Psoriasis patients have T-cells with reduced responsiveness to common mycobacterial antigens

Bay, Maria-Luisa; Lehrer, A.R.; Bressanelli, Amalia; Morini, Julio; Stanford, J. L.

doi:10.1111/j.1574-695x.1998.tb01150.x

Cited by 12 publications

(6 citation statements)

References 23 publications

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“…Upper respiratory tract infections have been implicated in the development of psoriasis, and increasing evidence points to a triggering role for bacterial superantigens in providing the T-cell activating stimulus [6,7]. We have shown lymphocytes of psoriasis patients to respond less to group i, common mycobacterial antigens, than do healthy persons [8], suggesting an abnormal response to environmental mycobacteria which may be an aetiological factor in the disease.…”

Section: Introductionmentioning

confidence: 67%

Immunotherapy with Mycobacterium vaccae in the treatment of psoriasis

Lehrer

1998

FEMS Immunology and Medical Microbiology

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A placebo-controlled study of immunotherapy with Mycobacterium vaccae for chronic plaque psoriasis showed improvement in the psoriasis area severity index in 19 of 21 immunotherapy recipients (P<0.005). Minor improvement, not reaching statistical significance for the group, occurred in nine of 14 placebo recipients. There were losses to follow-up and the placebo used, tetanus toxoid, was not ideal. Clinical improvement after immunotherapy persisted for 6 months and another injection of the immunotherapeutic given to a few volunteers from either group resulted in benefits lasting a year. Lymphoproliferative tests were carried out at each clinic visit, and on 50 matched controls. Starting with reduced responses to mycobacterial antigens and concanavalin A, both treatment groups showed a fall after 3 months, and diverged at 6 months with M. vaccae recipients rising to values similar to those of healthy controls, whereas placebo recipients continued to fall. Conclusions reached were that immunotherapy with M. vaccae gave long-lasting clinical benefit to most patients, with minimal side effects. This accompanied a return towards normal cellular immune responsiveness to mycobacterial antigens, which did not follow the use of the placebo.

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Section: Introductionmentioning

confidence: 67%

Immunotherapy with Mycobacterium vaccae in the treatment of psoriasis

Lehrer

1998

FEMS Immunology and Medical Microbiology

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“…6 Some authors have suggested an abnormal lymphocytic response to environmental mycobacteria as an etiologic factor. 7 However, the role of mycobacterial infection has not been conclusively proven.…”

Section: Discussionmentioning

confidence: 99%

Severe psoriasis entering remission after treatment for latent tuberculosis with isoniazid: Report of two cases

Partarrieu-Mejías

Hernández-Bel

Weth

et al. 2019

The Journal of Dermatology

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Psoriasis is a multifactorial systemic disease with predominantly cutaneous manifestations. The role of tuberculosis infection in the pathogenesis of psoriasis has not been consistently proven. Current guidelines recommend screening for tuberculosis infection in any patient with psoriasis when the initiation of biologic therapy is being considered. Isoniazid is an antibiotic with high bactericidal effect on replicating mycobacteria and constitutes the most commonly prescribed treatment for latent tuberculosis infection. Here, we report two cases of patients with psoriasis who presented at our clinic with extensive cutaneous involvement despite previous treatments with topical and systemic therapies. Both were considered as candidates for biologic therapy. As part of the screening protocol, a tuberculin test was performed with a positive result. In the absence of symptoms and chest radiography findings, isoniazid 300 mg/day for 6 months was prescribed to treat latent tuberculosis infection. This resulted in significant clearing of their skin lesions in the absence of any other concurrent treatment, apart from emollients. Both patients remained clinically stable and with no need of further systemic treatment. This situation has only been described twice before in the English‐language published work. These cases highlight the possible role of tuberculosis infection in the pathogenesis of psoriasis, suggesting the possible existence of a link between untreated infection and skin lesions. This can lead to consideration of novel therapeutic strategies and new lines of investigation.

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“…However, a possible reason is that patients with psoriasis have an associated reduced T cell responsiveness to mycobacterium antigens. 149 Furthermore, dendritic cells and macrophages have been shown to be increased in the skin of patients with psoriasis underoing M. vaccae therapy, with an increased production of IL-10. 143 Since IL-10 is an immunosuppressing cytokine, stimulating immunity to mycobacterium with increased IL-10 may alter the immune balance to favor psoriasis clearance.…”

Section: Potential For Vaccine and Immunotherapy In Psoriasismentioning

confidence: 99%

Current and potential immune therapies and vaccines in the management of psoriasis

Kaffenberger

Lee

Tyler

et al. 2014

Human Vaccines & Immunotherapeutics

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Psoriasis is a chronic, immune skin disease associated with significant morbidity. Development of psoriasis is influenced by numerous genes, one allele is HLA-CW*0602. Other genes and single nucleotide polymorphisms affect immunologic pathways and antimicrobial peptide synthesis. Dendritic cells initiate psoriasis by activating T-cells toward a Th1 and Th17 response, with increased cytokines including TNF-α, IL-6, -12, -17, -22, and -23. IL-22 appears to promote keratinocyte dedifferentiation and increased antimicrobial peptide synthesis while TNF-α and IL-17 induce leukocyte localization within the psoriatic plaque. These recent insights identifying key cytokine pathways have led to the development of inhibitors with significant efficacy in the treatment of psoriasis. While a strategy for vaccine modulation of the immune response in psoriasis is in progress, with new technology they may provide a cost-effective long-term treatment that may induce tolerance or targeted self-inhibition for patients with autoimmune disorders, such as psoriasis.

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Psoriasis patients have T-cells with reduced responsiveness to common mycobacterial antigens

Cited by 12 publications

References 23 publications

Immunotherapy with Mycobacterium vaccae in the treatment of psoriasis

Immunotherapy with Mycobacterium vaccae in the treatment of psoriasis

Severe psoriasis entering remission after treatment for latent tuberculosis with isoniazid: Report of two cases

Current and potential immune therapies and vaccines in the management of psoriasis

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