Dermatology research team

Research group information

Contact information

Research group leader

  • Professor
    Kaisa Tasanen-Määttä

Research group description

More than skin deep: risk factors and co-morbidities of skin diseases in Finnish population

To understand better the life-course determinants and pathways to skin diseases we have performed full dermatologic status investigation of 1932 members of the Northern Finland Birth Cohort 1966 (NFBC 1966). NFBC 1966 is a longitudinal research program which included initially all 12058 children whose expected time of delivery was in the year 1966. The whole NFBC 1966 cohort has been followed on a regular basis since antenatal period by health care records, questionnaires and clinical examinations as well as data on their parents and offspring. During a 46-year follow-up survey, 1932 cohort members were evaluated by multidisciplinary examination including body index, blood pressure, heart echo recording, dental status and several other health measurements.

Another source for epidemiological data is the national registries. The Finnish Care Register for Health Care (CRHC), maintained by Finnish institute of Health and Welfare, is one of the longest-standing individual-level hospital discharge registries. It contains data from both hospitalized patients and those treated in the outpatient clinic of all hospitals across Finland. CRHC contains personal and hospital identification codes, data on age, gender, length of stay and subsidiary diagnoses. Data about all reimbursed medications purchased in Finland can also be found from national registry (KELA). By combining these registry data, we can study in nationwide-level the medication use and comorbidities in several skin diseases. Currently, we have built up three cohorts, in which we study comorbidities in atopic dermatitis, basal cell carcinoma and in hand eczemas.

In addition, we work as part of FinnGen-project. The FinnGen Research Project (https://www.finngen.fi/en) was designed to establish a resource that combines data from the Finnish national registers (CRHC, KELA) with genome-wide variant data from 500 000 Finns. The premise of the project is based on Finland’s high degree of genetic homogeneity, which is due to the country’s unique population history. This makes it easier to identify novel risk alleles in a relatively homogeneous population than it would be in a more genetically diverse one. New GWAS data releases are executed every 6 months.

 

Bullous pemphigoid: predisposing factors and mechanisms of autoimmunization

Bullous pemphigoid (BP) is an autoimmune blistering skin disease of elderly. Its symptoms include large blisters and severe pruritus. It is a chronic disease associated with heightened mortality rate. The incidence of BP has increased during the recent decade in several countries, including Finland. Type 2 diabetics with gliptin treatment and patients with multiple sclerosis (MS) have markedly increased risk for developing BP. The most important autoantigen in BP is collagen XVII (ColXVII) which is a transmembrane component of hemidesmosomes. Evidence for the pathogenic role of ColXVII autoantibodies comes from clinical findings and experimental BP mouse models, but the factors leading to the initiation of the autoimmunity in the aging skin are poorly understood.

Aside from the contribution of HLA class II allele variants, genetic factors predisposing to BP are largely unknown. We are utilizing the data from the FinnGen Research Project to obtain novel information concerning genetic susceptibility to BP. We believe that gliptin- and MS-associated BP provide a valuable model to investigate the breakdown of immune tolerance to BP180. Some gliptin users and MS patients without BP diagnosis have non-pathogenic autoantibodies against BP180. It is not known whether gliptin medication alone is sufficient to induce BP or if other factors are involved. It is also debated whether the gliptin treatment should be discontinued following a BP diagnosis. BP usually requires 1–2 years of treatment, 30 to 50% of patients experience a relapse within a few months of withdrawal. Nationwide data of reimbursed drugs from KELA allows us to determine whether some medications predispose to BP and to compare detailed real-life registry information on current treatment options. We are identifying the relapsing cases by finding BP patients with multiple periods of immunosuppressants and compare their co-morbidities, medication use and mortality to patients who have been treated with a single continuous course of treatment. The analysis of the longitudinal health register data of disease trajectories will also clarify the similarities and differences between gliptin-associated BP and “regular” BP.

Where are we headed

More than skin deep: risk factors and co-morbidities of skin diseases in Finnish population

  • To analyze the genetic, biological, social or behavioral risk factors of skin diseases in NFBC 1966.
  • To analyze risk factors, co-morbidities and the effects of treatment on morbidity in atopic dermatitis, hand eczema and basal cell carcinoma from national cohorts obtained from the Finnish Care Register for Health Care.
  • To clarify genetic risk factors for dermatological diseases like atopic dermatitis, psoriasis and acne using unique nationwide Finngen-data.

Bullous pemphigoid: predisposing factors and mechanisms of autoimmunization

  • To identify genetic factors that predispose for BP by using the data available in the ongoing FinnGen Research Project
  • To identify novel predisposing factors for BP, detailed features of gliptin-associated BP and assess the impact of drugs used to treat BP by using a national BP cohort (n=5957) obtained from the Finnish Care Register for Health Care (CRHC), and KELA
  • To perform the longitudinal characterization of BP autoantibodies and inflammatory markers in patients with MS or those with gliptin treatment for T2D
  • To examine gliptin-induced changes in inflammatory signaling and proteolytic processing of cutaneous proteins including BP180
  • To test therapeutic interventions and predisposing factors using our dNC14A mice with spontaneous BP-like symptoms as a preclinical animal model

Our team

Our main collaborators

  • Prof. Enno Schmidt and Prof. Hauke Busch, Dept. of Dermatology, University of Lübeck, Germany
  • Prof. Johannes Kettunen and Dr Eeva Sliz, Center for Life Course Health Research, Faculty of Medicine, and Biocenter Oulu, University of Oulu
  • Prof. Markku Timonen Unit of General Practice, University of Oulu
  • Jari Jokelainen, MSc, Infrastructure for population studies, University of Oulu
  • Prof. Juha Auvinen, Unit of General Practice, University of Oulu
  • Prof. Terhi Piltonen, Dept. of Gynaegology, University of Oulu
  • Assoc. Prof. Zhi Jane Chen, Faculty of Biochemistry and Molecular Medicine, University of Oulu
  • Assoc. Prof. Valerio Izzi, Faculty of Biochemistry and Molecular Medicine, University of Oulu

How to find us

  • kaisa.tasanen-maatta[at]oulu.fi
  • laura.huilaja[at]oulu.fi