Skin-infiltrating, interleukin-22–producing T cells differentiate pediatric psoriasis from adult psoriasis - 12/08/17

Doi : 10.1016/j.jaad.2017.05.017

Kelly M. Cordoro, MD ^a,^⁎ , Maria Hitraya-Low, BS ^b, Keyon Taravati, BS ^a, Priscila Munoz Sandoval, BS ^a, Esther Kim, MD ^c, Jeffrey Sugarman, MD, PhD ^a, Mariela L. Pauli, MS ^a, Wilson Liao, MD ^a, Michael D. Rosenblum, MD, PhD ^a
^a Department of Dermatology, University of California, San Francisco, California
^b San Francisco School of Medicine, University of California, San Francisco, California
^c Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California, San Francisco, California

^∗Correspondence to: Kelly M. Cordoro, MD, University of California, San Francisco, 1701 Divisadero St, San Francisco, CA 94115.University of California, San Francisco1701 Divisadero StSan FranciscoCA94115

Abstract

Background

Evidence from adult psoriasis studies implicates an imbalance between regulatory and effector T cells, particularly T_H-17–producing T cells, in the pathogenesis of psoriasis. Little is known about the immunopathology of psoriasis in children.

Objective

We sought to functionally characterize the inflammatory cell profiles of psoriatic plaques from pediatric patients and compare them with healthy, age-matched controls and adult psoriasis patients.

Methods

Skin samples from pediatric psoriasis patients and healthy controls were analyzed by multiparameter flow cytometry to determine the dominant immune cell subsets present and cytokines produced.

Results

Lesional tissue from pediatric psoriasis patients had significantly increased interleukin (IL) 22 derived from CD4⁺ and CD8⁺ cells compared with the tissues from healthy pediatric controls and adult psoriasis patients. Tissue from pediatric psoriasis patients had significantly less elevation of IL-17 derived from CD4⁺ and CD8⁺ cells compared with the tissue from adult psoriasis patients. In contrast with the lesions from adult patients, lesional skin in pediatric patients with psoriasis did not have increases in regulatory T cells.

Limitations

This is a pilot study, thus the sample size is small.

Conclusion

Significant differences in IL-17 and IL-22 expression were observed in the pediatric psoriasis patients compared with pediatric healthy controls and adult psoriasis patients. IL-22 might be relevant in the pathogenesis of pediatric psoriasis and represents a potential treatment target unique to pediatric psoriasis.

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Key words : IL-17, IL-22, immunophenotype, pediatric psoriasis, psoriasis

Abbreviations used : BSA, IFN-γ, IL, TNF-α, T regs, UCSF

Plan

Methods

Participants

Skin biopsy and flow cytometry

Statistical analyses

Results

Discussion

	Funding sources: Supported by a William Weston pilot grant from the Society for Pediatric Dermatology. Drs Rosenblum and Cordoro are supported by Dermatology Foundation Career Development Awards.
	Conflicts of interest: None declared.
	Reprints not available from the authors.