Cytokines and Effector/Regulatory Cells Characterization in the Physiopathology of Cutaneous Lupus Erythematous: A Cross-Sectional Study

Abstract

We compared the presence of diverse cytokines and regulatory T and B cells in skin biopsies of discoid lupus erythematosus (DLE) and subacute cutaneous lupus erythematosus (SCLE). We included 19 patients with DLE, 13 with SCLE, 8 healthy controls, and 5 patients with hypertrophic scars. We assessed the CLASI activity score. To determine IL-22-producing cells and the subpopulation of CD4+/IL-17A+-, CD4+/IL-4+-, and CD4+/IFN-γ +-expressing T cells, CD123+/IDO+ pDCs, CD25+/Foxp3+ Tregs, and CD20+/IL-10+-producing B cells, an immunostaining procedure was performed. Also intracellular IL-22, IL-17, IL-4, IFN-γ, and Foxp3 in CD4 T cells, IL-10 in B cells, and IDO in pDCs were analyzed by flow cytometry in peripheral blood. The main cellular participation in both lupus groups was IL-17- and IL-22-producing cell responses both at skin and at peripheral blood but prevailed in DLE. The CLASI activity scores negatively correlated with Th22 subpopulation and positively correlated with CD25+/Foxp3+ Treg cells. In conclusion a proinflammatory and regulatory imbalance coexists in cutaneous lupus, both responses being more intense in DLE.

The role of interleukin‐4 in rheumatic diseases

“…It indicates its potential as markers of the amount and extent of periodontal damage in patients with SLE. The dermis and epidermis from tissues of patients with SLE had significantly higher percentage of IL‐4 + /CD4 + T cells compared to healthy donor groups . The above research indicates that IL‐4 plays a significant role in local lesion tissue in SLE, although at insignificant serum levels.…”

“…The dermis and epidermis from tissues of patients with SLE had significantly higher percentage of IL-4 + /CD4 + T cells compared to healthy donor groups. 44 The above research indicates that IL-4 plays a significant role in local lesion tissue in SLE, although at insignificant serum levels. Most studies have focused on the B-cell stimulatory properties of IL-4 in the development of autoantibody production.…”

JAK‐STAT signaling pathway inhibition: a role for treatment of discoid lupus erythematosus and dermatomyositis

“…A significant understanding of the cellular infiltrate found in psoriasis lesions exists in that there are elevated levels of IL‐17A and IL‐22; however, in DLE lesions, one study has found low levels of these cytokines and only IFN‐ γ producing CD4 + T cells . Notably, other studies have produced contrasting data in which IFN‐ γ , IL‐17A, and IL‐22 producing CD4 + T cells are all elevated in DLE skin lesions; this contrast reflects the complexity and broad nature of immunological involvement in this cutaneous condition . Although this discrepancy exists, there is still evidence of unique aspects of DLE pathophysiology with respect to targeting IFN‐ γ and the Th1 cell inflammatory immune response.…”

“…Specific analysis of DLE lesions has been conducted to determine the molecular transcriptome of DLE; the transcription and expression of certain genes; and involvement of immunological signal transduction pathways . Furthermore, some studies have compared the histology of DLE lesions with those of psoriasis.…”

“…16 in this cutaneous condition. 19 Although this discrepancy exists, As shown, JAK inhibitors in humans and lupus mouse models reduced the number of cutaneous lesions and suppressed levels of inflammatory cellular infiltrate. there is still evidence of unique aspects of DLE pathophysiology with respect to targeting IFN-c and the Th1 cell inflammatory immune response.…”