No / In recent years, different genes and proteins have been highlighted as potential biomarkers for psoriasis, one of the most common inflammatory skin diseases worldwide. However, most of these markers are not only psoriasis-specific but also found in other inflammatory disorders. We performed an unsupervised cluster analysis of gene expression profiles in 150 psoriasis patients and other inflammatory skin diseases (atopic dermatitis, lichen planus, contact eczema, and healthy controls). We identified a cluster of IL-17/tumor necrosis factor-α (TNFα)-associated genes specifically expressed in psoriasis, among which IL-36γ was the most outstanding marker. In subsequent immunohistological analyses, IL-36γ was confirmed to be expressed in psoriasis lesions only. IL-36γ peripheral blood serum levels were found to be closely associated with disease activity, and they decreased after anti-TNFα-treatment. Furthermore, IL-36γ immunohistochemistry was found to be a helpful marker in the histological differential diagnosis between psoriasis and eczema in diagnostically challenging cases. These features highlight IL-36γ as a valuable biomarker in psoriasis patients, both for diagnostic purposes and measurement of disease activity during the clinical course. Furthermore, IL-36γ might also provide a future drug target, because of its potential amplifier role in TNFα- and IL-17 pathways in psoriatic skin inflammation.

Yes / Interleukin-36 cytokines are predominantly expressed by epithelial cells. Significant upregulation of epidermal IL-36 is now a recognised characteristic of psoriatic skin inflammation. IL-36 is known to induce inflammatory responses in dendritic cells, fibroblasts and epithelial cells. Although vascular alterations are a hallmark of psoriatic lesions and dermal endothelial cells are well known to play a critical role in skin inflammation, the effects of IL-36 on endothelial cells are unexplored. We here show that endothelial cells including dermal microvascular cells express a functionally active IL-36 receptor. Adhesion molecules VCAM-1 and ICAM-1 are upregulated by IL-36γ stimulation and this is reversed by the presence of the endogenous IL-36 receptor antagonist. IL-36γ stimulated endothelial cells secrete the proinflammatory chemokines IL-8, CCL2 and CCL20. Chemotaxis assays showed increased migration of T cells following IL-36γ stimulation of endothelial cells. These results suggest a role for IL-36γ in the dermal vascular compartment and it is likely to enhance psoriatic skin inflammation by activating endothelial cells and promoting leukocyte recruitment.

