMrp14-/- mice remain prothrombotic. Treating KC-Tie2xMrp14-/- mice with anti-IL-23p19 antibodies reversed the skin inflammation, improved thrombosis, and decreased IL-6. In comparison, IL-6 deletion from KC-Tie2 animals improved thrombosis despite sustained skin inflammation, suggesting that thrombosis improvements following IL-23 inhibition occur secondary to IL-6 decreases. Psoriasis patient skin has elevated IL-6 and IL-6 receptor is present in human coronary atheroma, supporting a link between skin and distant vessel disease in patient tissue. Together, these results identify a critical role for skin-derived IL-6 linking skin inflammation with thrombosis, and shows that in the absence of IL-6 the connection between skin inflammation and thrombosis comorbidities is severed.
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Affiliation(s)
- Yunmei Wang
- Division of Cardiovascular Medicine, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, Ohio, USA
| | - Jackelyn B Golden
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Yi Fritz
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Xiufen Zhang
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Doina Diaconu
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Maya I Camhi
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Huiyun Gao
- Division of Cardiovascular Medicine, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, Ohio, USA
| | - Sean M Dawes
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Santhi K Ganesh
- Department of Internal Medicine, Division of Cardiovascular Medicine, and Department of Human Genetics, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Daniel I Simon
- Division of Cardiovascular Medicine, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, Ohio, USA
| | - Thomas S McCormick
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Nicole L Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
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27
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Monin L, Gudjonsson JE, Childs EE, Amatya N, Xing X, Verma AH, Coleman BM, Garg AV, Killeen M, Mathers A, Ward NL, Gaffen SL. MCPIP1/Regnase-1 Restricts IL-17A- and IL-17C-Dependent Skin Inflammation. J Immunol 2016; 198:767-775. [PMID: 27920272 DOI: 10.4049/jimmunol.1601551] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 11/04/2016] [Indexed: 12/14/2022]
Abstract
The IL-17 family cytokines IL-17A and IL-17C drive the pathogenesis of psoriatic skin inflammation, and anti-IL-17A Abs were recently approved to treat human psoriasis. Little is known about mechanisms that restrain IL-17 cytokine-mediated signaling, particularly IL-17C. In this article, we show that the endoribonuclease MCP-1-induced protein 1 (MCPIP1; also known as regnase-1) is markedly upregulated in human psoriatic skin lesions. Similarly, MCPIP1 was overexpressed in the imiquimod (IMQ)-driven mouse model of cutaneous inflammation. Mice with an MCPIP1 deficiency (Zc3h12a+/-) displayed no baseline skin inflammation, but they showed exacerbated pathology following IMQ treatment. Pathology in Zc3h12a+/- mice was associated with elevated expression of IL-17A- and IL-17C-dependent genes, as well as with increased accumulation of neutrophils in skin. However, IL-17A and IL-17C expression was unaltered, suggesting that the increased inflammation in Zc3h12a+/- mice was due to enhanced downstream IL-17R signaling. Radiation chimeras demonstrated that MCPIP1 in nonhematopoietic cells is responsible for controlling skin pathology. Moreover, Zc3h12a+/-Il17ra-/- mice given IMQ showed almost no disease. To identify which IL-17RA ligand was essential, Zc3h12a+/-Il17a-/- and Zc3h12a+/-Il17c-/- mice were given IMQ; these mice had reduced but not fully abrogated pathology, indicating that MCPIP1 inhibits IL-17A and IL-17C signaling. Confirming this hypothesis, Zc3h12a-/- keratinocytes showed increased responsiveness to IL-17A and IL-17C stimulation. Thus, MCPIP1 is a potent negative regulator of psoriatic skin inflammation through IL-17A and IL-17C. Moreover, to our knowledge, MCPIP1 is the first described negative regulator of IL-17C signaling.
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Affiliation(s)
- Leticia Monin
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA 15260
| | | | - Erin E Childs
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA 15260
| | - Nilesh Amatya
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA 15260
| | - Xianying Xing
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109
| | - Akash H Verma
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA 15260
| | - Bianca M Coleman
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA 15260
| | - Abhishek V Garg
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA 15260
| | - Meaghan Killeen
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA 15260; and
| | - Alicia Mathers
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA 15260; and
| | - Nicole L Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106
| | - Sarah L Gaffen
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA 15260;
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28
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Santilli S, Kast DR, Grozdev I, Cao L, Feig RL, Golden JB, Debanne SM, Gilkeson RC, Orringer CE, McCormick TS, Ward NL, Cooper KD, Korman NJ. Visualization of atherosclerosis as detected by coronary artery calcium and carotid intima-media thickness reveals significant atherosclerosis in a cross-sectional study of psoriasis patients in a tertiary care center. J Transl Med 2016; 14:217. [PMID: 27448600 PMCID: PMC4957305 DOI: 10.1186/s12967-016-0947-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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: 06/23/2015] [Accepted: 06/17/2016] [Indexed: 02/08/2023] Open
Abstract
Background Psoriasis is a chronic inflammatory disease of the skin and joints that may also have systemic inflammatory effects, including the development of cardiovascular disease (CVD). Multiple epidemiologic studies have demonstrated increased rates of CVD in psoriasis patients, although a causal link has not been established. A growing body of evidence suggests that sub-clinical systemic inflammation may develop in psoriasis patients, even from a young age. We aimed to evaluate the prevalence of atherosclerosis and identify specific clinical risk factors associated with early vascular inflammation. Methods We conducted a cross-sectional study of a tertiary care cohort of psoriasis patients using coronary artery calcium (CAC) score and carotid intima-media thickness (CIMT) to detect atherosclerosis, along with high sensitivity C-reactive protein (hsCRP) to measure inflammation. Psoriasis patients and controls were recruited from our tertiary care dermatology clinic. Presence of atherosclerosis was defined using validated numeric values within CAC and CIMT imaging. Descriptive data comparing groups was analyzed using Welch’s t test and Pearson Chi square tests. Logistic regression was used to analyze clinical factors associated with atherosclerosis, and linear regression to evaluate the relationship between psoriasis and hsCRP. Results 296 patients were enrolled, with 283 (207 psoriatic and 76 controls) having all data for the hsCRP and atherosclerosis analysis. Atherosclerosis was found in 67.6 % of psoriasis subjects versus 52.6 % of controls; Psoriasis patients were found to have a 2.67-fold higher odds of having atherosclerosis compared to controls [95 % CI (1.2, 5.92); p = 0.016], after adjusting for age, gender, race, BMI, smoking, HDL and hsCRP. In addition, a non-significant trend was found between HsCRP and psoriasis severity, as measured by PASI, PGA, or BSA, again after adjusting for confounders. Conclusions A tertiary care cohort of psoriasis patients have a high prevalence of early atherosclerosis, increased hsCRP, and psoriasis remains a risk factor for the presence of atherosclerosis even after adjustment of key confounding clinical factors. Psoriasis may contribute to an accelerated systemic inflammatory cascade resulting in increased risk of CVD and CV events. Electronic supplementary material The online version of this article (doi:10.1186/s12967-016-0947-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- S Santilli
- Department of Dermatology, University Hospitals Case Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA.,The Murdough Family Center for Psoriasis, Cleveland, USA
| | - D R Kast
- Department of Dermatology, University Hospitals Case Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA.,The Murdough Family Center for Psoriasis, Cleveland, USA
| | - I Grozdev
- Department of Dermatology, University Hospitals Case Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA.,The Murdough Family Center for Psoriasis, Cleveland, USA
| | - L Cao
- Department of Dermatology, University Hospitals Case Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA.,The Murdough Family Center for Psoriasis, Cleveland, USA
| | - R L Feig
- Department of Dermatology, University Hospitals Case Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA.,The Murdough Family Center for Psoriasis, Cleveland, USA
| | - J B Golden
- Department of Dermatology, University Hospitals Case Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA.,The Murdough Family Center for Psoriasis, Cleveland, USA.,Department of Pathology, Case Western Reserve University, Cleveland, USA
| | - S M Debanne
- Center For Clinical Investigation, Case Western Reserve University, Cleveland, USA.,Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, USA
| | - R C Gilkeson
- Department of Dermatology, University Hospitals Case Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA
| | - C E Orringer
- Department of Dermatology, University Hospitals Case Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA.,The Murdough Family Center for Psoriasis, Cleveland, USA.,University of Miami, Miller School of Medicine, Miami, FL, 33125, USA
| | - T S McCormick
- Department of Dermatology, University Hospitals Case Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA. .,The Murdough Family Center for Psoriasis, Cleveland, USA.
