T cell-regulated neutrophilic inflammation in autoinflammatory diseases
JOURNAL OF IMMUNOLOGY
Authors: Keller, M; Spanou, Z; Schaerli, P; Britschgi, M; Yawalkar, N; Seitz, M; Villiger, PM; Pichler, WJ
Abstract
Previous studies of acute generalized exanthematous pustulosis, a peculiar drug hypersensitivity reaction, suggested that CXCL8-producing T cells regulate sterile, polymorphonuclear neutrophil-rich skin inflammations. In this study, we test the hypothesis of whether CXCL8-producing T cells are present in autoinflammatory diseases like pustular psoriasis and Behcet's disease. Immunohistochemistry of normal skin revealed few CD4(+) and CD8(+) T cells, few CXCL8(+) cells, and no neutrophilic infiltration, whereas in acute exacerbations of atopic dermatitis, numerous CD4(+) T cells but few CD8(+) T cells, neutrophils, or CXCL8(+) cells were detected. In contrast, a pronounced infiltration of neutrophils and of predominantly CD4(+) T cells was observed in skin biopsies from pustular psoriasis, Beh et's disease, and acute generalized exanthematous pustulosis, with infiltrating T cells strongly positive for CXCL8 and the chemokine receptor CCR6. Skin-derived T cell clones from pustular skin reactions were positive for CCR6 but negative for CCR8 and secreted high amounts of CXCL8 and GM-CSF, often together with IFN-gamma and TNF-alpha after in vitro stimulation. Moreover, some skin-derived T cell clones from Behcet's disease and from pustular psoriasis predominantly produced CXCL8 and GM-CSF, but failed to secrete IL-5 and IFN-gamma. These cells might represent a particular subset as they differ from both Th1 as well as Th2 T cells and are associated with a unique, neutrophil-rich sterile inflammation. Our findings suggest that CXCL8/GM-CSF-producing T cells may orchestrate neutrophil-rich pathologies of chronic autoinflammatory diseases like pustular psoriasis and Behcet's disease.
The utility of serum C-C chemokine ligand 1 in sarcoidosis: A comparison to IgG4-related disease
CYTOKINE
Authors: Komatsu, Masamichi; Yamamoto, Hiroshi; Yasuo, Masanori; Ushiki, Atsuhito; Nakajima, Tomoyuki; Uehara, Takeshi; Kawakami, Satoshi; Hanaoka, Masayuki
Abstract
We previously reported higher levels of C-C chemokine ligand (CCL) 1 in the bronchoalveolar lavage (BAL) fluid (BALF) of patients with sarcoidosis than in BALF of patients with immunoglobulin G4 (IgG4)-related disease (IgG4-RD), indicating that CCL1 might act as a marker of disease activity in sarcoidosis. Notably, less invasive sampling sources are desirable, as BAL cannot always be performed due to its inherent risk. In this study, we sought to decipher the correlation between serum levels of CCL1 and clinical characteristics of sarcoidosis. Serum samples were obtained from 44 patients with clinically confirmed sarcoidosis, 14 patients with IgG4-RD, and 14 healthy controls. The clinical and radiological findings were retrospectively evaluated. Serum levels of CCL1 were measured using a sandwich enzyme-linked immunosorbent assay. Serum levels of other 17 cytokines and chemokines were measured using a MILLIPLEX (R) MAP KIT and Luminex (R) magnetic beads. Serum levels of CCL1 were significantly higher in patients with sarcoidosis than in patients with IgG4-RD and healthy controls. Serum CCL1 was positively correlated with the degree of hilar lymph node swelling on chest computed tomography and serum levels of soluble interleukin 2 receptor. Positive correlations were also observed between serum CCL1 and total cell counts, lymphocyte counts in BALF, and serum T helper 1 mediators such as IP-10 and TNF-alpha in patients with sarcoidosis. Serum CCL1 levels were significantly elevated in sarcoidosis and correlated with clinical parameters of the disease. In addition, serum and BALF levels of CCL1 were positively correlated in a statistically significant manner. Although further research in this field is necessary, CCL1 might have the potential to be a reliable serological marker of disease activity in sarcoidosis.