Studies on Immune Effects of CGRP Signalling Through Endothelial Cells

Grantee: Richard Granstein, Professor, Joan and Sanford I. Weill Medical College of Cornell University

Amount: DKK 3,041,442

Grant category: Research Grants in open competition

Year: 2022

Geography: USA

This project initiative by Richard Granstein extends research previously funded by the LEO Foundation into the role of calcitonin gene-related peptide (CGRP) in regulating skin immunity by acting on endothelial cells (ECs – the cell type which lines the interior wall of blood vessels) and aims to elaborate on this regulation by studying the potential involvement of non-skin located ECs.

Recent studies have defined a novel pathway by which CGRP can skew the outcome of an immune response away from one type of T-cell mediated immunity (Th1-type) and toward another type (Th17-type) through actions on ECs. This work was originally done in cell cultures but subsequent studies using mice specifically lacking functional CGRP receptors on ECs found that this pathway indeed operates in vivo. Immunization of these mice led to decreased generation of Th17-type T cells in regional lymph nodes, but increased generation of Th1-type helper T cells. In addition, these mice were found to have severely depressed contact hypersensitivity responses. It is not known if the reduction in contact hypersensitivity responses relates to the observed changes in T helper cell differentiation. These results suggest that it may be possible to therapeutically manipulate diseases involving Th17 mechanisms, such as psoriasis, and, perhaps, other hypersensitivity disorders affecting the skin.

Given these results, it will be important to know more about the physiology of this novel pathway. Preliminary data suggest that ECs not in the skin may be sufficient targets for CGRP to exert the effects seen on T helper cell responses. Richard’s project proposes experiments to 1) test the hypothesis that ECs within regional lymph nodes are sufficient for the T helper cell effect observed in vivo and 2) to further define the mechanisms by which contact hypersensitivity is reduced in mice lacking functional CGRP receptors on ECs. Ultimately, these studies may suggest novel new routes for therapies.

Development of theragnostic approach to atopic dermatitis

Grantee: Larisa Geskin, Professor, Columbia University

Amount: DKK 3,601,500

Grant category: Research Grants in open competition

Year: 2022

Geography: USA

Cutaneous T-cell lymphoma (CTCL), a cancer of white blood cells, can look like atopic dermatitis. This project from Larisa Geskin aims to develop and validate a screening test for patients with atopic dermatitis (AD) which will aid in identifying undiagnosed CTCL in these patients.

Interleukin-4 (IL-4) and interleukin-13 (IL-13) are essential cytokines (i.e., signaling molecules released from cells to the environment in order to affect other cells), in the pathogenesis of AD. Targeting these cytokines with antibodies such as dupilumab or tralokinumab has proven to be highly effective for therapy of AD.

However, patients with AD may have an increased risk for lymphoma, especially CTCL. There are numerous reports of patients with AD who received dupilumab and later developed CTCL, lethal in some cases. Therefore, therapies targeting IL-4/IL-13 are currently contraindicated for patients with CTCL. However, differentiation between AD and CTCL is difficult because of similar manifestations in the skin and lack of specific markers (i.e., molecules that are uniquely present or expressed in a given condition) for these diseases.

In their preliminary studies Larisa and her team have screened the blood of patients with biopsy-confirmed CTCL and AD for 18 highly selected potential biomarkers using an efficient screening method. Of the 18 tested biomarkers, 9 demonstrated sensitivity and specificity potentially adequate to differentiate CTCL from benign dermatoses. These data serve as a proof of principle and justify further studies, as described in this proposed project, to test a broader set of biomarkers to find the most promising biomarker panel with the highest sensitivity and specificity to develop a simple, robust and inexpensive test, which may be widely accessible to all treating physicians before initiating therapy for AD.

Single Cell Transcriptomic Classification of Inflammatory Skin Disease

Grantee: Jeffrey Cheng, Associate Professor, The Regents of the University of California San Francisco

Amount: DKK 3,999,960

Grant category: Research Grants in open competition

Year: 2022

Geography: USA

Jeffrey Cheng’s project aims to improve our understanding and discrimination of chronic atypical skin rashes which do not fit into well-defined clinical categories. Jeffrey along with his team will approach this by first mapping gene expression variations on a single cell level for a number of prototypical rash types. This will allow them to create a framework to identify variations that can discriminate between well characterized rash types, which each have different treatment regimens. While they have already done this for rashes with atopic dermatitis- and psoriasis-like features, this project will add information about rashes with features common to cutaneous sarcoidosis and lupus erythematosus. Based on these findings, Jeffrey aims to establish a more accessible approach to classify these rashes by assessing tissue samples for presence of disease-relevant proteins.

If successful, Jeffrey and his team will provide important guidance for optimal classification and subsequent treatment of otherwise indeterminant rashes.

Molecular genetics of recalcitrant warts

Grantee: Hassan Vahidnezhad, Assistant Professor, Thomas Jefferson University

Amount: DKK 2,131,526

Grant category: Research Grants in open competition

Year: 2022

Geography: USA

This project led by Hassan Vahidnezhad aims to elucidate the mechanisms behind skin warts that do not resolve automatically.

Warts are very common, approximately present in 20-35% of the general population. While they typically disappear within a few months, some linger and may be hard to get rid of. These persistent warts are caused by infection with Human Papilloma Virus (HPV) in persons where the immune response is insufficient due to genetic defects. Particularly, defects in T cells are suspected as a causation, but exactly how the warts are formed and how they persist is to a large degree unknown.

Hassan and his team seek to identify the genetic and molecular causes of recalcitrant warts, which will not only better the understanding of the skin’s immunological response to HPV infection, but may also provide diagnostic, prognostic and therapeutic improvements for patients with recalcitrant warts.

