IL-36, IL-37, and IL-38 Cytokines in Skin and Joint Inflammation: A Comprehensive Review of Their Therapeutic Potential.

The interleukin (IL)-1 family of cytokines is composed of 11 members, including the most recently discovered IL-36α, β, γ, IL-37, and IL-38. Similar to IL-1, IL-36 cytokines are initiators and amplifiers of inflammation, whereas both IL-37 and IL-38 display anti-inflammatory activities. A few studies have outlined the role played by these cytokines in several inflammatory diseases. For instance, IL-36 agonists seem to be relevant for the pathogenesis of skin psoriasis whereas, despite being expressed within the synovial tissue, their silencing or overexpression do not critically influence the course of arthritis in mice. In this review, we will focus on the state of the art of the molecular features and biological roles of IL-36, IL-37, and IL-38 in representative skin- and joint-related inflammatory diseases, namely psoriasis, rheumatoid arthritis, and psoriatic arthritis. We will then offer an overview of the therapeutic potential of targeting the IL-36 axis in these diseases, either by blocking the proinflammatory agonists or enhancing the physiologic inhibitory feedback on the inflammation mediated by the antagonists IL-37 and IL-38

Expression and therapeutic interest of Interleukin-38 in Rheumatoid Arthritis : basic antagonist of interleukin 36 or novel inhibitor of inflammation?

Les IL-36α, β et γ sont des cytokines appartenant à la famille de l’IL-1. Elles sont exprimées notamment dans la peau et sont impliquées dans la pathogenèse du psoriasis. Leurs inhibiteurs connus ou hypothétiques l’IL-36Ra et l’IL-38 agissent en limitant l’inflammation. Dans la polyarthrite rhumatoïde (PR) et la maladie de Crohn, l’expression et le rôle de ces cytokines sont encore débattues. Les travaux de cette thèse se consacrent à l’étude du profil d’expression des IL-36 et de leurs inhibiteurs ainsi qu’à déterminer l’impact d’une surexpression de l’IL-38 in vivo et in vitro. La première étude a été réalisée chez les patients atteints de PR en comparaison avec les patients psoriasiques et ceux atteints de maladie de Crohn ainsi que dans les modèles murins correspondants. Cette étude a montré que ces cytokines étaient exprimées majoritairement par les kératinocytes et les macrophages mais possédaient cependant des profils d’expression distincts. Elle a également permis d’identifier un sous-groupe de patients pour lesquelles les IL-36 pourraient avoir un rôle important et pourraient représenter une cible en clinique. La seconde partie de la thèse a permis de montrer un effet anti-inflammatoire d’une surexpression de l’inhibiteur IL-38 dans différents modèles d’arthrite in vivo et dans des macrophages in vitro. Les thérapies basées sur l’inhibition de cytokines ont déjà prouvé leur efficacité en clinique et sont une cible thérapeutique très prometteuse. Cette thèse a pour objectifs d’une part de mieux comprendre la biologie des nouvelles cytokines de la famille de l’IL-1 et d’autre part de participer à la découverte de nouvelles cibles thérapeutiques dans les pathologies inflammatoires chroniques telles que la PR.IL-36α, β and γ are cytokines belonging to the IL-1 family. IL- 36 are expressed especially in the skin and are involved in the pathogenesis of psoriasis. Their inhibitors (well-known or hypothetical) IL-36Ra and IL-38 act in reducing inflammation. In rheumatoid arthritis (RA) and Crohn's disease, the expression and role of these cytokines need to be elucidated. This thesis is dedicated to the study of IL-36 agonists and antagonists expression profile and the better understanding of in vivo and in vitro impact of IL-38 overexpression. The firts study was conducted in patients with RA in comparison with psoriasis and Crohn's disease patients as well as in the corresponding relevant murine models. This study showed that these cytokines were expressed predominantly by keratinocytes and macrophages but had distinct expression profiles. A subgroup of patients for which the IL-36 could have an important role and may represent a clinical target was also identified. In the second part of the thesis, we demonstrated an anti-inflammatory effect following overexpression of the inhibitor IL-38 in several in vivo arthritis models and in macrophages in vitro. Cytokine neutralization based therapies have already proven effective in the clinic and are still a promising therapeutic target. This thesis aims firstly to better understand the biology of new IL-1 family cytokines and also to participate in the discovery of new therapeutic targets in chronic inflammatory diseases such as RA

Response to: ‘Does IL-38 act on macrophages and/or dendritic cells in arthritis?’ by Jiang et al.

