Low expression of the IL-23/Th17 pathway in atopic dermatitis compared to psoriasis

E Guttman-Yassky, MA Lowes… - The Journal of …, 2008 - journals.aai.org
E Guttman-Yassky, MA Lowes, J Fuentes-Duculan, LC Zaba, I Cardinale, KE Nograles…
The Journal of Immunology, 2008journals.aai.org
Abstract The classical Th1/Th2 paradigm previously defining atopic dermatitis (AD) and
psoriasis has recently been challenged with the discovery of Th17 T cells that synthesize IL-
17 and IL-22. Although it is becoming evident that many Th1 diseases including psoriasis
have a strong IL-17 signal, the importance of Th17 T cells in AD is still unclear. We
examined and compared skin biopsies from AD and psoriasis patients by gene microarray,
RT-PCR, immunohistochemistry, and immunofluorescence. We found a reduced genomic …
Abstract
The classical Th1/Th2 paradigm previously defining atopic dermatitis (AD) and psoriasis has recently been challenged with the discovery of Th17 T cells that synthesize IL-17 and IL-22. Although it is becoming evident that many Th1 diseases including psoriasis have a strong IL-17 signal, the importance of Th17 T cells in AD is still unclear. We examined and compared skin biopsies from AD and psoriasis patients by gene microarray, RT-PCR, immunohistochemistry, and immunofluorescence. We found a reduced genomic expression of IL-23, IL-17, and IFN-γ in AD compared with psoriasis. To define the effects of IL-17 and IL-22 on keratinocytes, we performed gene array studies with cytokine-treated keratinocytes. We found lipocalin 2 and numerous other innate defense genes to be selectively induced in keratinocytes by IL-17. IFN-γ had no effect on antimicrobial gene-expression in keratinocytes. In AD skin lesions, protein and mRNA expression of lipocalin 2 and other innate defense genes (hBD2, elafin, LL37) were reduced compared with psoriasis. Although AD has been framed by the Th1/Th2 paradigm as a Th2 polar disease, we present evidence that the IL-23/Th17 axis is largely absent, perhaps accounting for recurrent skin infections in this disease.
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