Skip to main content
Frontiers in Immunology logoLink to Frontiers in Immunology
. 2026 Mar 12;17:1776623. doi: 10.3389/fimmu.2026.1776623

Interleukin-24 in type 2 immune diseases

Xiaoting Song 1,†, Dong Lan 2, Fang Liu 1,*
PMCID: PMC13017265  PMID: 41909717

Abstract

Interleukin (IL)-24, a member of the IL-20 cytokine family, is secreted by multiple cell types, such as immune cells (T cells, B cells, NK cells, macrophages), and non-immune cells (epithelial cells and fibroblasts). IL-24 and its downstream signaling pathways mediate vital biological processes, including processes governing cell growth, fate determination, cell death, and inflammation, albeit with effects that are context-dependent across disease states. In this review, we present comprehensive summary and recent breakthroughs in IL-24 characterization and its emerging pathogenic functions in type 2 immune diseases, including chronic spontaneous urticaria (CSU), atopic dermatitis (AD), allergic contact dermatitis (ACD), bullous pemphigoid (BP), chronic nodular prurigo (CNPG), and allergic airway diseases, in an attempt to provide valuable insights for developing its potential as biomarkers or therapeutic targets.

Keywords: atopic allergic diseases, IL-24 cytokine, JAK - STAT signaling pathway, targeted therapy, type 2 immune diseases

1. Introduction

Type 2 immune diseases comprise chronic allergic and atopic conditions that arise at epithelial barrier sites—including the skin, airways, and gastrointestinal tract. These disorders are characterized by (1) a predominant type 2 inflammatory response driven by IL-4, IL-5, and IL-13; (2) the involvement of key effector cells including Th2 cells, type 2 innate lymphoid cells (ILC2s), eosinophils, and mast cells; and (3) elevated levels of type 2-associated biomarkers such as IgE and periostin (1).

IL-24, a cytokine in the IL-20 family, was first discovered in human melanoma cells following treatment with interferon-β (IFN-β) and mezerein (a protein kinase C activator) in 1996, receiving its initial name as the melanoma differentiation-associated (MDA)-7 antigen (2). It shares 69% homology with mouse FISP (3) and 78% with rat C49a/mob-5 (4). It was subsequently renamed IL-24, following recognition that it functions as a multifunctional cytokine within the IL-20 family (a subset of the IL-10 family), which includes IL-19, IL-20, IL-22, IL-24, and IL-26 (5). Early investigations revealed that IL-24 primarily exerts inhibitory effects on the proliferation of various tumor types, thereby conferring extensive anticancer properties. Beyond its antitumor effects, IL-24 engages in diverse physiological processes—tissue repair and remodeling, immune and inflammatory regulation, and host homeostatic balance—and critically contributes to autoimmune and inflammatory pathogenesis, particularly in type 2 immune diseases. In this review, we focus on the pathogenesis of IL-24 in various type 2 immune disorders, such as chronic spontaneous urticaria (CSU), atopic dermatitis (AD), allergic contact dermatitis (ACD), bullous pemphigoid (BP), chronic nodular prurigo (CNPG), and allergic airway diseases, and provide a synopsis of recent advances in IL-24- and receptor-targeted clinical investigations, thereby offering new perspectives for the development of potential therapeutic strategies.

2. Source and target cells of IL-24

IL-24 can be synthesized by and function on both immune cells (T cells, and B cells, NK cells, macrophages) and non-immune cells (keratinocytes, bronchial epithelial cells, fibroblasts and tumor cells) in various situations. Compared with activated T cells, monocytes/macrophages, and epithelial cells, B cells and NK cells constitute secondary or minor sources and responders of IL-24, with their participation being largely confined to specific experimental settings or disease contexts rather than representing a dominant biological role. IL-24 is known to be upregulated by a spectrum of cytokines encompassing Th1 (IFN-γ), Th2 (IL-4, IL-13, IL-31), Th17 (IL-17A), Th22 (IL-22), and pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) (Figure 1) (6). Among these inducers, the effect of type 2 cytokines on IL-24 generation has been extensively investigated. Spontaneous development of chronic inflammatory skin lesions with persistent pruritus was observed in IL-4 transgenic mice, which exhibited IL-24 expression levels several hundred times higher than wild-type controls (7). Through chromatin immunoprecipitation sequencing (ChIP-seq), Wei et al. demonstrated robust STAT6-mediated activation of IL-24 in Th2 cells (8). Similarly, STAT6-dependent IL-24 generation also occurs in keratinocytes and bronchial epithelial cells (9). However, in mitogen-stimulated PBMCs, IL-24 is selectively induced by IL-2, IL-7, IL-15, TNF-α, GM-CSF, and IL-1β, but not by interferons or Th2 cytokines (10). The cellular sources and regulatory stimuli for IL-24 are summarized in Figure 1.

Figure 1.

Infographic illustrating the triggers, sources, targets, and effects of IL-24. The upper panel lists triggers and cellular sources of IL-24, including bronchial epithelial cells, keratinocytes, fibroblasts, peripheral blood mononuclear cells (PBMCs), monocytes, macrophages, T cells, B cells, and NK cells. The lower panel summarizes IL-24 effects on non-immune cells (e.g., enhanced IL-17A production in bronchial epithelial cells, altered keratinocyte proliferation and differentiation, and modulation of extracellular matrix gene expression in fibroblasts) and immune cells (e.g., increased cytokine production in PBMCs, enhanced migration of neutrophils and macrophages, B-cell maturation, and T-cell polarization).

Cell resources and effects of IL-24.

2.1. T cells

IL-24 serves as a functional mediator in type 2 immune responses, which is principally derived from activated Th2 cells (3). Studies demonstrate that IL-24 expression in Th2 cells requires both TCR-PKC and IL-4R-STAT6 signaling pathways (3). STAT6 activation of the IL-24 gene in Th2 cells has been established through ChIP-seq evidence (8). In this process, c-Jun partners with STAT6 to orchestrate IL-24 promoter binding and gene expression in Th2 cells (11). In type 2 immune responses, IL-24 play a immunomodulatory role, through inhibiting IFN-γ-producing Th1 and IL-17A-producing Th17 cells, which has been documented in healthy naive CD4+ T cell models (12), lymphatic filariasis (13), pulmonary tuberculosis (14).