| | - N L Ward
- Department of Dermatology, University Hospitals Case Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA.,The Murdough Family Center for Psoriasis, Cleveland, USA
| | - K D Cooper
- Department of Dermatology, University Hospitals Case Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA.,The Murdough Family Center for Psoriasis, Cleveland, USA.,Louis Stokes VA Medical Center, Cleveland, OH, USA
| | - N J Korman
- Department of Dermatology, University Hospitals Case Medical Center, 11000 Euclid Ave, Cleveland, OH, 44106, USA.,The Murdough Family Center for Psoriasis, Cleveland, USA
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29
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Peterson SC, Eberl M, Vagnozzi AN, Belkadi A, Veniaminova NA, Verhaegen ME, Bichakjian CK, Ward NL, Dlugosz AA, Wong SY. Basal cell carcinoma preferentially arises from stem cells within hair follicle and mechanosensory niches. Cell Stem Cell 2016; 16:400-12. [PMID: 25842978 DOI: 10.1016/j.stem.2015.02.006] [Citation(s) in RCA: 231] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 01/13/2015] [Accepted: 02/10/2015] [Indexed: 11/19/2022]
Abstract
Basal cell carcinoma (BCC) is characterized by frequent loss of PTCH1, leading to constitutive activation of the Hedgehog pathway. Although the requirement for Hedgehog in BCC is well established, the identity of disease-initiating cells and the compartments in which they reside remain controversial. By using several inducible Cre drivers to delete Ptch1 in different cell compartments in mice, we show here that multiple hair follicle stem cell populations readily develop BCC-like tumors. In contrast, stem cells within the interfollicular epidermis do not efficiently form tumors. Notably, we observed that innervated Gli1-expressing progenitors within mechanosensory touch dome epithelia are highly tumorigenic. Sensory nerves activate Hedgehog signaling in normal touch domes, while denervation attenuates touch dome-derived tumors. Together, our studies identify varying tumor susceptibilities among different stem cell populations in the skin, highlight touch dome epithelia as "hot spots" for tumor formation, and implicate cutaneous nerves as mediators of tumorigenesis.
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Affiliation(s)
- Shelby C Peterson
- Departments of Dermatology and Cell and Developmental Biology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Markus Eberl
- Departments of Dermatology and Cell and Developmental Biology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Alicia N Vagnozzi
- Departments of Dermatology and Cell and Developmental Biology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Abdelmadjid Belkadi
- Departments of Dermatology and Neuroscience, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Natalia A Veniaminova
- Departments of Dermatology and Cell and Developmental Biology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Monique E Verhaegen
- Departments of Dermatology and Cell and Developmental Biology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Christopher K Bichakjian
- Departments of Dermatology and Cell and Developmental Biology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Nicole L Ward
- Departments of Dermatology and Neuroscience, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Andrzej A Dlugosz
- Departments of Dermatology and Cell and Developmental Biology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Sunny Y Wong
- Departments of Dermatology and Cell and Developmental Biology, University of Michigan, Ann Arbor, MI 48109, USA.
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30
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Li Y, Stoll SW, Sekhon S, Talsma C, Camhi MI, Jones JL, Lambert S, Marley H, Rittié L, Grachtchouk M, Fritz Y, Ward NL, Elder JT. Transgenic expression of human amphiregulin in mouse skin: inflammatory epidermal hyperplasia and enlarged sebaceous glands. Exp Dermatol 2016; 25:187-93. [PMID: 26519132 DOI: 10.1111/exd.12886] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2015] [Indexed: 12/15/2022]
Abstract
To explore the role of amphiregulin in inflammatory epidermal hyperplasia, we overexpressed human AREG (hAREG) in FVB/N mice using a bovine K5 promoter. A construct containing AREG coding sequences flanked by 5' and 3' untranslated region sequences (AREG-UTR) led to a >10-fold increase in hAREG expression compared to an otherwise-identical construct containing only the coding region (AREG-CDR). AREG-UTR mice developed tousled, greasy fur as well as elongated nails and thickened, erythematous tail skin. No such phenotype was evident in AREG-CDR mice. Histologically, AREG-UTR mice presented with marked epidermal hyperplasia of tail skin (2.1-fold increase in epidermal thickness with a 9.5-fold increase in Ki-67(+) cells) accompanied by significantly increased CD4+ T-cell infiltration. Dorsal skin of AREG-UTR mice manifested lesser but still significant increases in epidermal thickness and keratinocyte hyperplasia. AREG-UTR mice also developed marked and significant sebaceous gland enlargement, with corresponding increases in Ki-67(+) cells. To determine the response of AREG-UTR animals to a pro-inflammatory skin challenge, topical imiquimod (IMQ) or vehicle cream was applied to dorsal and tail skin. IMQ increased dorsal skin thickness similarly in both AREG-UTR and wild type mice (1.7- and 2.2-fold vs vehicle, P < 0.001 each), but had no such effect on tail skin. These results confirm that keratinocyte expression of hAREG elicits inflammatory epidermal hyperplasia, and are consistent with prior reports of tail epidermal hyperplasia and increased sebaceous gland size in mice expressing human epigen.
