Smoking enhances Toll-like receptor-9 responsiveness and type I interferon production in plasmacytoid dendritic cells in patients with cutaneous lupus erythematosus

Chasset, François; Françès, Camille; Arnaud, Laurent

doi:10.1016/j.jaad.2015.05.023

Cited by 8 publications

(4 citation statements)

References 13 publications

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“…Although the pathological mechanisms by which tobacco can induce or aggravate LE have not yet been established, it is believed that carcinogenic substances, including tars, other aromatic amines, and free radicals, can interact with DNA, causing genetic mutations and inducing activation of genes responsible for autoimmune diseases; increasing the expression of Fas on the surface of T and B lymphocytes thus inducing apoptosis; activating matrix metalloproteinases that cause tissue damage; and increasing inflammatory cytokines, such as interleukine (IL)-6, and phototoxicity induced by tar. 21 The lower efficacy of AMs in smokers seems to be related to the induction of the P450 enzyme complex and the increased production of interferon (IFN)-1 by plasmacytoid dendritic cells, which makes Toll-like-9 receptors less sensitive to blockade by AMs. 21…”

Section: Discussionmentioning

confidence: 99%

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Cutaneous lupus erythematosus: factors related to cutaneous activity and damage in a cohort of 260 patients from A Coruña, Spain

Bermúdez

Paradela

Balboa‐Barreiro

et al. 2020

Lupus

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Background Cutaneous lupus erythematosus is a chronic autoimmune disease that can leave important sequelae. Objective To determine the factors that predict the activity and damage of the skin disease, and the impact of tobacco on the efficacy of antimalarials using the Cutaneous Lupus Erythematosus Disease Area and Severity Index. Materials and Methods A consecutive case series was performed on 260 patients with cutaneous lupus erythematosus (α = 0.05; precision ± 6.5%). We carried out a descriptive analysis of the variables included, with a multivariate analysis to measure the association of variables with the Cutaneous Lupus Erythematosus Disease Area and Severity Index activity and damage ( p value < 0.05). Results The Cutaneous Lupus Erythematosus Disease Area and Severity Index activity was greater in smokers than non-smokers (4.0 ±5.3 vs 1.2 ±3.4, p = 0.006). No significant differences were observed in the Cutaneous Lupus Erythematosus Disease Area and Severity Index activity when the efficacy of antimalarials was analyzed between smokers and non-smokers. Cutaneous Lupus Erythematosus Disease Area and Severity Index damage was higher in smokers than in non-smokers (2.0 ± 3.6 vs 1.2 ± 2.6, p = 0.029). Cutaneous Lupus Erythematosus Disease Area and Severity Index activity was associated with: (a) being an active smoker (odds ratio 3.04, 95% confidence interval 1.68–5.51, p < 0.001; regression coefficient 2.05, 95% confidence interval 0.69–3.42, p = 0.003); (b) the chronic cutaneous lupus erythematosus subtype (odds ratio 1.98, 95% confidence interval 1.02–3.84, p = 0.044); and (c) C-reactive protein increase (≥0.5 mg/dL) (regression coefficient 2.56, 95% confidence interval 0.40–4.71, p = 0.020). Cutaneous Lupus Erythematosus Disease Area and Severity Index damage was associated with: (a) the activity (regression coefficient 0.11, 95% confidence interval 0.01–0.20, p = 0.024); (b) the chronic cutaneous lupus erythematosus subtype (regression coefficient 2.46, 95% confidence interval 1.37–3.56, p < 0.001); (c) the use of topical treatment (regression coefficient 1.31, 95% confidence interval 0.01–2.61, p = 0.049); and (d) systemic treatment (regression coefficient 1.44, 95% confidence interval 0.35–2.53, p < 0.010). Conclusion Smoking is related to an increase risk and a greater activity of cutaneous lupus erythematosus. The chronic cutaneous lupus erythematosus subtype and an increased C-reactive protein level were also associated with a higher disease activity. The sequelae were related to the activity, the chronic cutaneous lupus erythematosus subtype, and the use of topical and systemic treatment. The impact of tobacco on the efficacy of antimalarials may be caused by an increase in the severity of the disease more than by resistance in smokers.

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Section: Discussionmentioning

confidence: 99%

“…21 The lower efficacy of AMs in smokers seems to be related to the induction of the P450 enzyme complex and the increased production of interferon (IFN)-1 by plasmacytoid dendritic cells, which makes Toll-like-9 receptors less sensitive to blockade by AMs. 21…”

Section: Discussionmentioning

confidence: 99%

Cutaneous lupus erythematosus: factors related to cutaneous activity and damage in a cohort of 260 patients from A Coruña, Spain

Bermúdez

Paradela

Balboa‐Barreiro

et al. 2020

Lupus

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“…Il pourrait donc être supposé compte tenu des ces résultats que les pDC des patients LEC fumeurs soient plus réactives à la stimulation de TLR-9 et donc hyper réactives. Le mode d'action principal des APS étant l'inhibition de TLR-7 et TLR-9, ceci pourrait expliquer la résistance des fumeurs aux APS226 mais cette hypothèse n'a pas encore été confirmée à l'heure actuelle.…”

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The effect of increasing the dose of hydroxychloroquine (HCQ) in patients with refractory cutaneous lupus erythematosus (CLE): An open-label prospective pilot study

Chasset

Arnaud

Costédoat-Chalumeau

et al. 2016

Journal of the American Academy of Dermatology

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“…Furthermore, smoking is associated with loss of efficacy of hydroxychloroquine (see the section “Pharmacological therapy“) with a twofold decrease in the proportion of patients with CLE achieving cutaneous improvement 54. This may be due to enhancing Toll-like receptor-9 responsiveness and type I interferon production by plasmacytoid dendritic cells 55,56…”

Section: Treatmentmentioning

confidence: 99%

<p>A review of cutaneous lupus erythematosus: improving outcomes with a multidisciplinary approach</p>

Jarrett¹,

Werth²

2019

JMDH

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Cutaneous lupus erythematosus encompasses a spectrum of cutaneous disease with different phenotypes, and it potentially intersects with many disciplines in medicine. This review examines the epidemiology, clinical subtypes, pathology, psychology and intervention options for this disorder. It is important to understand the psychological distress that cutaneous lupus can cause and if needed actively investigate this possibility with the patient. Careful liaison between disciplines will achieve the optimum outcome.

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Smoking enhances Toll-like receptor-9 responsiveness and type I interferon production in plasmacytoid dendritic cells in patients with cutaneous lupus erythematosus

Cited by 8 publications

References 13 publications

Cutaneous lupus erythematosus: factors related to cutaneous activity and damage in a cohort of 260 patients from A Coruña, Spain

Cutaneous lupus erythematosus: factors related to cutaneous activity and damage in a cohort of 260 patients from A Coruña, Spain

The effect of increasing the dose of hydroxychloroquine (HCQ) in patients with refractory cutaneous lupus erythematosus (CLE): An open-label prospective pilot study

<p>A review of cutaneous lupus erythematosus: improving outcomes with a multidisciplinary approach</p>

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