Psychological stress-mediated systemic hormones can aggravate psoriasis severity. However, some studies have shown that stress can also ameliorate this disease. We aimed to investigate the effects of a high physiological epinephrine dose, as observed in stressed individuals, in imiquimod (IMQ)-induced skin inflammation ex vivo. Normal human skin explants were treated ex vivo with 56 nM (a high physiological level) epinephrine, and then three days later, topically treated with IMQ for 6 consecutive days. Human keratinocytes were treated in vitro with IMQ or epinephrine. The administration of 56 nM epinephrine reduced the epidermal area and increased the protein levels of IL-10 in IMQ-treated human skin. The blockade of β1- andβ2-adrenergic receptors (β1-/β2-AR), the IL-10 receptor, and cAMP reversed the reduction in epidermal area induced by epinephrine levels (56 nM) in IMQ-treated skin. In human keratinocytes, a physiological epinephrine level and IMQ increased the protein levels of β2-AR, cAMP, and IL-10. In conclusion, a high physiological level of epinephrine ameliorates IMQ-induced skin inflammation via cAMP and IL-10 production.
WHO (2016) Global Report on Psoriasis. World Health Organization.
[3]
Romiti, R., Carvalho, A.V.E.d. and Duarte, G.V. (2021) Brazilian Consensus on Psoriasis 2020 and Treatment Algorithm of the Brazilian Society of Dermatology. AnaisBrasileirosdeDermatologia, 96, 778-781. https://doi.org/10.1016/j.abd.2021.03.007
[4]
Rendon, A. and Schäkel, K. (2019) Psoriasis Pathogenesis and Treatment. InternationalJournalofMolecularSciences, 20, Article 1475. https://doi.org/10.3390/ijms20061475
[5]
Tian, D. and Lai, Y. (2022) The Relapse of Psoriasis: Mechanisms and Mysteries. JIDInnovations, 2, Article 100116. https://doi.org/10.1016/j.xjidi.2022.100116
[6]
Vileikyte, L. (2007) Stress and Wound Healing. ClinicsinDermatology, 25, 49-55. https://doi.org/10.1016/j.clindermatol.2006.09.005
[7]
Lee, C.M., Watson, R.E.B. and Kleyn, C.E. (2019) The Impact of Perceived Stress on Skin Ageing. JournaloftheEuropeanAcademyofDermatologyandVenereology, 34, 54-58. https://doi.org/10.1111/jdv.15865
[8]
Peters, E.M.J. (2016) Stressed Skin?—A Molecular Psychosomatic Update on Stress-Causes and Effects in Dermatologic Diseases. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 14, 233-252. https://doi.org/10.1111/ddg.12957
[9]
Seville, R.H. (1977) Psoriasis and Stress. BritishJournalofDermatology, 97, 297-302. https://doi.org/10.1111/j.1365-2133.1977.tb15186.x
[10]
Gisondi, P., Geat, D., Bellinato, F., Spiazzi, L., Danese, E., Montagnana, M., et al. (2021) Psychological Stress and Salivary Cortisol Levels in Patients with Plaque Psoriasis. JournalofPersonalizedMedicine, 11, Article 1069. https://doi.org/10.3390/jpm11111069
[11]
Donato‐Trancoso, A., Cristina de Souza Ribeiro, B., Barrozo do Canto, F., de Souza Nogueira, J. and Romana‐Souza, B. (2023) Chronic Psychological Stress Aggravates Psoriasis-Like Skin Inflammation via Overactivation of β2-Adrenoceptor and Nuclear Factor Kappa B Pathways. ScandinavianJournalofImmunology, 97, e13258. https://doi.org/10.1111/sji.13258
