RESUMO
Autologous fat transplantation is a widely used procedure for surgical reconstruction of tissues. The resorption rate of this transplantation remains high and unpredictable, reinforcing the need of adjuvant treatments that increase the long-term stability of grafts. Adipose-derived stem cells (ASC) introduced as single cells in fat has been shown clinically to reduce the resorption of fat grafts. On the other hand, the formulation of ASC into cell spheroids results in the enhancement of their regenerative potential. In this study, we developed a novel method to produce highly homogeneous ASC spheroids and characterized their features and efficacy on fat transplantation. Spheroids conserved ASC markers and multipotency. A regenerative gene expression profile was maintained, and genes linked to autophagy were upregulated whereas proliferation was decreased. Their secreted proteome was enriched in comparison with single-cell ASC suspension. Addition of spheroids to fat graft in an animal model of transplantation resulted in a better graft long-term stability when compared to single ASC suspension. In conclusion, we provide a novel method to manufacture homogenous ASC spheroids. These ASC spheroids are superior to ASC in single-cell suspension to improve the stability of fat transplants, reinforcing their potential in reconstructive surgery.
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Tecido Adiposo , Células-Tronco , Adipócitos , Tecido Adiposo/metabolismo , Animais , Autoenxertos , SuspensõesRESUMO
PURPOSE OF REVIEW: The cellular pathogenesis of fibrotic disorders including systemic sclerosis (SSc) remains largely speculative. Currently, the altered function of endothelial cells and fibroblasts under the influence of an inappropriate immune response are considered central pathogenic events in SSc. Adding to this complexity, novel evidence here reviewed suggests that keratinocytes may concur in the development of skin fibrosis. RECENT FINDINGS: Epidermal equivalents (EE) generated from primary SSc keratinocytes display a distinct gene expression program when compared to healthy donor (HD) EE. SSc-EE, among others, exhibited enhanced oxidative and metabolic response pathways. Immunohistochemical studies demonstrated similarities between SSc-EE and SSc epidermis including altered keratinocyte differentiation, enhanced expression of activation markers, and reduced rate of basal keratinocytes proliferation. SSc-EE supernatants more than HD-EE modified the inflammatory and extracellular matrix deposition/resorption program of dermal fibroblasts. Further evidence indicated that the relative lack rather than the excess of interleukin-25 in keratinocytes may contribute to enhanced dermal fibrotic changes. Overall, these data support keratinocyte-intrinsic SSc-related modifications. SUMMARY: Improved methods for engineering epidermal and skin equivalents are helping to address the question whether keratinocyte alterations in SSc are primary and capable to dysregulate dermal homeostasis or secondary following dermal fibrotic changes.
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Interleucina-17 , Escleroderma Sistêmico , Células Endoteliais/metabolismo , Fibroblastos/patologia , Fibrose , Humanos , Interleucina-17/metabolismo , Queratinócitos/metabolismo , Queratinócitos/patologia , Escleroderma Sistêmico/metabolismo , Pele/patologiaRESUMO
OBJECTIVES: Evidence shows that dysfunctional SSc keratinocytes contribute to fibrosis by altering dermal homeostasis. Whether IL-25, an IL-17 family member regulating many epidermal functions, takes part in skin fibrosis is unknown. Here we address the role of IL-25 in skin fibrosis. METHODS: The expression of IL-25 was evaluated by immunofluorescence and in situ hybridization in 10 SSc and seven healthy donor (HD) skin biopsies. Epidermal equivalents (EE) reconstituted by primary HD keratinocytes were used as a model to study transcriptomic changes induced by IL-25 in the epidermis. RNA expression profile in EEs was characterized by RNAseq. The conditioned medium (CM) from primary SSc and HD keratinocytes primed with IL-25 was used to stimulate fibroblasts. IL-6, IL-8, MMP-1, type-I collagen (Col-I), and fibronectin production by fibroblasts was assessed by ELISA. RESULTS: SSc epidermis expressed lower levels of IL-25 compared with HDs. In EEs, IL-25 regulated several molecular pathways related to wound healing and extracellular matrix remodelling. Compared with control CM, the CM from IL-25-primed keratinocytes enhanced the fibroblast production of MMP-1, IL-6 and IL-8, but not of Col-I nor fibronectin. However, IL-25 significantly reduced the production of Col-I when applied directly to fibroblasts. The activation of keratinocytes by IL-25 was receptor-dependent and evident after a very short incubation time (10 min), largely mediated by IL-1, suggesting enhanced and specific release of preformed mediators. CONCLUSIONS: These results show that IL-25 participates in skin homeostasis, and its decreased expression in SSc may contribute to skin fibrosis by favouring extracellular matrix deposition over degradation.