Le psoriasis est une maladie cutanée chronique et complexe à médiation immunitaire qui implique un large éventail de cellules épithéliales et immunitaires. Les mécanismes sous-jacents qui régissent les défauts épidermiques et le dysfonctionnement immunologique restent largement incompris. L'IL-17A, une cytokine de grande importance dans la pathogenèse du psoriasis, est en mesure d'activer les kératinocytes, lesquels sécrètent à leur tour diverses cytokines et chimiokines, conduisant à la chronicisation des lésions psoriasiques. Ces dernières années, l'émergence de nouveaux modèles plus sophistiqués a permis l'évolution de nos connaissances sur la pathogénèse du psoriasis. En raison des différences importantes entre l'immunité cutanée de l'humain et de l'animal, de nombreux effets secondaires imprévus et indésirables sont observés en clinique lors du développement de nouvelles thérapies contre le psoriasis. Il y a alors un réel besoin pour le développement de modèles précliniques humains adéquats pour l'étude du psoriasis. Le premier objectif de cette thèse était d'évaluer le profil d'expression génique du modèle de peau psoriasique de l'équipe du Dre Pouliot. De façon intéressante, bien que celui-ci ne soit produit qu'à partir de deux types cellulaires, soit les fibroblastes et les kératinocytes provenant de lésions cutanées de patients atteints de psoriasis, une quantité importante de gènes dont l'expression est dérégulée entre les conditions psoriasiques et leurs contrôles sains a pu être observée. Cependant, en raison de l'absence de la composante immunitaire dans le modèle psoriasique, certains gènes reconnus comme étant dérégulés dans la peau psoriasique native n'ont pas été révélés dans le modèle à l'étude. Le second objectif de cette thèse visait à optimiser le modèle de peau psoriasique enrichi en lymphocytes T. Les résultats issus de cette étude ont montré que le changement des méthodes de culture des lymphocytes T, notamment aux niveaux de leur isolation et activation, permet pour la première fois la production d'IL-17A dans les substituts psoriasiques. Cette étude a permis de présenter un nouveau modèle de peau psoriasique produit à partir de cellules cutanées psoriasiques, enrichi en lymphocytes T et présentant le microenvironnement pro-inflammatoire caractéristique du psoriasis, notamment par la présence d'IL-17A. Finalement, le dernier objectif de cette thèse visait à étudier de façon plus approfondie les mécanismes cellulaires et moléculaires impliqués dans le psoriasis à l'aide de ce modèle optimisé. Cette étude a mis de l'avant la dérégulation du produit du gène PTPRM dans les kératinocytes psoriasiques et sa contribution dans la pathogenèse du psoriasis via l'activation excessive de la signalisation ERK1/2. Globalement, nos travaux soutiennent l'importance des kératinocytes dans le développement des lésions psoriasiques. Les recherches présentées dans cette thèse ont également mené à la proposition d'un modèle sophistiqué de peau psoriasique enrichie en lymphocytes T qui peut s'avérer un outil intéressant pour le développement de nouvelles cibles thérapeutiques, ainsi que pour la médecine personnalisée. / Psoriasis is a chronic and complex immune-mediated skin disease involving a wide range of epithelial and immune cells. The underlying mechanisms governing epidermal defects and immunological dysfunction remain largely misunderstood. IL-17A, a cytokine of great importance in the pathogenesis of psoriasis, can activate keratinocytes, which in turn secrete a variety of cytokines and chemokines, leading to the chronicization of psoriatic lesions. In recent years, the emergence of new and more sophisticated models has allowed the evolution of our knowledge on the pathogenesis of psoriasis. Because of the significant differences between human and animal skin immunity, many unexpected and undesirable side effects are observed in the clinic when developing new psoriasis therapies. There is therefore a real need for the development of adequate preclinical human models for the study of psoriasis. The first objective of this thesis was to evaluate the gene expression profile of Dr. Pouliot's psoriatic skin model. Interestingly, although the model is produced from only two cell types, fibroblasts and keratinocytes derived from skin lesions of psoriasis patients, a significant amount of deregulated gene expression between the psoriatic conditions and their healthy controls has been observed. However, due to the absence of the immune component in the psoriatic model, some genes known to be deregulated in native psoriatic skin were not revealed in this model. The second objective of this thesis was to optimize the T cell-enriched psoriatic skin model. The results of this study showed that the change in T cell culture methods, especially in their isolation and activation, allows for the first time the production of IL-17A in psoriatic substitutes. This study allowed the presentation of a new psoriatic skin model produced from psoriatic skin cells, enriched in T cells, and presenting the pro-inflammatory microenvironment characteristic of psoriasis, notably by the presence of IL-17A. Finally, the last objective of this thesis was to further investigate the cellular and molecular mechanisms involved in psoriasis using this optimized model. This study highlighted the deregulation of the PTPRM gene product in psoriatic keratinocytes and its contribution to the pathogenesis of psoriasis via excessive activation of ERK1/2 signaling. Overall, our work supports the importance of keratinocytes in the development of psoriatic lesions. The work presented in this thesis has also led to the proposal of a sophisticated T cell-enriched psoriatic skin model that may prove to be an interesting tool for the development of new therapeutic targets, as well as for personalized medicine.

Dans le cadre de ce projet de maîtrise, le but principal était de poursuivre le développement d'un modèle de peau psoriasique reconstruit par génie tissulaire et de caractériser le rôle de l'innervation sensorielle dans le phénotype psoriasique de ces derniers. Le développement de cet équivalent vise avant tout à mieux comprendre la pathogénèse du psoriasis et potentiellement ouvrir la porte à de nouvelles voies thérapeutiques permettant de contrôler la maladie ou ses symptômes. Avec nos protocoles, nous avons pu démontrer que l'ajout d'innervation à un équivalent de peau reconstruit par génie tissulaire exacerbait le phénotype psoriasique en tout ou en partie. Jusqu'à présent, la caractérisation des cytokines étudiées dans nos protocole nous laisse croire que le facteur de croissance neuronal (NGF) est le principal médiateur de la prolifération kératinocytaire caractérisant les peaux psoriasiques.

Between 250.000 and  300.000 people live with psoriasis in Sweden today. 50% develop psoriasis before they are 25 years old. When living with psoriasis, one have an increased risk of developing comorbidities, which include overweight, joint problems, high blood pressure, cardiovascular diseases and depression, among others. Based on recent findings, people living with psoriasis can achieve health benefits and improve the symptoms of the condition through living and good life style. I have developed a lifestyle system named "núna", which will empower the patient, encourage a good lifestyle, prevent comorbidities and improve the healthcare personnel and patient communication. The system includes an application which consists of five different main categories (Activity, diet, quit smoking, photography documentation and administrating issues related to ones healthcare providers), and an activity tracker with two different portable docks and a charging station.

The present study was designed to determine the effect of skin-temperature-biofeedback training on cellular proliferation in three psoriasis patients. It was hypothesized that (a) psoriasis patients would be able to consciously decrease skin temperature of psoriatic tissue, and (b) there would be a positive correlation between rate of cellular proliferation and temperature change. Results obtained indicated biofeedback training to be effective in decreasing the surface temperature of psoriatic tissue. A 2 X 7 analysis of variance for two repeated measures indicated the change in skin temperatures as a function of sample period to be significant, F (6,26) = 3.29, p < .02. Generalization of temperature-training effects from the biofeedback to the no-feedback condition were observed. Rate of proliferation decreased from pretraining to posttraining biopsies.

