title: A role for CCR5(+)CD4 T cells in cutaneous psoriasis and for CD103(+) CCR4(+) CD8 Teff cells in the associated systemic inflammation.
abstract: Recent results have identified critical components of the T cell response involved in the initiation and amplification phases of psoriasis. However the link between T cell responses arising in the skin and the systemic inflammation associated with severe psoriasis is largely unknown. We hypothesized that specific subsets of memory T cells recirculating from the skin could play a role. We therefore dissected the circulating memory T cell compartment in patients by analyzing the TCM, TEM and Teff phenotype, the pattern of CCR4 and CCR5 chemokine receptor expression and the expression of the tissue homing molecule CD103. For each subset we calculated the correlation with the Psoriasis Area and Severity Index (PASI) and with the extent of systemic inflammation measured as serum level of the prototypic short pentraxin, C reactive protein (CRP). Validation was performed by comparison with gene expression data in psoriatic plaques. We found that circulating CD103(+)CCR4(+)CCR5(+) and CCR4(+)CCR6(-) CD8(+) Teff cells, were highly correlated with CRP levels as well as with the validated index PASI, reflecting a link between skin involvement and systemic inflammation in patients with severe psoriasis. In addition we observed a contraction of circulating CCR5(+) T cells in psoriasis patients, with a highly significant inverse correlation between CCR5(+)CD4 T cells and the PASI score. Increased expression of CCR5 and CCL5 genes in psoriatic skin lesions was consistent with an accumulation of CCR5(+) cells in psoriatic plaques indicating a role for CCR5/CCL5 axis in disease pathogenesis.
authors.affiliation: I.R.C.C.S Istituto Ortopedico Galeazzi, Laboratory of Translational Immunology, Via Riccardo Galeazzi, 4, 20161 Milan, Italy. Electronic address: f.sgambell@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sgambelluri
authors.affiliation: I.R.C.C.S Istituto Ortopedico Galeazzi, Department of Dermatology and Venereology, University of Milan, Via Riccardo Galeazzi, 4, 20161 Milan, Italy. Electronic address: marco.diani@hotmail.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Diani
authors.affiliation: I.R.C.C.S Istituto Ortopedico Galeazzi, Department of Dermatology and Venereology, University of Milan, Via Riccardo Galeazzi, 4, 20161 Milan, Italy. Electronic address: sqaltom@fastwebnet.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Altomare
authors.affiliation: I.R.C.C.S Istituto Ortopedico Galeazzi, Department of Dermatology and Venereology, University of Milan, Via Riccardo Galeazzi, 4, 20161 Milan, Italy. Electronic address: eb.frigerio@gmail.com.
authors.forename: Elena
authors.initials: E
authors.lastname: Frigerio
authors.affiliation: I.R.C.C.S. Istituto Ortopedico Galeazzi, Laboratory of Clinical Chemistry and Microbiology, Via Riccardo Galeazzi, 4, 20161, Milan Italy. Electronic address: lorenzo.drago@unimi.it.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Drago
authors.affiliation: Department of Biotechnology and Biosciences, Piazza della Scienza 2, University of Milano-Bicocca, Milan, Italy; Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano, Milan, Italy. Electronic address: francesca.granucci@unimib.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Granucci
authors.affiliation: I.R.C.C.S Istituto Ortopedico Galeazzi, Laboratory of Translational Immunology, Via Riccardo Galeazzi, 4, 20161 Milan, Italy; I.R.C.C.S Istituto Ortopedico Galeazzi, Department of Dermatology and Venereology, University of Milan, Via Riccardo Galeazzi, 4, 20161 Milan, Italy; I.R.C.C.S. Istituto Ortopedico Galeazzi, Laboratory of Clinical Chemistry and Microbiology, Via Riccardo Galeazzi, 4, 20161, Milan Italy. Electronic address: banfi.giuseppe@fondazionesanraffaele.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Banfi
authors.affiliation: I.R.C.C.S Istituto Ortopedico Galeazzi, Department of Dermatology and Venereology, University of Milan, Via Riccardo Galeazzi, 4, 20161 Milan, Italy. Electronic address: gianfranco.altomare@unimi.it.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Altomare
authors.affiliation: I.R.C.C.S Istituto Ortopedico Galeazzi, Laboratory of Translational Immunology, Via Riccardo Galeazzi, 4, 20161 Milan, Italy. Electronic address: eva.reali@grupposandonato.it.
authors.forename: Eva
authors.initials: E
authors.lastname: Reali
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000378:metabolism; D015415:Biomarkers; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology* / Q000378:metabolism; D016022:Case-Control Studies; D002465:Cell Movement; D016000:Cluster Analysis; D003131:Combined Modality Therapy; D016207:Cytokines / Q000097:blood / Q000378:metabolism; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D007156:Immunologic Memory; D007249:Inflammation / Q000150:complications; D039001:Integrin alpha Chains / Q000378:metabolism; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011565:Psoriasis / Q000150:complications / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism*; D054398:Receptors, CCR4 / Q000378:metabolism; D019713:Receptors, CCR5 / Q000235:genetics / Q000378:metabolism; D012720:Severity of Illness Index; D016176:T-Lymphocyte Subsets / Q000276:immunology* / Q000378:metabolism
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; D016207:Cytokines; D039001:Integrin alpha Chains; D054398:Receptors, CCR4; D019713:Receptors, CCR5; C091367:alpha E integrins
keywords: Circulating memory T cell subsets; Psoriatic disease; Skin immunology/immunopathology; Systemic inflammation; T cell trafficking