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Interleucina-17 , Queratinócitos , Escleroderma Sistêmico , Humanos , Células Cultivadas , Meios de Cultivo Condicionados/farmacologia , Epiderme/metabolismo , Epiderme/patologia , Fibroblastos/metabolismo , Fibronectinas/metabolismo , Fibrose , Interleucina-17/metabolismo , Interleucina-6/metabolismo , Interleucina-8/metabolismo , Queratinócitos/metabolismo , Metaloproteinase 1 da Matriz/metabolismo , Escleroderma Sistêmico/patologia , Pele/patologiaRESUMO
IL-25, also known as IL-17E, is a unique cytokine of the IL-17 family. Indeed, IL-25 exclusively was shown to strongly induce expression of the cytokines associated with type 2 immunity. Although produced by several types of immune cells, such as T cells, dendritic cells, or group 2 innate lymphoid cells, a vast amount of IL-25 derives from epithelial cells. The functions of IL-25 have been actively studied in the context of physiology and pathology of various organs including skin, airways and lungs, gastrointestinal tract, and thymus. Accumulating evidence suggests that IL-25 is a "barrier surface" cytokine whose expression depends on extrinsic environmental factors and when upregulated may lead to inflammatory disorders such as atopic dermatitis, psoriasis, or asthma. This review summarizes the progress of the recent years regarding the effects of IL-25 on the regulation of immune response and the balance between its homeostatic and pathogenic role in various epithelia. We revisit IL-25's general and tissue-specific mechanisms of action, mediated signaling pathways, and transcription factors activated in immune and resident cells. Finally, we discuss perspectives of the IL-25-based therapies for inflammatory disorders and compare them with the mainstream ones that target IL-17A.
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Células Epiteliais/imunologia , Imunidade Inata/imunologia , Interleucina-17/imunologia , Animais , Humanos , Inflamação/imunologia , Transdução de Sinais/imunologiaRESUMO
Atopic dermatitis and psoriasis are two diseases that are thought to be distinct from each other, both clinically as well as pathogenetically. Substantial progress has been made in their treatment through the introduction of targeted therapies, blocking key steps in the respective pathogenetic pathways. Interestingly, introduction of a specific therapy for one of these diseases can occasionally trigger onset of the other. This observation helps to better understand the pathophysiology of both diseases and directly impacts their management.
La dermatite atopique et le psoriasis sont deux maladies qui semblaient distinctes cliniquement et pathogéniquement. L'introduction de thérapies ciblées bloquant des étapes clés dans leurs voies pathogéniques respectives a permis d'améliorer considérablement leurs traitements. Cependant, il est important de noter que l'application d'une thérapie spécifique pour l'une de ces deux maladies peut occasionnellement déclencher le début de l'autre. Cette observation permet de mieux comprendre la pathophysiologie de ces deux maladies et a un impact direct sur leur prise en charge.