Further mechanistic studies demonstrated that both Radix Rubiae and realgar were capable of inducing cellular apoptosis on HaCaT cells in a dose- and time-dependent manner as shown by morphological inspection, DNA fragmentation, TUNEL assay, cell cycle analysis, annexin V---PI staining and Western blot analysis. HPLC fingerprintings were constructed for quality control of the Radix Rubiae extract using mollugin as the chemical marker. Further phytochemical study found that ethyl acetate fraction of this herb possessed potent growth inhibition on HaCaT cells, with IC50 of 0.9 microg/ml. However, the chemical compounds obtained from commercial sources including mollugin, alizarin, purpurin, and quinizarin failed to induce growth inhibition. Meanwhile, arsenic trioxide, arsenic pentoxide and arsenic iodide, three arsenic salts presented in realgar, had significant anti-proliferative effect on HaCaT cells, with IC50 values of 2.4, 16 and 6.8 microM, respectively; and cellular apoptosis was found to be the underlying mechanism for the observed growth inhibitory activity. Furthermore, Radix Rubiae, realgar and arsenic compounds were also revealed to possess growth inhibition when evaluated in a PHA-activated PBMC model, and all of the substances except arsenic pentoxide significantly attenuated the release of inflammatory cytokines such as IFN-y, TNF-alpha and IL-2 in PBMC, indicating an anti-inflammatory effect. The in vivo mouse tail model experiments demonstrated that arsenic trioxide, arsenic pentoxide and arsenic iodide were able to markedly induce mouse tail keratinocyte differentiation, while such differentiation-modulating effect observed in the fraction of Radix Rubiae was only marginal. / In summary, Radix Rubiae and realgar extracts and three arsenic compounds have been identified and characterized as potential anti-psoriatic agents. The discoveries from the present PhD project not only help put the traditional use of these medicinal substances for psoriasis treatment on a scientific footing, but also open up new opportunities for their development into novel anti-psoriatic therapies. / Psoriasis, a chronic inflammatory skin disorder affecting approximately 2-3% of the population worldwide, is characterized histologically by hyperproliferation and aberrant differentiation of epidermal keratinocytes. Many conventional therapies are offered for psoriasis treatment but there exist problems such as unsatisfactory efficacy, side effects and drug resistance. Many patients therefore turn to alternative and complementary medicines for help. Traditionally, Chinese herbal medicine has been extensively used to treat psoriasis and produced promising clinical results. The present PhD study was conducted to investigate psoriasis-treating Chinese herbal medicines with an aim to identify effective anti-psoriatic agents. Sixty Chinese medicinal materials were selected for the screening project based on their ethnomedical use in psoriasis. The ethanolic extracts of these medicinal substances were evaluated for their anti-proliferative action on cultured HaCaT human keratinocytes using microplate SRB and MTT assays. Among them, the root of Rubia cordifolia L. (Radix Rubiae) and realgar were found to have significant anti-proliferative effects, with IC50 values of 1.4 and 6.6 microg/ml, respectively as measured by MTT assay, while they exerted mild significant cytotoxicity on the human fibroblast Hs-68 cell line. / Tse, Wai Pui. / Advisers: C. T. Che; Z. X. Lin. / Source: Dissertation Abstracts International, Volume: 70-09, Section: B, page: . / Thesis submitted in: October 2008. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 298-340). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 4 uppsatser.

Psoriasis är en hudsjukdom som syns på grund av dess röda och fjällande hudflagor på huden. Sjukdomen beror på både miljö- och genetiska faktorer. Det kan vara både psykiskt och fysiskt påfrestande att leva med diagnosen eftersom sjukdomen innebär en livslång behandling men går inte att bota. Vårt syfte är att undersöka hur personer med psoriasis accepterar sin livssituation. Metoden som användes var en allmän litteraturstudie. Resultatet visade på att personer med psoriasis kan acceptera sin livssituation med hjälp av familj och vänner, social samhörighet och genom anpassningar i deras liv. Detta genom att de drabbade fick stöd från närstående och kunde prata ut med andra personer som befann sig i samma situation, då var det enklare att acceptera sin livssituation. Förmågan att kunna koppla bort negativa kommentarer och fokusera på sin inre krets istället var till hjälp. Genom att belysa hur personer med psoriasis upplever sin livssituation kan det underlätta till acceptans hos den drabbade. / Psoriasis is a skin disease that is visible due to its red and scaly skin flakes on the skin. The disease is due to both environmental and genetic factors. It can be both mentally and physically stressful to live with the diagnosis because the disease involves a lifelong treatment but can not be cured. Our purpose is to investigate how people with psoriasis accept their disease. The method used was a general literature study. The result showed that people with psoriasis can accept their life situation with family and friends, social cohesion and through adjustments in their lives. This because the victims were given support from related people and were able to communicate with other people who were in the same situation, it was easier to accept their life situation. The ability to disconnect negative comments and focus on their inner circle instead was helpful. By highlighting how people with psoriasis experience their life situation, it can facilitate acceptance of the victim.

