Controversial Issues of Immunopathogenesis of Psoriasis and Atopic Dermatitis

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Psoriasis (PsO) and atopic dermatitis (AD have much in common: both diseases are widespread, characterized by a chronic relapsing course, primarily affect the skin and lead to a quality reduction of life of patients, regardless of their age. The pathogenesis of these two dermatoses, which are the most common in the practice of a pediatric dermatologist, is quite different. PsO is a chronic inflammatory skin disease, the pathogenesis of which is associated with the involvement of the Th1 pathway: Th17 cells and the IL-23/IL-17 axis. AD, in turn, is usually associated with high levels of IL-4, IL-5, IL-13, IL-31 and IFN-γ produced by activated T-helper 2 (Th2) cells. The clinical symptoms and immunopathological responses of these two skin conditions tend to differ. However, patients with PsO may sometimes present with a skin rash resembling AD combined with intense itching and laboratory increase in immunoglobulin E (IgE) which may indicate the need to change the paradigm of dominance of only one type of T-inflammation in patients with these diseases.

Full Text

Restricted Access

About the authors

Eduard T. Ambarchian

Pediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery

Author for correspondence.
Email: edo_amb@mail.ru
ORCID iD: 0000-0002-8232-8936

MD, PhD

Russian Federation, Moscow

Leila S. Namazova-Baranova

Pediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University (Pirogov Medical University)

Email: leyla.s.namazova@gmail.com
ORCID iD: 0000-0002-2209-7531

MD, PhD, Professor, Academician of the RAS

Russian Federation, Moscow; Moscow

Anastasiia D. Kuzminova

Pediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery

Email: kuzminova_derma@mail.ru
ORCID iD: 0000-0003-3003-9398

MD

Russian Federation, Moscow

Vladislav V. Ivanchikov

Pediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery

Email: awdawd22@yandex.ru
ORCID iD: 0000-0002-6760-3119

MD

Russian Federation, Moscow

Elena A. Vishneva

Pediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University (Pirogov Medical University)

Email: vishneva.e@yandex.ru
ORCID iD: 0000-0001-7398-0562

MD, PhD, Professor of the RAS

Russian Federation, Moscow; Moscow

Marika I. Ivardava

Pediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery

Email: makussa@mail.ru
ORCID iD: 0000-0002-4669-9510

MD, Phd

Russian Federation, Moscow

Kamilla E. Efendiyeva

Pediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University (Pirogov Medical University)

Email: kamillaef@inbox.ru
ORCID iD: 0000-0003-0317-2425

MD, PhD, Associate Professor

Russian Federation, Moscow; Moscow

Juliya G. Levina

Pediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University (Pirogov Medical University)

