Abstract
The predominant cutaneous side effect of lithium is the exacerbation or aggravation of psoriasis, but the pathogenesis is still unclear. The hyperproliferation of keratinocytes and a dense lesional infiltrate of mononuclear cells are the hallmarks of psoriatic skin lesions. Interactions between keratinocytes and T cells are thought to be one reason for an incrased secretion of proinflammatory cytokines and growth factors. To investigate whether lithium influences cytokines of the ‘psoriatic cytokine network’, we established a coculture model with keratinocytes from psoriatic patients and from healthy controls cultured with HUT 78 lymphocytes and measured the cytokine levels of Il-2, Il-6, Il-8, IFNγ and TGFα in the culture supernatants after treatment with lithium. Il-6 levels were slightly elevated in the supernatants obtained from psoriatic and control keratinocyte cultures after lithium treatment, but IFNγ and Il-2 levels were elevated only in the lithium-treated cocultures with psoriatic keratinocytes. In contrast, these two cytokines were not affected by lithium in HUT 78 monocultures or in cocultures with normal epidermal cells. We also found slightly elevated TGFα levels in lithium-treated psoriatic cocultures but not in control cultures. We therefore demonstrated that lithium influences the cell communication of psoriatic keratinocytes with HUT 78 lymphocytes by triggering the secretion of TGFα, Il-2 and, massively, IFNγ. It seems possible that lithium also influences similar parts of the psoriatic cytokine network in vivo.
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References
Abel EA, DiCocco LM, Orenberg EK, Fraki JE, Farber EM (1986) Drugs in exacerbation of psoriasis. J Am Acad Dermatol 15: 1007–1022
Ansel J, Perry P, Brown J, Damm D, Phan T, Hart C, Luger T, Hefeneider S (1990) Cytokine modulation of keratinocyte cytokines. J Invest Dermatol 94: 101S-107S
Antilla HSI, Reitamo S, Erkko P, Ceska M, Moser B, Baggiolini M (1992) Interleukin-8 immunoreactivity in the skin of healthy subjects and patients with palmoplantar pustulosis and psoriasis. J Invest Dermatol 98: 96–101
Baker, S, Frey L (1992) The immunology of psoriasis. Br J Dermatol 126: 1–9
Barker JNWN (1991) The pathophysiology of psoriasis. Lancet 338: 227–230
Barker JNWN, Groves RW, Allen MH, MacDonald DM (1992) Preferential adherence of T lymphocytes and neutrophils to psoriatic epidermis. Br J Dermatol 127: 205–211
Beyaert R, Schulze-Osthoff K, Roy F van, Fiers W (1992) Synergistic induction of interleukin-6 by tumor necrosis factor and lithium chloride in mice: possible role in the triggering, and exacerbation of psoriasis by lithium treatment. Eur J Immunol 22: 2181–2184
Boyce S, Ham RG (1983) Normal human epidermal keratinocytes. In: Weber MM, Sekely L (eds) In vitro models for cancer resarch. CRC Press, Boca Raton, pp 245–274
Castells-Rodellas A, Castel JV, Ramirez-Bosca A, Nicolas JF, Valcuende-Cavero F, Thivolet J (1992) Interleukin-6 in normal skin and psoriasis. Acta Derm Venereol (Stockh) 72: 165–168
Chang EY, Hammerberg C, Fisher G, Baadsgaard O (1992) T-cell activation is potentiated by cytokines released by lesional psoriatic, but not normal, epidermis. Arch Dermatol 128: 1479–1485
Delaporte E, Bieber T, Viac J, Faure M, Nicolas J-F (1994) Cytokine éidermiques et inflammation cutanée. Ann Dermatol Venereol 121: 836–843
Elder JT, Klein SB, Tavakkol A, Fisher GJ, Nickoloff BJ, Voorhees JJ (1990) Growth factor and proto-oncogene expression in psoriasis. J Invest Dermatol 95: 7S-9S
Fierlbeck G, Rasser G, Müller C (1990) Psoriasis induced at the injection site of recombinant interferon gamma. Arch Dermatol 126: 351–355
Fivenson DP, Nickoloff BJ, Sae GM (1994) Quantitative PCR analysis of Th1 cytokines in HUT 78 cells after exposure to PUVA in vitro. J Invest Dermatol 102: 587
Furue M, Gaspari AA, Katz SI (1988) The effect of CyA on epidermal cells. II. Cyclosporin A inhibits proliferation of normal and transformed keratinocytes. J Invest Dermatol 90: 796–800
