In a new study published in the Nature journal Scientific Reports, researchers from the University of Maryland School of Medicine (UMSOM) have identified a previously unknown form of erythroderma using an innovative diagnostic platform.
The research team, led by Dr. Shawn Kwatra, developed a novel blood test utilizing flow cytometry to identify specific cytokine signatures in individual circulating blood cells. This now-patented method, known as “peripheral blood flow cytometry-based immunophenotyping,” enabled the researchers to find the new form of erythroderma. Dr. Kwatra is the Joseph W. Burnett Endowed Professor and Chair of Dermatology at UMSOM and Chief of Service Dermatology at the University of Maryland Medical Center.
The study focused on a male patient presenting with erythroderma, characterized by red, exfoliating skin lesions covering 80% of his body. Despite months of traditional therapies, including steroids, topicals, and immunosuppressive drugs, the patient experienced minimal relief.
Dr. Kwatra’s team employed their innovative diagnostic technique to analyze the patient's blood samples. They discovered elevated levels of two cytokines, interleukin-13 and interleukin-17, compared to healthy controls and patients with known causes of erythroderma.
Based on these findings, the researchers initiated dual therapy using monoclonal antibodies dupilumab and secukinumab, targeting the identified cytokines. This approach led to a dramatic reduction in symptoms and eventual resolution of the patient’s condition.
Dr. Hannah Cornman, the study’s first author, emphasized the significance of identifying these specific cytokines in a press release. “We found a new role for interleukin-13 and interleukin-17 in the blood samples taken from this patient which supported the use of those two particular medications,” she said. “These cytokines appeared to be the key in defining the disease.” The team monitored the decline in immunopathogenic cell numbers and cytokine levels throughout the treatment course.
Dr. Kwatra said this discovery has far-reaching implications for dermatology. “We are now exploring developing our diagnostic test to a range of other inflammatory skin [conditions].” He believes this research represents a promising step toward developing sophisticated diagnostic tools employing immunophenotyping to pinpoint causes of non-specific inflammatory conditions.
Dr. Mark T. Gladwin, Dean of UMSOM, highlighted the potential impact: “Patients with these conditions urgently need access to precision-based therapies to help them better manage their symptoms and lead productive lives.”
The study, funded by the U.S. National Institutes of Health, involved collaboration with researchers from Duke University School of Medicine, George Washington University School of Medicine, and Johns Hopkins University School of Medicine.
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