Aktuelle Dermatologie 2007; 33(11): 413-416
DOI: 10.1055/s-2007-967005
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Der Beitrag von Keratinozyten an der Pathogenese des kutanen Lupus erythematodes[*]

Contribution of Keratinocytes to the Pathogenesis of Cutaneous Lupus ErythematosusM.  Wittmann1
  • 1Klinik und Poliklinik für Dermatologie und Venerologie der Medizinischen Hochschule Hannover
Further Information

Publication History

Publication Date:
12 November 2007 (online)

Zusammenfassung

Hautveränderungen sind eine häufige Manifestationsform der Autoimmunerkrankung Lupus erythematodes (LE). Derzeit steht keine kurative Therapie zur Verfügung. Eine Voraussetzung für die Entwicklung einer effektiven Lokaltherapie besteht in einem besseren Verständnis der zugrunde liegenden Pathomechanismen. Keratinozyten werden als Zielzellen des auto-aggressiven Angriffs gesehen. Es mehren sich jedoch die Hinweise, dass Keratinozyten auch - mittels Mediatorfreisetzung - aktiv an der Regulation und Aufrechterhaltung der Lupuspathologie beteiligt sind. In der vorgestellten Untersuchung haben wir das pro-entzündliche Antwortmuster von Keratinozyten von LE-Patienten im Vergleich zu Keratinozyten von gesunden Spendern untersucht.

Abstract

Lupus erythematosus (LE) is an autoimmune disorder and cutaneous manifestations belong to the most common clinical features of LE. Up to now, there exists no causative treatment regimen. However, a prerequisite for development of effective local therapeutics is the better understanding of the underlying pathophysiological mechanisms. In cutaneous LE (CLE), keratinocytes are considered to be target cells for immunological injury. Next to their role as target cells, evidence is accumulating that keratinocytes play an important role in actively regulating and maintaining the pathology in CLE by virtue of mediator release. In this study, we were interested in determining differences in the proinflammatory response of patient-derived keratinocytes.

1 Förderung durch die Deutsche Forschungsgemeinschaft (Wi1822/5-1).
Vortrag beim wissenschaftlichen Jahres-Symposium der Berliner Stiftung für Dermatologie, 12. Mai 2007, Berlin.

