Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
J Allergy Clin Immunol. 2018 Mar;141(3):972-981.e10. doi: 10.1016/j.jaci.2017.07.033. Epub 2017 Sep 21.
A better understanding of the means by which topical vitamin D analogues exert their therapeutic effect on psoriasis is of theoretical and practical importance.
We sought to clarify whether and how the topical vitamin D analogue calcipotriol (CAL) controls the IL-17A-mediated pathogenesis of murine psoriasis-like dermatitis in vivo.
Psoriasis-like dermatitis was induced by the topical application of an imiquimod (IMQ)-containing cream on the murine ear for 4 to 6 consecutive days. For topical CAL treatment, mice were treated daily with CAL solution on the ear before IMQ application.
Mice treated topically with CAL exhibited much milder IMQ-induced psoriasis-like dermatitis compared with vehicle-treated mice, with impaired accumulation of IL-17A-committed T (T17) cells in the lesional skin. The IMQ-induced upregulation of Il12b and Il23a was marked in the epidermis and was abrogated by CAL application, suggesting CAL-mediated suppression of IL-23 expression. CAL inhibited Il12b and Il23a expression by Langerhans cells ex vivo stimulated with IMQ and CD40 cross-linking. Topical CAL also inhibited T17 cell expansion in the draining lymph nodes of IMQ-treated skin, implying a possible effect on T17 cell-mediated dermatitis at distant sites. In fact, topical CAL application on the IMQ-treated left ear resulted in amelioration of T17 cell accumulation and psoriasis-like dermatitis in the right ear subsequently treated with IMQ.
Topical CAL can exert its antipsoriatic effect on CAL-treated lesions and, concomitantly, distant lesions by attenuating the T17 cell accumulation in both CAL-treated lesions and draining lymph nodes.
深入了解局部维生素 D 类似物治疗银屑病的作用机制具有理论和实际意义。
我们旨在阐明局部维生素 D 类似物卡泊三醇(CAL)是否以及如何控制体内银屑病样皮炎的 IL-17A 介导的发病机制。
通过在小鼠耳朵上连续 4-6 天涂抹咪喹莫特(IMQ)乳膏诱导银屑病样皮炎。在应用 IMQ 之前,用 CAL 溶液对耳朵进行每日局部 CAL 治疗。
与载体处理的小鼠相比,局部用 CAL 处理的小鼠表现出更温和的 IMQ 诱导的银屑病样皮炎,病变皮肤中累积的 IL-17A 承诺的 T(T17)细胞减少。CAL 应用可显著抑制表皮中 IL-12b 和 Il23a 的上调,并阻断其表达,表明 CAL 介导的 IL-23 表达抑制。CAL 通过体外用 IMQ 刺激朗格汉斯细胞和 CD40 交联抑制 Il12b 和 Il23a 的表达。局部 CAL 还抑制了 IMQ 处理皮肤引流淋巴结中 T17 细胞的扩增,暗示其对远处部位 T17 细胞介导的皮炎可能具有影响。事实上,在 IMQ 处理的左耳上局部应用 CAL 可改善随后用 IMQ 处理的右耳中 T17 细胞的积累和银屑病样皮炎。
CAL 可通过减轻 CAL 处理病变和引流淋巴结中 T17 细胞的积累,对 CAL 处理的病变和远处病变发挥其抗银屑病作用。