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Affiliation(s)
- Yong Li
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Stefan W Stoll
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Sahil Sekhon
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - Caroline Talsma
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Maya I Camhi
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - Jennifer L Jones
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - Sylviane Lambert
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Hue Marley
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Laure Rittié
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Marina Grachtchouk
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Yi Fritz
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - Nicole L Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - James T Elder
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA.,Ann Arbor VA Hospital, Ann Arbor, MI, USA
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31
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Golden JB, Wang Y, Fritz Y, Diaconu D, Zhang X, Debanne SM, Simon DI, McCormick TS, Ward NL. Chronic, not acute, skin-specific inflammation promotes thrombosis in psoriasis murine models. J Transl Med 2015; 13:382. [PMID: 26675482 PMCID: PMC4681031 DOI: 10.1186/s12967-015-0738-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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: 06/23/2015] [Accepted: 11/23/2015] [Indexed: 02/08/2023] Open
Abstract
Background Psoriasis patients exhibit an increased risk of atherothrombotic events, including myocardial infarction and stroke. Clinical evidence suggests that psoriasis patients with early onset and more severe disease have the highest risk for these co-morbidities, perhaps due to the extent of body surface involvement, subsequent levels of systemic inflammation, or chronicity of disease. We sought to determine whether acute or chronic skin-specific inflammation was sufficient to promote thrombosis. Methods We used two experimental mouse models of skin-specific inflammation generated in either an acute (topical Aldara application onto wild-type C57Bl/6 mice for 5 days) or chronic (a genetically engineered K5-IL-17C mouse model of psoriasiform skin inflammation) manner. Arterial thrombosis was induced using carotid artery photochemical injury (Rose Bengal-green light laser) and carotid artery diameters were measured post-clot formation. We also examined measures of clot formation including prothrombin (PT) and activated partial thromboplastin time (aPTT). Skin inflammation was examined histologically and we profiled plasma-derived lipids. The number of skin-draining lymph-node (SDLN) and splenic derived CD11b+Ly6Chigh pro-inflammatory monocytes and CD11b+Ly6G+ neutrophils was quantified using multi-color flow cytometry. Results Mice treated with topical Aldara for 5 days had similar carotid artery thrombotic occlusion times to mice treated with vehicle cream (32.2 ± 3.0 vs. 31.4 ± 2.5 min, p = 0.97); in contrast, K5-IL-17C mice had accelerated occlusion times compared to littermate controls (15.7 ± 2.1 vs. 26.5 ± 3.5 min, p < 0.01) while carotid artery diameters were similar between all mice. Acanthosis, a surrogate measure of inflammation, was increased in both Aldara-treated and K5-IL-17C mice compared to their respective controls. Monocytosis, defined as elevated SDLN and/or splenic CD11b+Ly6Chigh cells, was significantly increased in both Aldara-treated (SDLN: 3.8-fold, p = 0.02; spleen: 2.0-fold, p < 0.01) and K5-IL-17C (SDLN: 3.4-fold, p = 0.02; spleen: 3.5-fold, p < 0.01) animals compared to controls while neutrophilia, defined as elevated SDLN and/or splenic CD11b+Ly6G+ cells, was significantly increased in only the chronic K5-IL-17C model (SDLN: 11.6-fold, p = 0.02; spleen: 11.3-fold, p < 0.01). Plasma-derived lipid levels, PT and aPTT times showed no difference between the Aldara-treated mice or the K5-IL-17C mice and their respective controls. Conclusions Chronic, but not acute, skin-specific inflammation was associated with faster arterial thrombotic occlusion. Increased numbers of splenic and SDLN monocytes were observed in both acute and chronic skin-specific inflammation, however, increased splenic and SDLN neutrophils were observed only in the chronic skin-specific inflammation model. Understanding the cellular response to skin-specific inflammation may provide insights into the cellular participants mediating the pathophysiology of major adverse cardiovascular events associated with psoriasis. Electronic supplementary material The online version of this article (doi:10.1186/s12967-015-0738-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jackelyn B Golden
- Department of Dermatology, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106, USA. .,Department of Pathology, Case Western Reserve University, Cleveland, OH, USA.
| | - Yunmei Wang
- Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Yi Fritz
- Department of Dermatology, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106, USA.
| | - Doina Diaconu
- Department of Dermatology, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106, USA.
| | - Xiufen Zhang
- Department of Dermatology, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106, USA. .,Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Sara M Debanne
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA.
| | - Daniel I Simon
- Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA. .,The Murdough Family Center for Psoriasis, Case Western Reserve University, Cleveland, OH, USA.
| | - Thomas S McCormick
- Department of Dermatology, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106, USA. .,The Murdough Family Center for Psoriasis, Case Western Reserve University, Cleveland, OH, USA.
| | - Nicole L Ward
- Department of Dermatology, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106, USA. .,The Murdough Family Center for Psoriasis, Case Western Reserve University, Cleveland, OH, USA.
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32
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Golden JB, Groft SG, Squeri MV, Debanne SM, Ward NL, McCormick TS, Cooper KD. Chronic Psoriatic Skin Inflammation Leads to Increased Monocyte Adhesion and Aggregation. J Immunol 2015; 195:2006-18. [PMID: 26223654 PMCID: PMC4686256 DOI: 10.4049/jimmunol.1402307] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 06/09/2015] [Indexed: 01/18/2023]
Abstract
Psoriasis patients exhibit an increased risk of death by cardiovascular disease (CVD) and have elevated levels of circulating intermediate (CD14(++)CD16(+)) monocytes. This elevation could represent evidence of monocyte dysfunction in psoriasis patients at risk for CVD, as increases in circulating CD14(++)CD16(+) monocytes are predictive of myocardial infarction and death. An elevation in the CD14(++)CD16(+) cell population has been previously reported in patients with psoriatic disease, which has been confirmed in the cohort of our human psoriasis patients. CD16 expression was induced in CD14(++)CD16(-) classical monocytes following plastic adhesion, which also elicited enhanced β2 but not β1 integrin surface expression, suggesting increased adhesive capacity. Indeed, we found that psoriasis patients have increased monocyte aggregation among circulating PBMCs, which is recapitulated in the KC-Tie2 murine model of psoriasis. Visualization of human monocyte aggregates using imaging cytometry revealed that classical (CD14(++)CD16(-)) monocytes are the predominant cell type participating in these aggregate pairs. Many of these pairs also included CD16(+) monocytes, which could account for apparent elevations of intermediate monocytes. Additionally, intermediate monocytes and monocyte aggregates were the predominant cell type to adhere to TNF-α- and IL-17A-stimulated dermal endothelium. Ingenuity Pathway Analysis demonstrated that monocyte aggregates have a distinct transcriptional profile from singlet monocytes and monocytes following plastic adhesion, suggesting that circulating monocyte responses to aggregation are not fully accounted for by homotypic adhesion, and that further factors influence their functionality.
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Affiliation(s)
- Jackelyn B Golden
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106; Department of Pathology, Case Western Reserve University, Cleveland, OH 44106
| | - Sarah G Groft
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106
| | - Michael V Squeri
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106
| | - Sara M Debanne
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH 44106
| | - Nicole L Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106; Murdough Family Center for Psoriasis, Cleveland, OH 44106; University Hospitals Case Medical Center, Cleveland, OH 44106; and
| | - Thomas S McCormick
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106; Murdough Family Center for Psoriasis, Cleveland, OH 44106; University Hospitals Case Medical Center, Cleveland, OH 44106; and
| | - Kevin D Cooper
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106; Department of Pathology, Case Western Reserve University, Cleveland, OH 44106; Murdough Family Center for Psoriasis, Cleveland, OH 44106; University Hospitals Case Medical Center, Cleveland, OH 44106; and Veterans Affairs Medical Center, Cleveland, OH 44106
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33
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Ward NL, Bhagathavula N, Johnston A, Dawes SM, Fu W, Lambert S, Dame MK, Warner RL, Gudjonsson JE, Varani J, Elder JT. Erlotinib-induced skin inflammation is IL-1 mediated in KC-Tie2 mice and human skin organ culture. J Invest Dermatol 2015; 135:910-913. [PMID: 25310408 PMCID: PMC4323891 DOI: 10.1038/jid.2014.445] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Nicole L Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA.
| | | | - Andrew Johnston
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Sean M Dawes
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Wen Fu
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sylviane Lambert
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Michael K Dame
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Roscoe L Warner
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - James Varani
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - James T Elder
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA; Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA.
