Publication
IL-36γ drives skin toxicity induced by EGFR/MEK inhibition and commensal Cutibacterium acnes.
Journal Paper/Review - Mar 2, 2020
Satoh Takashi K, Mellett Mark, Meier-Schiesser Barbara, Fenini Gabriele, Otsuka Atsushi, Beer Hans-Dietmar, Rordorf Tamara, Maul Julia-Tatjana, Hafner Jürg, Navarini Alexander A, Contassot Emmanuel, French Lars E
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Journal
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Issn Electronic
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Brief description/objective
Epidermal growth factor receptor (EGFR) and MEK inhibitors (EGFRi/MEKi) are beneficial for the treatment of solid cancers but are frequently associated with severe therapy-limiting acneiform skin toxicities. The underlying molecular mechanisms are poorly understood. Using gene expression profiling we identified IL-36γ and IL-8 as candidate drivers of EGFRi/MEKi skin toxicity. We provide molecular and translational evidence that EGFRi/MEKi in concert with the skin commensal bacterium Cutibacterium acnes act synergistically to induce IL-36γ in keratinocytes and subsequently IL-8, leading to cutaneous neutrophilia. IL-36γ expression was the combined result of C. acnes-induced NF-κB activation and EGFRi/MEKi-mediated expression of the transcription factor Krüppel-like factor 4 (KLF4), due to the presence of both NF-κB and KLF4 binding sites in the human IL-36γ gene promoter. EGFRi/MEKi increased KLF4 expression by blockade of the EGFR/MEK/ERK pathway. These results provide an insight into understanding the pathological mechanism of the acneiform skin toxicities induced by EGFRi/MEKi and identify IL-36γ and the transcription factor KLF4 as potential therapeutic targets.