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Alopecia areata profiling shows TH1, TH2, and IL-23 cytokine activation without parallel TH17/TH22 skewing.
J Allergy Clin Immunol. 2015 Nov; 136(5):1277-87.JA

Abstract

BACKGROUND

Alopecia areata (AA) is a common T cell-mediated disorder with limited therapeutics. A molecular profile of cytokine pathways in AA tissues is lacking. Although studies have focused on TH1/IFN-γ responses, several observations support a shared genetic background between AA and atopy.

OBJECTIVE

We sought to define the AA scalp transcriptome and associated biomarkers with comparisons with atopic dermatitis (AD) and psoriasis.

METHODS

We performed microarray and RT-PCR profiling of 27 lesional and 17 nonlesional scalp samples from patients with AA for comparison with normal scalp samples (n = 6). AA gene expression was also compared with samples from patients with lesional or nonlesional AD and those with psoriasis. A fold change of greater than 1.5 and a false discovery rate of less than 0.05 were used for differentially expressed genes (DEGs).

RESULTS

We established the AA transcriptomes (lesional vs nonlesional: 734 DEGs [297 upregulated and 437 downregulated]; lesional vs normal: 4230 DEGs [1980 upregulated and 2250 downregulated]), including many upregulated immune and downregulated hair keratin genes. Equally impressive as upregulation in TH1/interferon markers (IFNG and CXCL10/CXCL9) were those noted in TH2 (IL13, CCL18, CCL26, thymic stromal lymphopoietin, and periostin), TH9/IL-9, IL-23 (p40 and p19), and IL-16 mediators (all P < .05). There were no increases in TH17/TH22 markers. Hair keratin (KRT) expressions (ie, KRT86 and KRT85) were significantly suppressed in lesional skin. Greater scalp involvement (>25%) was associated with greater immune and keratin dysregulation and larger abnormalities in nonlesional scalp samples (ie, CXCL10 and KRT85).

CONCLUSIONS

Our data associate the AA signature with TH2, TH1, IL-23, and IL-9/TH9 cytokine activation, suggesting consideration of anti-TH2, anti-TH1, and anti-IL-23 targeting strategies. Similar to psoriasis and AD, clinical trials with selective antagonists are required to dissect key pathogenic pathways.

Authors+Show Affiliations

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Genetics and Genomics Science, Icahn School of Medicine at Mount Sinai, New York, NY; Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY; Laboratory for Investigative Dermatology, Rockefeller University, New York, NY.Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY; Laboratory for Investigative Dermatology, Rockefeller University, New York, NY.Laboratory for Investigative Dermatology, Rockefeller University, New York, NY.Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.Laboratory for Investigative Dermatology, Rockefeller University, New York, NY.Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.Laboratory for Investigative Dermatology, Rockefeller University, New York, NY.Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.Department of Dermatology, Tel-Hashomer, Tel Aviv, Israel.Laboratory for Investigative Dermatology, Rockefeller University, New York, NY.Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Genetics and Genomics Science, Icahn School of Medicine at Mount Sinai, New York, NY; Laboratory for Investigative Dermatology, Rockefeller University, New York, NY; Department of Immunology, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: Emma.Guttman@mountsinai.org.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26316095

