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2017 ; 137
(7
): 1474-1483
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Endogenous Glucocorticoid Deficiency in Psoriasis Promotes Inflammation and
Abnormal Differentiation
#MMPMID28259685
Sarkar MK
; Kaplan N
; Tsoi LC
; Xing X
; Liang Y
; Swindell WR
; Hoover P
; Aravind M
; Baida G
; Clark M
; Voorhees JJ
; Nair RP
; Elder JT
; Budunova I
; Getsios S
; Gudjonsson JE
J Invest Dermatol
2017[Jul]; 137
(7
): 1474-1483
PMID28259685
show ga
The factors involved in maintaining a localized inflammatory state in psoriatic
skin remain poorly understood. Here, we demonstrate through metabolomic and
transcriptomic profiling marked suppression of glucocorticoid biosynthesis in the
epidermis of psoriatic skin leading to localized deficiency of cortisol.
Utilizing a 3D human epidermis model, we demonstrate that glucocorticoid
biosynthesis is suppressed by proinflammatory cytokines and that glucocorticoid
deficiency promotes inflammatory responses in keratinocytes. Finally, we show
in vitro and in vivo that treatment with topical glucocorticoids leads to rapid
restoration of glucocorticoid biosynthesis gene expression coincident with
normalization of epidermal differentiation and suppression of inflammatory
responses. Taken together, our data suggest that localized glucocorticoid
deficiency in psoriatic skin interferes with epidermal differentiation and
promotes a sustained and localized inflammatory response. This may shed new light
on the mechanism of action of topical steroids, and demonstrates the critical
role of endogenous steroid in maintaining both inflammatory and differentiation
homeostasis in the epidermis.