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Dermatite Atópica , Psoríase , Dermatite Atópica/epidemiologia , Dermatite Atópica/terapia , Eczema , Humanos , Psoríase/epidemiologia , Psoríase/terapiaRESUMO
Several cytokines signalling via Janus Kinase (JAK) proteins have been implicated in the pathogenesis of immune-mediated inflammatory diseases, including psoriasis and rheumatoid arthritis (RA). Tofacitinib, a small JAK inhibitor, is approved for the treatment of RA and has demonstrated good efficacy in psoriasis phase III clinical trials. In this work, we analysed the in vitro effects of tofacitinib on the functions of human dendritic cells (DCs) and macrophages. When assessing the effects of tofacitinib on monocyte-derived DCs, we observed reduced differentiation of monocytes into immature DCs, as evidenced by a decreased transcription of CD209 and CD80. Phenotype assessment in the presence of tofacitinib suggested a switch towards a M1-like macrophage phenotype, as evidenced by the expression of M1 markers such as iNOS, as well as cytokines typically expressed by M1 cells, including IL-12 and IL-23. Of note, Arginase1 and CD200R, typically expressed by M2 cells, were absent on tofacitinib-treated DCs. Furthermore, tofacitinib affected the response of differentiated DCs to maturation stimuli such as LPS and IFNγ, resulting in a partial up-regulation of IL-23 and down-regulation of IL-12, as assessed by qPCR. When investigating macrophage development, we found that tofacitinib inhibited the ability of monocytes to differentiate and polarize into regulatory M2 macrophages, while rather enhancing the ability to develop into inflammatory M1-like macrophages, as evidenced by decreased expression of the M2 marker CD200R and enhanced production of IL-12 and IL-23. In conclusion, tofacitinib impacts the differentiation of human DCs and macrophages, it particularly favours generation of M1-like pro-inflammatory macrophages.
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Diferenciação Celular/efeitos dos fármacos , Inibidores de Janus Quinases/farmacologia , Células de Langerhans/fisiologia , Macrófagos/fisiologia , Monócitos/fisiologia , Piperidinas/farmacologia , Pirimidinas/farmacologia , Células Cultivadas , Células Dendríticas , Regulação para Baixo/efeitos dos fármacos , Expressão Gênica/efeitos dos fármacos , Humanos , Interferon gama/farmacologia , Interleucina-12/genética , Interleucina-23/genética , Lipopolissacarídeos/farmacologia , Receptores de Orexina/metabolismo , Fenótipo , RNA Mensageiro/metabolismo , Regulação para Cima/efeitos dos fármacosRESUMO
Inflammation is a fundamental defense mechanism to protect the body from danger, which becomes potentially harmful if it turns chronic. Therapeutic strategies aimed at specifically blocking proinflammatory signals, particularly cytokines, such as IL-4, IL-6, IL-13, IL-17A, or TNF-α, have substantially improved our ability to effectively and safely treat chronic inflammatory diseases. Much less effort has been made to better understand the role of potential anti-inflammatory mechanisms. Here we summarize the current understanding of regulatory cell populations in the context of chronic inflammation, namely macrophages, Langerhans cells, myeloid-derived suppressor cells, and regulatory T and B lymphocytes. Emphasis is given to the skin because many different immune-related diseases occur in the skin. Development, phenotype, function, and evidence for their role in animal models of inflammation, as well as in the corresponding human diseases, are described. Finally, the feasibility of using regulatory cells as targets for potentially disease-modifying therapeutic strategies is discussed.
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Inflamação/imunologia , Pele/imunologia , Animais , Anti-Inflamatórios/farmacologia , Linfócitos B/imunologia , Humanos , Inflamação/patologia , Células de Langerhans/imunologia , Macrófagos/imunologia , Células Supressoras Mieloides/imunologia , Pele/patologia , Linfócitos T Reguladores/imunologiaRESUMO
Interleukin 17A is a key effector cytokine in numerous chronic inflammatory diseases. Its neutralization is therapeutically effective and approved in the treatment of chronic inflammatory conditions. Recently, five additional members of the IL-17 cytokine family have been identified, which also contribute to chronic inflammation. Innovative therapeutic strategies therefore aim to simultaneously block not one, but several members of this cytokine family in order to further increase therapeutic efficacy. This article reviews the current knowledge regarding the role of the IL-17 cytokine family in chronic inflammation.
L'interleukine-17 A (IL-17A) est reconnue comme étant une cytokine effectrice clé impliquée dans de nombreuses maladies inflammatoires chroniques. La neutralisation de l'IL-17A est une technique efficace, approuvée dans le traitement des inflammations chroniques. Ces dernières années, cinq autres cytokines IL-17 ont été identifiées, contribuant elles aussi substantiellement à l'inflammation chronique. De nouvelles stratégies thérapeutiques innovantes ont pour but de bloquer simultanément plusieurs cytokines IL-17 afin d'augmenter encore plus l'effet des traitements. Cet article propose une mise à jour des connaissances actuelles concernant le rôle des différentes cytokines de la famille des IL-17 dans l'inflammation chronique.