Citation

Suárez-Fariñas, Mayte, et al. "Alopecia Areata Profiling Shows TH1, TH2, and IL-23 Cytokine Activation Without Parallel TH17/TH22 Skewing." The Journal of Allergy and Clinical Immunology, vol. 136, no. 5, 2015, pp. 1277-87.
Suárez-Fariñas M, Ungar B, Noda S, et al. Alopecia areata profiling shows TH1, TH2, and IL-23 cytokine activation without parallel TH17/TH22 skewing. J Allergy Clin Immunol. 2015;136(5):1277-87.
Suárez-Fariñas, M., Ungar, B., Noda, S., Shroff, A., Mansouri, Y., Fuentes-Duculan, J., Czernik, A., Zheng, X., Estrada, Y. D., Xu, H., Peng, X., Shemer, A., Krueger, J. G., Lebwohl, M. G., & Guttman-Yassky, E. (2015). Alopecia areata profiling shows TH1, TH2, and IL-23 cytokine activation without parallel TH17/TH22 skewing. The Journal of Allergy and Clinical Immunology, 136(5), 1277-87. https://doi.org/10.1016/j.jaci.2015.06.032
Suárez-Fariñas M, et al. Alopecia Areata Profiling Shows TH1, TH2, and IL-23 Cytokine Activation Without Parallel TH17/TH22 Skewing. J Allergy Clin Immunol. 2015;136(5):1277-87. PubMed PMID: 26316095.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alopecia areata profiling shows TH1, TH2, and IL-23 cytokine activation without parallel TH17/TH22 skewing. AU - Suárez-Fariñas,Mayte, AU - Ungar,Benjamin, AU - Noda,Shinji, AU - Shroff,Anjali, AU - Mansouri,Yasaman, AU - Fuentes-Duculan,Judilyn, AU - Czernik,Annette, AU - Zheng,Xiuzhong, AU - Estrada,Yeriel D, AU - Xu,Hui, AU - Peng,Xiangyu, AU - Shemer,Avner, AU - Krueger,James G, AU - Lebwohl,Mark G, AU - Guttman-Yassky,Emma, Y1 - 2015/08/24/ PY - 2015/05/06/received PY - 2015/06/24/revised PY - 2015/06/25/accepted PY - 2015/8/29/entrez PY - 2015/9/1/pubmed PY - 2016/3/2/medline KW - Alopecia areata KW - IL-23 KW - T(H)1 KW - T(H)2 KW - T cell KW - atopic dermatitis KW - hair keratin SP - 1277 EP - 87 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 136 IS - 5 N2 - BACKGROUND: Alopecia areata (AA) is a common T cell-mediated disorder with limited therapeutics. A molecular profile of cytokine pathways in AA tissues is lacking. Although studies have focused on TH1/IFN-γ responses, several observations support a shared genetic background between AA and atopy. OBJECTIVE: We sought to define the AA scalp transcriptome and associated biomarkers with comparisons with atopic dermatitis (AD) and psoriasis. METHODS: We performed microarray and RT-PCR profiling of 27 lesional and 17 nonlesional scalp samples from patients with AA for comparison with normal scalp samples (n = 6). AA gene expression was also compared with samples from patients with lesional or nonlesional AD and those with psoriasis. A fold change of greater than 1.5 and a false discovery rate of less than 0.05 were used for differentially expressed genes (DEGs). RESULTS: We established the AA transcriptomes (lesional vs nonlesional: 734 DEGs [297 upregulated and 437 downregulated]; lesional vs normal: 4230 DEGs [1980 upregulated and 2250 downregulated]), including many upregulated immune and downregulated hair keratin genes. Equally impressive as upregulation in TH1/interferon markers (IFNG and CXCL10/CXCL9) were those noted in TH2 (IL13, CCL18, CCL26, thymic stromal lymphopoietin, and periostin), TH9/IL-9, IL-23 (p40 and p19), and IL-16 mediators (all P < .05). There were no increases in TH17/TH22 markers. Hair keratin (KRT) expressions (ie, KRT86 and KRT85) were significantly suppressed in lesional skin. Greater scalp involvement (>25%) was associated with greater immune and keratin dysregulation and larger abnormalities in nonlesional scalp samples (ie, CXCL10 and KRT85). CONCLUSIONS: Our data associate the AA signature with TH2, TH1, IL-23, and IL-9/TH9 cytokine activation, suggesting consideration of anti-TH2, anti-TH1, and anti-IL-23 targeting strategies. Similar to psoriasis and AD, clinical trials with selective antagonists are required to dissect key pathogenic pathways. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/26316095/Alopecia_areata_profiling_shows_TH1_TH2_and_IL_23_cytokine_activation_without_parallel_TH17/TH22_skewing_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(15)00931-8 DB - PRIME DP - Unbound Medicine ER -