Addition of zinc and manganese to a biological dressing.

BACKGROUND: Zinc and manganese, which are used in vivo because of their healing properties, have been shown to modulate in vitro integrin expression and to enhance keratinocyte migration. In addition, at the clinical level, a dressing of keratinocytes suspended in a fibrin glue has been proposed for the treatment of chronic wounds. OBJECTIVE: To investigate whether the addition of trace elements to this dressing could modulate the migratory phenotype of keratinocytes via the modulation of integrin expression in a manner similar to an in vitro model and thus increase the healing properties of this dressing. METHODS: Keratinocytes were mixed with Tissucol and maintained in culture for 12 days in a medium either supplemented or not with zinc or manganese. Then, integrin expression was studied by immunohistochemistry on fibrin clot cryosections. RESULTS: We observed a significant increase of alpha5beta1 with zinc compared to the control medium. Zinc also enhanced alphaVbeta6 expression and manganese alpha5beta1, alphaVbeta5 and alphaVbeta6 expression, however without reaching a significant level. CONCLUSION: By modulating integrin expression, trace elements can improve the efficiency of a biological dressing made of keratinocytes in a fibrin glue matrix and, thus, it appears beneficial to add them to this biological dressing for the treatment of skin defects.

Anti-inflammatory effects of lithium gluconate on keratinocytes: a possible explanation for efficiency in seborrhoeic dermatitis.

Topical lithium (Li) gluconate has a beneficial effect on seborrhoeic dermatitis (SD), unlike oral lithium (Li) used in psychiatry. SD is an inflammatory dermatitis associated, in most of cases, with colonization by lipophilic yeasts of the genus Malassezia. However, the exact mechanism of action of Li gluconate in SD still remains unknown. The aim of our study was to investigate the effect of topical Li on cytokine secretion and innate immunity. For this purpose, we investigated first the modulatory effect of Li on two pro-inflammatory and two anti-inflammatory cytokine secretion and second, the modulatory effect of Li on Toll-like receptor (TLR) 2 and 4 expression by unstimulated and stimulated keratinocytes. Two different skin models were used: keratinocytes in monolayer and skin explants. In some of them, inflammation was induced with LPS (1 mug/ml) or zymosan (2 mg/ml). Then the skin models were incubated with Li gluconate (Labcatal*, Montrouge, France) at three different concentrations (1.6, 3, 5 mM) determined according to viability MTT test. Expression of TNFalpha, IL6, IL10, TGFbeta1, TLR2 and TLR4 was detected by immunohistochemistry (IHC). Cytokines were quantified by ELISA methods. Our results showed that the effect of Li on keratinocytes is dose-dependent. At low concentration (1.6 mM), Li enhanced TNFalpha secretion, whereas, at higher concentration (5 mM), Li significantly enhanced IL10 expression and secretion. However, there was no significant modulation of Li on IL6 and TGFbeta1 secretion. Moreover, Li at 5 mM significantly decreased TLR2 and TLR4 expressions by differentiated keratinocytes. As Li concentration during topical treatment is probably closer to 5 mM than to 1 mM, the therapeutic effect of Li gluconate in DS may be explained by two anti-inflammatory actions: an increased expression and secretion of IL10 and a decreased expression of TLR2 and TLR4 by keratinocytes. The diminution of TLR2 expression by Li may not allow MF to trigger inflammation response in lesional skin.

Induction of toll-like receptors by Propionibacterium acnes.

BACKGROUND: The bacterium Propionibacterium acnes is involved in the induction and maintenance of the inflammatory phase of acne. Recent studies have found that keratinocytes express toll-like receptors (TLRs) implicated in immediate immunity. No studies have, to date, been carried out on the action of P. acnes upon TLR activation in keratinocytes. OBJECTIVES: Focusing on the inflammatory phase of acne, to clarify the role of P. acnes in immediate immunity by inducing expression of TLR-2 and TLR-4 by keratinocytes. We also studied how the secretion and expression of matrix metalloproteinase (MMP)-9 is induced by P. acnes. METHODS: The work was carried out on two levels: in vivo with the study of the expression of TLR-2 and TLR-4 proteins in biopsies of acne lesions and in vitro on cultured keratinocyte monolayers to study the modulating effects of P. acnes on the expression of TLR-2 and TLR-4 and also on the expression and secretion of MMP-9. RESULTS: Our findings reveal that in vivo TLR-2 and TLR-4 expression is increased in the epidermis of acne lesions. In vitro, an increase in TLR-2 and TLR-4 expression by human keratinocytes occurred in the first hours of incubation with bacterial fractions as well as an increase of the expression and secretion by the keratinocytes of MMP-9, which plays a role in inflammation. CONCLUSIONS: This work demonstrates that P. acnes induces TLR expression and that this mechanism could play an essential role in acne-linked inflammation. These receptors could be involved notably in acute acne.

