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Atopic dermatitis (AD) is a complex, multifactorial skin disease, characterized by pruritus and predominant Th2 inflammation. Innate immune cells may play a role in AD development and are composed of granulocytes, macrophages, innate-like T cells, and innate lymphoid cells. This study investigates the phenotypic and functional profile of circulating CLA + natural killer (NK) cells and its role in the skin-homing to NK cells infiltrated in adults’ skin with AD. We selected 44 AD patients and 27 non-AD volunteers for the study. The results showed increased frequencies of both CLA + CD56 bright and CLA + CD56 dim NK cell populations in the peripheral blood, mainly in severe AD patients. Upon SEB stimulation, we observed an augmented percentage of CLA + CD56 dim NK cells expressing CD107a, IFN-γ, IL-10, and TNF, reinforcing the role of staphylococcal enterotoxins in AD pathogenesis. Additionally, we demonstrated increased dermal expression of both NK cell markers NCAM-1/CD56 and pan-granzyme, corroborating the skin-homing, mostly in severe AD. Further studies are necessary to elucidate the potential role of NK cells in the chronification of the inflammatory process in AD skin, as well as their possible relationship with staphylococcal enterotoxins, and as practicable therapeutic targets.

Obesity is increasing in incidence worldwide, especially in women, which can affect the outcome of pregnancy. During this period, viral infections represent a risk to the mother, the placental unit, and the fetus. The Zika virus (ZIKV) outbreak in Brazil has been the cause of congenital Zika syndrome (CZS), with devastating consequences such as microcephaly in newborns. Herein, we analyzed the impact of maternal overweight/obesity on the antiviral factors’ expression in the placental tissue of Zika-infected mothers. We accessed placentas from women with and without obesity from 34 public health units (São Paulo) and from Zika-infected mothers with and without obesity from the Clinical Cohort Study of ZIKV pregnant women (Rio de Janeiro, Brazil). We first verified that obesity, without infection, did not alter the constitutive transcriptional expression of antiviral factors or IFN type I/III expression. Interestingly, obesity, when associated with ZIKV infection, showed a decreased transcriptional expression of RIG-I and IFIH1 (MDA-5 protein precursor gene). At the protein level, we also verified a decreased RIG-I and IRF-3 expression in the decidual placenta from the Zika-infected obese group, regardless of microcephaly. This finding shows, for the first time, that obesity associated with ZIKV infection leads to an impaired type I IFN downstream signaling pathway in the maternal–fetal interface.

Leprosy is a chronic infectious disease whose evolution involves complex immune mechanisms of the host that influence the clinical presentation of the disease. For many years, the main interpretation of the host defense response was based on characterization of the established immune paradigm between T helper (Th) 1 and Th2 lymphocytes. However, with advances in the knowledge of immunology, new approaches have emerged along with the development of new immunological pathways that have changed the interpretation of the long-established paradigm of the polar forms of the disease, especially with the identification of new subtypes of T lymphocytes such as Th9, Th17, Th22, and Tregs. Thus, this review discusses the role of these new subtypes of T helper lymphocytes and how the development of the immune response of these cells modifies the pattern of the Th1/Th2 response in the immunopathogenesis of leprosy.