Besides its well-characterized production by Th2 cells, IL-24 can also be generated by Th17 and Th9 cells and can modulate their function. IL-24, upregulated by IL-17A/NF-κB signaling, has been demonstrated to attenuate Th17-associated inflammatory responses and confer protection against autoimmune uveitis in experimental models (15). IL-24 expression in Th9 cells is enhanced by pre-exposure to Staphylococcus aureus (S. aureus) (16).

2.2. B cells

Within human follicular B cells, IL-24 is predominantly expressed by CD27 positive memory and CD5 positive B cells, whereas centroblasts and plasma cells show minimal to no expression (17). Peripheral B cells from patients with active inflammatory bowel disease (IBD) are reported to produce IL-24 (18). IL-24 elicits context-dependent, paradoxical effects on B cell biology. In the presence of CD40L, IL-24 enhances B cell proliferation while suppressing plasma cell differentiation and antibody production (17). Conversely, in CD40L-naive conditions, IL-24 induces apoptosis in human B cells by initially triggering cell cycle arrest, followed by the activation of the mitochondrial pathway at a later stage (19).

2.3. NK cells

NK cells serve as a functional link between innate and adaptive immune arms (20). IL-24 expression in murine NK cells is triggered by type 1 interferon through the STAT6 pathway (21) and by mitogenic stimuli (10). The effects of IL-24 on NK cells are controversial, possibly due to differences in source/format, functional outcomes, and disease background. IL-24 from decidual stromal cells facilitates NK cell differentiation (22), whereas recombinant IL-24 fails to influence NK cell activation or migration in human NK-92 cell line (23).

2.4. Macrophages

Macrophages were the primary source of IL-24 expression, along with T cells, in mitogen-stimulated PBMC cultures (10). Macrophage-derived IL-24 is upregulated by LPS and IL-4 via STAT6 (21, 24). In mammary tumors, IL-24 expression was induced in macrophages in vitro by co-stimulation with IL-4 and TLR4 agonists (25). Conversely, IL-24 could act solely or in concert with IL-4 to promote macrophage M2 polarization through the same pathway (26, 27). IL-24 promotes the migration of human monocytes in vitro and orchestrates myeloid cell chemotaxis in vivo (28).

2.5. Epithelial cells

Keratinocytes, specifically the CD45-Krt10+ subset, were shown to increase IL-24 production under conditions of para-phenylenediamine (PPD)-mediated contact hypersensitivity (29). In an experimental murine dermal wound model, IL-24 is specifically upregulated in wound-edge epithelial stem cells under the control of hypoxia and STAT3 (30). In vitro cell arrays, IL-24 production by keratinocytes and bronchial epithelial cells is induced by IL-13 through STAT6 signaling (9).

2.6. Fibroblasts

IL-24 has been detected in gingival fibroblast cells (31), colon fibroblasts (32, 33), synovial myofibroblasts (34). A WNT5A+/IL24+ fibroblast state was identified in skin lesions of psoriasis, and signals from WNT5A+/IL24+ fibroblasts have been shown in in-silico and in-vitro studies to upregulate multiple inflammatory genes in keratinocytes (35). Single-cell RNA sequencing identified IL-24 as a highly upregulated gene shared between keratinocytes and fibroblasts in PM-exposed ex vivo skin (36).

3. The IL-24 downstream signaling pathways

IL-24 can interact with receptors in the cell membrane, endoplasmic reticulum (ER), cytoplasm, and mitochondria (Figure 2). Canonical IL-24 signaling proceeds via sequential activation events: plasma membrane IL-20 receptor engagement and downstream cytoplasmic Janus protein tyrosine kinases (JAK) and signal transducers and activators of transcription (STAT) cascade induction.

Figure 2.

Schematic illustration of IL-24 signaling pathways. The upper panel depicts the shared receptor subunits of IL-24 with other IL-20 family cytokines. The lower panel illustrates that IL-24 interacts with Type I and Type II receptor complexes at the cell membrane, activating JAK and TYK kinases and triggering downstream signaling through STAT. Other receptor-dependent intracellular signaling cascades include the activation of PKA and the p38 pathway. The left panel shows additional IL-24 effects involving PKR in the proteasome, Grim19 in mitochondria, and BiP/GRP78 and Sig1R in the endoplasmic reticulum.

IL-24 signaling pathways and shared receptor subunits.

The noncanonical, JAK/STAT-independent arms of IL-24 signaling recruit distinct cellular machinery: cytosolic protein kinase R (PKR), mitochondrial respiratory chain proteins, and ER chaperones exemplified by sigma 1 receptor (Sig1R).

3.1. JAK/STAT-dependent signaling pathway

IL-24 signals through two distinct heterodimeric receptor complexes: the type I receptor (IL-20RA/IL-20RB), shared with IL-19 and IL-20, and the type II receptor (IL-22RA1/IL-20RB), shared with IL-20. The three receptor subunits are all expressed on non-immune cells, such as keratinocytes and bronchial epithelial cells, while IL-20RB is also expressed on immune cells. In different tissues, while IL-22RA1 is highly expressed in epithelial-rich tissues including the skin, intestine, liver, kidneys, and pancreas, IL-20RA exhibit a broader but distinct distribution pattern with robust expression in the skin, lungs, and reproductive organs (ovary, testes, placenta) and notably low levels in the intestine and liver (37). Specifically, in keratinocytes, the expression of IL-22RA1 was approximately 10 times higher than that of IL-20RA (38), suggesting that IL-20 and IL-24 primarily act on these cells via the type II receptor complex. Compared to IL-22RA1, which is largely restricted to epithelial cells, IL-20RA shows broader expression, including low-level constitutive expression on monocytes and dendritic cells (39, 40) and can be further induced in macrophages under inflammatory conditions (41). This differential expression pattern suggests that IL-24 signaling through IL-22RA1/IL-20RB predominantly affects epithelial homeostasis, while IL-20RA/IL-20RB signaling may modulate immune cell function in inflammatory contexts. IL-22, in contrast, exclusively uses the IL-22RA1/IL-10RB complex. Despite sharing the IL-22RA1 receptor subunit, IL-24 and IL-22 exhibit fundamentally distinct cellular sources and modes of action. IL-24 originates from ubiquitous epithelial expression, ensuring broad autocrine signaling. Conversely, IL-22 is mainly synthesized by immune cells (T cells and innate lymphoid cells) that penetrate the epidermis for focused, proximity-dependent delivery (42). IL-26 signals through IL-10RB/IL-20RA. Although these cytokines share receptor subunits and exhibit functional overlap in STAT3 activation and epithelial responses, emerging evidence indicates context-specific, non-redundant roles: immune activation for IL-19, skin homeostasis for IL-20, and tumor apoptosis and terminal keratinocyte differentiation inhibition for IL-24, whereas IL-22 promotes epithelial proliferation, IL-26 exhibits unique antimicrobial properties (41, 43).