Interleukin-15 expression in cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome).

BACKGROUND: Cytokines are of potential importance in the pathogenesis of cutaneous T-cell mediated disorders, including cutaneous T-cell lymphoma (CTCL). OBJECTIVES: To compare interleukin (IL)-15 expression in certain inflammatory cutaneous diseases, with that in CTCL (mycosis fungoides and Sézary syndrome). METHODS: IL-15 mRNA and protein expression were examined by in situ hybridization and immunohistochemistry, respectively, on formalin-fixed, paraffin-embedded biopsies of normal human skin, atopic dermatitis, psoriasis, parapsoriasis and CTCL. RESULTS: Despite similar expression of IL-15 mRNA, we found differences in IL-15 protein expression between normal human skin, atopic dermatitis and psoriasis on the one hand, and parapsoriasis and CTCL on the other. IL-15 protein expression was not detected in normal human skin, atopic dermatitis or psoriasis, but was detected, mainly at low levels but in a few patients at higher levels, in epidermal keratinocytes in parapsoriasis, mycosis fungoides and Sézary syndrome. CONCLUSIONS: Induction of keratinocyte IL-15 expression appears to be a feature of CTCL. The factors stimulating such an expression remain unknown.

Zinc, copper and manganese enhanced keratinocyte migration through a functional modulation of keratinocyte integrins.

The migration of keratinocytes plays an important role in the re-epithelialization of cutaneous wounds. Zinc, copper and manganese are used in vivo for their healing properties and their mechanism of action is still only partially known. Thus, they have been shown both to promote keratinocyte proliferation and to modulate integrins expression. The aim of this study was to determine if trace elements induce an increase of the migration of keratinocytes and if this effect is related to the modulation of integrins. Two independent migration assays were used to study keratinocyte migration: the scratch assay using normal human keratinocytes and the modified Boyden chamber using HaCaT cells. Inhibition studies using function-blocking antibodies directed to alpha3, alpha6, alpha(v) and beta1 subunits were performed to investigate the modulator effect of trace elements on integrin function. In this way, zinc and copper gluconates increased alpha3, alpha(v) and beta1 function whereas manganese gluconate seems mainly able to modulate the function of alpha3 and beta1. The stimulating effect of these trace elements on keratinocyte migration does not appear related to alpha6 subunit. Thus, zinc, copper and manganese enhanced keratinocyte migration and one of the mechanisms was going through a modulation of integrin functions.

Minocycline modulation of alpha-MSH production by keratinocytes in vitro.

The anti-inflammatory mechanisms of minocycline, an antibiotic used in the treatment of the inflammatory component of acne, are only partially understood. In addition to inflammation due to cytokines (IL-1, IL-6, TNF-alpha, etc.), recent studies have shown that neuropeptide-mediated neurogenic inflammation may play an important role in cutaneous inflammation. The purpose of this study was to investigate minocycline-induced modulation of cutaneous production of alpha-melanocyte-stimulating hormone (alpha-MSH), a neuropeptide with known anti-inflammatory activity. Two different skin models were used: explants of inflammatory skin and reconstituted skin, both incubated with minocycline at different concentrations and for different time periods. Epidermal production of alpha-MSH, as evaluated by immunofluorescence and immunoperoxidase techniques, showed increased expression in both models. This neuropeptide, which has an anti-inflammatory activity (notably through production of IL-10, antagonism of IL-1 and inhibition of the chemotaxis of polymorphonuclear leukocytes), thus plays a role in the anti-inflammatory action of minocycline.

In vitro modulation of keratinocyte wound healing integrins by zinc, copper and manganese.