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Inflamação , Interleucina-17 , Anti-Inflamatórios , Citocinas , Humanos , Interleucina-17/fisiologiaRESUMO
Fumaric acid has an important role in the citric acid cycle. Its esters were first used by a German chemist to treat his own psoriasis, hypothesizing that the disease may be related to disturbances in this very cycle. Meanwhile, the mechanisms underlying its anti-inflammatory efficacy are much better understood. A monosubstance derived from the mix of esters used originally is now being authorized for treating multiple sclerosis, and in 2017 dimethylfumaric acid ester became a globally available option to treat psoriasis. This very practical therapeutic will most likely become quite popular amongst patients. Therefore, general practitioners might need to familiarize themselves with the profile of this drug, including its potential risks and some very rare but potentially important adverse effects.
L'acide fumarique joue un rôle important dans le cycle de Krebs. Ses esters ont été utilisés pour la première fois par un chimiste allemand pour traiter son propre psoriasis dans l'hypothèse d'une implication du cycle de Krebs. Depuis, les mécanismes anti-inflammatoires des esters d'acide fumarique ont été mieux décrits. Une mono-substance dérivée du mélange d'esters original est désormais autorisée pour traiter la sclérose en plaques. En 2017, le diméthylfumarate a été ainsi reconnu globalement comme une option thérapeutique pour le psoriasis. Très pratique, ce médicament deviendra probablement très populaire chez les patients. Pour cette raison, les médecins généralistes devraient se familiariser avec son profil pharmacologique, y compris ses risques potentiels et certains effets indésirables rares mais potentiellement dangereux.
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Suplementos Nutricionais , Fumaratos , Esclerose Múltipla , Psoríase , Ésteres , Fumaratos/uso terapêutico , Humanos , Esclerose Múltipla/dietoterapia , Psoríase/dietoterapiaRESUMO
OBJECTIVES: Interleukin (IL) 22 mRNA in systemic sclerosis (SSc) skin and Th22 cells in SSc peripheral blood are increased, but the role of IL-22 in fibrosis development remains poorly understood. METHODS: Biopsies were obtained from the involved skin of 15 SSc, 4 morphea and 8 healthy donors (HD). The presence of IL-22+ cells in the skin was determined by immunostaining. The in vitro response of HD and SSc fibroblasts to IL-22, IL-22 in conjunction with tumour necrosis factor (TNF) or keratinocyte conditioned medium was assessed by ELISA, radioimmunoassay (RIA), real-time PCR and western blot. The in vivo response in mice was assessed by histomorphometry. RESULTS: IL-22+ cells were over-represented in the dermis and epidermis of morphea and in the epidermis of SSc compared with HD. The majority of dermal IL-22+ cells were T cells. Dermal fibroblasts expressed both IL-22 receptor subunits IL-10RB and IL-22RA, expression of which was enhanced by TNF and reduced by transforming growth factor (TGF)-ß. IL-22 induced rapid phosphorylation of p38 and ERK1/2 in fibroblasts, but failed to induce the synthesis of chemokines and extracellular matrix components. However, IL-22 enhanced the production of monocyte chemotactic protein 1, IL-8 and matrix metalloproteinase 1 induced by TNF. Fibroblast responses were maximal in the presence of conditioned medium from keratinocytes activated by IL-22 in conjunction with TNF. Dermal thickness was maximal in mice injected simultaneously with IL-22 and TNF. CONCLUSIONS: IL-22 capacitates fibroblast responses to TNF and promotes a proinflammatory fibroblast phenotype by favouring TNF-induced keratinocyte activation. These results define a novel role for keratinocyte-fibroblast interactions in the context of skin fibrosis.