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Gilbert E, Ward NL. Efficacy of botulinum neurotoxin type A for treating recalcitrant plaque psoriasis. J Drugs Dermatol 2014; 13:1407-1408. [PMID: 25607710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Use of botulinum neurotoxin A (BoNTA) for treating inflammatory skin disease is an underexplored area in medical dermatology. Preclinical mouse studies have demonstrated efficacy of abobotulinumtoxinA in improving psoriasiform skin inflammation. We describe sustained local clearance of a psoriasis plaque in a patient following a single off-label injection of intradermal abobotulinumtoxinA. BoNTA may offer a novel therapeutic approach for treating recalcitrant plaque psoriasis. Case reports and anecdotal evidence suggests that onabotulinumtoxinA may be useful for treating inverse psoriasis.1,2 We previously reported an improvement in skin phenotype in a preclinical mouse model following a single intradermal injection of abobotulinumtoxinA.3 Here we present a patient case report demonstrating efficacy of abobotulinumtoxinA in reversing plaque psoriasis.
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Lundberg KC, Fritz Y, Johnston A, Foster AM, Baliwag J, Gudjonsson JE, Schlatzer D, Gokulrangan G, McCormick TS, Chance MR, Ward NL. Proteomics of skin proteins in psoriasis: from discovery and verification in a mouse model to confirmation in humans. Mol Cell Proteomics 2014; 14:109-19. [PMID: 25351201 DOI: 10.1074/mcp.m114.042242] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Herein, we demonstrate the efficacy of an unbiased proteomics screening approach for studying protein expression changes in the KC-Tie2 psoriasis mouse model, identifying multiple protein expression changes in the mouse and validating these changes in human psoriasis. KC-Tie2 mouse skin samples (n = 3) were compared with littermate controls (n = 3) using gel-based fractionation followed by label-free protein expression analysis. 5482 peptides mapping to 1281 proteins were identified and quantitated: 105 proteins exhibited fold-changes ≥2.0 including: stefin A1 (average fold change of 342.4 and an average p = 0.0082; cystatin A, human ortholog); slc25a5 (average fold change of 46.2 and an average p = 0.0318); serpinb3b (average fold change of 35.6 and an average p = 0.0345; serpinB1, human ortholog); and kallikrein related peptidase 6 (average fold change of 4.7 and an average p = 0.2474; KLK6). We independently confirmed mouse gene expression-based increases of selected genes including serpinb3b (17.4-fold, p < 0.0001), KLK6 (9-fold, p = 0.002), stefin A1 (7.3-fold; p < 0.001), and slc25A5 (1.5-fold; p = 0.05) using qRT-PCR on a second cohort of animals (n = 8). Parallel LC/MS/MS analyses on these same samples verified protein-level increases of 1.3-fold (slc25a5; p < 0.05), 29,000-fold (stefinA1; p < 0.01), 322-fold (KLK6; p < 0.0001) between KC-Tie2 and control mice. To underscore the utility and translatability of our combined approach, we analyzed gene and protein expression levels in psoriasis patient skin and primary keratinocytes versus healthy controls. Increases in gene expression for slc25a5 (1.8-fold), cystatin A (3-fold), KLK6 (5.8-fold), and serpinB1 (76-fold; all p < 0.05) were observed between healthy controls and involved lesional psoriasis skin and primary psoriasis keratinocytes. Moreover, slc25a5, cystatin A, KLK6, and serpinB1 protein were all increased in lesional psoriasis skin compared with normal skin. These results highlight the usefulness of preclinical disease models using readily-available mouse skin and demonstrate the utility of proteomic approaches for identifying novel peptides/proteins that are differentially regulated in psoriasis that could serve as sources of auto-antigens or provide novel therapeutic targets for the development of new anti-psoriatic treatments.
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Affiliation(s)
| | - Yi Fritz
- §Department of Dermatology, Case Western Reserve University, Cleveland, Ohio 44106
| | - Andrew Johnston
- ¶Dermatology, University of Michigan, Ann Arbor, Michigan 48109
| | | | - Jaymie Baliwag
- ¶Dermatology, University of Michigan, Ann Arbor, Michigan 48109
| | | | | | | | - Thomas S McCormick
- §Department of Dermatology, Case Western Reserve University, Cleveland, Ohio 44106
| | | | - Nicole L Ward
- §Department of Dermatology, Case Western Reserve University, Cleveland, Ohio 44106;
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Foster AM, Baliwag J, Chen CS, Guzman AM, Stoll SW, Gudjonsson JE, Ward NL, Johnston A. IL-36 promotes myeloid cell infiltration, activation, and inflammatory activity in skin. J Immunol 2014; 192:6053-61. [PMID: 24829417 DOI: 10.4049/jimmunol.1301481] [Citation(s) in RCA: 219] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The IL-1 family members IL-36α (IL-1F6), IL-36β (IL-1F8), and IL-36γ (IL-1F9) and the receptor antagonist IL-36Ra (IL-1F5) constitute a novel signaling system that is poorly understood. We now show that these cytokines have profound effects on the skin immune system. Treatment of human keratinocytes with IL-36 cytokines significantly increased the expression of CXCL1, CXCL8, CCL3, CCL5, and CCL20, potent chemotactic agents for activated leukocytes, and IL-36α injected intradermally resulted in chemokine expression, leukocyte infiltration, and acanthosis of mouse skin. Blood monocytes, myeloid dendritic cells (mDC), and monocyte-derived DC (MO-DC) expressed IL-36R and responded to IL-36. In contrast, no direct effects of IL-36 on resting or activated human CD4(+) or CD8(+) T cells, or blood neutrophils, could be demonstrated. Monocytes expressed IL-1A, IL-1B, and IL-6 mRNA and IL-1β and IL-6 protein, and mDC upregulated surface expression of CD83, CD86, and HLA-DR and secretion of IL-1β and IL-6 after treatment with IL-36. Furthermore, IL-36α-treated MO-DC enhanced allogeneic CD4(+) T cell proliferation, demonstrating that IL-36 can stimulate the maturation and function of DC and drive T cell proliferation. These data indicate that IL-36 cytokines actively propagate skin inflammation via the activation of keratinocytes, APC, and, indirectly, T cells.