Gearing AJH, Fincham NJ, Bird CR, Wadhwa M, Meager A, Cartwright JE, Camp RDR (1990) Cytokines in skin lesions of psoriasis. Cytokine 2: 68–75
Gilitzer R, Berger R, Mielke V, Müller C Wolff K, Stingl G (1991) Upper keratinocytes of psoriatic skin lesions express high levels of NAP-1/II-8 mRNA in situ. J Invest Dermatol 97: 73–79
Gomi T, Shiora T, Munakata T (1991) Interleukin-1α, tumornecrosis factor-α, and interferon-γ in psoriasis. Arch Dermatol 127: 827–830
Gottlieb AB (1990) Immunologic mechanisms in psoriasis. J Invest Dermatol 95: 18S-19S
Kemény L, Michel G, Bobozy A, Ruzicka T (1994) Cytokine system as potential target for antipsoriatic therapy. Exp Dermatol 3: 1–8
Kishimoto T (1992) Interleukin-6 and its receptor; from cloning to clinic. Int Arch Allergy Immunol 99: 172–177
Krueger JG, Krane JF, Carter DM, Gottlieb AB (1990) Role of growth factors cytokines and their receptors in the pathogenesis of psoriasis. J Invest Dermatol 94: 135S-140S
Lambert D, Beer F, Gisselman R, Bouilly D, Chapuis J-L (1982) Manifestation cutanées des thérapeutiques par le lithium. Ann Dermatol Venereol 109: 19–24
Lazarus GS, Gilgor RS (1979) Psoriasis, polymorphonuclear leukocytes, and lithium carbonate. Arch Dermatol 115: 1183–1184
Luger TA, Schwarz T (1990) Evidence for an epidermal cytokine network. J Invest Dermatol 95: 100S-104S
Nanney LB, Stoscheck CM, Magid M, King LE (1986) Altered [125I]Epidermal growth factor binding and receptor distribution in psoriasis. J Invest Dermatol 86: 260–265
Neuner P, Urbanski A, Trautinger F, Möller A, Kirnbauer R, Kapp A, Schöpf E, Schwarz T, Luger TA (1991) Increased IL-6 production by monocytes and keratinocytes in patients with psoriasis. J Invest Dermatol 97: 27–33
Nickoloff BJ, Baham TY, Merigan TC, Morhenn VB (1984) Anti-proliferative effects of recombinant α and γ-interferons on cultured human keratinocytes. Lab Invest 51: 697–701
Nickoloff BJ, Mitra RS, Shimizu Y, Barker JNWN, Karabin G, Stoof T, Stoolman LM (1992) HUT 78 T cells bind to noncytokine-stimulated keratinocytes using a non-CD 18-dependent adhesion pathway. Am J Pathol 140: 1365–1374
Powrie F, Coffman RL (1993) Cytokine regulation of T-cell function: potential for therapeutic intervention. Immunol Today 14: 270–274
Prinz JC, Groß B, Vollmer S, Trommler P, Strobel I, Meurer M, Plewig G (1994) T cell clones form psoriasis skin lesions can promote keratinocyte proliferation in vitro via secreted products. Eur J Immunol 24: 593–598
Sauder DN (1990) The role of epidermal cytokines in inflammatory skin diseases. J Invest Dermatol 95: 27S-28S
Savelkoul HFJ, Debets R (1993) Cytokine antagonists and their potential therapeutic use. Immunol Today 15: 455–458
Sharma SD (1982) Lithium modulates mitogen induced natural killer activity and interferon production. J Immunopharmacol 4: 303–312
Sticherling M, Bornscheuer E, Schröder J-M, Christophers E (1991) Localization of Nap-1/interleukin-8-immunoreactivity in normal and psoriatic skin. J Invest Dermatol 96: 26–30
Stoof TJ, Mitra RS, Sarma V, Dixit VM, Nickoloff BJ (1992) Keratinocyte activation following T lymphocyte binding. J Invest Dermatol 98: 92–95
Strange P, Cooper KD, Hansen ER, Fisher G, Larsen JK, Fox D, Krag C, Voorhees JJ, Baadsgaard O (1993) T-lymphocyte clones from lesional psoriatic skin release growth factors that induce, keratinocyte proliferation. J Invest Dermatol 101: 695–700
Uyemura K, Yamamura M, Fivenson DF, Modlin RL, Nickoloff BJ (1993) The cytokine network in lesional and lesionfree psoriatic skin is characterized by a T-helper type I cellmediated response. J Invest Dermatol 101: 701–705
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Ockenfels, H.M., Wagner, S.N., Keim-Maas, C. et al. Lithium and psoriasis: cytokine modulation of cultured lymphocytes and psoriatic keratinocytes by lithium. Arch Dermatol Res 288, 173–178 (1996). https://doi.org/10.1007/BF02505220
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DOI: https://doi.org/10.1007/BF02505220