The skin is the main barrier between the human body and the outside world, which not only plays the role of a physical barrier but also functions as the first line of defence of immunology. Langerhans cells (LCs), as dendritic cells (DC) that play an important role in the immune system, are mainly distributed in the epidermis. This review focuses on the role of these epidermal LCs in regulating skin threats (such as microorganisms, ultraviolet radiation and allergens), especially psoriasis. Since human and mouse skin DC subsets share common ontogenetic characteristics, we can further explore the role of LCs in psoriatic inflammation.

Psoriasis is a common immune-mediated, chronic inflammatory genetic-related disease that affects patients’ quality of life. Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of progenitor and immature myeloid cells which are expanded in psoriatic skin lesions and peripheral blood. However, the role of MDSCs in the pathogenesis of psoriasis remains unclear. Here, we confirmed that the accumulation of human MDSCs is remarkably increased in skin lesions of psoriasis patients by flow cytometry. Depleting MDSCs by Gemcitabine significantly suppresses IMQ-induced psoriatic inflammation and epidermal thickening as well as Th17 and Treg cell accumulation. Moreover, through the RNA-Seq technique, we validated some differentially expressed genes on CD4⁺ T-cells of IMQ-induced-MDSC-depleted mice such as IL-21 and Timd2, which are involved in Th17-cell differentiation or T-cell activation. Interestingly, neutralizing IL-21R by antibody reduces IMQ-induced epidermal thickening through downregulating the infiltration of MDSCs and Th17 cells. Our data suggest that targeting myeloid-derived suppressor cells is a novel strategy for antipsoriasis therapy. IL-21 may be a potential therapeutic target in psoriasis.

Competing endogenous RNAs (ceRNAs), including long noncoding RNA (lncRNA), circular RNA (circRNA), pseudogenes, synthetic miRNA inhibitors, etc. are classes of RNAs that can compete and interact with each other within an organism. There are regions in these RNAs that can be bound by messenger-RNA-interfering complementary RNA (microRNA), called microRNA response elements (MREs). These RNAs compete with each other to combine complementary microRNAs and MREs to form ceRNA regulatory mechanisms and participate in the regulation of many biological processes. The oxidative stress injury of melanocytes is one of the crucial mechanisms of vitiligo. However, it is unclear whether the ceRNA regulation mechanism is involved in the oxidative stress injury of melanocytes. The purpose of this study is to explore the changes of messenger RNA (mRNA), lncRNAs, and circRNAs in melanocytes under oxidative stress and to identify the key ceRNA regulatory networks. Compared with the normal cells, the chip detection of ceRNA expression profile showed that the expression of 491 mRNAs, 865 lncRNAs, and 1161 circRNAs were altered more than fivefold during the oxidative stress injury of melanocytes. The oxidative stress-related genes ( SOD2 , PTGS2 , DHFR , HMOX1 , FOSL1 , and PARP1 ), cell cycle-related genes ( CDK1 , CCNB1 , CCNA2 , OIP5 , and MK167 ), and apoptosis-related gene ( BIRC5 ) were identified in the formation of ceRNA regulation networks with lncRNAs and circRNAs, which shares the common MREs. Further verification found that LNCV6_120941_PI430048170 or hsa_circ_0048910 might regulate the expression of SOD2 by sponging hsa-miR-4755-3p, LNCV6_119109_PI430048170, or hsa_circ_0048909 might regulate the expression of HMOX1 by sponging hsa-miR-6721-5p in the oxidative stress injury of melanocytes. In conclusion, complex changes of the ceRNA regulatory network in the oxidative stress response of melanocytes are evident. Oxidative stress may mediate melanocyte injury through the ceRNA regulation mechanism and induce the pathogenesis of vitiligo.

In China, there is a lack of data regarding the awareness and treatment preferences among patients with vitiligo and their families. To address this gap, a cross-sectional questionnaire-based study was conducted to investigate disease awareness and treatment preferences in Chinese patients with vitiligo. The study also evaluated willingness to pay, using 2 standardized items, and assessed quality of life, using the Dermatology Life Quality Index (DLQI) score. Data from 307 patients with vitiligo (59.3% women, mean age 28.98 years, range 2–73 years) were analysed. Of these patients, 44.7% had insufficient knowledge of vitiligo, particularly those from rural areas or with low levels of education. Mean DLQI total score was 4.86 (5.24 for women and 4.30 for men). Among the most accepted treatments were topical drugs, phototherapy, and systemic therapy. Patients were relatively conservative about the duration and cost of treatment, with only 27.7% willing to pay more than 10,000 Chinese yuan renminbi (CNY) for complete disease remission. High level of education, high income, skin lesions in specific areas, and skin transplantation therapy predicted higher willingness to pay. Insufficient knowledge was associated with a higher burden of disease. In order to reduce the disease burden and improve treatment adherence it is crucial to enhance disease awareness and take into account patient preferences.