Epicutaneous Staphylococcus Aureus Induces Il-36 To Enhance Ige Production And Ensuing Allergic Disease

IgE induced by type 2 immune responses in atopic dermatitis is implicated in the progression of atopic dermatitis to other allergic diseases, including food allergies, allergic rhinitis, and asthma. However, the keratinocyte-derived signals that promote IgE and ensuing allergic diseases remain unclear. Herein, in a mouse model of atopic dermatitis-like skin inflammation induced by epicutaneous Staphylococcus aureus exposure, keratinocyte release of IL-36 alpha along with IL-4 triggered B cell IgE class-switching, plasma cell differentiation, and increased serum IgE levels-all of which were abrogated in IL-36R-deficient mice or anti-IL-36R-blocking antibody-treated mice. Moreover, skin allergen sensitization during S. aureus epicutaneous exposure-induced IL-36 responses was required for the development of allergen-specific lung inflammation. In translating these findings, elevated IL-36 cytokines in human atopic dermatitis skin and in IL-36 receptor antagonist- deficiency patients coincided with increased serum IgE levels. Collectively, keratinocyte-initiated IL-36 responses represent a key mechanism and potential therapeutic target against allergic diseases.