Dermatology: Research Update - Publication Highlights

JID Cover Article

The Journal of Investigative Dermatology (JID) has chosen Dr. Vincent Piguet's article "Dendritic Cells Promote the Spread of Human T-Cell Leukemia Virus Type 1 via Bidirectional Interactions with CD4+ T Cells" to be featured on the cover of their first January 2019 issue.

At least 5 to 10 million people worldwide are infected with human T-cell lymphotropic virus type 1 (HTLV-1). Although the epidemiology of this infection is not fully understood, Japan and some parts of the Caribbean have the highest prevalence, followed by parts of Colombia and French Guyana and some areas of intertropical Africa, among others.
 
HTLV-1-associated infective dermatitis (HAID) is the main paediatric manifestation of human T-cell lymphotropic virus type 1 (HTLV-1). Other manifestations include adult T-cell leukaemia/lymphoma (ATLL), an aggressive form or lymphoma as well as tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM). HAID may also progress to ATLL or TSP/HAM.
 
Dr. Piguet's recent study which resulted from a collaboration between Toronto, the UK and Japan describes some of the mechanisms of how HTLV-1 propagates within and between individuals. Primary infection typically occurs across mucosal surfaces via mother to child transmission (breastfeeding), sexual intercourse or contaminated products.
 
The study shows that a subset of immune cells called dendritic cells have a key role in the cell-to-cell propagation of the virus. More specifically, we identify some of the cellular structures involved in anterograde and retrograde transmission of the virus from DC to CD4+ T cells. Understanding the mechanisms of propagation of this disease is important as we still lack proven medical treatments for asymptomatic HTLV-1 infection. Read the full article.

JACI Article

Dr. Aaron Drucker had a commentary published in the Journal of Allergy and Clinical Immunology (JACI), co-authored with Dr. Paula Harvey, Physician in Chief of Medicine and Head, Division of Cardiology at Women's College Hospital.

Over the last five years, a number of studies have examined a potential link between atopic dermatitis and cardiovascular disease. A systematic review and meta-analysis of these studies was recently published in Journal of Allergy and Clinical Immunology, which found that atopic dermatitis was associated with a small increased risk of cardiovascular outcomes such as heart attacks.

Dr. Aaron Drucker and Dr. Paula Harvey (Cardiology) were asked to write a commentary on that review. In their commentary, Dr. Drucker and Dr. Harvey suggest that although there is an increased risk, the absolute risk associated with atopic dermatitis is so small that it does not necessitate any specific treatment or screening of atopicdermatitis patients for cardiovascular risk factors or outcomes. Additionally, it is unclear whether the association seen between severe atopic dermatitis and cardiovascular disease are the result of the inflammatory disease itself or the medications, such as systemic corticosteroids, often used in those patients. Patients with atopic dermatitis should be treated like anyone else from the general population, with age-appropriate cardiovascular screening and preventive measures by their general practitioners. Read the full commentary.