Upon binding, these receptors trigger the JAK-STAT pathway. This cascade encompasses the activation of JAK1, JAK3, and TYK2, which subsequently drives downstream phosphorylation of STAT1 and STAT3 (44). IL-24 activates both STAT1 and STAT3 through either receptor complex (44), with STAT3 activation occurring at low physiological ligand concentrations and STAT1 activation requiring substantially higher levels (41). Furthermore, via the JAK/STAT-dependent activation of SOCS1 and SOCS3, IL-24 could attenuate the inflammatory Th17 cytokine program, thereby reducing Th17 cell pathogenicity (15).

3.2. Noncanonical JAK/STAT-independent signaling pathways

IL-24 stimulation leads to activation of various receptor-dependent intracellular signaling cascades, including activation of PKA and p38 pathway (40), which can also further induce JAK/STAT-independent SOCS protein activation and stabilize IL-24 mRNA (45, 46). Within the ER, IL-24 engaged the molecular chaperones BiP/GRP78 (47) and Sig1R (48), leading to ER stress. At the inner mitochondrial membrane, IL-24 interacts with respiratory chain protein Grim19, driving STAT3 accumulation within mitochondria (49). In the cytosol, IL-24 also can interact with PKR, thereby inducing STAT1 phosphorylation (50).

4. The pathological role of IL-24 in allergic diseases

While IL-24 is broadly expressed, its major cellular sources are disease-specific. Th2 cells are common across these allergic diseases, yet distinct patterns predominate: keratinocytes (AD, BP, ACD), mast cells (CSU), fibroblasts (CNPG), and bronchial epithelial cells (airway diseases).

4.1. Chronic spontaneous urticaria

As a mast cell-driven disease, CSU encompasses autoimmune endotypes involving mast cell activation by IgE and/or IgG autoantibodies (51). IL-24 was identified by Schmetzer et al. as a common and specific autoantigen for IgE in CSU patients (52). Furthermore, it was shown that elevated IL-24 expression corresponds to greater disease severity in CSU (53). The immunological impact of autologous serum therapy encompasses a decline in IgE antibodies against IL-24 (53). In CSU patients, IL-24 is detectable in spontaneous urticarial wheals, with elevated gene and protein expression in PBMCs from a patient subset (54). In vitro studies have demonstrated that IL-24 induces histamine release from human mast cells sensitized with IgE purified from CSU patients, whereas control cells remain unresponsive (52). Moreover, it is reported that T cell-derived microvesicles induce mast cell production of IL-24, which suggests a role of T cell-mast cell-IL24 axis in disease pathogenesis (55). These results indicate that targeting IL-24 represents a fundamental mechanism underlying CSU treatment.

4.2. Atopic dermatitis

AD is a multifaceted condition with complex pathogenic processes including genetics, skin barrier dysfunction, skin microbiota disorder, and immune dysregulation. Experiments in normal human epidermal keratinocytes have shown that the IL-13/periostin/IL-24 signaling cascade disrupts epidermal barrier function by downregulating filaggrin expression in allergic skin inflammation (9). In IL-31-stimulated keratinocytes, IL-24, together with IL-20, downregulate the expression of filaggrin (56). Moreover, siRNA-mediated knockdown of IL-24 or its downstream effector STAT3 could enhance aryl hydrocarbon receptor (AHR) modulator-induced upregulation of filaggrin and loricrin, suggesting that IL-24/STAT3 axis inhibition may improves skin barrier dysfunction (57). Recently, Penta-O-Galloyl-b-D-Glucose (PGG), discovered by in silico screening, functions as an IL-24 signaling inhibitor that improves skin barrier function through STAT3 suppression (58).

As previously noted, Myles et al. discovered that IL-24 inhibits IL-1β expression in keratinocytes, which subsequently leads to decreased IL-17A expression in γδ T cells and increased neutrophil infiltration in the skin (59), which may facilitate the colonization of Staphylococcus aureus (S. aureus) in AD skin. In addition, IL-24 can promote type 2 immunity via the JAK-STAT-IL-33 axis in AD, thereby fueling methicillin-resistant S. aureus (MRSA)-induced AD-like inflammation (60).

AD is a highly heterogeneous inflammatory skin disease and can be classified as different endotypes based on the molecular profiling. Asian AD and pediatric AD patients show a Th17/Th2 or blended AD-psoriasis endotype (61). IL-24 has been reported to be upregulated in psoriatic epidermis and activated its downstream STAT3 triggered psoriasis-like skin inflammation in mice (62). In the keratin 5-driven IL-24 transgenic mouse model, IL-24 overexpression results in neonatal lethality and a psoriasiform phenotype characterized by marked epidermal hyperplasia with impaired keratinocyte differentiation, accompanied by prominent dermal infiltration of macrophages—consistent with the observation that keratinocyte-derived MCP-1 drives macrophage recruitment restricted to the dermal layer in human psoriasis (63). Therefore, these results suggest IL-24 involvement in Th2/Th17 or blended AD-psoriasis endotype of AD.