Although the trace elements zinc, copper and manganese are used in vivo for their healing properties, their mechanism of action is still only partially known. Some integrins expressed by basal layer keratinocytes play an essential part in healing, notably alpha2beta1, alpha3beta1, alpha6beta4 and alphaVbeta5, whose expression and distribution in epidermis are modified during the re-epithelialization phase. This study demonstrates how the expression of these integrins are modulated in vitro by trace elements. Integrin expression was studied in proliferating keratinocytes in monolayer cultures and in reconstituted skin that included a differentiation state. After 48 h incubation with zinc gluconate (0.9, 1.8 and 3.6 microg/mL), copper gluconate (1, 2 and 4 microg/mL), manganese gluconate (0.5, 1 and 2 microg/mL) and control medium, integrin expression was evaluated by FACScan and immunohistochemistry. Induction of alpha2, alpha3, alphaV and alpha6 was produced by zinc gluconate 1.8 microg/mL in monolayers, of alpha2, alpha6 and beta1 by copper gluconate 2 and 4 microg/mL and of all the integrins studied except alpha3 by manganese gluconate 1 microg/mL. Thus, alpha6 expression was induced by all three trace elements. The inductive effect of zinc was particularly notable on integrins affecting cellular mobility in the proliferation phase of wound healing (alpha3, alpha6, alphaV) and that of copper on integrins expressed by suprabasally differentiated keratinocytes during the final healing phase (alpha2, beta1 and alpha6), while manganese had a mixed effect.

Comparative study of the in vitro inflammatory activity of three nickel salts on keratinocytes.

Nickel, the allergen of contact dermatitis, induces the in vitro production of inflammation markers such as intracellular adhesion molecule-1, interleukin-1 and tumour necrosis factor-alpha by keratinocytes. The purpose of our study was to compare the effect in vitro of different nickel salts on keratinocyte activation in order to determine whether this process depends on the nature of the salt used. Cultured keratinocytes were incubated with three nickel salts for 24 h in MCDB153 medium without hydrocortisone. Nickel gluconate, nickel sulphate and nickel chloride were each used at four concentrations: 5.10(-5) M, 1.10(-4) M and 1.10 (-3) M. Keratinocyte activation was studied through the production of three inflammation markers: intracellular adhesion molecule-1, tumour necrosis factor-alpha and very late antigen-3 (an integrin with increased expression during contact dermatitis). Marker production was detected by immunocytochemistry and flow cytometry. Tumour necrosis factor-alpha production and intracellular adhesion molecule-1 and very late antigen-3 expression increased with addition of the three nickel salts, becoming maximal for nickel gluconate 1.10(-4) M. In a subsequent experiment, zinc gluconate (an anti-inflammatory molecule) at 9 micrograms/ml reduced the very late antigen-3 expression induced by nickel gluconate 1.10(-4) M. Therefore, this study enabled us to determine the concentration of a nickel salt (nickel gluconate) inducing optimal keratinocyte activation in our culture conditions and also indicated the potential interest of very late antigen-3 as an inflammation marker.

Control of growth and differentiation of normal human epithelial cells through the manipulation of reactive nitrogen species.

In this work, we addressed the issue of whether exogenous NO and ONOO- (peroxynitrite) are able to alter growth, viability and/or differentiation of normal epithelial cells using cultured normal human keratinocytes as a model. 3-Morpholino-sydnonimine (SIN-1), a donor of both NO and O2(-)., leading to the production of ONOO-, dose-dependently inhibited growth of human keratinocytes without loss of viability. This inhibitory effect was lowered when SIN-1 was transformed into a pure NO donor by scavenging O2(-). with superoxide dismutase/catalase. Finally, scavenging NO release from SIN-1 with carboxy-1H-imidazol-1-yloxy,2-(4-carboxyp henyl)-4,5-dihydro-4,4,5,5 -tetramethyl-3-oxide (PTIO) resulted in a loss of the inhibitory effect of SIN-1. Together these findings suggest that both ONOO- and NO exert a growth inhibitory effect on human keratinocytes without cytotoxicity. Further support for this conclusion came from the treatment of human keratinocytes with the NO. donor propanamine 3-(2-hydroxy-2-nitroso-1-propyl hydrazino) or with authentic peroxynitrite. Moreover, only SIN-1 or peroxynitrite, and not NO, was able to trigger the expression of markers of terminal differentiation in human keratinocytes. From a physiological perspective, the ability of peroxynitrite, a known genotoxic and potentially carcinogenic agent, to direct proliferating keratinocytes towards terminal differentiation may be crucial to protect the genomic stability of this barrier epithelium.