Atopic dermatitis (AD) is an inflammatory skin disease with intense pruritus, and chronic skin colonization by Staphylococcus aureus . To understand the inflammatory status in AD, we investigated the inflammasome complex, that activates ASC (Apoptosis-associated speck-like protein containing a CARD), caspase-1 and GSDMD (gasdermin-D), and production of IL-1β and IL-18. We aimed to evaluate the expression of the inflammasome pathway in the skin of adults with AD. Thirty patients with moderate to severe AD and 20 healthy controls were enrolled in the study. We performed the analysis of the inflammasome components NLRP1, NLRP3, AIM-2, IL-1β, IL-18, Caspase-1, ASC, GSDMD, and CD68 expression (macrophage marker) by immunohistochemistry and immunofluorescence. The main findings included increased expression of NLRP3, NLRP1 and AIM-2 at dermal level of severe AD; augmented IL-18 and IL-1β expression at epidermis of moderate and severe patients, and in the dermis of severe AD; augmented expression of ASC, caspase-1 and GSDMD in both epidermis and dermis of moderate and severe AD. We detected positive correlation between caspase-1, GSDMD and IL-1β (epidermis) and caspase-1 (dermis) and AD severity; NLRP3, AIM-2 and IL-1β, and NLRP3 with IL-18 in the epidermis; ASC, GSDMD and IL-1β, and NLRP3, AIM-2, caspase-1, and IL-18 in the dermis. We also evidenced the presence of CD68 + macrophages secreting GSDMD, ASC and IL-1β in moderate and severe AD. Cutaneous macrophages, early detected in moderate AD, have its role in the disease inflammatory mechanisms. Our study indicates a canonical activation pathway of inflammasomes, reinforced by the chronic status of inflammation in AD. The analysis of the inflammasome complex evidenced an imbalance in its regulation, with increased expression of the evaluated components, which is remarkably in severe AD, emphasizing its relevance as potential disease biomarkers and targets for immunomodulatory interventions.

SARS-CoV-2, a β-coronavirus, primarily affects the lungs, with non-specific lesions and no cytopathic viral effect in the skin. Cutaneous antiviral mechanisms include activation of TLR/IRF pathways and production of type I IFN. We evaluated the antiviral mechanisms involved in the skin of COVID-19 patients, including skin samples from 35 deceased patients who had contracted COVID-19 before the launch of the vaccine. Detection of SARS-CoV-2 in the skin was performed using transmission electron microscopy and RT-qPCR. Microscopic and molecular effects of the virus in skin were evaluated by histopathology, RT-qPCR, and immunohistochemistry (IHC). The results revealed the presence of SARS-CoV-2 and microscopic changes, including microvascular hyaline thrombi, perivascular dermatitis, and eccrine gland necrosis. There was increased transcription of TBK1 and a reduction in transcription of TNFα by RT-qPCR in the COVID-19 group. IHC revealed reduced expression of ACE2, TLR7, and IL-6, and elevated expression of IFN-β by epidermal cells. In the dermis, there was decreased expression of STING, IFN-β, and TNF-α and increased expression of IL-6 in sweat glands. Our results highlight the role of type I IFN in the skin of COVID-19 patients, which may modulate the cutaneous response to SARS-CoV-2.

Chronic urticaria (CU) is a skin disease characterized by recurrent episodes of urticaria and/or angioedema, persisting for more than six weeks. Chronic urticaria is classified as chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU). Histamine, released by mast cells and basophils, is the central mediator in the development of signs and symptoms, especially pruritus. IL-31 activates pruritus via IL-31RA. Th2 cytokines also contributes to the inflammatory environment, releasing further IL-31. We aimed to investigate the quantification of mast cells, expression of pro-inflammatory cytokines in skin samples from individuals with CU and cell activation by the basophil activation test. Thirteen patients with CSU, 11 patients with CIndU and 10 healthy controls (HC) were enrolled in the study. We performed histologic quantification of the mast cells, metachromatic stained with toluidine blue, in CSU and CIndU lesional samples; IL-31, IL-31RA, IL-4 and IFN-γ expression by immunohistochemistry; and basophil activation test (BAT) by flow cytometry. The main findings were increased mast cell quantification in CSU; increased epidermal and dermal expression of IL-31 in CSU lesional samples and increased dermal expression in CIndU samples; augmented IL-31RA expression at epidermis and dermis of CSU group; augmented expression IL-4 at epidermis of CSU patients. We also found enhanced BAT positivity in CSU, reinforcing the autoimmune profile of our CSU patients. The analysis of the proinflammatory cytokines related to pruritus, showed increased expression of the evaluated components. These remarkable findings in CSU emphasize their relevance as potential disease biomarkers and targets for immunomodulatory interventions.

