Dithranol targets keratinocytes, their crosstalk with neutrophils and inhibits the IL-36 inflammatory loop in psoriasis

• Published in: eLife Vol. 9
• Main Authors: Benezeder, Theresa, Painsi, Clemens, Patra, VijayKumar, Dey, Saptaswa, Holcmann, Martin, Lange-Asschenfeldt, Bernhard, Sibilia, Maria, Wolf, Peter
• Format: Journal Article
• Language: English
• Published: England eLife Sciences Publications Ltd 02.06.2020; eLife Sciences Publications, Ltd
• Subjects: AMPs; Animals; anthralin; Anthralin - pharmacology; Antimicrobial peptides; Antiviral drugs; Biopsy; c-Jun protein; Chemokines, CXC - metabolism; Chemotactic factors; Defensins; Dermatologic Agents - pharmacology; dithranol; Erythema; Hyperplasia; IL-36; Imiquimod; Immunology and Inflammation; Immunosuppressive agents; Infiltration; Inflammation; Interleukin 1; Interleukin 17; Interleukin 23; Interleukin-1 - genetics; Interleukin-1 - metabolism; JunB protein; Keratinocytes; Keratinocytes - drug effects; Keratinocytes - metabolism; Leukocytes (neutrophilic); Lymphocytes T; Mice; Neutrophils; Neutrophils - drug effects; Neutrophils - metabolism; Pore Forming Cytotoxic Proteins - metabolism; Psoriasis; Psoriasis - immunology; Psoriasis - metabolism; Serpins - metabolism; Signal Transduction - drug effects; Signal Transduction - genetics; Signal Transduction - immunology; Skin; Skin - drug effects; Skin - pathology; Transcription factors; AMPs; mouse; inflammation; dithranol; psoriasis; IL-36; keratinocytes; human; immunology; anthralin
• ISSN: 2050-084X; 2050-084X
• DOI: 10.7554/eLife.56991

Despite the introduction of biologics, topical dithranol (anthralin) has remained one of the most effective anti-psoriatic agents. Serial biopsies from human psoriatic lesions and both the c-Jun/JunB and imiquimod psoriasis mouse model allowed us to study the therapeutic mechanism of this drug. Top differentially expressed genes in the early response to dithranol belonged to keratinocyte and epidermal differentiation pathways and IL-1 family members (i.e. but not elements of the IL-17/IL-23 axis. In human psoriatic response to dithranol, rapid decrease in expression of keratinocyte differentiation regulators (e.g. involucrin, and ), antimicrobial peptides (e.g. ß-defensins like S100 proteins like ), chemotactic factors for neutrophils (e.g. ) and neutrophilic infiltration was followed with much delay by reduction in T cell infiltration. Targeting keratinocytes rather than immune cells may be an alternative approach in particular for topical anti-psoriatic treatment, an area with high need for new drugs.