Un réseau de cytokine complexe a été décrit dans le psoriasis mettant en évidence le rôle central des cytokines proinflammatoires dans la physiopathologie de cette maladie. Notre tentative de modéliser l'inflammation cutanée a montré que la combinaison de l'IL-17A, IL-22, IL-1α, oncostatine M (OSM) et le TNFα, augmente de manière synergique l'expression de chimiokines et de peptides antimicrobiens, reflétant certaines caractéristiques du psoriasis. D'autres caractéristiques de cette maladie sont l'acanthose et le blocage de la différenciation des kératinocytes. Notre premier objectif était d'étudier le rôle respectif de ces cytokines sur la différenciation des kératinocytes en comparaison avec les lésions de patients psoriasiques. Toutes ces cytokines inhibent l'expression des marqueurs de différentiation des kératinocytes, parmi lesquelles l’IL-22 et l’OSM sont les plus puissantes et le mélange M5 présente des effets synergiques. Si l'IL-22 et l'OSM déclenchent plus spécifiquement l'hyperplasie épidermique et le blocage de la différenciation, l’IL-1α, IL-17A et le TNFα sont plutôt impliqués dans l'activation de l'immunité innée. Le rôle fonctionnel de chacune de ces cytokines in vivo a été étudié dans un modèle d'inflammation cutanée de type psoriasique induit par l'imiquimod (IMQ), un agoniste TLR7, en utilisant des souris déficientes en cytokines. L'absence de l'OSM ou de l'OSMRβ n'a pas modifié le développement des lésions inflammatoires induites par l’IMQ. Une hypothèse est que d'autres cytokines peuvent avoir des effets redondants avec l'OSM. L'absence de l'IL-22 chez la souris diminue partiellement les lésions cutanées induites par l'IMQ, démontrant que son retrait du réseau cytokinique rompt une partie des effets synergiques des cytokines in vivo comme présenté dans le modèle M5. L'absence de l'IL-1α ou de l'IL-1β ne modifie pas l'inflammation cutanée induite par l'IMQ, ce qui n'est pas surprenant au vu des activités redondantes de ces deux cytokines. La diminution partielle de l'inflammation en absence d'IL-1α ET d'IL-1β OU de la chaine réceptrice commune IL-1RI confirme ces observations. A long terme ces études devraient permettre de proposer des stratégies anti-cytokine ciblées et combinées pour tenter de rompre la synergie et diminuer ainsi toutes les composantes de la réponse inflammatoire cutanée. / A complex cytokine network has been described in psoriasis and highlighted a central role of proinflammatory cytokines produced by infiltrated immune cells. Our attempt to model skin inflammation showed that the combination of IL-17A, IL-22, IL-1α, OSM and TNFα (Mix M5) synergistically increases chemokines and antimicrobial-peptides expression, recapitulating some features of psoriasis. Other characteristics of psoriasis are acanthosis and down-regulation of keratinocyte differentiation markers. Our aim was to characterize the specific roles of these cytokines on keratinocyte differentiation, and to compare with psoriatic lesion features. All cytokines decrease keratinocytes differentiation markers expression, but IL-22 and OSM were the most powerful, and the M5 strongly synergized the effects. If IL-22 and OSM more specifically drive epidermal hyperplasia and differentiation loss, IL-1α, IL-17A and TNFα were more involved in the activation of innate immunity. Functional role of these cytokines in vivo was studied in imiquimod-induced psoriasis-like skin inflammation by using knockout mice. Imiquimod (IMQ) is a TLR7 ligand. The absence of OSM or OSMRβ did not affect skin lesions after IMQ treatment. We supposed that other cytokines might be redundant with the OSM effects. The absence of IL-22 in mice partially reduced skin lesions induced by IMQ, demonstrating that removal of IL-22 in cytokine network break synergistic effects of cytokines in vivo as observed in in vitro with M5. The absence of IL-1α or IL-1β did not affect skin lesions after IMQ treatment, supporting the potential redundant activity of these cytokines, since the response is attenuated in mice deficient for both IL-1α and IL-1β or for IL-1RI. In the long term these studies should propose strategies targeted and combined anti-cytokine in order to break the synergy and thus reduce all components of the inflammatory skin response.