Characterization of clinical photosensitivity in cutaneous lupus erythematosus

Cutaneous lupus erythematosus (CLE) is a disfiguring and common manifestation in systemic lupus erythematosus (SLE), and the etiology of this predisposition for cutaneous inflammation is unknown. Here, we sought to examine the keratinocyte as an important source of IL-6 and define the mechanism for its increased production in CLE. Evaluation of discoid and subacute cutaneous lupus erythematosus lesions revealed significant epidermal upregulation of IL-6 when compared with control via real-time PCR and immunohistochemistry. Keratinocytes from unaffected skin of lupus patients produced significantly more IL-6 compared with healthy controls following exposure to TLR2, 3, or 4 agonists, or exposure to UVB radiation. Importantly, pretreatment with type I interferons (IFNα and IFNκ) increased IL-6 production by control keratinocytes, and type I IFN blockade decreased IL-6 secretion by lupus keratinocytes. Secretion of keratinocyte-specific IFNκ was significantly increased after TLR2 and UVB treatment in lupus keratinocytes and neutralization of IFNκ decreased IL-6 production by lupus keratinocytes. Thus, lupus keratinocytes are primed for IL-6 hyper-production in a type I IFN-dependent manner. Increased production of IFNκ by lupus keratinocytes drives this response, indicating that IFNκ may play a pathogenic role in CLE and serve as a novel target for treatment.

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“…(Foering et al, 2013; Kuhn et al, 2001). However, why lupus skin is predisposed to inflammatory lesions after UV exposure is unclear.…”

Section: Introductionmentioning

confidence: 99%

Lupus Skin Is Primed for IL-6 Inflammatory Responses through a Keratinocyte-Mediated Autocrine Type I Interferon Loop

Stannard

Reed

Myers

et al. 2017

Journal of Investigative Dermatology

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“…UV irradiation is able to trigger activation of systemic lupus disease in male BXSB mice [29]. In line with this data, photosensitive patients with robust cutaneous infiltrates have more systemic symptoms, such as fatigue and arthralgias, than patients without skin inflammation after UV exposure [22]. Other murine models of skin inflammation also suggest a link with systemic disease.…”

Section: Pathogenesismentioning

confidence: 89%

“…UV exposure is a common trigger for CLE, with photosensitivity rates reported at 81% [22]. UV induces keratinocyte apoptosis, inflammatory cytokine production, and autoantigen exposure [23].…”

Section: Pathogenesismentioning

confidence: 99%

Cutaneous lupus erythematosus: updates on pathogenesis and associations with systemic lupus

Stannard

Kahlenberg

2016

Current Opinion in Rheumatology

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Purpose of Review Cutaneous lupus erythematosus (CLE) is a common manifestation among systemic lupus patients. There are no FDA approved therapies for CLE, and these lesions are frequently disfiguring and refractory to treatment. This will review will cover the recent inroads made into understanding the mechanisms behind CLE lesions and discuss promising therapeutic developments. Recent Findings The definition of cutaneous lupus is being refined to facilitate diagnostic and research protocols. Research into the pathogenesis of CLE is accelerating, and discoveries are now identifying genetic and epigenetic changes which may predispose to particular disease manifestations. Further, unique features of disease subtypes are being defined. Murine work supports a connection between cutaneous inflammation and systemic lupus disease activity. Importantly, human trials of type I interferon blockade hold promise for improving our treatment armamentarium for refractory CLE lesions. Summary Continued research to understand the mechanisms driving CLE will provide new methods for prevention and treatment of cutaneous lesions. These improvements may also have important effects on systemic disease activity, and thus, efforts to understand this link should be supported.

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“…The people who suffer from SLE and actinic keratosis, 'as a life practice' must avoid sun exposure [13]. However the avoidance of sun exposure is difficult to achieve because of several obvious reasons that might warrant the outdoor movements and activities.…”

Section: Discussionmentioning

confidence: 99%

Efficacy or Exaggeration The Likely Role of Evefresh Cream for SLE

Aruna¹,

Soundharya²,

Gayathri³

2017

Drug Des

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The present study deals with photo protection benefit of Evefresh cream. We have used a rapid and an extremely sensitive tool-cyanotype paper to study the effect of the cream. The findings show that Evefresh cream provides photo protection and hence may be of great medical use for SLE patients to achieve photo protection from short exposure to sun. Evefresh cream being a face cream is regular use will certainly enable the users to achieve the above benefits. The paper reports the findings in detail.

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Characterization of clinical photosensitivity in cutaneous lupus erythematosus

Cited by 51 publications

References 34 publications

Lupus Skin Is Primed for IL-6 Inflammatory Responses through a Keratinocyte-Mediated Autocrine Type I Interferon Loop

Lupus Skin Is Primed for IL-6 Inflammatory Responses through a Keratinocyte-Mediated Autocrine Type I Interferon Loop

Cutaneous lupus erythematosus: updates on pathogenesis and associations with systemic lupus

Efficacy or Exaggeration The Likely Role of Evefresh Cream for SLE

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