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Skin Autoimmunity

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Front. Immunol. | doi: 10.3389/fimmu.2019.01198

Autoreactive T-lymphocytes in inflammatory skin diseases

  • 1Geneva University Hospitals (HUG), Switzerland

The presence of one or several autoantigen(s) and a response by the adaptive immune system are the key criteria to classify a pathology as an autoimmune disease. The list of entities fulfilling this criterion is currently growing in the light of recent advancements in the pathogenetic understanding of a number of important dermatoses. The role of autoreactive T-lymphocytes differs amongst these pathologies. While they are directly involved as effector cells attacking and sometimes killing their respective target in some diseases (e.g. vitiligo), they provide help to B-lymphocytes, which in turn produce the pathogenic autoreactive antibodies in others (pemphigus and pemphigoid). Atopic dermatits is a chimera in this regard, as there is evidence for both functions. Psoriasis is an example for an entity where autoantigens were finally identified, suggesting that at least a subgroup of patients should be classified as suffering from a true autoimmune rather than autoinflammatory condition. Identification of resident memory T-lymphocytes (TRM) helped to understand why certain diseases relapse at the same site after seemingly effective therapy. Therefore, the in-depth characterization of autoreactive T-lyphocytes goes way beyond an academic exercise and opens the door towards improved therapies yielding durable responses. TRM are particularly suitable targets in this regard, and the clinical efficacy of some established and emerging therapeutic strategies such as the inhibition of Janus Kinase 3 or interleukin 15 may rely on their capacity to prevent TRM differentiation and maintenance. Research in this field brings us closer to the ultimate goal in the management of autoimmunity at large, namely resetting the immune system in order to restore the state of tolerance.

Keywords: T-Lymphocytes, Psoriasis, atopic dermatitis, Vitiligo, Alopecia Areata, Pemphigus, Pemphigoid, Regulatory T-lymphocytes, resident memory T cell, autologous stem cell transplant (ASCT), Sleroderma, systemic

Received: 01 Mar 2019; Accepted: 13 May 2019.

Edited by:

Katja Bieber, Universität zu Lübeck, Germany

Reviewed by:

Andras Perl, Upstate Medical University, United States
Kentaro Izumi, Hokkaido University, Japan
Christoph M. Hammers, Universität zu Lübeck, Germany  

Copyright: © 2019 Boehncke and Brembilla. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Wolf H. Boehncke, Geneva University Hospitals (HUG), Genève, Switzerland, wolf-henning.boehncke@hcuge.ch