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Fibroblastos/metabolismo , Interleucinas/metabolismo , Escleroderma Sistêmico/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Adulto , Idoso , Animais , Estudos de Casos e Controles , Epiderme/metabolismo , Feminino , Fibrose , Humanos , Queratinócitos/metabolismo , Masculino , Camundongos , Pessoa de Meia-Idade , Esclerodermia Localizada/metabolismo , Esclerodermia Localizada/patologia , Escleroderma Sistêmico/patologia , Pele/patologia , Adulto Jovem , Interleucina 22RESUMO
Interleukin (IL)-36 cytokines belong to the IL-1 family and include three agonists, IL-36 α, ß and γ and one inhibitor, IL-36 receptor antagonist (IL-36Ra). IL-36 and IL-1 (α and ß) activate similar intracellular pathways via their related heterodimeric receptors, IL-36R/IL-1RAcP and IL-1R1/IL-1RAcP, respectively. However, excessive IL-36 versus IL-1 signaling induces different phenotypes in humans, which may be related to differential expression of their respective receptors. We examined the expression of IL-36R, IL-1R1 and IL-1RAcP mRNA in human peripheral blood, tonsil and skin immune cells by RT-qPCR. Monocyte-derived dendritic cells (MDDC), M0, M1 or M2-polarized macrophages, primary keratinocytes, dermal macrophages and Langerhans cells (LC) were stimulated with IL-1ß or IL-36ß. Cytokine production was assessed by RT-qPCR and immunoassays. The highest levels of IL-36R mRNA were found in skin-derived keratinocytes, LC, dermal macrophages and dermal CD1a(+) DC. In the blood and in tonsils, IL-36R mRNA was predominantly found in myeloid cells. By contrast, IL-1R1 mRNA was detected in almost all cell types with higher levels in tonsil and skin compared to peripheral blood immune cells. IL-36ß was as potent as IL-1ß in stimulating M2 macrophages, keratinocytes and LC, less potent than IL-1ß in stimulating M0 macrophages and MDDC, and exerted no effects in M1 and dermal macrophages. Levels of IL-1Ra diminished the ability of M2 macrophages to respond to IL-1. Taken together, these data are consistent with the association of excessive IL-36 signaling with an inflammatory skin phenotype and identify human LC and M2 macrophages as new IL-36 target cells.
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Inflamação/metabolismo , Proteína Acessória do Receptor de Interleucina-1/metabolismo , Queratinócitos/metabolismo , Células de Langerhans/metabolismo , Macrófagos/metabolismo , Receptores Tipo I de Interleucina-1/metabolismo , Receptores de Interleucina/metabolismo , Células Cultivadas , Células Dendríticas/metabolismo , Humanos , Monócitos/metabolismo , Células Mieloides/metabolismo , RNA Mensageiro/metabolismo , Pele/metabolismoRESUMO
OBJECTIVE: Levels of interleukin-17A (IL-17A) have been found to be increased in synovial fluid from individuals with systemic sclerosis (SSc). This study was undertaken to investigate whether IL-17A-producing cells are present in affected SSc skin, and whether IL-17A exerts a role in the transdifferentiation of myofibroblasts. METHODS: Skin biopsy samples were obtained from the involved skin of 8 SSc patients and from 8 healthy control donors undergoing plastic surgery. Immunohistochemistry and multicolor immunofluorescence techniques were used to identify and quantify the cell subsets in vivo, including IL-17A+, IL-4+, CD3+, tryptase-positive, α-smooth muscle actin (α-SMA)-positive, myeloperoxidase-positive, and CD1a+ cells. Dermal fibroblast cell lines were generated from all skin biopsy samples, and quantitative polymerase chain reaction, Western blotting, and solid-phase assays were used to quantify α-SMA, type I collagen, and matrix metalloproteinase 1 (MMP-1) production by the cultured fibroblasts. RESULTS: IL-17A+ cells were significantly more numerous in SSc skin than in healthy control skin (P = 0.0019) and were observed to be present in both the superficial and deep dermis. Involvement of both T cells and tryptase-positive mast cells in the production of IL-17A was observed. Fibroblasts positive for α-SMA were found adjacent to IL-17A+ cells, but not IL-4+ cells. However, IL-17A did not induce α-SMA expression in cultured fibroblasts. In the presence of IL-17A, the α-SMA expression induced in response to transforming growth factor ß was decreased, while MMP-1 production was directly enhanced. Furthermore, the frequency of IL-17A+ cells was higher in the skin of SSc patients with greater severity of skin fibrosis (lower global skin thickness score). CONCLUSION: IL-17A+ cells belonging to the innate and adaptive immune system are numerous in SSc skin. IL-17A participates in inflammation while exerting an inhibitory activity on myofibroblast transdifferentiation. These findings are consistent with the notion that IL-17A has a direct negative-regulatory role in the development of dermal fibrosis in humans.