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Affiliation(s)
- Alexander M Foster
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109; and
| | - Jaymie Baliwag
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109; and
| | - Cynthia S Chen
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109; and
| | - Andrew M Guzman
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109; and
| | - Stefan W Stoll
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109; and
| | | | - Nicole L Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106
| | - Andrew Johnston
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109; and
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Diaconu D, Fritz Y, Dawes SM, Loyd CM, Ward NL. VEGF-Trap decreases CD4+ T cells, Th17 cytokines improving psoriasis-like skin inflammation in KC-Tie2 mice. J Dermatol Sci 2013; 72:322-5. [PMID: 24005035 PMCID: PMC3926202 DOI: 10.1016/j.jdermsci.2013.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 07/19/2013] [Accepted: 08/05/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Doina Diaconu
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Yi Fritz
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Sean M. Dawes
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Candace M. Loyd
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Nicole L. Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA
- The Murdough Family Center for Psoriasis, University Hospitals Case Medical Center, Cleveland, OH 44106, USA
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Foster AM, Baliwag J, Chen CS, Guzman AM, Stoll SW, Gudjonsson JE, Ward NL, Johnston A. 82. Cytokine 2013. [DOI: 10.1016/j.cyto.2013.06.085] [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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Abstract
The nervous and vascular systems contain many common organizational features and develop similarly in terms of anatomical patterning. During embryogenesis and in regions of the brain undergoing postnatal neurogenesis, neural stem cells and endothelial cells are found in close proximity, or within a so-called vascular niche. The similarities in patterning and proximity may reflect coordinated development based on responsiveness to similar growth factors such as vascular endothelial growth factor, semaphorin, and ephrins/Ephs: molecules involved in the development and maintenance of both the nervous and vascular systems. Despite the blatant similarities between the vascular and nervous systems, little is still known about the co-dependence and/or interactions between the two systems during development and following alterations in metabolic demand as seen during aging, exercise, and disease processes. The interactions between the two systems involving common growth factors suggest these two systems have evolved in an interconnected way.
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Affiliation(s)
- Nicole L Ward
- Department of Anatomy, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA.
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Howell SJ, Mekhail MN, Azem R, Ward NL, Kern TS. Degeneration of retinal ganglion cells in diabetic dogs and mice: relationship to glycemic control and retinal capillary degeneration. Mol Vis 2013; 19:1413-21. [PMID: 23825921 PMCID: PMC3695756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Accepted: 06/25/2013] [Indexed: 12/05/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate (i) the effect of diabetes on retinal ganglion cell death in diabetic dogs and mice, (ii) the effect of prolonged glycemic control on diabetes-induced death of retinal ganglion cells, (iii) whether retinal ganglion cell death in diabetes is associated with degeneration of retinal capillaries, and (iv) the effect of diet on diabetes-induced degeneration of retinal ganglion cells in mice. METHODS Diabetes was induced in dogs using streptozotocin, and levels of glycemic control (good, moderate, and poor) were maintained for 5 years. Diabetes was studied in two mouse models (diabetes induced in C57Bl/6J mice using streptozotocin and spontaneously diabetic Ins2Akita mice). Retinal ganglion cell death was investigated by counting the number of axons from the ganglion cells in the optic nerve and with terminal transferase deoxyuridine triphosphate nick-end labeling and annexin V staining in mice. RESULTS As reported previously, the development and severity of vascular lesions of diabetic retinopathy in diabetic dogs were strongly associated with glycemic control. Loss of retinal ganglion cells was extensive in dogs kept in poor glycemic control, and was essentially prevented in diabetic dogs kept in good glycemic control for the 5 years of study. In contrast, "moderate" glycemic control (intermediate between poor and good glycemic control) caused a significant increase in vascular pathology, but did not cause loss of retinal axons in the optic nerve. Using this validated optic nerve axon counting method, the two mouse models of diabetic retinopathy were studied to assess ganglion cell death. Despite 10 months of diabetes (a duration that has been shown to cause retinal capillary degeneration in both models), neither mouse model showed loss of optic nerve axons (thus suggesting no loss of retinal ganglion cells). Likewise, other parameters of cell death (terminal transferase deoxyuridine triphosphate nick-end labeling and annexin V labeling) did not suggest ganglion cell death in diabetic C57Bl/6J mice, and ganglion cell death was not increased by a different commercial diet. CONCLUSIONS Retinal ganglion cell death in diabetic dogs is significantly inhibited by good or even moderate glycemic control. The finding that diabetic dogs in moderate glycemic control had appreciable vascular disease without apparent retinal ganglion cell degeneration does not support the postulate that neural degeneration causes the vascular pathology. Studies of diabetic mice in our colony again fail to find evidence of ganglion cell death due to prolonged diabetes in this species.
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Affiliation(s)
- Scott J. Howell
- Department of Opthamology, Case Western Reserve University, Cleveland, OH
| | - Mena N. Mekhail
- Department of Opthamology, Case Western Reserve University, Cleveland, OH
| | - Rami Azem
- Department of Dermatology and Neurosciences, Case Western Reserve University, Cleveland, OH
| | - Nicole L. Ward
- Department of Dermatology and Neurosciences, Case Western Reserve University, Cleveland, OH
| | - Timothy S. Kern
- Department of Opthamology, Case Western Reserve University, Cleveland, OH,Department of Medicine and Pharmacology, School of Medicine, Case Western Reserve University, Cleveland, OH
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Johnston A, Fritz Y, Dawes SM, Diaconu D, Al-Attar PM, Guzman AM, Chen CS, Fu W, Gudjonsson JE, McCormick TS, Ward NL. Keratinocyte overexpression of IL-17C promotes psoriasiform skin inflammation. J Immunol 2013; 190:2252-62. [PMID: 23359500 DOI: 10.4049/jimmunol.1201505] [Citation(s) in RCA: 217] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
IL-17C is a functionally distinct member of the IL-17 family that binds IL-17 receptor E/A to promote innate defense in epithelial cells and regulate Th17 cell differentiation. We demonstrate that IL-17C (not IL-17A) is the most abundant IL-17 isoform in lesional psoriasis skin (1058 versus 8 pg/ml; p < 0.006) and localizes to keratinocytes (KCs), endothelial cells (ECs), and leukocytes. ECs stimulated with IL-17C produce increased TNF-α and KCs stimulated with IL-17C/TNF-α produce similar inflammatory gene response patterns as those elicited by IL-17A/TNF-α, including increases in IL-17C, TNF-α, IL-8, IL-1α/β, IL-1F5, IL-1F9, IL-6, IL-19, CCL20, S100A7/A8/A9, DEFB4, lipocalin 2, and peptidase inhibitor 3 (p < 0.05), indicating a positive proinflammatory feedback loop between the epidermis and ECs. Psoriasis patients treated with etanercept rapidly decrease cutaneous IL-17C levels, suggesting IL-17C/TNF-α-mediated inflammatory signaling is critical for psoriasis pathogenesis. Mice genetically engineered to overexpress IL-17C in KCs develop well-demarcated areas of erythematous, flakey involved skin adjacent to areas of normal-appearing uninvolved skin despite increased IL-17C expression in both areas (p < 0.05). Uninvolved skin displays increased angiogenesis and elevated S100A8/A9 expression (p < 0.05) but no epidermal hyperplasia, whereas involved skin exhibits robust epidermal hyperplasia, increased angiogenesis and leukocyte infiltration, and upregulated TNF-α, IL-1α/β, IL-17A/F, IL-23p19, vascular endothelial growth factor, IL-6, and CCL20 (p < 0.05), suggesting that IL-17C, when coupled with other proinflammatory signals, initiates the development of psoriasiform dermatitis. This skin phenotype was significantly improved following 8 wk of TNF-α inhibition. These findings identify a role for IL-17C in skin inflammation and suggest a pathogenic function for the elevated IL-17C observed in lesional psoriasis skin.
