Molecular and Morphological Characterization of Inflammatory Infiltrate in Rosacea Reveals Activation of Th1/Th17 Pathways.

Abstract

Rosacea is a common chronic inflammatory skin disease of unknown etiology. Our knowledge about an involvement of the adaptive immune system is very limited. We performed detailed transcriptome analysis, quantitative real-time reverse-transcriptase-PCR, and quantitative immunohistochemistry on facial biopsies of rosacea patients, classified according to their clinical subtype. As controls, we used samples from patients with facial lupus erythematosus and healthy controls. Our study shows significant activation of the immune system in all subtypes of rosacea, characterizing erythematotelangiectatic rosacea (ETR) already as a disease with significant influx of proinflammatory cells. The T-cell response is dominated by Th1/Th17-polarized immune cells, as demonstrated by significant upregulation of IFN-γ or IL-17, for example. Chemokine expression patterns support a Th1/Th17 polarization profile of the T-cell response. Macrophages and mast cells are increased in all three subtypes of rosacea, whereas neutrophils reach a maximum in papulopustular rosacea. Our studies also provide evidence for the activation of plasma cells with significant antibody production already in ETR, followed by a crescendo pattern toward phymatous rosacea. In sum, Th1/Th17 polarized inflammation and macrophage infiltration are an underestimated hallmark in all subtypes of rosacea. Therapies directly targeting the Th1/Th17 pathway are promising candidates in the future treatment of this skin disease.

• Authors: Timo Buhl, Mathias Sulk, Pawel Nowak, Jörg Buddenkotte, Ian McDonald, Jérôme Aubert, Isabelle Carlavan, Sophie Déret, Pascale Reiniche, Michel Rivier, Johannes J Voegel, Martin Steinhoff
• Journal: The Journal of investigative dermatology (J Invest Dermatol) Vol. 135 Issue 9 Pg. 2198-2208 (Sep 2015) ISSN: 1523-1747 [Electronic] United States
• PMID: 25848978 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Chemokines

Topics

• Adaptive Immunity (immunology, physiology)
• Adult
• Biopsy, Needle
• Case-Control Studies
• Cell Proliferation
• Chemokines (metabolism)
• Female
• Humans
• Immunohistochemistry
• Inflammation (immunology, physiopathology)
• Macrophages (immunology)
• Male
• Mast Cells (immunology)
• Middle Aged
• Molecular Targeted Therapy (methods)
• Reference Values
• Rosacea (drug therapy, immunology, pathology)
• Th1 Cells (immunology)
• Th17 Cells (immunology)