Inositoylated Platelet-Activating Factor (Ino-C2-PAF) Modulates Dynamic Lymphocyte–Endothelial Cell Interactions and Alleviates Psoriasis-Like Skin Inflammation in Two Complementary Mouse Models

Psoriasis, a tumor necrosis factor alpha (TNFα)-governed inflammatory disorder with prominent dysregulation of cutaneous vascular functions, has evolved into a model disorder for studying anti-inflammatory therapies. We present experimental in vitro and in vivo data on 1-O-octadecyl-2-O-(2-(myo-inositolyl)-ethyl)-sn-glycero-3-(R/S)-phosphatidyl-choline (Ino-C2-PAF), the lead compound of a class of synthetic glycosylated phospholipids, in anti-inflammatory therapy. Ino-C2-PAF strongly induced apoptosis only in TNFα-stimulated, but not in untreated human vascular endothelial cells. Moreover, TNFα-induced endothelial adhesion molecules that mediated the rolling and firm adhesion of leukocytes (vascular cell adhesion protein-1 (VCAM-1), E-selectin, and ICAM-1) were selectively downregulated by Ino-C2-PAF. Similarly, expression of L-selectin, VCAM-1 receptor α4β1 integrin, and lymphocyte function-associated antigen-1 on human peripheral blood mononuclear cells was reduced without induction of apoptosis. Functionally, these changes were accompanied by significant impairment of rolling and adhesion of human peripheral blood lymphocytes on TNFα-activated endothelial cells in a dynamic flow chamber system. When the therapeutic potential of Ino-C2-PAF was assessed in two complementary mouse models of psoriasis, K5.hTGFβ1 transgenic and JunB/c-Jun-deficient mice, Ino-C2-PAF led to significant alleviation of the clinical symptoms and normalized the pathological cutaneous changes including vascularization. There were no overt adverse effects. These findings suggested that Ino-C2-PAF is a potential candidate in the therapy of inflammatory skin diseases that include abnormal vascular functions

Anti-inflammatory effects of the inositoylated platelet-activating factor (Ino-C2-PAF) in vitro and in vivo

Die Psoriasis ist mit einer Prävalenz von 1-3% eine der häufigsten chronisch-entzündlichen Erkrankungen. Histopathologisch ist sie gekennzeichnet durch epidermale Hyperkeratose und Akanthose, gesteigerte Angiogenese sowie ein gemischtzelliges leukozytäres Infiltrat. Aus aktueller Sicht wird sie als eine komplexe primär T-Zell vermittelte Autoimmunerkrankung mit genetischer Prädisposition verstanden. Psoriasis kann mit kardiovaskulären, metabolischen und psychiatrischen Erkrankungen assoziiert sein (Komorbidität). Hier wurde erstmals die Wirkung des inositoylierten Plättchen-aktivierenden Faktors (Ino-C2-PAF), eines synthetischen Alkylphospholipids mit geringer Toxizität, in experimentellen Modellen chronisch-entzündlicher (Haut)-Erkrankungen untersucht. Die Wirkung beruht auf Zellmembran-Interaktionen, wodurch der Cholesterol- und Phospholipidmetabolismus verändert und zelluläre Signalkaskaden der Proliferation, Apoptose und Motilität beeinträchtigt werden. Ino-C2- PAF reguliert außerdem entzündungsrelevante Proteine herab. In vitro lag der Schwerpunkt auf der Wirkung von Ino-C2-PAF auf Endothelzellen und Leukozyten. Ino-C2-PAF hemmte die Proliferation humaner Endothelzellen moderat, steigerte allerdings die Apoptose TNFα-stimulierter Endothelzellen sehr deutlich. Diese Wirkung war begleitet von einer Reduktion der durch TNFα stimulierbaren endothelialen Adhäsionsmoleküle VCAM-1, ICAM-1 und E-Selektin sowie der lymphozytären Adhäsionsmoleküle CD49d, CD11a, CD62L und CLA. Funktionell führte dies zu einer signifikanten Abnahme dynamischer Interaktionen (Rollen und feste Adhäsion) von Leukozyten und aktivierten Endothelzellen in Flusskammerexperimenten. Die anti-entzündliche Wirkung von Ino-C2-PAF wurde in zwei komplementären Modellen in vivo bestätigt. Sowohl in K5.hTFGß-transgenen als auch in JunB/c-Jun-defizienten Mäusen bewirkte Ino-C2-PAF eine signifikante Besserung des psoriasiformen Phänotyps sowohl auf makroskopischer als auch auf histopathologischer Ebene. Die Ergebnisse dieser Arbeit legen nahe, dass Ino-C2-PAF oder verwandte Substanzen zur Behandlung entzündlicher Erkrankungen wie der Psoriasis eingesetzt werden könnten

Atopic skin diathesis rather than atopic dermatitis is associated with specific contact allergies

