27 Feb Rebalancing Immune System May Help Bring Atopic Dermatitis – Eczema – Under Control

MedicalResearch.com Interview with:

Dr. Kim

Brian S. Kim, MD, MTR, FAAD
Associate Professor of Medicine (Dermatology)
Co-Director, Center for the Study of Itch and Sensory Disorders
Division of Dermatology, Department of Medicine
Washington University School of Medicine
St. Louis, MO 63110

MedicalResearch.com: What is the background for this study?

Response: It has been known well for decades that a specific part of your immune system called the “type 2 immune response” is overactive in atopic disease. Indeed, that is what new drugs like dupilumab block so effectively and thus revolutionized the treatment of atopic disorders just in the last few years. In fact, our lab focuses predominantly on this part of the immune system.

However, increasingly it is becoming recognized that the immune system is not just about whether it is “on or off” but rather a balance like yin and yang. Along these lines, we noticed that a cell that could theoretically counterbalance atopic inflammation was significantly deficient in many patients with eczema. This cell is the natural killer (NK) cell.

MedicalResearch.com: What are the main findings?

Response: We found that NK cell numbers are low in the blood in many patients with eczema and they, in part, appear to be dying off due to stress from chronic inflammation.

Second, if we use a drug that selectively boosts NK cell survival and expansion in a mouse model of eczema, the disease largely resolves. Thus, we have found that rebalancing the immune system by bringing NK cell numbers back up and beyond the normal level is entirely novel therapeutic strategy.

MedicalResearch.com: What should readers take away from your report?

Response: There are likely many ways to treat eczema and if the current strategies fail, there is still much hope. Many patients live in fear that if the new treatments stop working, “what will I do”? 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: This study not only changes how we view atopic disorders but also NK cell biology. Major remaining questions include, can this be also applied to other diseases like asthma? Food allergy? How precisely are NK cells able to balance the immune system? Are there new functions of these cells that we have not yet discovered yet which they do this?

Any disclosures?

I have consulted significantly for Regeneron and Sanofi, companies that make dupilumab. Additionally, we have filed a patent on IL-15 superagonists to boost NK cells and treat eczema. 

Citation:

Blood natural killer cell deficiency reveals an immunotherapy strategy for atopic dermatitis

BY MADISON R. MACK, JONATHAN R. BRESTOFF, MELISSA M. BERRIEN-ELLIOTT, ANNA M. TRIER, TING-LIN B. YANG, MATTHEW MCCULLEN, PATRICK L. COLLINS, HAIXIA NIU, NANCY D. BODET, JULIA A. WAGNER, EUGENE PARK, AMY Z. XU, FANG WANG, REBECCA CHIBNALL, M. LAURIN COUNCIL, CARRIE HEFFINGTON, FRIEDERIKE KREISEL, DAVID J. MARGOLIS, DAVID SHEINBEIN, PAOLA LOVATO, ERIC VIVIER, MARINA CELLA, MARCO COLONNA, WAYNE M. YOKOYAMA, EUGENE M. OLTZ, TODD A. FEHNIGER, BRIAN S. KIM

SCIENCE TRANSLATIONAL MEDICINE26 FEB 2020

https://stm.sciencemag.org/content/12/532/eaay1005

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Last Updated on February 27, 2020 by Marie Benz MD FAAD