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Affiliation(s)
- Andrew Johnston
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109, USA
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Ward NL, Pieretti A, Dowd SE, Cox SB, Goldstein AM. Intestinal aganglionosis is associated with early and sustained disruption of the colonic microbiome. Neurogastroenterol Motil 2012; 24:874-e400. [PMID: 22626027 DOI: 10.1111/j.1365-2982.2012.01937.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [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: 02/06/2023]
Abstract
BACKGROUND Congenital aganglionosis (Hirschsprung's disease) results in colonic dysmotility and a risk for Hirschsprung's-associated enterocolitis (HAEC), whose cause is unknown. We hypothesized that aganglionosis leads to microbiome changes that may contribute to HAEC risk. METHODS Colon and fecal samples were collected from endothelin receptor B-null (Ednrb(-/-) ) mice, an established model of colorectal aganglionosis, at postnatal day 7 (P7), P20, and P24. We determined microbiome composition by 16S ribosomal RNA gene pyrosequencing and fecal metabolite profile by nuclear magnetic resonance spectroscopy. KEY RESULTS Wild-type (WT) mice exhibited increasing species diversity with age, with mutant mice possessing even greater diversity. WT and mutant microbiomes, both fecal and colonic, significantly segregated by principal coordinates analysis based on species composition at all ages examined. Importantly, mutant mice contained more Bacteroidetes and less Firmicutes than WT, with additional genus- and species-level differences observed. Notably, mutant P7 colon was dominated by coagulase-negative Staphylococcus species, which were rare in WT. Mutant fecal metabolite profiles also differed, particularly in the abundance of formate, a short-chain fatty acid product of microbial fermentation. CONCLUSIONS & INFERENCES Colorectal aganglionosis is associated with early and sustained disruption of the normal colonic and fecal microbiome, supporting the enteric nervous system as a determinant of microbiome composition. Furthermore, the differences observed suggest a potential contributory role for the microbiome in the etiology of HAEC. These findings provide a basis for further studies to determine the causative role of specific bacterial communities in HAEC and the potential to restore the normal microbiome in Hirschsprung's disease.
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Affiliation(s)
- N L Ward
- Department of Molecular Biology, University of Wyoming, Laramie, WY, USA
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Wang Y, Gao H, Loyd CM, Fu W, Diaconu D, Liu S, Cooper KD, McCormick TS, Simon DI, Ward NL. Chronic skin-specific inflammation promotes vascular inflammation and thrombosis. J Invest Dermatol 2012; 132:2067-75. [PMID: 22572815 PMCID: PMC3402600 DOI: 10.1038/jid.2012.112] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [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] [Indexed: 11/09/2022]
Abstract
Patients with psoriasis have systemic and vascular inflammation and are at increased risk for myocardial infarction, stroke, and cardiovascular death. However, the underlying mechanism(s) mediating the link between psoriasis and vascular disease is incompletely defined. This study sought to determine whether chronic skin-specific inflammation has the capacity to promote vascular inflammation and thrombosis. Using the KC-Tie2 doxycycline-repressible (Dox-off) murine model of psoriasiform skin disease, spontaneous aortic root inflammation was observed in 33% of KC-Tie2 compared with 0% of control mice by 12 months of age (P=0.04) and was characterized by the accumulation of macrophages, T lymphocytes, and B lymphocytes, as well as by reduced collagen content and increased elastin breaks. Importantly, aortic inflammation was preceded by increases in serum tumor necrosis factor-α, IL-17A, vascular endothelial growth factor, IL-12, monocyte chemotactic protein-1, and S100A8/A9, as well as splenic and circulating CD11b(+)Ly-6C(hi) pro-inflammatory monocytes. Doxycycline treatment of old mice with severe skin disease eliminated skin inflammation and the presence of aortic root lesion in 1-year-old KC-Tie2 animals. Given the bidirectional link between inflammation and thrombosis, arterial thrombosis was assessed in KC-Tie2 and control mice; mean time to occlusive thrombus formation was shortened by 64% (P=0.002) in KC-Tie2 animals; and doxycycline treatment returned thrombosis clotting times to that of control mice (P=0.69). These findings demonstrate that sustained skin-specific inflammation promotes aortic root inflammation and thrombosis and suggest that aggressive treatment of skin inflammation may attenuate pro-inflammatory and pro-thrombotic pathways that produce cardiovascular disease in psoriasis patients.
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Affiliation(s)
- Yunmei Wang
- Department of Medicine, Division of Cardiovascular Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- The Harrington-McLaughlin Heart & Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH 44106, USA
| | - Huiyun Gao
- Department of Medicine, Division of Cardiovascular Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- The Harrington-McLaughlin Heart & Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH 44106, USA
| | - Candace M. Loyd
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Wen Fu
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Doina Diaconu
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Shijian Liu
- Department of Medicine, Division of Cardiovascular Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- The Harrington-McLaughlin Heart & Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH 44106, USA
| | - Kevin D. Cooper
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA
- The Murdough Family Center for Psoriasis, University Hospitals Case Medical Center, Cleveland, OH 44106, USA
| | - Thomas S. McCormick
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA
- The Murdough Family Center for Psoriasis, University Hospitals Case Medical Center, Cleveland, OH 44106, USA
| | - Daniel I. Simon
- Department of Medicine, Division of Cardiovascular Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- The Harrington-McLaughlin Heart & Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH 44106, USA
| | - Nicole L. Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA
- The Murdough Family Center for Psoriasis, University Hospitals Case Medical Center, Cleveland, OH 44106, USA
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Loyd CM, Diaconu D, Fu W, Adams GN, Brandt E, Knutsen DA, Wolfram JA, McCormick TS, Ward NL. Transgenic overexpression of keratinocyte-specific VEGF and Ang1 in combination promotes wound healing under nondiabetic but not diabetic conditions. Int J Clin Exp Pathol 2012; 5:1-11. [PMID: 22295141 PMCID: PMC3267480] [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] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 12/14/2011] [Indexed: 05/31/2023]
Abstract
VEGF and Angiopoietin (Ang)1 are growth factors that independently improve wound healing outcomes. Using a tet-repressible mouse model coupled with streptozotocin-induced diabetes, we examined wound healing in diabetic and nondiabetic mice engineered to overexpress keratinocyte-specific (K5) VEGF, Ang1 or Ang1-VEGF combined. All nondiabetic mice healed more rapidly than their diabetic counterparts; however overexpression of VEGF, Ang1 or the combination failed to improve wound closure under diabetic conditions. Conversely, under nondiabetic conditions, combining Ang1 and VEGF resulted in rapid wound closure. Molecular analyses of diabetic and nondiabetic K5-Ang1-VEGF skin revealed no differences in VEGF expression but an 80% decrease in Ang1 under diabetic conditions, suggesting an integral role for Ang1. Nondiabetic K5-Ang1 mice healed more quickly and had significant increases in granulation tissue and a 60% decrease in re-epithelialization 7 days after wounding. Furthermore, Ang1 stimulated primary mouse keratinocytes showed significantly less migration into a wound bed in an in vitro wound healing bioassay and had decreased pMAPK, pNFκB, pAkt, and pStat3 signaling. These data suggest that combined Ang1-VEGF overexpression cannot overcome diabetes-induced delays in wound healing but is efficacious under nondiabetic conditions possibly via Ang1-mediated delays in re-epithelialization and enhancement of granulation tissue formation, thereby allowing more rapid secondary intention healing.