We performed a bioinformatics analysis of IL-24 expression using the publicly available human transcriptomic dataset GSE130588, which comprises 208 samples: normal skin (n=20), pre-treatment lesional skin (preL, n=51), pre-treatment non-lesional skin (preNL, n=42), post-treatment lesional skin (postL, n=73), and post-treatment non-lesional skin (postNL, n=22). Using unpaired t-tests, we observed that IL-24 expression was significantly upregulated in lesional skin compared with non-lesional skin prior to treatment (p < 0.0001) and significantly downregulated in lesional skin following dupilumab treatment (p < 0.01) (Supplementary Figure 1). These findings suggest the important role of IL-24 in AD pathogenesis and its response to treatment.

Taken together, IL-24 is crucial for barrier dysfunction that occurs in type 2 inflammation, facilitates S. aureus colonization, and triggers psoriasis-like inflammatory responses in the pathogenesis of AD. However, studies specifically quantifying IL-24 and its correlation with disease severity scores in AD patients remain to be conducted.

4.3. Allergic contact dermatitis

Para-Phenylenediamine (PPD) is a common contact allergen used in hair dyes. In PPD allergic patients, IL-24 levels are elevated in affected skin compared to uninvolved areas, and the increased expression correlates positively with the severity of clinical symptoms (29). In mouse models, IL-22RA1, IL-20RB, and IL-24 knockout show partial resistance to PPD-induced contact hypersensitivity (29). In addition, in a mouse model of ACD induced by topical application of 2,4-dinitrofluorobenzene (DNFB), elevated expression of IL-24 has also been observed (38).

In keratinocyte-specific conditional knockout mice, by attenuating Il24 gene expression in keratinocytes, HMGB1-mediated chromatin remodeling confers protection from ACD (64). However, in a T cell-dependent contact hypersensitivity model, IL-20RB-deficient mice exhibited increased sensitivity to the contact allergen trinitrochlorobenzene (65), suggesting IL-20RB signaling dampens antigen-specific T cell activation. These conflicting findings may be explained by several factors: (1) allergen characteristics, with para-phenylenediamine being a hapten-type allergen requiring metabolic activation versus direct sensitizers; (2) differential receptor engagement, with IL-22RA1/IL-20RB signaling in epithelial keratinocytes versus IL-20RB on T cells potentially modulating distinct phases of the hypersensitivity response; and (3) context-dependent IL-24 function, which can exert either pro-inflammatory or regulatory effects depending on the predominant cellular target. The role of IL-24 and its receptors in different allergen mediated contact dermatitis remains to be further explored.

4.4. Bullous pemphigoid

Bullous pemphigoid (BP) is the most common autoimmune bullous disorder, driven by type 2 inflammation and immunity. Elevated IL-24 has been observed in BP patients, correlating with more severe disease (66). Moreover, IL-24-treated HaCaT cells show reduced BP180 levels, suggesting that IL-24 may disrupt keratinocyte function and contribute to BP by modulating proteins crucial for skin integrity (66). In addition, IL-24 was one of upregulated cytokines when primary keratinocytes were stimulated with IgG from BP patients (67), while the role of IL-24 identified in BP-IgG-treated keratinocytes warrants further investigation.

4.5. Chronic nodular prurigo

CNPG presents clinically as hyperkeratotic nodules with severe pruritus, predominantly affecting the extremities and trunk. A study profiled CNPG using single-cell RNA sequencing and found that, compared with AD and healthy controls, CNPG exhibited markers associated with extracellular matrix remodeling, collagen production, and fibrosis, featuring a distinct group of CXCL14-IL24+ secretory papillary fibroblasts (68).

4.6. Allergic airway diseases

Type 2 immune inflammation and tissue damage pathways are common to allergic airway diseases such as allergic rhinitis and asthma. In patients with allergic asthma, sputum IL-24 was increased during the allergic asthma season, and elevated nasal IL-24 was correlated with poor asthma control scores (69). Flow cytometric analysis of sputum revealed elevated IL-24 was correlated inversely with Treg cells (69). Experiments in primary normal human bronchial epithelial cells showed that IL-24 expression was induced by IL-4 stimulation (70). These findings suggest IL-24 might act as a representative nasal biomarker for allergic airway diseases.

5. Therapeutic application

IL-24 plays a crucial role in the pathophysiology of type 2 immune diseases. Therapeutic strategies targeting IL-24, its receptor complexes, or downstream signaling molecules hold promising potential. Up to now, there have been limited clinical studies on the treatment of type 2 immune diseases by targeting IL-24.

The IL-22RA1 monoclonal antibody ARGX-112 (temtokibart) has shown considerable therapeutic potential and is currently in phase II clinical trials for patients with moderate to severe AD. Phase I (NCT05099133, NCT03514511), phase IIa (NCT04922021, NCT05470114, EUCTR2020–005541-16-DE) have completed and demonstrated its safety and tolerability. The phase IIa trial results (NCT04922021) in 58 adults demonstrated that temtokibart achieved significant clinical improvement in AD (71). By week 16, the temtokibart arm showed a mean EASI decrease of 15.3 points (65.4% improvement) compared with 3.5 points (19.7% improvement) in the placebo group (p = 0.003). Response rates favoring temtokibart included EASI-75 (41.6% vs 13.7%; p = 0.011), EASI-90 (30.8% vs 3.5%; p = 0.003), and EASI-100 (20.9% vs 0%; p = 0.006). Temtokibart therapy over 16 weeks yielded a significant 65.4% improvement in the primary efficacy endpoint (EASI), an effect size comparable to dupilumab at similar development stages (72)and surpassing that of experimental OX-40 pathway antagonists (73). IL-22RA1 blockade reverses histopathological and molecular aberrations underlying AD across in vitro, ex vivo, and in vivo model systems (42), which indicated that targeting IL-22RA1 ameliorates clinical symptoms through multiple pathways, including modulation of immune inflammation and restoration of skin barrier function. The results from the phase IIb trial (NCT05923099) in 262 adult patients with AD showed that investigational agent temtokibart met its primary endpoint and well-tolerated at week16, that is, it achieved percentage change in the eczema area and severity index (EASI) compared with placebo (−41.7%) for the three doses treatment groups (600 mg, −61.2%, p<0.01; 450 mg, −57.1%, p<0.05; 300 mg, −64.3%, p<0.01) (74, 75). The pooled data also demonstrated that temtokibart-treated patients (n=22 at baseline, n=14 at week 16) achieved a 97% improvement in immune gene expression and significant restoration of epidermal barrier-related gene expression by week 16 (76).