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Derme/patologia , Interleucina-17/metabolismo , Miofibroblastos/patologia , Escleroderma Sistêmico/patologia , Imunidade Adaptativa/imunologia , Adulto , Idoso , Biomarcadores/metabolismo , Contagem de Células , Transdiferenciação Celular , Derme/imunologia , Derme/metabolismo , Feminino , Humanos , Imunidade Inata/imunologia , Interleucina-17/imunologia , Masculino , Pessoa de Meia-Idade , Miofibroblastos/metabolismo , Escleroderma Sistêmico/imunologia , Escleroderma Sistêmico/metabolismoRESUMO
Psoriasis is a common chronic inflammatory skin disease, associated with substantial comorbidity. TH17 lymphocytes, differentiating under the influence of dendritic cell-derived IL-23, and mediating their effects via IL-17A, are believed to be central effector cells in psoriasis. This concept is underlined by the unprecedented efficacy of therapeutics targeting this pathogenetic axis. In recent years, numerous observations made it necessary to revisit and refine this simple "linear" pathogenetic model. It became evident that IL-23 independent cells exist that produce IL-17A, that IL-17 homologues may exhibit synergistic biological effects, and that the blockade of IL-17A alone is clinically less effective compared to the inhibition of several IL-17 homologues. In this review, we will summarize the current knowledge around IL-17A and its five currently known homologues, namely IL-17B, IL-17C, IL-17D, IL-17E (also known as IL-25) and IL-17F, in relation to skin inflammation in general and psoriasis in particular. We will also re-visit the above-mentioned observations and integrate them into a more comprehensive pathogenetic model. This may help to appreciate current as well as developing anti-psoriatic therapies and to prioritize the selection of future drugs' mode(s) of action.
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Dermatite , Psoríase , Humanos , Interleucina-17 , Citocinas , Psoríase/tratamento farmacológico , Psoríase/etiologia , Dermatite/complicações , Terapias em Estudo/efeitos adversos , Interleucina-23RESUMO
From the clinical standpoint, systemic sclerosis (SSc) is characterized by skin and internal organ fibrosis, diffuse fibroproliferative vascular modifications, and autoimmunity. Clinical presentation and course are highly heterogenous and life expectancy variably affected mostly dependent on lung and heart involvement. SSc touches more women than men with differences in disease severity and environmental exposure. Pathogenetic events originate from altered homeostasis favored by genetic predisposition, environmental cues and a variety of endogenous and exogenous triggers. Epigenetic modifications modulate SSc pathogenesis which strikingly associate profound immune-inflammatory dysregulation, abnormal endothelial cell behavior, and cell trans-differentiation into myofibroblasts. SSc myofibroblasts show enhanced survival and enhanced extracellular matrix deposition presenting altered structure and altered physicochemical properties. Additional cell types of likely pathogenic importance are pericytes, platelets, and keratinocytes in conjunction with their relationship with vessel wall cells and fibroblasts. In SSc, the profibrotic milieu is favored by cell signaling initiated in the one hand by transforming growth factor-beta and related cytokines and in the other hand by innate and adaptive type 2 immune responses. Radical oxygen species and invariant receptors sensing danger participate to altered cell behavior. Conventional and SSc-specific T cell subsets modulate both fibroblasts as well as endothelial cell dysfunction. Beside autoantibodies directed against ubiquitous antigens important for enhanced clinical classification, antigen-specific agonistic autoantibodies may have a pathogenic role. Recent studies based on single-cell RNAseq and multi-omics approaches are revealing unforeseen heterogeneity in SSc cell differentiation and functional states. Advances in system biology applied to the wealth of data generated by unbiased screening are allowing to subgroup patients based on distinct pathogenic mechanisms. Deciphering heterogeneity in pathogenic mechanisms will pave the way to highly needed personalized therapeutic approaches.