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Affiliation(s)
- Candace M Loyd
- Department of Dermatology, Case Western Reserve University Cleveland, OH 44106, USA
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Silver R, Helms A, Fu W, Wang H, Diaconu D, Loyd CM, Rollins AM, Ward NL. Using optical coherence tomography for the longitudinal non-invasive evaluation of epidermal thickness in a murine model of chronic skin inflammation. Skin Res Technol 2011; 18:225-31. [PMID: 22092854 DOI: 10.1111/j.1600-0846.2011.00558.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Non-invasive methods are desirable for longitudinal studies examining drug efficacy and disease resolution defined as decreases in epidermal thickness in mouse models of psoriasiform skin disease. This would eliminate the need for either sacrificing animals or collecting serial skin biopsies to evaluate changes in disease progression during an individual study. The quantitation of epidermal thickness using optical coherence tomography (OCT) provides an alternative to traditional histology techniques. METHODS Using the KC-Tie2 doxycycline-repressible psoriasiform skin disease mouse model, OCT imaging was completed on diseased back skin of adult KC-Tie2 (n = 3-4) and control (n = 3-4) mice, followed immediately by the surgical excision of the same region for histologic analyses. Animals were then treated with doxycycline to suppress transgene expression and to reverse the skin disease and additional OCT images and tissues were collected 2 and 4 weeks following. Epidermal thickness was measured using OCT and histology. RESULTS Optical coherence tomography and histology both demonstrated that KC-Tie2 mice had significantly thicker epidermis (~4-fold; P < 0.0001) than control animals. By 2 weeks following gene repression, decreases in epidermal thickness were observed using both OCT and histology, and were sustained through 4 weeks. Correlation analyses between histology and OCT values at all time points and in all animals revealed high significance (R(2) = 0.78); with correlation being highest in KC-Tie2 mice (R(2) = 0.92) compared to control animals (R(2) = 0.16). CONCLUSION Non-invasive OCT imaging provided similar values as those collected using standard histologic measures in thick skin of KC-Tie2 mice but became less reliable in thinner control mouse skin, possibly reflecting limitations in resolution of OCT. Future advances in resolution of OCT may improve and allow greater accuracy of epidermal thickness measurements.
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Affiliation(s)
- Rachel Silver
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio 44106, USA
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Ostrowski SM, Belkadi A, Loyd CM, Diaconu D, Ward NL. Cutaneous denervation of psoriasiform mouse skin improves acanthosis and inflammation in a sensory neuropeptide-dependent manner. J Invest Dermatol 2011; 131:1530-8. [PMID: 21471984 PMCID: PMC3116081 DOI: 10.1038/jid.2011.60] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Nervous system involvement in psoriasis pathogenesis is supported by increases in nerve fiber numbers and neuropeptides in psoriatic skin and by reports detailing spontaneous plaque remission following nerve injury. Using the KC-Tie2 psoriasiform mouse model, we investigated the mechanisms by which nerve injury leads to inflammatory skin disease remission. Cutaneous nerves innervating dorsal skin of KC-Tie2 animals were surgically axotomized and beginning 1 day after denervation, CD11c(+) cell numbers decreased by 40% followed by a 30% improvement in acanthosis at 7 days and a 30% decrease in CD4(+) T-cell numbers by 10 days. Restoration of substance P (SP) signaling in denervated KC-Tie2 skin prevented decreases in CD11c(+) and CD4(+) cells, but had no effect on acanthosis; restoration of calcitonin gene-related peptide (CGRP) signaling reversed the improvement in acanthosis and prevented denervated-mediated decreases in CD4(+) cells. Under innervated conditions, small-molecule inhibition of SP in KC-Tie2 animals resulted in similar decreases to those observed following surgical denervation for cutaneous CD11c(+) and CD4(+) cell numbers; whereas small-molecule inhibition of CGRP resulted in significant reductions in CD4(+) cell numbers and acanthosis. These data demonstrate that sensory nerve-derived peptides mediate psoriasiform dendritic cell and T-cell infiltration and acanthosis and introduce targeting nerve-immunocyte/KC interactions as potential psoriasis therapeutic treatment strategies.
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Affiliation(s)
- Stephen M Ostrowski
- Department of Neurosciences, Case Western Reserve University, Cleveland, Ohio, USA
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Ward NL, Loyd CM, Wolfram JA, Diaconu D, Michaels CM, McCormick TS. Depletion of antigen-presenting cells by clodronate liposomes reverses the psoriatic skin phenotype in KC-Tie2 mice. Br J Dermatol 2011; 164:750-8. [PMID: 21070202 DOI: 10.1111/j.1365-2133.2010.10129.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is ongoing debate regarding the initiation of psoriatic plaque as primarily arising from an anomaly in epidermal keratinocytes (KCs) or from abnormalities in immunocytes that secondarily activate otherwise normal KCs. In mice engineered to overexpress the angiopoietin receptor Tie2 in KCs, skin spontaneously develops the characteristic clinical, histological and immune cell phenotypes of psoriasis which can be reversed with either transgene repression or ciclosporin administration, suggesting key roles for both KCs and T cells in mediating the skin disease in this murine model. OBJECTIVES To determine if antigen-presenting cells (APCs) and macrophages alone are sufficient to sustain psoriasiform inflammation in the KC-Tie2 murine model of psoriasis. METHODS Clodronate liposomes were intradermally injected into involved dorsal skin of KC-Tie2 or control animals once a week for 6weeks and acanthosis, angiogenesis, immune cell infiltration and cytokine production were quantitated using immunohistochemistry and interactive image analyses, enzyme-linked immunosorbent assay (ELISAs) and quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS Clodronate liposome injection eliminated CD11c+, F4/80+ and CD11b+ cells in the skin and returned CD8+ T-cell numbers to control mouse levels. APC depletion in KC-Tie2 mouse skin resulted in resolution of the acanthotic skin phenotype, decreased dermal angiogenesis, and a return to control mouse levels for interleukin (IL)-1α, IL-6, IL-23 and tumour necrosis factor (TNF)-α expression and modest reductions in interferon-γ and IL-17. CONCLUSIONS These findings suggest a critical role for APCs and myeloid cell-derived IL-23 and TNF-α and underscore the importance of Th1 and Th17 T cells in maintaining the psoriasiform skin phenotype in the KC-Tie2 mouse model.
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Affiliation(s)
- N L Ward
- Departments of Dermatology, Neurosciences, and Pathology, Case Western Reserve University, BRB519, 10900 Euclid Ave, Cleveland, OH 44106, USA.
