title: Neutrophil extracellular trap formation is increased in psoriasis and induces human β-defensin-2 production in epidermal keratinocytes.
abstract: Neutrophil extracellular traps (NETs) have been implicated in the development of certain immune-mediated diseases, but their role in psoriasis has not been clearly defined. Human β-defensin-2 (HBD-2) is an important antimicrobial peptide overexpressed in psoriasis epidermis. We evaluated whether the amount of NETs is increased in psoriasis and determined the effect of NETs on HBD-2 production in epidermal keratinocytes. Using fluorescent microscopy, we found that patients with psoriasis (n = 48) had higher amount of NETotic cells in their peripheral blood compared to healthy controls (n = 48) and patients with eczema (n = 35). Psoriasis sera showed increased ability to induce NET formation in control neutrophils but normal NET degradation ability. The amount of NETs in the peripheral blood correlated with psoriasis disease severity. NETosis was also observed in the majority (18 of 20) of psoriasis skin specimens. Furthermore, NETs induced HBD-2 mRNA and protein production in keratinocytes, and immunohistochemical analysis confirmed strong expression of HBD-2 in psoriasis lesional skin. In summary, NET formation is increased in peripheral blood and lesional skin of psoriasis patients and correlates with disease severity. Additionally, NET-induced HBD-2 production may provide a novel mechanism for the decreased susceptibility of psoriasis plaques to microbial infections.
authors: Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors: Stephen Chu-Sung
authors: SC
authors: Hu
authors: Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.|National Institute of Environmental Health Sciences, National Health Research Institutes, Taipei, Taiwan.
authors: Hsin-Su
authors: HS
authors: Yu
authors: Department of Fragrance and Cosmetic Science, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Feng-Lin
authors: FL
authors: Yen
authors: Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.|Department of Dermatology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.
authors: Chi-Ling
authors: CL
authors: Lin
authors: Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors: Gwo-Shing
authors: GS
authors: Chen
authors: Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors: Cheng-Che E
authors: CC
authors: Lan
mesh_terms: D000328:Adult; D004817:Epidermis / Q000378:metabolism; D065206:Extracellular Traps / Q000276:immunology*; D005260:Female; D006801:Humans; D015603:Keratinocytes / Q000378:metabolism*; D007958:Leukocyte Count; D008297:Male; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology*; D011565:Psoriasis / Q000097:blood* / Q000276:immunology*; D023083:beta-Defensins / Q000378:metabolism*
chemical_list: C106641:DEFB4A protein, human; D023083:beta-Defensins