Email: julia.levina@mail.ru
ORCID iD: 0000-0002-2460-7718

MD, PhD, Associate Professor

Russian Federation, Moscow; Moscow

References

  1. Christophers E, Henseler T. Contrasting disease patterns in psoriasis and atopic dermatitis. Arch Dermatol Res. 1987;279(Suppl):S48–51. doi: https://doi.org/10.1007/BF00585919
  2. Garofalo L, Pisani V, Mazzotta F, et al. Psoriasis in atopic children. Acta Derm Venereol Suppl (Stockh). 1989;146:63–65.
  3. Benn CS, Bendixen M, Krause TG, et al. Questionable coexistence of TH1- and TH2-related diseases. J Allergy Clin Immunol. 2002;110(2):328–329. doi: https://doi.org/10.1067/mai.2002.126480
  4. Lowes MA, Kikuchi T, Fuentes-Duculan J, et al. Psoriasis vulgaris lesions contain discrete populations of Th1 and Th17 T cells. J Invest Dermatol. 2008;128(5):1207–1211. doi: https://doi.org/10.1038/sj.jid.5701213
  5. Li LF, Sujan SA, Yang H, et al. Serum immunoglobulins in psoriatic erythroderma. Clin Exp Dermatol. 2005;30(2):125–127. doi: https://doi.org/10.1111/j.1365-2230.2004.01717.x
  6. Ovcina-Kurtovic N, Kasumagic-Halilovic E. Serum levels of total immunoglobulin E in patients with psoriasis: relationship with clinical type of disease. Med Arh. 2010;64(1):28–29.
  7. Maliyar K, Sibbald C, Pope E, et al. Diagnosis and Management of Atopic Dermatitis. Adv Skin Wound Care. 2018;31(12):538–550. doi: https://doi.org/10.1097/01.asw.0000547414.38888.8d
  8. Мурашкин Н.Н., Намазова-Баранова Л.С., Опрятин Л.А., и др. Биологическая терапия среднетяжелых и тяжелых форм атопического дерматита в детском возрасте // Вопросы современной педиатрии. — 2020. — Т. 19. — № 6. — С. 432–443. [Murashkin NN, Namazova-Baranova LS, Opryatin LA, et al. Biologic Therapy of Moderate and Severe Forms of Atopic Dermatitis in Children. Voprosy sovremennoi pediatrii — Current Pediatrics. 2020;19(6):432–443. (In Russ.)] doi: https://doi.org/10.15690/vsp.v19i6.2145
  9. McGirt LY, Beck LA. Innate immune defects in atopic dermatitis. J Allergy Clin Immunol. 2006;118(1):202–208. doi: https://doi.org/10.1016/j.jaci.2006.04.033
  10. Bao L, Zhang H, Chan LS. The involvement of the JAK-STAT signaling pathway in chronic inflammatory skin disease atopic dermatitis. JAKSTAT. 2013;2(3):e24137. doi: https://doi.org/10.4161/jkst.24137
  11. Lundin A, Fredens K, Michaëlsson G, et al. The eosinophil granulocyte in psoriasis. Br J Dermatol. 1990;122(2):181–193. doi: https://doi.org/10.1111/j.1365-2133.1990.tb08264.x
  12. Guttman-Yassky E, Suárez-Fariñas M, Chiricozzi A, et al. Broad defects in epidermal cornification in atopic dermatitis identified through genomic analysis. J Allergy Clin Immunol. 2009;124(6):1235–1244.e58. doi: https://doi.org/10.1016/j.jaci.2009.09.031
  13. Elias PM, Hatano Y, Williams ML. Basis for the barrier abnormality in atopic dermatitis: outside-inside-outside pathogenic mechanisms. J Allergy Clin Immunol. 2008;121(6):1337–1343. doi: https://doi.org/10.1016/j.jaci.2008.01.022
  14. Proksch E, Brandner JM, Jensen JM. The skin: an indispensable barrier. Exp Dermatol. 2008;17(12):1063–1072. doi: https://doi.org/10.1111/j.1600-0625.2008.00786.x
  15. Moy AP, Murali M, Kroshinsky D, et al. Immunologic Overlap of Helper T-Cell Subtypes 17 and 22 in Erythrodermic Psoriasis and Atopic Dermatitis. JAMA Dermatol. 2015;151(7):753–760. doi: https://doi.org/10.1001/jamadermatol.2015.2
  16. Kero J, Gissler M, Hemminki E, et al. Could TH1 and TH2 diseases coexist? Evaluation of asthma incidence in children with coeliac disease, type 1 diabetes, or rheumatoid arthritis: A register study. J Allergy Clin Immunol. 2001;108(5):781–783. doi: https://doi.org/10.1067/mai.2001.119557
  17. Joel MZ, Fan R, Damsky W, e al. Psoriasis associated with asthma and allergic rhinitis: a US-based cross-sectional study using the All of US Research Program. Arch Dermatol Res. 2023;315(6):1823–1826. doi: https://doi.org/10.1007/s00403-023-02539-z