Temtokibart targets the IL-22RA1 subunit shared by both the IL-22 receptor (IL-10RB/IL-22RA1) and the type II receptor (IL-20RB/IL-22RA1). Consequently, its therapeutic efficacy likely reflects dual blockade of IL-22 and IL-24 signaling rather than selective IL-22 inhibition alone. This simultaneous interference with IL-20 and IL-24 pathways via the IL-20RB/IL-22RA1 heterodimer likely underlies the enhanced efficacy observed with IL-22RA1-directed therapy compared with exclusive IL-22 inhibition (71, 77, 78).

6. Conclusion and future perspectives

This review offers a comprehensive look at the latest research exploring the involvement of IL-24 and its downstream signaling pathways in type 2 immune diseases, suggests its potential as a therapeutic candidate for type 2 immune diseases. IL-24 initiates its biological effects by interacting with its specific receptors, a process that may engage the JAK/STAT signaling cascade or operate via alternative pathways. The concentration of IL-24 has been shown to correlate with the severity of some type 2 immune diseases and responses to treatment, suggesting its potential utility as a predictive biomarker for disease trajectory and treatment outcomes.

Although considerable progress has been made, these blind spots continue to obscure the full picture of IL-24’s role in type 2 immunity: (1) heterogeneous experimental designs and disease models that frustrate cross-study and cross-disease comparisons; (2) an incomplete map of how IL-24 intersects with broader cytokine networks; and (3) the absence of longitudinal data tracking IL-24 dynamics throughout disease progression. Due to the current limitations in available data, additional research is crucial to elucidate the exact roles and underlying mechanisms of IL-24 in these areas. At present, exploration of therapeutic application targeting IL-24 and its receptors in type 2 immune diseases remains in its early stages.

Funding Statement

The author(s) declared that financial support was received for this work and/or its publication. This work was supported by Beijing Natural Science Foundation (Grant Number: 7264278) and Beijing Chao-Yang Hospital Golden Seeds Foundation (Grant Number: CYJZ202524). The funders had no role in the design, data collection, data analysis, data interpretation, writing of the report, or decision to submit the article for publication.

Footnotes

Edited by: Luciana Cavalheiro Marti, Albert Einstein Israelite Hospital, Brazil

Reviewed by: Katharina Bier, Novartis, Switzerland

Alexandre Giannecchini Romagnolo, Faculdade Israelita de Ciências da Saúde Albert Einstein Hospital Israelita Albert Einstein, Brazil

Author contributions

XS: Conceptualization, Funding acquisition, Investigation, Visualization, Writing – original draft. DL: Supervision, Visualization, Writing – review & editing. FL: Supervision, Validation, Writing – review & editing.

Conflict of interest

The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Generative AI statement

The author(s) declared that generative AI was not used in the creation of this manuscript.

Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fimmu.2026.1776623/full#supplementary-material

Supplementary Figure 1

Analysis of IL-24 expression using the publicly available GSE130588 dataset. Normal skin (n=20), preL, pre-treatment lesional skin (n=51), preNL, pre-treatment non-lesional skin (n=42), postL, post-treatment lesional skin (n=73), postNL, post-treatment non-lesional skin (n=22).

DataSheet1.docx (51.4KB, docx)

