Lübeck Institute of Experimental Dermatology and Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany.
Incyte Research Institute, Wilmington, DE, United States.
Front Immunol. 2022 Sep 28;13:865241. doi: 10.3389/fimmu.2022.865241. eCollection 2022.
Chronic blistering at the skin and/or mucous membranes, accompanied by a varying degree of inflammation, is the clinical hallmark of pemphigoid diseases that impose a major medical burden. Pemphigoid diseases are caused by autoantibodies targeting structural proteins of the epithelial basement membrane. One major pathogenic pathway of skin blistering and inflammation is activation of myeloid cells following Fc gamma receptor-dependent binding to the skin-bound immune complexes. This process requires activation of specific kinases, such as PI3Kδ, which have emerged as potential targets for the treatment of pemphigoid diseases. Yet, it is unknown if global cutaneous kinase activity present in lesional pemphigoid disease correlates with therapeutic effects following treatment with a given target-selective kinase inhibitor. To address this, we here first determined the kinase activity in three different mouse models of pemphigoid diseases: Antibody transfer-induced mucous membrane pemphigoid (MMP), antibody transfer-induced epidermolysis bullosa acquisita (EBA) and immunization-induced EBA. Interestingly, the kinome signatures were different among the three models. More specifically, PI3Kδ was within the kinome activation network of antibody transfer-induced MMP and immunization-induced EBA, but not in antibody transfer-induced EBA. Next, the therapeutic impact of the PI3Kδ-selective inhibitor parsaclisib was evaluated in the three model systems. In line with the kinome signatures, parsaclisib had therapeutic effects in antibody transfer-induced MMP and immunization-induced EBA, but not in autoantibody-induced EBA. In conclusion, kinase activation signatures of inflamed skin, herein exemplified by pemphigoid diseases, correlate with the therapeutic outcomes following kinase inhibition, demonstrated here by the PI3Kδ inhibitor parsaclisib.
皮肤和/或黏膜慢性水疱,伴有不同程度的炎症,是类天疱疮疾病的临床特征,给医疗带来了重大负担。类天疱疮疾病是由针对上皮基底膜结构蛋白的自身抗体引起的。皮肤水疱和炎症的一个主要致病途径是,Fcγ受体依赖性结合皮肤免疫复合物后,髓样细胞的激活。这个过程需要特定激酶的激活,如 PI3Kδ,它已成为治疗类天疱疮疾病的潜在靶点。然而,尚不清楚病变性类天疱疮疾病中存在的全身性皮肤激酶活性是否与特定靶标选择性激酶抑制剂治疗后的治疗效果相关。为了解决这个问题,我们首先在三种不同的类天疱疮疾病小鼠模型中确定了激酶活性:抗体转移诱导的黏膜类天疱疮(MMP)、抗体转移诱导的获得性大疱性表皮松解症(EBA)和免疫诱导的 EBA。有趣的是,这三种模型中的激酶组特征不同。更具体地说,PI3Kδ 位于抗体转移诱导的 MMP 和免疫诱导的 EBA 的激酶激活网络内,但不在抗体转移诱导的 EBA 中。接下来,评估了 PI3Kδ 选择性抑制剂 parsaclisib 在三种模型系统中的治疗效果。与激酶组特征一致,parsaclisib 在抗体转移诱导的 MMP 和免疫诱导的 EBA 中具有治疗效果,但在自身抗体诱导的 EBA 中没有。总之,本文通过 PI3Kδ 抑制剂 parsaclisib 证明,炎症皮肤的激酶激活特征与激酶抑制后的治疗效果相关,在此以类天疱疮疾病为例。