[12]
Ge, H., Mao, Y., Chen, W., Li, Z., Yu, Y., Luo, S., et al. (2023) Stress Aggravates Imiquimod-Induced Psoriasiform Inflammation by Promoting M1 Macrophage Polarization. InternationalImmunopharmacology, 124, Article 110899. https://doi.org/10.1016/j.intimp.2023.110899
[13]
Wang, Y., Li, P., Zhang, L., Fu, J., Di, T., Li, N., et al. (2020) Stress Aggravates and Prolongs Imiquimod-Induced Psoriasis-Like Epidermal Hyperplasis and IL-1β/IL-23p40 Production. JournalofLeukocyteBiology, 108, 267-281. https://doi.org/10.1002/jlb.3ma0320-363rr
[14]
Singh, T.P., Zhang, H.H., Hwang, S.T. and Farber, J.M. (2019) IL-23-and Imiquimod-Induced Models of Experimental Psoriasis in Mice. CurrentProtocolsinImmunology, 125, e71. https://doi.org/10.1002/cpim.71
[15]
Das, N.S., Chowdary, T.N., Sobhanadri, C. and Rao, K.V. (1978) The Effect of Topical Isoprenaline on Psoriatic Skin. BritishJournalofDermatology, 99, 197-200. https://doi.org/10.1111/j.1365-2133.1978.tb01982.x
[16]
Vegas, O., Poligone, B., Blackcloud, P., Gilmore, E.S., VanBuskirk, J., Ritchlin, C.T., etal. (2018) Chronic Social Stress Ameliorates Psoriasiform Dermatitis through Upregulation of the Hypothalamic-Pituitary-Adrenal Axis. Brain, Behavior, andImmunity, 68, 238-247. https://doi.org/10.1016/j.bbi.2017.10.022
[17]
Ağaç, D., Estrada, L.D., Maples, R., Hooper, L.V. and Farrar, J.D. (2018) The β2-Adrenergic Receptor Controls Inflammation by Driving Rapid IL-10 Secretion. Brain, Behavior, andImmunity, 74, 176-185. https://doi.org/10.1016/j.bbi.2018.09.004
[18]
Bellinger, D. and Lorton, D. (2018) Sympathetic Nerve Hyperactivity in the Spleen: Causal for Nonpathogenic-Driven Chronic Immune-Mediated Inflammatory Diseases (IMIDs)? InternationalJournalofMolecularSciences, 19, Article 1188. https://doi.org/10.3390/ijms19041188
[19]
Deyrieux, A.F. and Wilson, V.G. (2007) In Vitro Culture Conditions to Study Keratinocyte Differentiation Using the HaCaT Cell Line. Cytotechnology, 54, 77-83. https://doi.org/10.1007/s10616-007-9076-1
[20]
Varma, S.R., Sivaprakasam, T.O., Mishra, A., Prabhu, S., M, R. and P, R. (2017) Imiquimod-Induced Psoriasis-Like Inflammation in Differentiated Human Keratinocytes: Its Evaluation Using Curcumin. EuropeanJournalofPharmacology, 813, 33-41. https://doi.org/10.1016/j.ejphar.2017.07.040
[21]
Romana-Souza, B., Otranto, M., Almeida, T.F., Porto, L.C. and Monte-Alto-Costa, A. (2011) Stress-Induced Epinephrine Levels Compromise Murine Dermal Fibroblast Activity through β-Adrenoceptors. ExperimentalDermatology, 20, 413-419. https://doi.org/10.1111/j.1600-0625.2010.01239.x
[22]
Wortsman, J., Frank, S. and Cryer, P.E. (1984) Adrenomedullary Response to Maximal Stress in Humans. TheAmericanJournalofMedicine, 77, 779-784. https://doi.org/10.1016/0002-9343(84)90512-6
[23]
Guber, H.A., Oprea, M. and Russell, Y.X. (2022) Evaluation of Endocrine Function. In: McPherson, R.A. and Pincus, M.R., Eds., Henry’sClinicalDiagnosisandManagementbyLaboratoryMethods, Elsevier, 200-350.