References

  • 1. Chovatiya R, Hawkes JE, DiRuggiero D, Pansch LA, Simcox E, Gonzalez T. Type 2 inflammation and its role in dermatologic diseases. Int J Dermatol. (2025) 64:978–91. doi:  10.1111/ijd.17707, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2. Jiang H, Su ZZ, Lin JJ, Goldstein NI, Young CS, Fisher PB. The melanoma differentiation associated gene mda-7 suppresses cancer cell growth. Proc Natl Acad Sci USA. (1996) 93:9160–5. doi:  10.1073/pnas.93.17.9160, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3. Schaefer G, Venkataraman C, Schindler U. Cutting edge: FISP (IL-4-induced secreted protein), a novel cytokine-like molecule secreted by Th2 cells. J Immunol. (2001) 166:5859–63. doi:  10.4049/jimmunol.166.10.5859, PMID: [DOI] [PubMed] [Google Scholar]
  • 4. Soo C, Shaw WW, Freymiller E, Longaker MT, Bertolami CN, Chiu R, et al. Cutaneous rat wounds express c49a, a novel gene with homology to the human melanoma differentiation associated gene, mda-7. J Cell Biochem. (1999) 74:1–10. doi:  10.1002/(SICI)1097-4644(19990701)74:1<1::AID-JCB1>3.0.CO;2-M [DOI] [PubMed] [Google Scholar]
  • 5. Caudell EG, Mumm JB, Poindexter N, Ekmekcioglu S, Mhashilkar AM, Yang XH, et al. The protein product of the tumor suppressor gene, melanoma differentiation-associated gene 7, exhibits immunostimulatory activity and is designated IL-24. J Immunol. (2002) 168:6041–6. doi:  10.4049/jimmunol.168.12.6041, PMID: [DOI] [PubMed] [Google Scholar]
  • 6. Jin SH, Choi D, Chun YJ, Noh M. Keratinocyte-derived IL-24 plays a role in the positive feedback regulation of epidermal inflammation in response to environmental and endogenous toxic stressors. Toxicol Appl Pharmacol. (2014) 280:199–206. doi:  10.1016/j.taap.2014.08.019, PMID: [DOI] [PubMed] [Google Scholar]
  • 7. Bao L, Zhang H, Mohan GC, Shen K, Chan LS. Differential expression of inflammation-related genes in IL-4 transgenic mice before and after the onset of atopic dermatitis skin lesions. Mol Cell Probes. (2016) 30:30–8. doi:  10.1016/j.mcp.2015.11.001, PMID: [DOI] [PubMed] [Google Scholar]
  • 8. Wei L, Vahedi G, Sun HW, Watford WT, Takatori H, Ramos HL, et al. Discrete roles of STAT4 and STAT6 transcription factors in tuning epigenetic modifications and transcription during T helper cell differentiation. Immunity. (2010) 32:840–51. doi:  10.1016/j.immuni.2010.06.003, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9. Mitamura Y, Nunomura S, Nanri Y, Ogawa M, Yoshihara T, Masuoka M, et al. The IL-13/periostin/IL-24 pathway causes epidermal barrier dysfunction in allergic skin inflammation. Allergy. (2018) 73:1881–91. doi:  10.1111/all.13437, PMID: [DOI] [PubMed] [Google Scholar]
  • 10. Poindexter NJ, Walch ET, Chada S, Grimm EA. Cytokine induction of interleukin-24 in human peripheral blood mononuclear cells. J Leukoc Biol. (2005) 78:745–52. doi:  10.1189/jlb.0205116, PMID: [DOI] [PubMed] [Google Scholar]
  • 11. Sahoo A, Lee C-G, Jash A, Son J-S, Kim G, Kwon H-K, et al. Stat6 and c-Jun mediate Th2 cell-specific IL-24 gene expression. J Immunol (Baltimore Md 1950). (2011) 186:4098–109. doi:  10.4049/jimmunol.1002620, PMID: [DOI] [PubMed] [Google Scholar]
  • 12. Oral HB, Kotenko SV, Yilmaz M, Mani O, Zumkehr J, Blaser K, et al. Regulation of T cells and cytokines by the interleukin-10 (IL-10)-family cytokines IL-19, IL-20, IL-22, IL-24 and IL-26. Eur J Immunol. (2006) 36:380–8. doi:  10.1002/eji.200425523, PMID: [DOI] [PubMed] [Google Scholar]
  • 13. Anuradha R, George PJ, Hanna LE, Kumaran P, Chandrasekaran V, Nutman TB, et al. Expansion of parasite-specific CD4+ and CD8+ T cells expressing IL-10 superfamily cytokine members and their regulation in human lymphatic filariasis. PloS NeglTrop Dis. (2014) 8:e2762. doi:  10.1371/journal.pntd.0002762, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14. Kumar NP, Moideen K, Banurekha VV, Nair D, Babu S. Modulation of Th1/Tc1 and Th17/Tc17 responses in pulmonary tuberculosis by IL-20 subfamily of cytokines. Cytokine. (2018) 108:190–6. doi:  10.1016/j.cyto.2018.04.005, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15. Chong WP, Mattapallil MJ, Raychaudhuri K, Bing SJ, Wu S, Zhong Y, et al. The cytokine IL-17A limits Th17 pathogenicity via a negative feedback loop driven by autocrine induction of IL-24. Immunity. (2020) 53:384–397.e385. doi:  10.1016/j.immuni.2020.06.022, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16. Badolati I, van der Heiden M, Brodin D, Zuurveld M, Szilágyi S, Björkander S, et al. Staphylococcus aureus-derived factors promote human Th9 cell polarization and enhance a transcriptional program associated with allergic inflammation. Eur J Immunol. (2023) 53:e2250083. doi:  10.1002/eji.202250083, PMID: [DOI] [PubMed] [Google Scholar]
  • 17. Maarof G, Bouchet-Delbos L, Gary-Gouy H, Durand-Gasselin I, Krzysiek R, Dalloul A. Interleukin-24 inhibits the plasma cell differentiation program in human germinal center B cells. Blood. (2010) 115:1718–26. doi:  10.1182/blood-2009-05-220251, PMID: [DOI] [PubMed] [Google Scholar]
  • 18. Fonseca-Camarillo G, Furuzawa-Carballeda J, Granados J, Yamamoto-Furusho JK. Expression of interleukin (IL)-19 and IL-24 in inflammatory bowel disease patients: a cross-sectional study. Clin Exp Immunol. (2014) 177:64–75. doi:  10.1111/cei.12285, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19. Hadife N, Nemos C, Frippiat JP, Hamadé T, Perrot A, Dalloul A, et al. Interleukin-24 mediates apoptosis in human B-cells through early activation of cell cycle arrest followed by late induction of the mitochondrial apoptosis pathway. Leuk Lymphoma. (2013) 54:587–97. doi:  10.3109/10428194.2012.717079, PMID: [DOI] [PubMed] [Google Scholar]