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Escleroderma Sistêmico , Masculino , Humanos , Feminino , Escleroderma Sistêmico/etiologia , Autoanticorpos , Fibrose , Autoimunidade , Citocinas , Pele/patologiaRESUMO
Chronic wounds, ie, non-healing ulcers, have a prevalence of ~1% in the general population. Chronic wounds strongly affect the quality of life and generate considerable medical costs. A fraction of chronic wounds will heal within months of appropriate treatment; however, a significant fraction of patients will develop therapy-refractory chronic wounds, leading to chronic pain, infection, and amputation. Given the paucity of therapeutic options for refractory wounds, cell therapy and in particular the use of adipose-derived stromal cells (ASC) has emerged as a promising concept. ASC can be used as autologous or allogeneic cells. They can be delivered in suspension or in 3D cultures within scaffolds. ASC can be used without further processing (stromal vascular fraction of the adipose tissue) or can be expanded in vitro. ASC-derived non-cellular components, such as conditioned media or exosomes, have also been investigated. Many in vitro and preclinical studies in animals have demonstrated the ASC efficacy on wounds. ASC efficiency appears to occurs mainly through their regenerative secretome. Hitherto, the majority of clinical trials focused mainly on safety issues. However more recently, a small number of randomized, well-controlled trials provided first convincing evidences for a clinical efficacy of ASC-based chronic wound therapies in humans. This brief review summarizes the current knowledge on the mechanism of action, delivery and efficacy of ASC in chronic wound therapy. It also discusses the scientific and pharmaceutical challenges to be solved before ASC-based wound therapy enters clinical reality.
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Adipócitos , Qualidade de Vida , Animais , Humanos , Tecido Adiposo , Cicatrização , Células EstromaisRESUMO
Modern treatments continue to be developed based on identifying targets within the innate and adaptive immune pathways associated with psoriasis. Whilst there is a sound biologic rationale for increased risk of infection following treatment with immunomodulators, the clinical evidence is confounded by these agents being used in patients affected with several comorbidities. In an era characterized by an ever greater and growing risk of infections, it is necessary to always be updated on this risk. In this mini-review, we will discuss recent updates in psoriasis immunopathogenesis as a rationale for systemic therapy, outline the risk of infections linked to the disease itself and systemic therapy as well, and provide an overview of the prevention and management of infections.
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Skin disorders affect â¼40% of the human population. One of the most debilitating cutaneous disorders is Hidradenitis suppurativa (HS), a noncommunicable chronic inflammatory disease with an estimated global prevalence of 0.4% to 2.5%. In January 2011, high levels of IL-17 were discovered in skin lesions of HS patients. In the following years, translational and clinical research led to a better understanding of the pathogenesis of HS. In June 2023, more than 12 years after the initial note, secukinumab, an anti-IL-17A monoclonal antibody, was approved for the treatment of moderate to severe HS. This is the next milestone in improving the treatment of these patients after the approval of the anti-TNF-α monoclonal antibody adalimumab in 2015. In this review article, we present the IL-17 pathway in HS and discuss the use of secukinumab as a therapeutic option for this disease. Our review starts with a description of the epidemiology, clinical features, etiology, and pathogenesis of HS. An overview of the IL-17/IL-17 receptor system in general and a detailed description of the known facts about the expression and action of IL-17 in HS follow. Afterward, we consider the results of clinical trials evaluating the safety and efficacy of IL-17 inhibitors in HS. Finally, a comparison is made between secukinumab and adalimumab and the characteristics of the patients that may be particularly suitable for each of these biologics are described.