Literatur

  • 1 Alarcon-Riquelme M E. The genetics of systemic lupus erythematosus: understanding how SNPs confer disease susceptibility.  Springer Semin Immunopathol. 2006;  28 109-117
  • 2 Graham R R, Kozyrev S V, Baechler E C, Reddy M V, Plenge R M, Bauer J W, Ortmann W A, Koeuth T, Gonzalez Escribano M F, Pons-Estel B, Petri M, Daly M, Gregersen P K, Martin J, Altshuler D, Behrens T W, Alarcon-Riquelme M E. A common haplotype of interferon regulatory factor 5 (IRF5) regulates splicing and expression and is associated with increased risk of systemic lupus erythematosus.  Nat Genet. 2006;  38 550-555
  • 3 Graham R R, Kyogoku C, Sigurdsson S, Vlasova I A, Davies L R, Baechler E C, Plenge R M, Koeuth T, Ortmann W A, Hom G, Bauer J W, Gillett C, Burtt N, Cunninghame Graham D S, Onofrio R, Petri M, Gunnarsson I, Svenungsson E, Ronnblom L, Nordmark G, Gregersen P K, Moser K, Gaffney P M, Criswell L A, Vyse T J, Syvanen A C, Bohjanen P R, Daly M J, Behrens T W, Altshuler D. Three functional variants of IFN regulatory factor 5 (IRF5) define risk and protective haplotypes for human lupus.  Proc Natl Acad Sci USA. 2007;  104 6758-6763
  • 4 Asanuma Y, Chung C P, Oeser A, Shintani A, Stanley E, Raggi P, Stein C M. Increased concentration of proatherogenic inflammatory cytokines in systemic lupus erythematosus: relationship to cardiovascular risk factors.  J Rheumatol. 2006;  33 539-545
  • 5 Davas E M, Tsirogianni A, Kappou I, Karamitsos D, Economidou I, Dantis P C. Serum IL-6, TNFalpha, p55 srTNFalpha, p75srTNFalpha, srIL-2alpha levels and disease activity in systemic lupus erythematosus.  Clin Rheumatol. 1999;  18 17-22
  • 6 Linker-Israeli M, Deans R J, Wallace D J, Prehn J, Ozeri-Chen T, Klinenberg J R. Elevated levels of endogenous IL-6 in systemic lupus erythematosus. A putative role in pathogenesis.  J Immunol. 1991;  147 117-123
  • 7 Lauwerys B R, Garot N, Renauld J C, Houssiau F A. Interleukin-10 blockade corrects impaired in vitro cellular immune responses of systemic lupus erythematosus patients.  Arthritis Rheum. 2000;  43 1976-1981
  • 8 Farkas L, Beiske K, Lund-Johansen F, Brandtzaeg P, Jahnsen F L. Plasmacytoid dendritic cells (natural interferon-alpha/beta-producing cells) accumulate in cutaneous lupus erythematosus lesions.  Am J Pathol. 2001;  159 237-243
  • 9 Nousari H C, Kimyai-Asadi A, Tausk F A. Subacute cutaneous lupus erythematosus associated with interferon beta-1a.  Lancet. 1998;  352 1825-1826
  • 10 Wong C K, Li E K, Ho C Y, Lam C W. Elevation of plasma interleukin-18 concentration is correlated with disease activity in systemic lupus erythematosus.  Rheumatology (Oxford). 2000;  39 1078-1081
  • 11 Wong C K, Ho C Y, Li E K, Tam L S, Lam C W. Elevated production of interleukin-18 is associated with renal disease in patients with systemic lupus erythematosus.  Clin Exp Immunol. 2002;  130 345-351
  • 12 Amerio P, Frezzolini A, Abeni D, Teofoli P, Girardelli C R, De Pita O, Puddu P. Increased IL-18 in patients with systemic lupus erythematosus: relations with Th-1, Th-2, pro-inflammatory cytokines and disease activity. IL-18 is a marker of disease activity but does not correlate with pro-inflammatory cytokines.  Clin Exp Rheumatol. 2002;  20 535-538
  • 13 Calvani N, Richards H B, Tucci M, Pannarale G, Silvestris F. Up-regulation of IL-18 and predominance of a Th1 immune response is a hallmark of lupus nephritis.  Clin Exp Immunol. 2004;  138 171-178
  • 14 Park M C, Park Y B, Lee S K. Elevated interleukin-18 levels correlated with disease activity in systemic lupus erythematosus.  Clin Rheumatol. 2004;  23 225-229
  • 15 Toro J R, Finlay D, Dou X, Zheng S C, LeBoit P E, Connolly M K. Detection of type 1 cytokines in discoid lupus erythematosus.  Arch Dermatol. 2000;  136 1497-1501
  • 16 Popovic K, Ek M, Espinosa A, Padyukov L, Harris H E, Wahren-Herlenius M, Nyberg F. Increased expression of the novel proinflammatory cytokine high mobility group box chromosomal protein 1 in skin lesions of patients with lupus erythematosus.  Arthritis Rheum. 2005;  52 3639-3645
  • 17 Zampieri S, Alaibac M, Iaccarino L, Rondinone R, Ghirardello A, Sarzi-Puttini P, Peserico A, Doria A. Tumour necrosis factor alpha is expressed in refractory skin lesions from patients with subacute cutaneous lupus erythematosus.  Ann Rheum Dis. 2006;  65 545-548
  • 18 Wenzel J, Uerlich M, Worrenkamper E, Freutel S, Bieber T, Tuting T. Scarring skin lesions of discoid lupus erythematosus are characterized by high numbers of skin-homing cytotoxic lymphocytes associated with strong expression of the type I interferon-induced protein MxA.  Br J Dermatol. 2005;  153 1011-1015
  • 19 Bauer J W, Baechler E C, Petri M, Batliwalla F M, Crawford D, Ortmann W A, Espe K J, Li W, Patel D D, Gregersen P K, Behrens T W. Elevated Serum Levels of Interferon-Regulated Chemokines Are Biomarkers for Active Human Systemic Lupus Erythematosus.  PloS Med. 2006;  3 e491
  • 20 Kim J M, Rasmussen J P, Rudensky A Y. Regulatory T cells prevent catastrophic autoimmunity throughout the lifespan of mice.  Nat Immunol. 2007;  8 191-197