  • 20. Kucuksezer UC, Aktas Cetin E, Esen F, Tahrali I, Akdeniz N, Gelmez MY, et al. The role of natural killer cells in autoimmune diseases. Front Immunol. (2021) 12:622306. doi:  10.3389/fimmu.2021.622306, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21. Dabitao D, Hedrich CM, Wang F, Vacharathit V, Bream JH. Cell-specific requirements for STAT proteins and type I IFN receptor signaling discretely regulate IL-24 and IL-10 expression in NK cells and macrophages. J Immunol. (2018) 200:2154–64. doi:  10.4049/jimmunol.1701340, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22. Yang H-L, Zhou W-J, Lu H, Lei S-T, Ha S-Y, Lai Z-Z, et al. Decidual stromal cells promote the differentiation of CD56bright CD16- NK cells by secreting IL-24 in early pregnancy. Am J Reprod Immunol (New York NY 1989). (2019) 81:e13110. doi:  10.1111/aji.13110, PMID: [DOI] [PubMed] [Google Scholar]
  • 23. Tang Y, Sun X, Wang Y, Luan H, Zhang R, Hu F, et al. Role of IL-24 in NK cell activation and its clinical implication in systemic lupus erythematosus. Clin Rheumatol. (2021) 40:2707–15. doi:  10.1007/s10067-021-05618-6, PMID: [DOI] [PubMed] [Google Scholar]
  • 24. Garn H, Schmidt A, Grau V, Stumpf S, Kaufmann A, Becker M, et al. IL-24 is expressed by rat and human macrophages. Immunobiology. (2002) 205:321–34. doi:  10.1078/0171-2985-00135, PMID: [DOI] [PubMed] [Google Scholar]
  • 25. Wang B, Xia Y, Zhou C, Zeng Y, Son HG, Demehri S, et al. CD4+ T helper 2 cell-macrophage crosstalk induces IL-24-mediated breast cancer suppression. JCI Insight. (2025) 10. doi:  10.1172/jci.insight.180962, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26. Rao LZ, Wang Y, Zhang L, Wu G, Zhang L, Wang FX, et al. IL-24 deficiency protects mice against bleomycin-induced pulmonary fibrosis by repressing IL-4-induced M2 program in macrophages. Cell Death Differ. (2021) 28:1270–83. doi:  10.1038/s41418-020-00650-6, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 27. Ma R, Wang A, Yang M, Huang Z, Liu G, Wei Q, et al. Hsa_circ_0000092 up-regulates IL24 by SMC1A to induce macrophages M2 polarization. Heliyon. (2024) 10:e36517. doi:  10.1016/j.heliyon.2024.e36517, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 28. Buzas K, Oppenheim JJ, Howard OMZ. Myeloid cells migrate in response to IL-24. Cytokine. (2011) 55:429–34. doi:  10.1016/j.cyto.2011.05.018, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29. Van Belle AB, Cochez PM, de Heusch M, Pointner L, Opsomer R, Raynaud P, et al. IL-24 contributes to skin inflammation in Para-Phenylenediamine-induced contact hypersensitivity. Sci Rep. (2019) 9:1852. doi:  10.1038/s41598-018-38156-4, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 30. Liu S, Hur YH, Cai X, Cong Q, Yang Y, Xu C, et al. A tissue injury sensing and repair pathway distinct from host pathogen defense. Cell. (2023) 186:2127–2143.e2122. doi:  10.1016/j.cell.2023.03.031, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31. Stolf CS, Sacramento CM, Alvarenga C, Vieira JR, Araújo CF, Monteiro MF, et al. Immune response characterization of primary gingival fibroblasts from Grade C periodontitis patients. J Periodontol. (2023) 94:429–38. doi:  10.1002/jper.22-0356, PMID: [DOI] [PubMed] [Google Scholar]
  • 32. Ónody A, Veres-Székely A, Pap D, Rokonay R, Szebeni B, Sziksz E, et al. Interleukin-24 regulates mucosal remodeling in inflammatory bowel diseases. J Transl Med. (2021) 19:237. doi:  10.1186/s12967-021-02890-7, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 33. Rokonay R, Veres-Székely A, Szebeni B, Pap D, Lippai R, Béres NJ, et al. Role of IL-24 in the mucosal remodeling of children with coeliac disease. J Transl Med. (2020) 18:36. doi:  10.1186/s12967-020-02221-2, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 34. Shibata N, Ohashi Y, Tsukada A, Iwase D, Aikawa J, Mukai M, et al. IL24 expression in synovial myofibroblasts: Implications for female osteoarthritis pain through propensity score matching analysis. Med (Kaunas). (2024) 60. doi:  10.3390/medicina60050741, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 35. Francis L, McCluskey D, Ganier C, Jiang T, Du-Harpur X, Gabriel J, et al. Single-cell analysis of psoriasis resolution demonstrates an inflammatory fibroblast state targeted by IL-23 blockade. Nat Commun. (2024) 15:913. doi:  10.1038/s41467-024-44994-w, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 36. Seong SH, Kim JY, Kim SH, Lee J, Lee EJ, Bae YJ, et al. Interleukin-24: A molecular mediator of particulate matter's impact on skin aging. Ecotoxicol Environ Saf. (2024) 282:116738. doi:  10.1016/j.ecoenv.2024.116738, PMID: [DOI] [PubMed] [Google Scholar]
  • 37. Rutz S, Wang X, Ouyang W. The IL-20 subfamily of cytokines--from host defence to tissue homeostasis. Nat Rev Immunol. (2014) 14:783–95. doi:  10.1038/nri3766, PMID: [DOI] [PubMed] [Google Scholar]
  • 38. Kunz S, Wolk K, Witte E, Witte K, Doecke W-D, Volk H-D, et al. Interleukin (IL)-19, IL-20 and IL-24 are produced by and act on keratinocytes and are distinct from classical ILs. Exp Dermatol. (2006) 15:991–1004. doi:  10.1111/j.1600-0625.2006.00516.x, PMID: [DOI] [PubMed] [Google Scholar]
