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(American Journal of Pathology. 2006;168:170-175.)
© 2006 American Society for Investigative Pathology

Fas Pulls the Trigger on Psoriasis

Amos Gilhar*, Ron Yaniv{dagger}, Bedia Assy*, Sima Serafimovich*, Yehuda Ullmann* and Richard S. Kalish{ddagger}

From the Skin Research Laboratory,* The B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, and Flieman Medical Center, Haifa, Israel; Department of Dermatology,{dagger} Sheeba Medical Center, Ramat Gan, Israel; and the Department of Dermatology,{ddagger} State University of New York at Stony Brook, Stony Brook, New York

Fas/FasL signaling is best known for induction of apoptosis. However, there is an alternate pathway of Fas signaling that induces inflammatory cytokines, particularly tumor necrosis factor (TNF)-{alpha} and interleukin (IL)-8. This pathway is prominent in cells that express high levels of anti-apoptotic molecules such as Bcl-xL. Because TNF-{alpha} is central to the pathogenesis of psoriasis and psoriatic epidermis has a low apoptotic index with high expression of Bcl-xL, we hypothesized that inflammatory Fas signaling mediates induction of psoriasis by activated lymphocytes. Noninvolved skin from psoriasis patients was grafted to beige-severe combined immunodeficiency mice, and psoriasis was induced by injection of FasL-positive autologous natural killer cells that were activated by IL-2. Induction of psoriasis was inhibited by injection of a blocking anti-Fas (ZB4) or anti-FasL (4A5) antibody on days 3 and 10 after natural killer cell injection. Anti-Fas monoclonal antibody significantly reduced cell proliferation (Ki-67) and epidermal thickness, with inhibition of epidermal expression of TNF-{alpha}, IL-15, HLA-DR, and ICAM-1. Fas/FasL signaling is an essential early event in the induction of psoriasis by activated lymphocytes and is necessary for induction of key inflammatory cytokines including TNF-{alpha} and IL-15.




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