The role of eosinophils in atopic dermatitis skin inflammation and itch

Grantee: Nathan Archer Ph.D., Assistant Professor, Johns Hopkins School of Medicine

Amount: DKK 3,783,727

Grant category: Research Grants in open competition

Year: 2022

Geography: USA

This project led by Dr. Nathan Archer investigates the interplay between bacterial colonization and a specific immune cell, the eosinophil, in development of atopic dermatitis (AD).

AD is a very common skin disease, particularly amongst young people, and the associated healthcare costs in the U.S. alone are estimated at USD 5.2 billion. Thus, there is a strong incentive to better understand the disease to improve its treatment.

The cause of AD is still unclear, but one interesting observation is that a specific type of immune cell, the eosinophil, infiltrates the affected areas and correlates with disease severity. The role of these eosinophils in AD remains unknown, but initial observations by Dr. Archer and his team point to a link between skin colonization of a specific bacteria, Staphylococcus aureus, and the observed infiltration – which may lead to both inflammation and itch. This bacteria-immune cell interaction is unusual, and Dr. Archer and his team will investigate the observed interaction in detail, with an aim to provide novel therapeutic targets for the treatment of AD.

Adherens Junction Dysfunction in Hidradenitis Suppurativa

Grantee: Amanda Nelson, Assistant Professor, The Pennsylvania State University

Amount: DKK 3,996,947

Grant category: Research Grants in open competition

Year: 2022

Geography: USA

Amanda Nelson’s project investigates the role of two proteins, E-cadherin and p120, in the relatively common inflammatory skin disease Hidradenitis Suppurativa (HS), which is characterized by skin lesions that cause intense pain, odor, drainage and scarring.

The cause of HS remains unclear, and this limits the current treatment options. The current hypothesis is that there is a blockage in the hair follicle unit, which triggers the immune response. Amanda and her team have found that E-cadherin and p120, both important for skin integrity, are lost in HS-affected skin, and their project seeks to understand how this loss may contribute to the hair follicle breakdown and subsequent inflammation. If the link is proven it may provide novel approaches for treatment of HS.

The LEO Foundation Award 2022 – Region Americas

Grantee: Dr. Shadmehr Demehri, Associate Professor, Massachusetts General Hospital

Amount: USD 100,000

Grant category: LEO Foundation Awards

Year: 2022

Geography: USA

Dr. Shawn Demehri is Associate Professor at the Department of Dermatology at Massachusetts General Hospital, USA.

He receives the award for his more than noteworthy contributions to the dermatology field, his truly exciting trajectory within skin research as well as his clinical skills. Dr. Demehri is a brilliant and exceptionally talented physician-scientist who leads a creative and accomplished research team studying the intersection between the immune system and early cancer.

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SID Resident and Post Doc Retreat

Grantee: Society for Investigative Dermatology

Amount: EUR 15,000

Grant category: Education and Awareness Grants

Year: 2022

Geography: USA

The SID mission is to advance the sciences relevant to skin disease through education, advocacy and scholarly exchange of scientific information.

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Development of predictive psoriasis response endotypes using single cell transcriptomics in ustekinumab responders versus non-responders

Grantee: Kevin Cooper, Professor, University Hospitals Cleveland Medical Center

Amount: DKK 3,653,532

Grant category: Research Grants in open competition

Year: 2021

Geography: USA

Among the biological treatments approved for the treatment of psoriasis, is ustekinumab, which is a monoclonal antibody targeting the shared p40 subunit of two cytokines, IL12 and IL23.

This project aims to improve psoriasis treatment by understanding why some psoriasis patients respond well to treatment with ustekinumab (responders) and others do not (non-responders). Interestingly, some non-responders to ustekinumab still respond well to inhibition of the IL23 pathway alone via the unique p19 subunit.

The pattern of differentially expressed genes among responders and non-responders may enable prediction of which intervention will be most beneficial for the individual patient. The plan is to compare single-cell transcriptomic analyses from both responders and non-responders to identify treatment response-linked gene expression patterns, so-called ‘endotypes’.

One size does not fit all for these biological therapeutics, and the goal is for the research to contribute to the development of a ‘companion diagnostic’, which is a diagnostic test used as a companion to a therapeutic drug to determine its applicability to a specific person, and thereby to personalized medicine in psoriasis.

Melanocyte stem cell lineage determination and plasticity

Grantee: Deborah Lang, Associate Professor, Boston University School of Medicine

Amount: DKK 3,583,404

Grant category: Research Grants in open competition

Year: 2021

Geography: USA

Melanocytes are pigment-producing skin cells. They serve as an excellent model for stem cell research because they are easily obtainable from the skin and have the potential to be modified into other types of cells. The aims of this project are to define molecular events that promote stem cell maintenance and to test if melanocyte stem cells can be transformed into other cell types (such as nerves).

Deborah Lang has created a unique transgenic mouse model that fluorescently marks melanocyte stem cells.  This model is an innovative and powerful tool to visualize and isolate pure stem cells without contaminating non-stem cells. The Lang lab, along with Andrey Sharov and other collaborators at Boston University, will investigate gene expression in the stem cells, and how these stem cells change into pigment-producing melanocytes. Further, the team will test the ability of the melanocyte stem cells to turn in to other cells, such as neurons and neuron-like cells.

This project will provide new insights into melanocyte stem cell function and flexibility to become other cell types. The potential long-term impact of this project is that it will provide insight on normal melanocyte function, melanocyte dysfunction and pathology, and stem cell therapy.