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The enigmatic role of IL-38 in inflammatory diseases

International audienceIL-38 is the most recently discovered cytokine of the IL-1 family and is considered a potential inhibitor of the IL-1 and Toll-like receptor families. IL-38 exerts anti-inflammatory properties, especially on macrophages, by inhibiting secretion of pro-inflammatory cytokines, leading to reduced T-lymphocyte TH17 maturation. IL-38 has been studied most extensively in the context of chronic inflammatory diseases, particularly arthritis, where it is considered an attractive new drug candidate. IL-38 research has entered a new phase, with the realization that IL-38 is important in the pathophysiology of TH17 dependent-diseases (psoriasis, psoriatic arthritis and anky-losing spondylitis). In this review, we provide a critical evaluation of several controversial issues concerning IL-38 function and regulation. There is effectively contrasting data regarding IL-38: it is produced in conditions such as apoptosis, necrosis or inflammation, but data is lacking regarding IL-38 processing and biological function. Furthermore, the receptor for IL-38 has yet to be identified, although three candidate receptors – IL-1R1, IL-36R and IL-1RAPL1–have been proposed. Future studies will hopefully uncover new aspects of this enigmatic cytokine

Arthrose : des traitements à venir aux traitements d’avenir

International audienceOsteoarthritis affects hundreds of millions of people worldwide, and its prevalence is constantly increasing. While there is no effective treatment to date, new promising therapeutic strategies and targets are being investigated. Innovative cell therapies are reaching clinical trials, and the most recent progress in our understanding of the pathology is opening new routes for gene therapy. In the long term, the development of new biofabrication tools such as 3D bioprinting might pave the way for the use of personalized mini-joint models that would allow clinicians to screen drugs and personalize treatments. This review offers an overview of the most promising therapeutic approaches in the field of osteoarthritis, from coming treatments to those that are yet to be discovered.L’arthrose affecte des centaines de millions de personnes à travers le monde et sa prévalence ne fait qu’augmenter. Si aucun traitement ne permet de stopper le développement de l’arthrose à ce jour, de nouvelles stratégies et cibles thérapeutiques sont à l’étude. Ainsi, alors que des thérapies cellulaires de nouvelle génération font d’ores et déjà l’objet d’études cliniques, l’amélioration de la compréhension de cette pathologie ouvre la voie à de possibles thérapies géniques. À plus long terme, le développement d’outils de biofabrication tels que la bio-impression 3D permettent d’entrevoir l’utilisation de modèles personnalisés de mini-articulations pour le criblage de principes actifs et l’application de traitements sur mesure. Cette revue propose un tour d’horizon des approches thérapeutiques les plus prometteuses pour traiter l’arthrose, des traitements à venir à ceux qu’il reste à découvrir

Osteoarthritis: From upcoming treatments to treatments yet to come

International audienceOsteoarthritis affects hundreds of millions of people worldwide, and its prevalence is constantly increasing. While there is currently no treatment that can alter the course of the disease, promising therapeutic strategies and novel targets are being investigated. Innovative cell therapies are already reaching clinical trials, and recent progress in our understanding of the disease is opening new routes for gene therapy. In the long term, the development of new biofabrication tools, such as 3D bioprinting, may pave the way for personalized mini-joint models that could be used to screen drugs and to personalize treatments. This review provides an overview of the most promising therapeutic approaches in the field of osteoarthritis, from upcoming treatments to those that are yet to be discovered

Role of the IL-23/IL-17 Axis in Psoriasis and Psoriatic Arthritis: The Clinical Importance of Its Divergence in Skin and Joints.

Psoriasis is a chronic systemic inflammatory disease causing erythematosus and scaly skin plaques; up to 30% of patients with psoriasis develop Psoriatic Arthritis (PsA), which is characterised by inflammation and progressive damage of the peripheral joints and/or the spine and/or the entheses. The pathogenic mechanisms driving the skin disorder in psoriasis and the joint disease in PsA are sustained by the activation of inflammatory pathways that can be overlapping, but also, at least partially, distinct. Cytokines members of the IL-23/IL-17 family, critical in the development of autoimmunity, are abundantly expressed within the cutaneous lesions but also seem to be involved in chronic inflammation and damage of the synovium though, as it will be here discussed, not in all patients. In this review, we will focus on the state of the art of the molecular features of psoriatic skin and joints, focusing on the specific role of the IL-23/IL-17 pathway in each of these anatomical districts. We will then offer an overview of the approved and in-development biologics targeting this axis, emphasising how the availability of the "target" in the diseased tissues could provide a plausible explanation for the heterogeneous clinical efficacy of these drugs, thus opening future perspective of personalised therapies