  • 21 Franz B, Fritzsching B, Riehl A, Oberle N, Klemke C D, Sykora J, Quick S, Stumpf C, Hartmann M, Enk A, Ruzicka T, Krammer P H, Suri-Payer E, Kuhn A. Low number of regulatory T cells in skin lesions of patients with cutaneous lupus erythematosus.  Arthritis Rheum. 2007;  56 1910-1920
  • 22 Crispin J C, Martinez A, Alcocer-Varela J. Quantification of regulatory T cells in patients with systemic lupus erythematosus.  J Autoimmun. 2003;  21 273-276
  • 23 Banchereau J, Pascual V. Type I interferon in systemic lupus erythematosus and other autoimmune diseases.  Immunity. 2006;  25 383-392
  • 24 Casciola-Rosen L, Rosen A. Ultraviolet light-induced keratinocyte apoptosis: a potential mechanism for the induction of skin lesions and autoantibody production in LE.  Lupus. 1997;  6 175-180
  • 25 Kuhn A, Herrmann M, Kleber S, Beckmann-Welle M, Fehsel K, Martin-Villalba A, Lehmann P, Ruzicka T, Krammer P H, Kolb-Bachofen V. Accumulation of apoptotic cells in the epidermis of patients with cutaneous lupus erythematosus after ultraviolet irradiation.  Arthritis Rheum. 2006;  54 939-950
  • 26 Baima B, Sticherling M. Apoptosis in different cutaneous manifestations of lupus erythematosus.  Br J Dermatol. 2001;  144 958-966
  • 27 Pablos J L, Santiago B, Galindo M, Carreira P E, Ballestin C, Gomez-Reino J J. Keratinocyte apoptosis and p53 expression in cutaneous lupus and dermatomyositis.  J Pathol. 1999;  188 63-68
  • 28 Reefman E, Kuiper H, Jonkman M F, Limburg P C, Kallenberg C G, Bijl M. Skin sensitivity to UVB irradiation in systemic lupus erythematosus is not related to the level of apoptosis induction in keratinocytes.  Rheumatology (Oxford). 2006;  45 538-544
  • 29 Kaudewitz P, Ruzicka T, Meurer M, Rieber P, Braun-Falco O. Epidermal synthesis and expression of HLA-DR on keratinocytes in lupus erythematosus.  Arch Dermatol Res. 1985;  277 444-447
  • 30 Kuhn A, Sonntag M, Sunderkotter C, Lehmann P, Vestweber D, Ruzicka T. Upregulation of epidermal surface molecule expression in primary and ultraviolet-induced lesions of lupus erythematosus tumidus.  Br J Dermatol. 2002;  146 801-809
  • 31 Miori L, Bellosta M, Rabbiosi G. HLA-DR positivity in discoid lupus erythematosus.  J Am Acad Dermatol. 1989;  21 1316-1317
  • 32 Tebbe B, Mazur L, Stadler R, Orfanos C E. Immunohistochemical analysis of chronic discoid and subacute cutaneous lupus erythematosus-relation to immunopathological mechanisms.  Br J Dermatol. 1995;  132 25-31
  • 33 Meller S, Winterberg F, Gilliet M, Muller A, Lauceviciute I, Rieker J, Neumann N J, Kubitza R, Gombert M, Bunemann E, Wiesner U, Franken-Kunkel P, Kanzler H, Dieu-Nosjean M C, Amara A, Ruzicka T, Lehmann P, Zlotnik A, Homey B. Ultraviolet radiation-induced injury, chemokines, and leukocyte recruitment: An amplification cycle triggering cutaneous lupus erythematosus.  Arthritis Rheum. 2005;  52 1504-1516
  • 34 Furukawa F, Kashihara-Sawami M, Lyons M B, Norris D A. Binding of antibodies to the extractable nuclear antigens SS-A/Ro and SS-B/La is induced on the surface of human keratinocytes by ultraviolet light (UVL): implications for the pathogenesis of photosensitive cutaneous lupus.  J Invest Dermatol. 1990;  94 77-85
  • 35 Dorner T, Hucko M, Mayet W J, Trefzer U, Burmester G R, Hiepe F. Enhanced membrane expression of the 52 kDa Ro(SS-A) and La(SS-B) antigens by human keratinocytes induced by TNF alpha.  Ann Rheum Dis. 1995;  54 904-909
  • 36 Gerl V, Hostmann B, Johnen C, Waka A, Gerl M, Schumann F, Klein R, Radbruch A, Hiepe F. The intracellular 52-kd Ro/SSA autoantigen in keratinocytes is up-regulated by tumor necrosis factor alpha via tumor necrosis factor receptor I.  Arthritis Rheum. 2005;  52 531-538
  • 37 Wittmann M, Werfel T. Interaction of keratinocytes with infiltrating lymphocytes in allergic eczematous skin diseases.  Curr Opin Allergy Clin Immunol. 2006;  6 329-334
  • 38 Wenzel J, Henze S, Worenkamper E, Basner-Tschakarjan E, Sokolowska-Wojdylo M, Steitz J, Bieber T, Tuting T. Role of the chemokine receptor CCR4 and its ligand thymus- and activation-regulated chemokine/CCL17 for lymphocyte recruitment in cutaneous lupus erythematosus.  J Invest Dermatol. 2005;  124 1241-1248
  • 39 Limat A, French L E, Blal L, Saurat J H, Hunziker T, Salomon D. Organotypic cultures of autologous hair follicle keratinocytes for the treatment of recurrent leg ulcers.  J Am Acad Dermatol. 2003;  48 207-214
  • 40 Schwarz A, Stander S, Berneburg M, Bohm M, Kulms D, van Steeg H, Grosse-Heitmeyer K, Krutmann J, Schwarz T. Interleukin-12 suppresses ultraviolet radiation-induced apoptosis by inducing DNA repair.  Nat Cell Biol. 2002;  4 26-31
  • 41 Wozniacka A, Lesiak A, Narbutt J, McCauliffe D P, Sysa-Jedrzejowska A. Chloroquine treatment influences proinflammatory cytokine levels in systemic lupus erythematosus patients.  Lupus. 2006;  15 268-275

1 Förderung durch die Deutsche Forschungsgemeinschaft (Wi1822/5-1).
Vortrag beim wissenschaftlichen Jahres-Symposium der Berliner Stiftung für Dermatologie, 12. Mai 2007, Berlin.

Prof. Dr. med. Miriam Wittmann

Klinik und Poliklinik für Dermatologie und Venerologie
der Medizinischen Hochschule Hannover

Ricklinger Straße 5
30449 Hannover

Email: Wittmann.Miriam@MH-Hannover.de