  18. Chowdhury BA. Comparative efficacy of levalbuterol and racemic albuterol in the treatment of asthma. J Allergy Clin Immunol. 2002;110(2):324. doi: https://doi.org/10.1067/mai.2002.126374
  19. Asmus MJ, Hendeles L, Weinberger M, et al. Levalbuterol has not been established to have therapeutic advantage over racemic albuterol. J Allergy Clin Immunol. 2002;110(2):325. doi: https://doi.org/10.1067/mai.2002.126375
  20. Schmuth M, Blunder S, Dubrac S, et al. Epidermal barrier in hereditary ichthyoses, atopic dermatitis, and psoriasis. J Dtsch Dermatol Ges. 2015;13(11):1119–1123. doi: https://doi.org/10.1111/ddg.12827
  21. Ortiz-Lopez LI, Choudhary V, Bollag WB. Updated Perspectives on Keratinocytes and Psoriasis: Keratinocytes are More Than Innocent Bystanders. Psoriasis (Auckl). 2022;12:73–87. doi: https://doi.org/10.2147/PTT.S327310
  22. Łuczaj W, Wroński A, Domingues P, et al. Lipidomic analysis reveals specific differences between fibroblast and keratinocyte ceramide profile of patients with psoriasis vulgaris. Molecules. 2020;25(3):630. doi: https://doi.org/10.3390/molecules25030630
  23. Барилло А.А., Смирнова С.В. Персонифицированный подход к диагностике и лечению больных псориазом // Российский иммунологический журнал. — 2021. — Т. 24. — № 4. — С. 455–460. [Barilo AA, Smirnova SV. Personalized approach to diagnostics and therapy of patients with psoriasis. Russian Journal of Immunology / Rossiyskiy Immunologicheskiy Zhurnal. 2021;24(4):455–460. (In Russ.)] doi: https://doi.org/10.46235/1028-7221-1074-PAT
  24. Guttman-Yassky E, Krueger JG. Atopic dermatitis and psoriasis: two different immune diseases or one spectrum? Curr Opin Immunol. 2017;48:68–73. doi: https://doi.org/10.1016/j.coi.2017.08.008
  25. Ünal ES, Gül Ü, Dursun AB, et al. Prediction of atopy via total immunoglobulin E levels and skin prick tests in patients with psoriasis. Turk J Med Sci. 2017;47(2):577–582. doi: https://doi.org/10.3906/sag-1601-133
  26. Szegedi A, Aleksza M, Gonda A, et al. Elevated rate of Thelper1 (T(H)1) lymphocytes and serum IFN-gamma levels in psoriatic patients. Immunol Lett. 2003;86(3):277–280. doi: https://doi.org/10.1016/s0165-2478(03)00025-7
  27. Palmer CN, Irvine AD, Terron-Kwiatkowski A, et al. Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet. 2006;38(4):441–446. doi: https://doi.org/10.1038/ng1767
  28. Hollox EJ, Huffmeier U, Zeeuwen PL, et al. Psoriasis is associated with increased beta-defensin genomic copy number. Nat Genet. 2008;40(1):23–25. doi: https://doi.org/10.1038/ng.2007.48
  29. Cookson WO, Ubhi B, Lawrence R, et al. Genetic linkage of childhood atopic dermatitis to psoriasis susceptibility loci. Nat Genet. 2001;27(4):372–373. doi: https://doi.org/10.1038/86867
  30. Vinnik T, Kreinin A, Abildinova G, et al. Biological Sex and IgE Sensitization Influence Severity of Depression and Cortisol Levels in Atopic Dermatitis. Dermatology. 2020;236(4):336–344. doi: https://doi.org/10.1159/000504388
  31. Kasumagic-Halilovic E. Total Serum Immunoglobulin E Levels in Patients with Psoriasis. Mater Sociomed. 2020;32(2):105–107. doi: https://doi.org/10.5455/msm.2020.32.105-107
  32. Lotfi RA, El-Sayed MH, El-Gabry SH. Assessment of serum levels of IgE in psoriasis. Journal of the Egyptian Womenʼs Dermatologic Society. 2015;12(1):63–67. doi: https://doi.org/10.1097/01.ewx.0000450678.40084.23
  33. Chen C, Zheng X, Duan Q, et al. High Serum IgE Concentration in Patients with Psoriasis. Clin Res Dermatol Open Access. 2017;4(4):1–4. doi: https://doi.org/10.15226/2378-1726/4/4/00163
  34. Hasan T, Jansén CT. Erythroderma: A follow-up of fifty cases. J Am Acad Dermatol. 1983;8(6):836–840. doi: https://doi.org/10.1016/s0190-9622(83)80013-9
