ΔNp63 regulates IL-33 and IL-31 signaling in atopic dermatitis

Atopic dermatitis (AD) is the most common inflammatory skin disease with no well-delineated cause or effective cure. Here we show that the p53 family member p63, specifically the Delta Np63, isoform has a key role in driving keratinocyte activation in AD. We find that overexpression of Delta Np63 in transgenic mouse epidermis results in a severe skin phenotype that shares many of the key clinical, histological and molecular features associated with human AD. This includes pruritus, epidermal hyperplasia, aberrant keratinocyte differentiation, enhanced expression of selected cytokines and chemokines and the infiltration of large numbers of inflammatory cells including type 2 T-helper cells - features that are highly representative of AD dermatopathology. We further demonstrate several of these mediators to be direct transcriptional targets of Delta Np63 in keratinocytes. Of particular significance are two p63 target genes, IL-31 and IL-33, both of which are key players in the signaling pathways implicated in AD. Importantly, we find these observations to be in good agreement with elevated levels of Delta Np63 in skin lesions of human patients with AD. Our studies reveal an important role for Delta Np63 in the pathogenesis of AD and offer new insights into its etiology and possible therapeutic targets.