The interplay among Th17 and T regulatory cells in the immune dysregulation of chronic dermatophytic infection

Rai, Gargi; Das, Shukla; Ansari, M. A.; Singh, Praveen Kumar; Pandhi, Deepika; Tigga, Richa; Bhattacharya, Sambit; Gupta, Charu; Dar, Sajad Ahmad

doi:10.1016/j.micpath.2019.103921

Cited by 15 publications

(11 citation statements)

References 44 publications

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“…Recently, Rai et al reported an increasing number of Th17 cell subpopulations and raised levels of IFN‐γ with a low level of IL‐10 cytokines in chronic dermatophytosis cases. Thus, they indicated that the persistence of infection and chronicity might be due to the Th17 pathway's activation 36 . But in contrast, we noted a reduced population of the Th17cells (CD4 + IL‐17 + cells* absolute lymphocyte count) and IL‐17 + cells in patients with recurrent dermatophytosis.…”

Section: Discussionmentioning

confidence: 60%

Immunological response and clinical profile in patients with recurrent dermatophytosis

Jha

Shaw

Karim

et al. 2021

Mycoses

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Background: An alarming increase in the number of patients with chronic and recurrent dermatophytosis has invoked the need to study the immunological parameters of the host. Objectives: To evaluate delayed type of hypersensitivity (DTH) response and immediate hypersensitivity (IH) response by flow cytometry evaluation of immune cells from peripheral blood and intradermal trichophyton skin test in patients with recurrent dermatophytosis. Methods: A hundred patients with recurrent dermatophytosis and 50 controls (healthy controls and acute dermatophytosis controls) were included. Relevant risk factors for recurrence were analysed, and serum IgE levels were estimated. Flow cytometry evaluation of immune cells in peripheral blood and intradermal trichophyton skin test was done. Dermatophyte pathogens were isolated, and antifungal susceptibility was performed.Results: Trichophyton mentagrophytes complex (95.84%) and T. rubrum (4.16%) were isolated in culture. Serum IgE was elevated in 83.15% cases (p = .01). IFNγ + cells (p = .0501, p = .0001, p = .0014), Th1 cells (p = .1197, p = .0024, p = .0169), IL-17 + cells (p = .0127, p = .0006, p = .0007) and Th17 cells (p = .0634, p = .0001, p = .0054) were reduced, and IL-4 + cells (p = .0108, p = .0175, p = .0018) were increased in cases.Intradermal test demonstrated negative DTH response in all cases (p < .001, p < .001, p < .001), strongly positive IH response in 6%, and borderline positive IH response in 85% cases (p = .018, p < .001, p < .001). Topical corticosteroids application, undergarment types (tight fit), poor frequency of washing clothes, family history of tinea, sharing of towels were significant risk factors for recurrent dermatophytosis. Conclusions:Reduced IFNγ + , Th1, IL-17 + and Th17 cells population along with impaired DTH response by the intradermal test was observed in patients with recurrent dermatophytosis.

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Section: Discussionmentioning

confidence: 60%

Immunological response and clinical profile in patients with recurrent dermatophytosis

Jha

Shaw

Karim

et al. 2021

Mycoses

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“…[31][32][33] A recent study from India demonstrated a higher expression of Th17 and Treg cell markers on CD4+ cells of patients with chronic dermatophytosis as compared to controls. 34 It was speculated that the interaction between the cell wall antigen mannan with the host cell receptor triggers a cascade of dysregulated cytokines eliciting Th17 mediated inflammation but also leads to the unhindered activation of Treg cells undergoing a phenotype change to an alternate lineage. Hence, despite antifungals, the high fungal burden becomes detrimental to a beneficial effector T-cell response.…”

Section: Immunopathogenesis Of Chronic Dermatophytosismentioning

confidence: 99%

The unprecedented epidemic-like scenario of dermatophytosis in India: I. Epidemiology, risk factors and clinical features

Verma¹,

Panda²,

Nenoff³

et al. 2021

IJDVL

105

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Dermatophytosis has attained unprecedented dimensions in recent years in India. Its clinical presentation is now multifarious, often with atypical morphology, severe forms and unusually extensive disease in all age groups. We hesitate to call it an epidemic owing to the lack of population-based prevalence surveys. In this part of the review, we discuss the epidemiology and clinical features of this contemporary problem. While the epidemiology is marked by a stark increase in the number of chronic, relapsing and recurrent cases, the clinical distribution is marked by a disproportionate rise in the number of cases with tinea corporis and cruris, cases presenting with the involvement of extensive areas, and tinea faciei.

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“…demonstrated high Th17 and T-reg expression in peripheral blood of patients with chronic skin dermatophytoses, suggesting a complex interplay of T cell lineages in causing disease persistence. [ 64 ] A summary of the role of Th cells is listed in Table 2 . Here it is pertinent to point out that T Reg cells may effect a variety of sequels ranging from protective tolerance (defined as a host response that safeguards host's survival through a trade-off between sterilizing immune responses and their negative regulation, which limits pathogen elimination) to overt immunosuppression.…”

Section: Host Immune Response To Dermatophytesmentioning

confidence: 99%

Immunopathogenesis of Dermatophytoses and Factors Leading to Recalcitrant Infections

Sardana

Gupta

Mathachan

2021

Indian Dermatology Online Journal

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The pathogenesis of dermatophytic infections involves the interplay of three major factors: the dermatophyte, the inherent host defense, and the adaptive host immune response. The fungal virulence factors determine the adhesion and invasion of the skin while the immune response depends on an interaction of the pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMP) with pattern recognition receptors (PRRs) of the host, which lead to a differential Th (T helper) 1, Th2, Th17, and Treg response. While anthropophilic dermatophytes Trichophyton rubrum and now increasingly by T. interdigitale subvert the immune response via mannans, zoophilic species are eliminated due to a brisk immune response. Notably, delayed-type hypersensitivity (Th1) response of T lymphocytes causes the elimination of fungal infection, while chronic disease caused by anthropophilic species corresponds to toll-like receptor 2 mediated IL (interleukin)-10 release and generation of T-regulatory cells with immunosuppressive potential. Major steps that determine the ultimate clinical course and chronicity include genetic susceptibility factors, impaired epidermal and immunological barriers, variations in the composition of sebum and sweat, carbon dioxide tension, skin pH, and topical steroid abuse. It is important to understand these multifarious aspects to surmount the problem of recalcitrant dermatophytosis when the disorder fails conventional therapeutic agents.

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The interplay among Th17 and T regulatory cells in the immune dysregulation of chronic dermatophytic infection

Cited by 15 publications

References 44 publications

Immunological response and clinical profile in patients with recurrent dermatophytosis

Immunological response and clinical profile in patients with recurrent dermatophytosis

The unprecedented epidemic-like scenario of dermatophytosis in India: I. Epidemiology, risk factors and clinical features

Immunopathogenesis of Dermatophytoses and Factors Leading to Recalcitrant Infections

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