Are Newly Discovered Drivers of Immune-Mediated Skin Disorders Expressed in Normal Skin Regenerating from Standardized Surface Injury?

Abstract

Background: In healthy skin, tape stripping induces a transient wave of histological changes resembling immune-mediated skin diseases, such as psoriasis. The response to surface trauma may harbor mechanisms which are also relevant to the development of Koebner-positive skin disorders. However, studies on newly discovered drivers of inflammation in regenerative skin are lacking. Methods: The course of epidermal proliferation and keratinization as well as key representatives of innate and acquired immunity were studied during the first 72 h after tape stripping. Results: Epidermal rupture rapidly activates various epidermal processes, which remain upregulated for 72 h. Elastase+ and IL-17+ cells dominate the acute phase and their numbers decrease rapidly thereafter. The number of T-Bet+ cells increases more gradually, reaching maximum levels several hours later when the other cell types decrease. Conclusions: This model permits investigations on the sequence of crucial inflammatory processes set off by cutaneous injury, which are presumed to play a role within the pathogenesis of immune-mediated skin diseases exhibiting the Koebner phenomenon.

A model of skin inflammation in humans leads to a rapid and reproducible increase in the interferon response signature: a potential translational model for drug development

“…Previous observations [7] have shown that neutrophils are the main infiltrating cells in exudates formed after tape stripping and that the proportions of neutrophils to other leukocytes decrease with time after challenge; therefore, as the measurement in our study was 22-24 h post challenge, neutrophil numbers would be expected to be decreasing and this might be reflected in the lack of transcriptional changes in MPO. Other studies have also identified an important role for innate immune cells in response to tape stripping and these changes were observed within the dermal compartment of the skin [14]. CLEC4C was the other inflammatory cell marker up regulated after tape stripping in this study, indicating an increase in PDCs.…”

Paradoxical, Cupping-Induced Localized Psoriasis: A Koebner Phenomenon

“…4,5 Koebnerization as an immune-mediated response has been studied, and levels of elastase-positive and interleukin-17-positive cells have been found to rise rapidly, whereas Tbetpositive cells increase gradually, peaking after other cell levels decrease when a skin injury occurs. 6 The therapeutic approach commonly taken to eliminate blood heat and blood stasis is ultimately to activate the blood through cupping. 2 The general method of cupping therapy requires a plastic or glass bell-shaped or spherical cup, 1 to 3 inches in diameter, to be placed on the skin.…”

Histamine Iontophoresis as in vivo Model to Study Human Skin Inflammation with Minimal Barrier Impairment: Pilot Study Results of Application of the Model to a Sensitive Skin Panel

“…No clinical signs of irritation were visible at time points later than 1 h. On the other hand, the lack of activation of Langerhans cells in the epidermis and of influx of T cells in the dermis, evidenced by the unchanged numbers of CD1a- and CD3-positive cells, respectively, confirms that this model (at least with the parameters chosen in this study) is not suitable for studying key mediators of adaptive immunity activated by sustained inflammation. For studying these mediators, other in vivo models such as tape stripping and application of leukotriene B 4 would be more appropriate [3,4,5]. …”

“…The integrity of the SC as skin barrier depends on the interplay of several factors, including the process of proliferation of keratinocytes from the basal layer and their gradual differentiation to corneocytes across the epidermis. Upon disruption of the SC, the release of mediators from keratinocytes, including several interleukins and chemokines [2], prompts the onset of an inflammatory response, resulting in a transient infiltrate of immune cells in the dermis, and hyperproliferation and abnormal differentiation in the epidermis [3]. …”

“…These models consist in the application of minimally invasive and standardized challenges to the skin, followed by evaluation of skin reactions at one or several points in time. Examples include tape stripping, consisting in repeated application of adhesive tape to mimic disruption of the skin barrier in disease or following skin-material interactions [3,4], and application of leukotriene B 4 to mimic psoriasis-like infiltration of immune cells in the epidermis [5]. In this study, we focus on one such in vivo model: histamine iontophoresis.…”