Inhibition of CCR7/CCL19 axis in lesional skin is a critical event for clinical remission induced by TNF blockade in patients with psoriasis

Francesca Bosè, Luciana Petti, Marco Diani, Claudia Moscheni, Silvia Molteni, Andrea Altomare, Riccardo L. Rossi, Daniela Talarico, Raffaella Fontana, Vincenzo Russo, Gianfranco Altomare, Eva Reali

Research output: Contribution to journalArticlepeer-review

Abstract

Despite the evidence that tumor necrosis factor (TNF) inhibitors block TNF and the downstream inflammatory cascade, their primary mechanism of action in inhibiting the self-sustaining pathogenic cycle in psoriasis is not completely understood. This study has the aim to identify early critical events for the resolution of inflammation in skin lesions using anti-TNF therapy. We used a translational approach that correlates gene expression fold change in lesional skin with the Psoriasis Area and Severity Index score decrease induced by TNF blockade after 4 weeks of treatment. Data were validated by immunofluorescence microscopy on skin biopsy specimens. We found that the anti-TNF-modulated genes that mostly associated with the clinical amelioration were Ccr7, its ligand, Ccl19, and dendritic cell maturation genes. Decreased expression of T-cell activation genes and Vegf also associated with the clinical response. More important, the down-regulation of Ccr7 observed at 4 weeks significantly correlated with the clinical remission occurring at later time points. Immunofluorescence microscopy on skin biopsy specimens showed that reduction of CCR7+ cells and chemokine ligand (CCL) 19 was paralleled by disaggregation of the dermal lymphoid-like tissue. These data show that an early critical event for the clinical remission of psoriasis in response to TNF inhibitors is the inhibition of the CCR7/CCL19 axis and support its role in psoriasis pathogenesis.

Original languageEnglish
Pages (from-to)413-421
Number of pages9
JournalAmerican Journal of Pathology
Volume183
Issue number2
DOIs
Publication statusPublished - Aug 2013

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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