Effects of Retinoids on the Immune System1

Shapiro, Pavia; Rl, Edelson

doi:10.1159/000429406

Cited by 26 publications

(21 citation statements)

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“…The use of systemic iso tretinoin (Accutane) for the treatment of severe recalci trant nodulocystic acne, over the last decade, is reported to achieve dramatic improvement and prolonged remis sion of the disease in over 90% of treated patients [19,22,23], Experience with the use of isotretinoin in immunosuppressed organ-transplant recipients is limited. Reluc tance to use of isotretinoin in this patient population may reflect the concern stemming from experimental evidence suggesting that retinoids may increase the likelihood of allograft rejection [24,25], Based on several reports of the successful use of isotre tinoin in three CsA-trcated kidney transplant patients [26, Acne Caused by Cyclosporine Therapy Nephron 1996;72:679-682 27], and 2 heart transplant recipients [28,29] in whom severe acne developed during transplantation, we elected to treat our patient with a course of isotretinoin. We did not observe any deterioration in allograft function or changes in CsA drug level during the 4 months treatment period.…”

Section: Discussionmentioning

confidence: 99%

Acne: A Potential Side Effect of Cyclosporine A Therapy

El-Shahawy

Gadallah²,

Massry³

1996

Nephron

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A renal transplant recipient who developed severe acne 6 months after transplantation is described. Maintenance immunosuppression consisted of cyclosporine A (CsA), azathioprine and prednisone. Tapering the prednisone dose to as low as 5 mg/day, in addition to topical tetracycline, Retin-A cream, and systemic antimicrobial therapy failed to control the progression of the skin lesions. Despite therapy with isotretinoin (Accutane), the lesions continued to progress with nodulocystic transformation (acne conglobata) and isotretinoin was discontinued after 4 months. However, the condition continued to worsen with the development of a systemic illness with daily fever, diaphoresis, and depression. High fever (103 °F) with shaking chills prompted hospitalization. Withdrawal of CsA resulted in rapid and continuous improvement of the skin lesions. After 12 months of follow-up, the lesions significantly resolved except for residual areas of scarring. No episodes of acute allograft rejection occurred. In conclusion, we suggest that CsA therapy may be associated with the development of acne. Nodulocystic transformation (acne conglobata) may occur despite the use of isotretinoin. Finally, withdrawal of CsA may lead to resolution of the skin disease and should, therefore, be considered as a therapeutic option for severe and treatment-resistant cases.

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Section: Discussionmentioning

confidence: 99%

Acne: A Potential Side Effect of Cyclosporine A Therapy

El-Shahawy

Gadallah²,

Massry³

1996

Nephron

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“…In experiment 1, animals were assessed daily for weight and clinical signs for 3 wk. Clinical disease severity was graded on a scale of 1-5 as follows: 0, no signs; 1, tail paralysis; 2, tail paralysis and hind leg weakness; 3, hind leg paralysis; 4 Preparation ofIL-2-containing supernatant (IL-2sup) SC were removed from Lewis rats and cultured at 5 X 106/ml in presence of 4 ,ug/ml Con A as previously described (38). After 72 h the IL-2sup were removed, treated with 20 mg/ml a-methyl-mannoside, and frozen.…”

Section: Assessment Ofeaementioning

confidence: 99%

“…After 72 h ofculture, 4 x 107 viable SC per animal were injected i.p. to syngeneic naive recipients.…”

Section: Il-2 Assaymentioning

confidence: 99%

“…RA (tretinoin), 1 3-cRA (isotretinoin), and other retinoids have been described to exert a number ofsuppressive activities on T cell functions, including a decrease in production ofinterleukins (IL, [4][5][6][7][8][9][10][11][12][13][14][15]. However, immunostimulatory effects of 13-cRA and other retinoids on cellular and humoral immunity have also been reported (16)(17)(18)(19)(20)(21)(22)(23)(24).…”

Section: Introductionmentioning

confidence: 99%

“…However, 1 3-cRA, which has been demonstrated to retain most ofthe pharmacological activities of RA, is better tolerated for in vivo administration (1)(2)(3). This finding suggests that 1 3-cRA could represent an optimal retinoid for experimentation in autoimmune diseases, but the activity of pharmacological doses of this drug on T cell-mediated immunity has not been directly investigated (4).…”

Section: Introductionmentioning

confidence: 99%

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Immunosuppressive activity of 13-cis-retinoic acid and prevention of experimental autoimmune encephalomyelitis in rats.

Massacesi¹,

Castigli²,

Vergelli³

et al. 1991

J. Clin. Invest.

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Some activities of retinoids on cellular and humoral immunity have been described, but the available data are conflicting or obtained at concentrations that are toxic in vivo. In this study, we demonstrate that 13-cis-retinoic acid (13-cRA), a retinoid well tolerated in human therapy, can suppress T cell-mediated immunity in rats. Treatment with pharmacological concentrations of 13-cRA prevented active as well as passive transfer experimental autoimmune encephalomyelitis (EAE) and suppressed lymphocyte responsiveness to T cell mitogens, suggesting that the drug activity included suppression of an effector T cell response. In addition, mitogen-and antigen-induced lymphocyte proliferation was inhibited in vitro in the presence of concentrations of 13-cRA equivalent to or less than those achieved in vivo, further suggesting that the prevention of EAE was due to a suppressive activity on T cell-mediated immunity. The immunosuppressive activity of 13-cRA included suppression of interleukin 2, whose production was inhibited in splenocytes. These data indicate that, in an in vivo mammalian system, 13-cRA exerts a suppressive activity on T cell-mediated immunity intensive enough to suppress an ongoing immune response, and that this effect can be achieved at nontoxic concentrations that may also be attained in human therapy. (J. Clin.

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In vitro effects of retinoids on mitogen-induced peripheral blood leucocyte responses

Chaidaroglou

Degiannis

Koniavitoul

et al. 1998

Archives of Dermatological Research

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The aim of the present study was to investigate the influence of three different retinoids, isotretinoin, etretinate and acitretin, on the mitogenic response of peripheral blood mononuclear cells (PBMCs) to PHA and PMA in vitro. All three retinoids at high concentrations (10(-4)M) significantly inhibited the mitogenic response of PBMCs to these mitogens. At lower concentrations (10(-5) M and 10(-6) M) none of the three retinoids had any effect on PBMC proliferation in response to PHA. Interestingly, isotretinoin and etretinate significantly enhanced the PMA-induced stimulation of proliferation, whereas acitretin at 10(-5) M failed to influence the mitogenic response to PMA but enhanced it at 10(-6) M. The enhancing effects of retinoids on the proliferative response of PMA-stimulated PBMCs were reversed by rapamycin (10 ng/ml), an immunosuppressant known to inhibit the phorbol ester-induced protein kinase C pathway of lymphocyte activation. In conclusion, our study indicates that retinoids directly trigger the PMA-induced protein kinase C pathway of lymphocyte activation in a concentration-dependent manner. This observation could explain the findings of previous studies showing an in vivo immunopotentiating effect of retinoids on certain immune functions.

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Effects of Retinoids on the Immune System1

Cited by 26 publications

References 0 publications

Acne: A Potential Side Effect of Cyclosporine A Therapy

Acne: A Potential Side Effect of Cyclosporine A Therapy

Immunosuppressive activity of 13-cis-retinoic acid and prevention of experimental autoimmune encephalomyelitis in rats.

In vitro effects of retinoids on mitogen-induced peripheral blood leucocyte responses

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