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Swindell WR, Johnston A, Carbajal S, Han G, Wohn C, Lu J, Xing X, Nair RP, Voorhees JJ, Elder JT, Wang XJ, Sano S, Prens EP, DiGiovanni J, Pittelkow MR, Ward NL, Gudjonsson JE. Genome-wide expression profiling of five mouse models identifies similarities and differences with human psoriasis. PLoS One 2011; 6:e18266. [PMID: 21483750 PMCID: PMC3070727 DOI: 10.1371/journal.pone.0018266] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 02/23/2011] [Indexed: 12/05/2022] Open
Abstract
Development of a suitable mouse model would facilitate the investigation of pathomechanisms underlying human psoriasis and would also assist in development of therapeutic treatments. However, while many psoriasis mouse models have been proposed, no single model recapitulates all features of the human disease, and standardized validation criteria for psoriasis mouse models have not been widely applied. In this study, whole-genome transcriptional profiling is used to compare gene expression patterns manifested by human psoriatic skin lesions with those that occur in five psoriasis mouse models (K5-Tie2, imiquimod, K14-AREG, K5-Stat3C and K5-TGFbeta1). While the cutaneous gene expression profiles associated with each mouse phenotype exhibited statistically significant similarity to the expression profile of psoriasis in humans, each model displayed distinctive sets of similarities and differences in comparison to human psoriasis. For all five models, correspondence to the human disease was strong with respect to genes involved in epidermal development and keratinization. Immune and inflammation-associated gene expression, in contrast, was more variable between models as compared to the human disease. These findings support the value of all five models as research tools, each with identifiable areas of convergence to and divergence from the human disease. Additionally, the approach used in this paper provides an objective and quantitative method for evaluation of proposed mouse models of psoriasis, which can be strategically applied in future studies to score strengths of mouse phenotypes relative to specific aspects of human psoriasis.
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Affiliation(s)
- William R. Swindell
- Department of Genetics, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail: (WRS); (JEG)
| | - Andrew Johnston
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Steve Carbajal
- Division of Pharmacology & Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, Texas, United States of America
| | - Gangwen Han
- Departments of Pathology, Otolaryngology and Dermatology, University of Colorado, Denver, Colorado, United States of America
| | - Christian Wohn
- Departments of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Jun Lu
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Xianying Xing
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Rajan P. Nair
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - John J. Voorhees
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - James T. Elder
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, United States of America
| | - Xiao-Jing Wang
- Departments of Pathology, Otolaryngology and Dermatology, University of Colorado, Denver, Colorado, United States of America
| | - Shigetoshi Sano
- Department of Dermatology, Kochi Medical School, Kochi University, Okocho, Nankoku, Japan
| | - Errol P. Prens
- Departments of Dermatology and Rheumatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - John DiGiovanni
- Department of Nutritional Sciences, Dell Pediatric Research Institute, The University of Texas at Austin, Austin, Texas, United States of America
- Division of Pharmacology & Toxicology, Dell Pediatric Research Institute, The University of Texas at Austin, Austin, Texas, United States of America
| | - Mark R. Pittelkow
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Nicole L. Ward
- Department of Dermatology and the Murdough Family Center for Psoriasis, Case Western Reserve University and University Hospitals, Case Medical Center, Cleveland, Ohio, United States of America
| | - Johann E. Gudjonsson
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- * E-mail: (WRS); (JEG)
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Johnston A, Xing X, Guzman AM, Riblett M, Loyd CM, Ward NL, Wohn C, Prens EP, Wang F, Maier LE, Kang S, Voorhees JJ, Elder JT, Gudjonsson JE. IL-1F5, -F6, -F8, and -F9: a novel IL-1 family signaling system that is active in psoriasis and promotes keratinocyte antimicrobial peptide expression. J Immunol 2011; 186:2613-22. [PMID: 21242515 DOI: 10.4049/jimmunol.1003162] [Citation(s) in RCA: 236] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
IL-1F6, IL-1F8, and IL-1F9 and the IL-1R6(RP2) receptor antagonist IL-1F5 constitute a novel IL-1 signaling system that is poorly characterized in skin. To further characterize these cytokines in healthy and inflamed skin, we studied their expression in healthy control, uninvolved psoriasis, and psoriasis plaque skin using quantitative RT-PCR and immunohistochemistry. Expression of IL-1F5, -1F6, -1F8, and -1F9 were increased 2 to 3 orders of magnitude in psoriasis plaque versus uninvolved psoriasis skin, which was supported immunohistologically. Moreover, treatment of psoriasis with etanercept led to significantly decreased IL-1F5, -1F6, -1F8, and -1F9 mRNAs, concomitant with clinical improvement. Similarly increased expression of IL-1F5, -1F6, -1F8, and -1F9 was seen in the involved skin of two mouse models of psoriasis. Suggestive of their importance in inflamed epithelia, IL-1α and TNF-α induced IL-1F5, -1F6, -1F8, and -1F9 transcript expression by normal human keratinocytes. Microarray analysis revealed that these cytokines induce the expression of antimicrobial peptides and matrix metalloproteinases by reconstituted human epidermis. In particular, IL-1F8 increased mRNA expression of human β-defensin (HBD)-2, HBD-3, and CAMP and protein secretion of HBD-2 and HBD-3. Collectively, our data suggest important roles for these novel cytokines in inflammatory skin diseases and identify these peptides as potential targets for antipsoriatic therapies.
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Affiliation(s)
- Andrew Johnston
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109, USA
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Ward NL, Hatala DA, Wolfram JA, Knutsen DA, Loyd CM. Cutaneous manipulation of vascular growth factors leads to alterations in immunocytes, blood vessels and nerves: Evidence for a cutaneous neurovascular unit. J Dermatol Sci 2010; 61:14-22. [PMID: 21129919 DOI: 10.1016/j.jdermsci.2010.11.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 10/26/2010] [Accepted: 11/08/2010] [Indexed: 01/11/2023]
Abstract
BACKGROUND Skin cells produce soluble factors which influence keratinocyte proliferation, angiogenesis, nerve innervation and immunocyte response. OBJECTIVE To test the hypothesis that epidermal-dermal interactions influence neural outgrowth, vascular survival, immunocyte recruitment and keratinocyte proliferation. METHODS We genetically manipulated the epidermis to express excess vascular endothelial growth factor (VEGF) and/or angiopoietin-1 (Ang1) and then examined the epidermal and dermal phenotypes. We compared these findings with those occurring following overexpression of the Ang1 receptor Tie2 in endothelial cells or keratinocytes. RESULTS Keratinocyte-overexpression of Ang1 resulted in increased epidermal thickness compared to control littermates. Keratinocyte-specific overexpression of Ang1 or VEGF increased dermal angiogenesis compared to control animals and combined Ang1-VEGF lead to further increases. Cutaneous leukocyte examination revealed increases in CD4(+) T cell infiltration in mice with keratinocyte-specific overexpression of Ang1, VEGF and Ang1-VEGF combined; in contrast only keratinocyte-specific Ang1 overexpression increased cutaneous F4/80(+) macrophage numbers. Interestingly, combined keratinocyte-derived Ang1-VEGF overexpression reduced significantly the number of F4/80(+) and Cd11c(+) cells compared to mice overexpressing epidermal Ang1 alone. Endothelial cell-specific Tie2 overexpression increased dermal angiogenesis but failed to influence the epidermal and immune cell phenotypes. Keratinocyte-specific Tie2 expressing mice had the highest levels of CD4(+), CD8(+) and CD11c(+) cell numbers and acanthosis compared to all animals. Finally, increases in the number of cutaneous nerves were found in all transgenic mice compared to littermate controls. CONCLUSION These findings demonstrate that change to one system (vascular or epidermal) results in change to other cutaneous systems and suggest that individual molecules can exert effects on multiple systems.
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Affiliation(s)
- Nicole L Ward
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA.
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