ABSTRACT
TRIAL DESIGN: Human papillomavirus infection causes verruca vulgaris. CDK9 inhibitor FIT039 inhibits DNA virus proliferation in animal models. We conducted a multicenter, single-blind, placebo-controlled, randomized phase I/II clinical trial evaluating the safety and efficacy of FIT039 against verruca vulgaris. METHODS: Target lesions were treated with liquid nitrogen once, and a FIT039 patch or placebo patch was applied for 14 days. The primary endpoint was lesion disappearance. The secondary endpoints were safety and changes in dimension, cross-sectional area, and the number of petechial lesions. RESULTS: A total of 24 participants were randomly allocated to the FIT039 (n = 13, median age, 54 years) and placebo (n = 11, median age, 62 years) groups. Verruca vulgaris did not disappear. FIT039 decreased the dimension to 76% of the initial value on day 29, followed by an increase to 98% on day 57. Placebo showed a monotonic increase to 107% on day 57. Changes in the cross-sectional area and petechiae number were comparable between the groups. CONCLUSIONS: No drug-related adverse reactions occurred. FIT039 efficacy was not determined in this study.
Subject(s)
Dermatitis/immunology , Interleukin-17/metabolism , Psoriasis/immunology , T-Lymphocytes/immunology , Thromboxane A2/metabolism , Animals , Disease Models, Animal , Humans , Imiquimod , Mice , Mice, Inbred C57BL , Mice, Knockout , Receptors, Antigen, T-Cell, gamma-delta/metabolism , Receptors, G-Protein-Coupled/metabolism , Receptors, Thromboxane A2, Prostaglandin H2/genetics , Receptors, Thromboxane A2, Prostaglandin H2/metabolism , Thromboxane-A Synthase/genetics , Thromboxane-A Synthase/metabolismABSTRACT
BACKGROUND: A better understanding of the means by which topical vitamin D analogues exert their therapeutic effect on psoriasis is of theoretical and practical importance. OBJECTIVE: We sought to clarify whether and how the topical vitamin D analogue calcipotriol (CAL) controls the IL-17A-mediated pathogenesis of murine psoriasis-like dermatitis in vivo. METHODS: Psoriasis-like dermatitis was induced by the topical application of an imiquimod (IMQ)-containing cream on the murine ear for 4 to 6 consecutive days. For topical CAL treatment, mice were treated daily with CAL solution on the ear before IMQ application. RESULTS: Mice treated topically with CAL exhibited much milder IMQ-induced psoriasis-like dermatitis compared with vehicle-treated mice, with impaired accumulation of IL-17A-committed T (T17) cells in the lesional skin. The IMQ-induced upregulation of Il12b and Il23a was marked in the epidermis and was abrogated by CAL application, suggesting CAL-mediated suppression of IL-23 expression. CAL inhibited Il12b and Il23a expression by Langerhans cells ex vivo stimulated with IMQ and CD40 cross-linking. Topical CAL also inhibited T17 cell expansion in the draining lymph nodes of IMQ-treated skin, implying a possible effect on T17 cell-mediated dermatitis at distant sites. In fact, topical CAL application on the IMQ-treated left ear resulted in amelioration of T17 cell accumulation and psoriasis-like dermatitis in the right ear subsequently treated with IMQ. CONCLUSION: Topical CAL can exert its antipsoriatic effect on CAL-treated lesions and, concomitantly, distant lesions by attenuating the T17 cell accumulation in both CAL-treated lesions and draining lymph nodes.
Subject(s)
Imiquimod/adverse effects , Interleukin-17/immunology , Psoriasis/immunology , Th17 Cells/immunology , Animals , Calcitriol/analogs & derivatives , Calcitriol/pharmacology , Disease Models, Animal , Gene Expression Regulation/drug effects , Gene Expression Regulation/immunology , Humans , Imiquimod/pharmacology , Interleukin-12 Subunit p40/immunology , Interleukin-23 Subunit p19/immunology , Mice , Psoriasis/chemically induced , Psoriasis/drug therapy , Psoriasis/pathology , Th17 Cells/pathologySubject(s)
Antineoplastic Agents/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Brain Neoplasms/drug therapy , Melanoma/drug therapy , Aged , Brain Neoplasms/secondary , Humans , Imidazoles/administration & dosage , Male , Melanoma/secondary , Oximes/administration & dosage , Proto-Oncogene Proteins B-raf/antagonists & inhibitors , Pyridones/administration & dosage , Pyrimidinones/administration & dosage , Remission Induction , Skin Neoplasms/pathologySubject(s)
Epidermolysis Bullosa Acquisita/drug therapy , Immunoglobulins, Intravenous/therapeutic use , Mouth Diseases/drug therapy , Aged , Basement Membrane/pathology , Epidermolysis Bullosa Acquisita/diagnosis , Epidermolysis Bullosa Acquisita/pathology , Humans , Male , Mouth Diseases/diagnosis , Mouth Diseases/pathology , Pemphigoid, Benign Mucous Membrane/diagnosisABSTRACT
It remains largely unclear how antigen-presenting cells (APCs) encounter effector or memory T cells efficiently in the periphery. Here we used a mouse contact hypersensitivity (CHS) model to show that upon epicutaneous antigen challenge, dendritic cells (DCs) formed clusters with effector T cells in dermal perivascular areas to promote in situ proliferation and activation of skin T cells in a manner dependent on antigen and the integrin LFA-1. We found that DCs accumulated in perivascular areas and that DC clustering was abrogated by depletion of macrophages. Treatment with interleukin 1α (IL-1α) induced production of the chemokine CXCL2 by dermal macrophages, and DC clustering was suppressed by blockade of either the receptor for IL-1 (IL-1R) or the receptor for CXCL2 (CXCR2). Our findings suggest that the dermal leukocyte cluster is an essential structure for elicitating acquired cutaneous immunity.