Role of Epithelium-Derived Cytokines in Atopic Dermatitis and Psoriasis: Evidence and Therapeutic Perspectives

Abstract

Atopic dermatitis and psoriasis are two of the most common chronic skin conditions. Current target therapies represent viable and safe solutions for the most severe cases of these two dermatoses but, presently, several limitations exist in terms of efficacy and side effects. A new class of products, epithelium-derived cytokines (TSLP, IL-25, IL-33), show an increasing potential for use in target therapy for these patients, and demonstrate a direct link between a generalized inflammatory and oxidative stress status and the human skin. A review was conducted to better understand their role in the aforementioned conditions. Of these three molecules, TSLP led has been most often considered in studies regarding target therapies, and most of the results in the literature are related to this cytokine. These three cytokines share common stimuli and are linked to each other in both acute and chronic phases of these diseases, and have been challenged as target therapies or biomarkers of disease activity. The results lead to the conclusion that epithelium-derived cytokines could represent a therapeutic opportunity for these patients, especially in itch control. Furthermore, they might work better when paired together with currently available therapies or in combination with in-development treatments. Further studies are needed in order to verify the efficacy and safety of the biologic treatments currently under development.

Keywords: TSLP; atopic dermatitis; biological therapy; epithelium derived cytokine; inflammation; interleukin 25; interleukin 33; oxidative stress; psoriasis; skin.

Figure 1

At the center we have the main disease (Pso). This is linked to the three cytokines (TSLP, IL-25, IL-33) used in studies. Depending on the cytokine, we find different manifestations and local responses.

Figure 2

Atopic dermatitis, as in the previous image, has been represented in the middle with the three cytokines examined depicted around it. Secondary effects and symptoms consequent to epithelial cytokines have been represented on the side of the picture.