  35. Horiuchi Y. Senile erythroderma with hyper IgE: an independent and novel disease form. Asia Pac Allergy. 2022;12(2):e12. doi: https://doi.org/10.5415/apallergy.2022.12.e12
  36. Lajevardi V, Ghiasi M, Goodarzi A, et al. Total serum IgE concentration in patients with psoriasis: a case-control study. Acta Med Iran. 2014;52(7):515–518.
  37. Gebhardt M, Wenzel HC, Hipler UC, et al. Monitoring of serologic immune parameters in inflammatory skin diseases. Allergy. 1997;52(11):1087–10894. doi: https://doi.org/10.1111/j.1398-9995.1997.tb00180.x
  38. Hosseini P, Khoshkhui M, Hosseini RF, et al. Investigation of the relationship between atopy and psoriasis. Postepy Dermatol Alergol. 2019;36(3):276–281. doi: https://doi.org/10.5114/ada.2019.85639
  39. Jelinek DF. Regulation of B lymphocyte differentiation. Ann Allergy Asthma Immunol. 2000;84(4):375–385. doi: https://doi.org/10.1016/S1081-1206(10)62267-3
  40. Bacharier LB, Geha RS. Molecular mechanisms of IgE regulation. J Allergy Clin Immunol. 2000;105(2Pt2):S547–558. doi: https://doi.org/10.1016/s0091-6749(00)90059-9
  41. Eckl-Dorna J, Villazala-Merino S, Campion NJ, et al. Tracing IgE-Producing Cells in Allergic Patients. Cells. 2019;8(9):994. doi: https://doi.org/10.3390/cells8090994
  42. Komi DEA, Mortaz E, Amani S, et al. The Role of Mast Cells in IgE-Independent Lung Diseases. Clin Rev Allergy Immunol. 2020;58(3):377–387. doi: https://doi.org/10.1007/s12016-020-08779-5
  43. Perez-Witzke D, Miranda-García MA, Suárez N, et al. CTLA4Fcε, a novel soluble fusion protein that binds B7 molecules and the IgE receptors, and reduces human in vitro soluble CD23 production and lymphocyte proliferation. Immunology. 2016;148(1):40–55. doi: https://doi.org/10.1111/imm.12586
  44. Conti P, Gallenga CE, Ronconi G, et al. Activation of mast cells mediates inflammatory response in psoriasis: Potential new therapeutic approach with IL-37. Dermatol Ther. 2019;32(4):e12943. doi: https://doi.org/10.1111/dth.12943
  45. Georgescu SR, Tampa M, Caruntu C, et al. Advances in Understanding the Immunological Pathways in Psoriasis. Int J Mol Sci. 2019;20(3):739. doi: https://doi.org/10.3390/ijms20030739
  46. Yan KX, Huang Q, Fang X, et al. IgE and FcεRI are highly expressed on innate cells in psoriasis. Br J Dermatol. 2016;175(1):122–133. doi: https://doi.org/10.1111/bjd.14459
  47. Guttman-Yassky E, Lowes MA, Fuentes-Duculan J, et al. Major differences in inflammatory dendritic cells and their products distinguish atopic dermatitis from psoriasis. J Allergy Clin Immunol. 2007;119(5):1210–1217. doi: https://doi.org/10.1016/j.jaci.2007.03.006
  48. Schäbitz A, Eyerich K, Garzorz‐Stark N. So close, and yet so far away: The dichotomy of the specific immune response and inflammation in psoriasis and atopic dermatitis. J Intern Med. 2021;290(1):27–39. doi: https://doi.org/10.1111/joim.13235
  49. Abramovits W, Cockerell C, Stevenson LC, et al. PsEma — a hitherto unnamed dermatologic entity with clinical features of both psoriasis and eczema. Skinmed. 2005;4(5):275–281. doi: https://doi.org/10.1111/j.1540-9740.2005.03636.x
  50. Shi L, Liu C, Xiong H, et al. Elevation of IgE in patients with psoriasis: Is it a paradoxical phenomenon? Front Med (Lausanne). 2022;9:1007892. doi: https://doi.org/10.3389/fmed.2022.1007892
  51. Tsai YC, Tsai TF. Overlapping Features of Psoriasis and Atopic Dermatitis: From Genetics to Immunopathogenesis to Phenotypes. Int J Mol Sci. 2022;23(10):5518. doi: https://doi.org/10.3390/ijms23105518

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Рис. 1. Иммунопатогенез атопического дерматита, псориаза и их перекреста (адаптировано по: [50]): АтД — атопический дерматит; ПсО — псориаз; PsEma — перекрест атопического дерматита и псориаза

Download (344KB)

Copyright (c) 2023 "Paediatrician" Publishers LLC



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies