Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects 15 to 30% of children and ~5% of adults in industrialized countries. Although the pathogenesis of AD is not fully understood, the disease is thought to be mediated by an abnormal inflammatory response including immunoglobulin E (IgE) production in the setting of skin barrier dysfunction. Loss-of- function mutations in the Filaggrin gene encoding an epidermal protein that promotes the skin barrier, are strong predisposing factors for the development of AD. Because a hallmark of AD is an altered skin barrier, understanding of the mechanism by which Filaggrin deficiency increases the susceptibility to AD may provide critical insight into disease pathogenesis. Mast cells (MCs) contribute to IgE-mediated allergic disorders including AD. Upon activation with IgE and antigen or microbial stimuli, MCs release their membrane-bound cytosolic granules leading to the release of multiple molecules that are important in the pathogenesis of AD and host defense against bacterial pathogens. Notably, more than 90% of AD patients are colonized with Staphylococcus aureus in the lesional skin whereas the skin of most healthy individuals do not harbor the pathogen. Several Staphylococcal exotoxins (SEs) can act as superantigens and/or antigens in models of AD. However, the role of these SEs in disease pathogenesis remains unclear. We have identified ?-toxin, a peptide released by S. aureus that belongs to the peptide toxin family of phenol-soluble modulins (PSMs), as a potent inducer of MC degranulation. ?- toxin is a member of the family of phenol-soluble modulins that is produced by the virulence Agr quorum sensing of S. aureus. Importantly, S. aureus isolates recovered from AD patients produce high levels of ?-toxin. Notably, skin colonization with S. aureus, but not a mutant deficient in ?-toxin, promoted IgE and IL-4 production. Furthermore, enhancement of IgE production and dermatitis by ?-toxin were abrogated in MC-deficient mice and restored by MC reconstitution. In this application, we propose three specific Aims to understand how S. aureus is sensed by skin cells including keratinocytes to induce inflammation and IgE in the skin. Furthermore, we propose studies to link S. aureus ?-toxin and related PSMs to host immune signaling pathways that mediate skin inflammation. Understanding how S. aureus ?-toxin and related PSMs regulated by the Agr quorum sensing system contribute to allergic skin disease is expected to provide critical insight into the pathogenesis of AD and the development of new therapeutic approaches to prevent and/or treat AD.

Public Health Relevance

Atopic dermatitis (AD) is a common inflammatory disease of the skin caused by an inappropriate Th2 immune response in the presence of skin barrier defects. The lesional skin of ~90% patients with AD are colonized by Staphylococcus aureus which associated with disease flares. However, the mechanisms by which the bacterial pathogen contributes to disease and the pathways involved S. aureus-induced allergic inflammation remain poorly understood. In this grant application, we propose studies to understand the link between S aureus and allergic skin disease.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR069303-02
Application #
9506700
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Cibotti, Ricardo
Project Start
2017-07-01
Project End
2022-06-30
Budget Start
2018-07-01
Budget End
2019-06-30
Support Year
2
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Pathology
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Nakagawa, Seitaro; Matsumoto, Masanori; Katayama, Yuki et al. (2017) Staphylococcus aureus Virulent PSM? Peptides Induce Keratinocyte Alarmin Release to Orchestrate IL-17-Dependent Skin Inflammation. Cell Host Microbe 22:667-677.e5