Acta Dermato-Venereologica 97-10CompleteContent | Page 37

CORRESPONDENCE
1269
Microdialysis in Profiling Cytokines and Other Macromolecules in the Skin in Health and Disease:
A Comment to Falcone et al.
Bijar GHAFOURI 1 and Chris D. ANDERSON 2
1
Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, and 2 Department of Clinical and Experimental Medicine,
Faculty of Health Sciences, Linköping University, SE-581 85 Linköping, Sweden. E-mail: [e-mail]
The article by Falcone et al. (1) shows the outcome
of a systematic review of human, minimally invasive
techniques for the in-vivo measurement of interleukin
1a (IL-1α) and IL-1 receptor (IL1R).
The search has been well performed according to the
criteria of systematic review, but we take the opportunity
to comment that the search terms for target macromole-
cules are restrictive. Whilst these restrictions are to be
lauded according to the authors’ current expert o pinion of
the IL-1 family, the interests of researchers over the many
years covered by the literature search may not have had
similar knowledge (e.g. that it is more appropriate that
IL-1α rather than IL-1β should be analyzed) or may have
had entirely different interests as to relevant cytokines,
biomarkers of other macromolecules. The result is, in
our view, exclusion of valuable papers on the actually
“minimally invasive” techniques because the “wrong”
cytokines had been the subject of analysis.
In order to illustrate what this might result in we have
chosen our own “field of competence” microdialysis
to generate an alternative (but because of space not
exhaustive) view of which papers might be relevant for
researchers (whether they be an individual PhD student
or a research team leader) considering use of the techni-
que for IL-1α/IL-1R or indeed any other biomarker/
macromolecule.
The paper’s search technique yielded 3 articles on
microdialysis which is but a fraction of e.g. a simple
PubMed search of “microdialysis and cytokines” which
yielded 143 peer reviewed articles of 4,042 human mi-
crodialysis articles. Restriction of articles to publication
in the present journal gives two articles of direct rele-
vance to the authors motive for search (2, 3). A broader
perusal of the work of the research groups actually
referred to by Falcone et al. would also reveal further
interesting articles. If we were to add our own favorite
articles exemplifying use of microdialysis we would add
papers covering correlation of microdialysis to histologic
findings (4) and use in skin disease (5). In the paper by
Hersini et al. (3) there are numerous articles referred to
for their demonstration of cytokines in action (6, 7) or for
their role over the years in elucidation basic principles
of the technique (e.g. 8, 9).
If we had been given the question ”Could microdia-
lysis be used to collect quantifiable amounts of IL-11α,
IL-1RA and other biomarkers from the skin causing
no or minimal discomfort?”, we would have answered
“Yes, without a doubt”. But the evidence for this is not
provided adequately by the 3 articles surviving the cull
in the review of Falcone et al. (1).
In our view microdialysis is a sampling methodology
with many advantages and is well established in studies
of inflammatory mediators (3). Using microdialysis one
has the opportunity to discard the samples reflecting
the individual innate reactivity that is caused by tissue
or blood sampling. Thus the in vivo milieu is more ac-
curately reflected in samples obtained by microdialysis
than by other methods. Additionally the microdialysate
is a more “pure” sample.
We are in full agreement with Falcone et al. (1) that
we should try to measure in our target tissue the skin,
the proteins involved in disease processes. We offer the
content of this commentary as ancillary information on
one of the techniques (microdialysis) reviewed in their
article in the full knowledge that proponents of the other
7 techniques mentioned may well have similar views
on useful papers that the article’s search methodology
precluded.
REFERENCES
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invasive sampling of interleukin-1α and interleukin-1 receptor
antagonist from the skin: a systematic review of in vivo stu-
dies in humans. Acta Derm Venereol 2017; 97: 1066–1073.
2. Sjögren F, Anderson C. Sterile trauma to normal human
dermis invariably induces IL1b, IL6 and IL8 in an innate re-
sponse to “danger” Acta Derm Venereol 2009; 89: 459-465.
3. Hersini H, Melgaard L, Gazerani P, Petersen L. Microdialysisi
of inflammatory mediators in the skin: A review. Acta Derm
Venereol 2014; 94: 501-511.
4. Sjögren F, Anderson CD. Are cutaneous microdialysis cytokine
findings supported by end-point biopsy immunohistochem-
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5. Sjögren F, Davidsson K, Sjöström M, Anderson CD. Cutaneous
microdialysis; Cytokine evidence for altered innate reactivity
in the skin of psoriasis patients? JAAPS 2012; 14: 187-195.
6. Averbeck M, Beilharz S, Bauer M, Gebhardt C, Hartmann A,
Hochleitner K, et al. In situ profiling and quantification of
cytokines released during ultraviolet B-induced inflammation
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tion after insertion of a microdialysis probe visualized by
laser Doppler perfusion imaging. J Invest Dermatol 1994;
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9. Schmelz M, Luz O, Averbeck B, Bickel A. Plasma extravasation
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This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta
Journal Compilation © 2017 Acta Dermato-Venereologica.
doi: 10.2340/00015555-2802
Acta Derm Venereol 2017; 97: 1269–1270