Involvement of sphingosine kinase/sphingosine 1-phosphate metabolic pathway in spondyloarthritis

International audienceSpondyloarthritis (SpA) is a relatively common chronic inflammatory joint disorder, with a prevalence of about 0.2–0.5% worldwide. The primary target of the pathological process is the enthesis, where tendons and ligaments attach to underlying bone. These insertion sites are hotspots of bone formation (enthesophytes), which can lead to ankylosis. Unfortunately, the mechanisms causing the onset and progression of entheseal ossification remain largely unknown. Sphingosine 1-phosphate (S1P), a lipid generated after sphingosine phosphorylation by sphin-gosine kinases 1 and 2 (SK1/2), plays important roles in cell proliferation, differentiation and survival. S1P regulates fundamental biological processes such as cell cycle, inflammatory response or bone homeostasis. Indeed, S1P has been involved in some of most-spread skeletal diseases such as rheumatoid arthritis or osteoarthritis. On the other hand, the implication of S1P in SpA has not been explored yet. In the present work, we observed by ELISA that S1P content was significantly increased in the serum of SpA patients (6.1 ± 4.2 μM, n = 21) compared to healthy donors (1.6 ± 0.9 μM, n = 12). In vitro, gene expression of SK1 and SK2 as well as their activity were increased during differentiation of primary murine chondrocytes and osteoblasts into mineralizing cells. In addition, mRNA of the S1P-specific transporter Spns2 and S1P secretion were augmented. Using the pharmacological drugs SKi (SK pan-inhibitor), PF-543 (SK1 specific inhibitor) or K-145 (SK2 specific inhibitor), we showed that the inhibition of SK1 and/or SK2 decreased matrix mineralization, alkaline phosphatase activity and the mRNA expression of Runx2 and Bglap in chondrocytes and osteoblasts. To our knowledge, this is the first study indicating that S1P levels are significantly increased in serum from SpA patients. Moreover, we showed in vitro that SK activity was involved in the mineralization capacity of osteoblasts and chondrocytes. S1P metabolic pathway may represent an ingenious therapeutic target for SpA in the future

IL-38 overexpression induces anti-inflammatory effects in mice arthritis models and in human macrophages in vitro

Objectives Interleukin (IL)-38 is a newly characterised cytokine that belongs to the IL-1 family. This cytokine is expressed in the rheumatoid arthritis (RA) synovial tissue and IL-38 deficient mice have exacerbated arthritis. Here, we analysed the effect of IL-38 overexpression in the joints of arthritic mice, in human macrophages and synovial fibroblasts in vitro. Methods: Articular injections of an adeno-associated virus (AAV) 2/8 encoding IL-38 were performed in collagen-induced arthritis (CIA), K/BxN serum transfer-induced arthritis (STIA) and antigen-induced arthritis (AIA) in mice. The effect of IL-38 overexpression was evaluated through clinical scores, immunohistochemistry, microCT, Luminex and RT-qPCR analysis. THP-1 macrophages were transduced with a lentiviral vector to overexpress IL-38. Results: Clinical inflammatory scores were significantly decreased after AAV IL-38 injection in joints of mice with CIA and STIA, but not AIA. This decrease was accompanied by reduced macrophage infiltration and a decreased expression of Th17 cytokines (IL-17, IL-23, IL-22) and TNFα. However, IL-38 overexpression had no effect on cartilage or bone destruction. In vitro, the THP-1 monocytic cell line expressed less IL-6, TNFα and IL-23 after IL-38 overexpression. Conditioned media from these cells, containing released IL-38, also exert an anti-inflammatory effect on human primary macrophages and synovial fibroblasts from patients with RA. Conclusions: This study shows for the first time that IL-38 overexpression attenuates the severity of experimental arthritis. IL-38 may exert its anti-inflammatory effects by decreasing the production of proinflammatory cytokines by macrophages and synovial fibroblasts. This effect can lead to the development of novel treatment strategies in arthritis