[24]
Weigl, B.A. (1998) Immunoregulatory Mechanisms and Stress Hormones in Psoriasis (Part 1). InternationalJournalofDermatology, 37, 350-357. https://doi.org/10.1046/j.1365-4362.1998.00202.x
[25]
Pollak, C., Maier, H.B., Moschny, N., Jahn, K., Bleich, S., Frieling, H., et al. (2021) Epinephrine Levels Decrease in Responders after Electroconvulsive Therapy. JournalofNeuralTransmission, 128, 1917-1921. https://doi.org/10.1007/s00702-021-02420-1
[26]
Long, S., Fang, J., Shu, H., Xia, D., Wang, Z., Mi, W., et al. (2022) Correlation of Catecholamine Content and Clinical Influencing Factors in Depression among Psoriasis Patients: A Case-Control Study. BioPsychoSocialMedicine, 16, Article No. 17. https://doi.org/10.1186/s13030-022-00245-2
[27]
da Silva Carlos, E.C., Cristovão, G.A., Silva, A.A., de Santos Ribeiro, B.C. and Romana‐Souza, B. (2022) Imiquimod-Induced ex vivo Model of Psoriatic Human Skin via Interleukin-17A Signalling of T Cells and Langerhans Cells. ExperimentalDermatology, 31, 1791-1799. https://doi.org/10.1111/exd.14659
[28]
Pullar, C.E. and Isseroff, R.R. (2005) Cyclic AMP Mediates Keratinocyte Directional Migration in an Electric Field. JournalofCellScience, 118, 2023-2034. https://doi.org/10.1242/jcs.02330
[29]
Gaucher, S. and Jarraya, M. (2014) Technical Note: Comparison of the Prestoblue and LDH Release Assays with the MTT Assay for Skin Viability Assessment. CellandTissueBanking, 16, 325-329. https://doi.org/10.1007/s10561-014-9478-1
[30]
Romana-Souza, B., Silva-Xavier, W. and Monte-Alto-Costa, A. (2018) Topical Retinol Attenuates Stress-Induced Ageing Signs in Human Skin ex vivo, through EGFR Activation via EGF, but Not ERK and AP-1 Activation. ExperimentalDermatology, 28, 906-913. https://doi.org/10.1111/exd.13675
[31]
Souza, B.R., Cardoso, J.F., Amadeu, T.P., Desmoulière, A. and Costa, A.M.A. (2005) Sympathetic Denervation Accelerates Wound Contraction but Delays Reepithelialization in Rats. WoundRepairandRegeneration, 13, 498-505. https://doi.org/10.1111/j.1067-1927.2005.00070.x
[32]
Sivamani, R.K., Lam, S.T. and Isseroff, R.R. (2007) Beta Adrenergic Receptors in Keratinocytes. DermatologicClinics, 25, 643-653. https://doi.org/10.1016/j.det.2007.06.012
[33]
Asadullah, K., Döcke, W., Sabat, R., Volk, H. and Sterry, W. (2000) The Treatment of Psoriasis with IL-10: Rationale and Review of the First Clinical Trials. ExpertOpiniononInvestigationalDrugs, 9, 95-102. https://doi.org/10.1517/13543784.9.1.95
[34]
Xu, R., Feng, S., Ao, Z., Chen, Y., Su, C., Feng, X., et al. (2022) Long-Acting β2 Adrenergic Receptor Agonist Ameliorates Imiquimod-Induced Psoriasis-Like Skin Lesion by Regulating Keratinocyte Proliferation and Apoptosis. FrontiersinPharmacology, 13, Article 865715. https://doi.org/10.3389/fphar.2022.865715
[35]
Ernst, O., Failayev, H., Athamna, M., He, H., Tsfadia, Y. and Zor, T. (2020) A Dual and Conflicting Role for Imiquimod in Inflammation: A TLR7 Agonist and a Camp Phosphodiesterase Inhibitor. BiochemicalPharmacology, 182, Article 114206. https://doi.org/10.1016/j.bcp.2020.114206