Assuntos
Hidradenite Supurativa , Humanos , Hidradenite Supurativa/tratamento farmacológico , Hidradenite Supurativa/patologia , Adalimumab/uso terapêutico , Interleucina-17/metabolismo , Inibidores do Fator de Necrose Tumoral/uso terapêutico , BiologiaRESUMO
Aberrant mechanotransduction and compromised epithelial barrier function are associated with numerous human pathologies including inflammatory skin disorders. However, the cytoskeletal mechanisms regulating inflammatory responses in the epidermis are not well understood. Here we addressed this question by inducing a psoriatic phenotype in human keratinocytes and reconstructed human epidermis using a cytokine stimulation model. We show that the inflammation upregulates the Rho-myosin II pathway and destabilizes adherens junctions (AJs) promoting YAP nuclear entry. The integrity of cell-cell adhesion but not the myosin II contractility per se is the determinative factor for the YAP regulation in epidermal keratinocytes. The inflammation-induced disruption of AJs, increased paracellular permeability, and YAP nuclear translocation are regulated by ROCK2, independently from myosin II activation. Using a specific inhibitor KD025, we show that ROCK2 executes its effects via cytoskeletal and transcription-dependent mechanisms to shape the inflammatory response in the epidermis.
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This study evaluates the influence of a gelatin sponge on adipose-derived stromal cells (ASC). Transcriptomic data revealed that, compared to ASC in a monolayer, a cross-linked porcine gelatin sponge strongly influences the transcriptome of ASC. Wound healing genes were massively regulated, notably with the inflammatory and angiogenic factors. Proteomics on conditioned media showed that gelatin also acted as a concentrator and reservoir of the regenerative ASC secretome. This secretome promoted fibroblast survival and epithelialization, and significantly increased the migration and tubular assembly of endothelial cells within fibronectin. ASC in gelatin on a chick chorioallantoic membrane were more connected to vessels than an empty sponge, confirming an increased angiogenesis in vivo. No tumor formation was observed in immunodeficient nude mice to which an ASC gelatin sponge was transplanted subcutaneously. Finally, ASC in a gelatin sponge prepared from outbred rats accelerated closure and re-vascularization of ischemic wounds in the footpads of rats. In conclusion, we provide here preclinical evidence that a cross-linked porcine gelatin sponge is an optimal carrier to concentrate and increase the regenerative activity of ASC, notably angiogenic. This formulation of ASC represents an optimal, convenient and clinically compliant option for the delivery of ASC on ischemic wounds.
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OBJECTIVE: Among pleiotropic effects, the capacity of prostaglandin I(2) (PGI(2)) analogues to affect adaptive immunity remains poorly characterised. The purpose of this study was to assess whether PGI(2) analogues could affect T helper (Th) cell responses in patients with systemic sclerosis (SSc) and healthy donors (HD). METHODS: Peripheral blood mononuclear cells (PBMC) were obtained from 33 patients with SSc and 29 HD. Cytokine levels in PBMC and monocyte/CD4 T cell cultures were quantified by immunoassays. The frequencies of interleukin (IL)-17A, IL-22, interferon γ (IFNγ) and IL-4-producing CD4 T cells were assessed by multiparametric flow cytometry. Selective receptor antagonists, cytokine blocking antibodies and signalling protein inhibitors were used to identify the receptors and signalling pathways mediating PGI(2) analogue effects. RESULTS: Th17 and Th22 cells were more abundant in individuals with SSc than in HD. PGI(2) analogues (iloprost, treprostinil and beraprost) significantly increased IL-17A and IL-22 in vitro while decreasing IFNγ production both in SSc and HD PBMC. These effects relied on the specific expansion of Th17 and Th22 and inhibition of Th1 cells. The enhanced Th17 cell responses depended on increased IL-23 production by monocytes, involved the IP prostacyclin receptor and required protein kinase A activation. Importantly, in vivo administration of iloprost in individuals with SSc presenting with digital ulcers resulted in a significant increase in the frequency of Th17 cells. CONCLUSIONS: These findings demonstrate that PGI(2) analogues affect Th cell differentiation/expansion programmes, favouring Th17 and inhibiting Th1 cell responses in SSc. The impact of these changes on the disease course needs to be taken into consideration and further exploited to improve SSc.