BACKGROUND: The association of atopic dermatitis (AD) and allergic contact dermatitis has been a matter of considerable uncertainty. Study results range from lack of any association to increased sensitization for multiple allergens, but fail to identify consistent allergen associations. OBJECTIVE: We studied a large patch test cohort of patients stratified by their atopic skin diathesis using the Erlangen Atopy Score (EAS), independent of active skin disease. METHODS: Retrospective multi-center data analysis from five departments of dermatology in Germany with 4,509 patients. Patients were grouped as “no atopic skin diathesis” (n = 2,165) and “atopic skin diathesis” (n = 1,743), according to EAS. RESULTS: Significantly more individuals with atopic skin diathesis showed at least one positive patch test reaction to the baseline series compared to individuals without atopic skin diathesis (49.1 % vs. 38.3 %). In logistic regression analyses, atopic skin diathesis was associated with a significantly higher risk of sensitization to methylchloroisothiazolinone/methylisothiazolinone (OR 2.383) and methylisothiazolinone (OR 1.891), thiuram mix (OR 1.614), as well as nickel (OR 1.530), cobalt (OR 1.683), and chromium (OR 2.089). CONCLUSIONS: Atopic skin diathesis proved to be the most important intrinsic risk factor for contact sensitization to few, specific allergens. Past or present AD was a less relevant variable

Full-body blue light irradiation as treatment for atopic dermatitis : a randomized sham-controlled clinical trial (AD-Blue)

Background: Visible blue light (wavelength 400-495 nm) is a promising new treatment option for both psoriasis and atopic dermatitis (AD). Whilst previous clinical trials featured various devices and blue light at a variety of wavelengths, none of these interventions were challenged in objective clinical criteria. Patients and methods: Eighty-seven patients diagnosed with AD were enrolled in AD-Blue, an international, prospective, double-blinded, three-armed (415 nm vs. 450 nm vs. sham control), randomized trial designed to investigate the safety and efficacy of prototype full-body blue light devices. Results: Full-body irradiation with 450 nm blue light but not 415 nm had a significant impact on itch (Itch-VAS, -1.6 ± 2.3; p = 0.023 vs. sham irradiation). PO-SCORAD values also decreased significantly in response to irradiation at 415 nm (-11.5 ± 18.4; p = 0.028 vs. sham irradiation). None of the other outcome measures (EASI, SCORAD, IGA, DLQI) changed significantly. No safety signals were observed. Evaluation of skin transcriptomes, cytokine levels in serum, and ELISpots from peripheral blood mononuclear cells isolated from a subset of patients revealed moderate decreases in IL-31 in response to irradiation with blue light. Conclusions: Despite its favorable safety profile and moderate reductions in itch and IL-31 levels, full-body blue light irradiation did not lead to an amelioration of any of the objective measures of AD.</p

Molecular Genetic Screening in Patients With ACE Inhibitor/Angiotensin Receptor Blocker-Induced Angioedema to Explore the Role of Hereditary Angioedema Genes

Angioedema is a relatively rare but potentially life-threatening adverse reaction to angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs). As with hereditary forms of angioedema (HAE), this adverse reaction is mediated by bradykinin. Research suggests that ACEi/ARB-induced angioedema has a multifactorial etiology. In addition, recent case reports suggest that some ACEi/ARB-induced angioedema patients may carry pathogenic HAE variants. The aim of the present study was to investigate the possible association between ACEi/ARB-induced angioedema and HAE genes via systematic molecular genetic screening in a large cohort of ACEi/ARB-induced angioedema cases. Targeted re-sequencing of five HAE-associated genes (SERPING1, F12, PLG, ANGPT1, and KNG1) was performed in 212 ACEi/ARB-induced angioedema patients recruited in Germany/Austria, Sweden, and Denmark, and in 352 controls from a German cohort. Among patients, none of the identified variants represented a known pathogenic variant for HAE. Moreover, no significant association with ACEi/ARB-induced angioedema was found for any of the identified common [minor allele frequency (MAF) &gt;5%] or rare (MAF &lt; 5%) variants. However, several non-significant trends suggestive of possible protective effects were observed. The lowest p-value for an individual variant was found in PLG (rs4252129, p.R523W, p = 0.057, p.adjust &gt; 0.999, Fisher’s exact test). Variant p.R523W was found exclusively in controls and has previously been associated with decreased levels of plasminogen, a precursor of plasmin which is part of a pathway directly involved in bradykinin production. In addition, rare, potentially functional variants (MAF &lt; 5%, Phred-scaled combined annotation dependent depletion score &gt;10) showed a nominally significant enrichment in controls both: 1) across all five genes; and 2) in the F12 gene alone. However, these results did not withstand correction for multiple testing. In conclusion, our results suggest that HAE-associated mutations are, at best, a rare cause of ACEi/ARB-induced angioedema. Furthermore, we were unable to identify a significant association between ACEi/ARB-induced angioedema and other variants in the investigated genes. Further studies with larger sample sizes are warranted to draw more definite conclusions concerning variants with limited effect sizes, including protective variants

Accelerating the Evolution of Nonhuman Primate Neuroimaging

© 2019 Elsevier Inc. Nonhuman primate neuroimaging is on the cusp of a transformation, much in the same way its human counterpart was in 2010, when the Human Connectome Project was launched to accelerate progress. Inspired by an open data-sharing initiative, the global community recently met and, in this article, breaks through obstacles to define its ambitions