Allergic contact dermatitis (ACD) is a cutaneous inflammatory disorder mediated by allergen-specific memory T cells. Methylisothiazolinone (MI), a preservative widely used in industrial and cosmetic products and a component of Kathon CG, has led to a substantial rise in ACD cases. Despite increasing sensitization rates, the innate immune mechanisms and transcriptional responses induced by MI in the skin remain poorly understood. Individuals with positive patch tests exclusively to MI were recruited at the Contact Dermatitis Clinic of Hospital das Clínicas (São Paulo). Participants were re-exposed to MI or saline, and skin biopsies were collected 48 hours later. Healthy MI-negative controls were also exposed to MI and saline. Histopathology and RNA-sequencing were performed. Differentially expressed genes (DEGs) were analyzed, and key findings were validated by qPCR and protein expression of IL-9 and IL-24. Two distinct MI-responsive groups emerged among ACD patients:ACD-A (high responders): pronounced histopathology (spongiosis, microvesicles). ACD-B (low responders): milder reactions with absence of spongiosis. In ACD-A, MI exposure resulted in 1,588 upregulated and 2,090 downregulated genes compared to ACD-B. DEGs were enriched for innate immune and inflammatory pathways, including IL-24, IL-9, IL-13, and NTRK1 (upregulated), while IL-37 and IL-18 were downregulated. Compared to MI-negative ACD controls, ACD-A showed 1,169 upregulated and 321 downregulated genes. qPCR confirmed increased NTRK1 and IL-9 expression and reduced IL-18 levels. IL-9 and IL-24 protein levels were higher in the dermal layer of ACD-A. MI-sensitized individuals exhibit heterogeneous innate immune responses despite uniformly positive patch tests. IL-9, IL-24, and NTRK1 appear to play important roles in the heightened inflammatory response observed in high-responder individuals, while downregulation of IL-18 and IL-37 may contribute to impaired regulatory pathways. These findings highlight previously undescribed heterogeneity in MI-induced ACD and identify potential targets for better understanding disease pathogenesis.

Background Since macrophages are one of the major cell types involved in the Mycobacterium leprae immune response, roles of the M1 and M2 macrophage subpopulations have been well defined. However, the role of M4 macrophages in leprosy or other infectious diseases caused by mycobacteria has not yet been clearly characterized. This study aimed to investigate the presence and potential role of M4 macrophages in the immunopathology of leprosy. Methods We analyzed the presence of M4 macrophage markers (CD68, MRP8, MMP7, IL-6, and TNF-α) in 33 leprosy skin lesion samples from 18 patients with tuberculoid leprosy and 15 with lepromatous leprosy by immunohistochemistry. Results The M4 phenotype was more strongly expressed in patients with the lepromatous form of the disease, indicating that this subpopulation is less effective in the elimination of the bacillus and consequently is associated with the evolution to one of the multibacillary clinical forms of infection. Conclusion M4 macrophages are one of the cell types involved in the microbial response to M. leprae and probably are less effective in controlling bacillus replication, contributing to the evolution to the lepromatous form of the disease.

Atopic dermatitis (AD) is a chronic inflammatory immune-mediated skin disease characterized by skin colonization by Staphylococcus aureus . Interleukin (IL)-22, in cooperation with IL-17, triggers antimicrobial peptide elaboration and enhances certain immunological responses. In AD, IL-22 is related to epidermal hyperplasia, keratinocyte apoptosis, and inhibition of antimicrobial peptide (AMP) production. We aimed to evaluate the impact of staphylococcal enterotoxins on the Tc22/Th22 induction in the peripheral blood of AD patients and on CD4 +/ CD8 + T cells expressing IL-22 in AD skin. Our study showed inhibition of the staphylococcal enterotoxins A and B (SEA and SEB) response by Th22 (CD4 + IL-22 + IL-17A − IFN-γ − ) cells in AD patients. In contrast, Tc22 (CD8 + IL-22 + IL-17A − IFN-γ − ) cells were less susceptible to the inhibitory effects of staphylococcal enterotoxins and exhibited an enhanced response to the bacterial stimuli. In AD skin, we detected increased IL-22 transcript expression and T lymphocytes expressing IL-22. Together, our results provide two major findings in response to staphylococcal enterotoxins in adults with AD: dysfunctional CD4 + IL-22 secreting T cells and increased Tc22 cells. Our hypothesis reinforces the relevance of CD8 T cells modulated by staphylococcal enterotoxins as a potential source of IL-22 in adults with AD, which is relevant for the maintenance of immunological imbalance.