  • 39. Kragstrup TW, Greisen SR, Nielsen MA, Rhodes C, Stengaard-Pedersen K, Hetland ML, et al. The interleukin-20 receptor axis in early rheumatoid arthritis: novel links between disease-associated autoantibodies and radiographic progression. Arthritis Res Ther. (2016) 18:61. doi:  10.1186/s13075-016-0964-7, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 40. Bech R, Jalilian B, Agger R, Iversen L, Erlandsen M, Otkjaer K, et al. Interleukin 20 regulates dendritic cell migration and expression of co-stimulatory molecules. Mol Cell Ther. (2016) 4:1. doi:  10.1186/s40591-016-0046-x, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 41. Parrish-Novak J, Xu W, Brender T, Yao L, Jones C, West J, et al. Interleukins 19, 20, and 24 signal through two distinct receptor complexes. Differences in receptor-ligand interactions mediate unique biological functions. J Biol Chem. (2002) 277:47517–23. doi:  10.1074/jbc.M205114200, PMID: [DOI] [PubMed] [Google Scholar]
  • 42. Wasserer S, Litman T, Hebsgaard J, Jargosch M, Hillig C, Pilz AC, et al. Neutralizing IL-22RA1 improves histologic and molecular alterations associated with atopic dermatitis pathogenesis. J Allergy Clin Immunol. (2025). 157:653–65. doi:  10.1016/j.jaci.2025.08.033, PMID: [DOI] [PubMed] [Google Scholar]
  • 43. Georgieva B, Karanovic D, Velickovic I, Minchev D. Multifaceted roles of IL-26 in physiological and pathological conditions. Int J Mol Sci. (2025) 27. 325 doi:  10.3390/ijms27010325, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 44. Dumoutier L, Leemans C, Lejeune D, Kotenko SV, Renauld JC. Cutting edge: STAT activation by IL-19, IL-20 and mda-7 through IL-20 receptor complexes of two types. J Immunol. (2001) 167:3545–9. doi:  10.4049/jimmunol.167.7.3545, PMID: [DOI] [PubMed] [Google Scholar]
  • 45. Tian H, Zhang D, Gao Z, Li H, Zhang B, Zhang Q, et al. MDA-7/IL-24 inhibits Nrf2-mediated antioxidant response through activation of p38 pathway and inhibition of ERK pathway involved in cancer cell apoptosis. Cancer Gene Ther. (2014) 21:416–26. doi:  10.1038/cgt.2014.45, PMID: [DOI] [PubMed] [Google Scholar]
  • 46. Smith S, Lopez S, Kim A, Kasteri J, Olumuyide E, Punu K, et al. Interleukin 24: Signal transduction pathways. Cancers (Basel). (2023) 15. 3365 doi:  10.3390/cancers15133365, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 47. Gupta P, Walter MR, Su ZZ, Lebedeva IV, Emdad L, Randolph A, et al. BiP/GRP78 is an intracellular target for MDA-7/IL-24 induction of cancer-specific apoptosis. Cancer Res. (2006) 66:8182–91. doi:  10.1158/0008-5472.Can-06-0577, PMID: [DOI] [PubMed] [Google Scholar]
  • 48. Do W, Herrera C, Mighty J, Shumskaya M, Redenti SM, Sauane M. Sigma 1 receptor plays a prominent role in IL-24-induced cancer-specific apoptosis. Biochem Biophys Res Commun. (2013) 439:215–20. doi:  10.1016/j.bbrc.2013.08.057, PMID: [DOI] [PubMed] [Google Scholar]
  • 49. Sie C, Kant R, Peter C, Muschaweckh A, Pfaller M, Nirschl L, et al. IL-24 intrinsically regulates Th17 cell pathogenicity in mice. J Exp Med. (2022) 219. e20212443 doi:  10.1084/jem.20212443, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 50. Davidson S, Yu CH, Steiner A, Ebstein F, Baker PJ, Jarur-Chamy V, et al. Protein kinase R is an innate immune sensor of proteotoxic stress via accumulation of cytoplasmic IL-24. Sci Immunol. (2022) 7:eabi6763. doi:  10.1126/sciimmunol.abi6763, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 51. Kolkhir P, Bonnekoh H, Metz M, Maurer M. Chronic spontaneous urticaria: A review. Jama. (2024) 332:1464–77. doi:  10.1001/jama.2024.15568, PMID: [DOI] [PubMed] [Google Scholar]
  • 52. Schmetzer O, Lakin E, Topal FA, Preusse P, Freier D, Church MK, et al. IL-24 is a common and specific autoantigen of IgE in patients with chronic spontaneous urticaria. J Allergy Clin Immunol. (2018) 142:876–82. doi:  10.1016/j.jaci.2017.10.035, PMID: [DOI] [PubMed] [Google Scholar]
  • 53. Yu L, Buttgereit T, Stahl Skov P, Schmetzer O, Scheffel J, Kocatürk E, et al. Immunological effects and potential mechanisms of action of autologous serum therapy in chronic spontaneous urticaria. J Eur Acad Dermatol Venereol. (2019) 33:1747–54. doi:  10.1111/jdv.15640, PMID: [DOI] [PubMed] [Google Scholar]
  • 54. de Montjoye L, Herman A, Hendrickx E, Chéou P, Blanchetot C, Hofman E, et al. Increased expression of IL-24 in chronic spontaneous urticaria. Allergy. (2019) 74:1811–3. doi:  10.1111/all.13832, PMID: [DOI] [PubMed] [Google Scholar]
  • 55. Shefler I, Pasmanik-Chor M, Kidron D, Mekori YA, Hershko AY. T cell-derived microvesicles induce mast cell production of IL-24: relevance to inflammatory skin diseases. J Allergy Clin Immunol. (2014) 133:217–224.e211-213. doi:  10.1016/j.jaci.2013.04.035, PMID: [DOI] [PubMed] [Google Scholar]
  • 56. Cornelissen C, Marquardt Y, Czaja K, Wenzel J, Frank J, Luscher-Firzlaff J, et al. IL-31 regulates differentiation and filaggrin expression in human organotypic skin models. J Allergy Clin Immunol. (2012) 129:426–433, 433 e421-428. doi:  10.1016/j.jaci.2011.10.042, PMID: [DOI] [PubMed] [Google Scholar]
  • 57. Vu YH, Hashimoto-Hachiya A, Takemura M, Yumine A, Mitamura Y, Nakahara T, et al. IL-24 negatively regulates keratinocyte differentiation induced by tapinarof, an aryl hydrocarbon receptor modulator: Implication in the treatment of atopic dermatitis. Int J Mol Sci. (2020) 21. 9412 doi:  10.3390/ijms21249412, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 58. Kim JY, Lee EJ, Jang G, Park S, Na H-w, Cha N, et al. Targeting IL-24 signaling to restore skin barrier function: Discovery of penta-O-galloyl-b-D-glucose through in silico screening. J Invest Dermatol. (2025), 145:3210–3. doi:  10.1016/j.jid.2025.05.017, PMID: [DOI] [PubMed] [Google Scholar]
  • 59. Myles IA, Fontecilla NM, Valdez PA, Vithayathil PJ, Naik S, Belkaid Y, et al. Signaling via the IL-20 receptor inhibits cutaneous production of IL-1β and IL-17A to promote infection with methicillin-resistant Staphylococcus aureus. Nat Immunol. (2013) 14:804–11. doi:  10.1038/ni.2637, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 60. Qian X, Tong M, Zhang T, Li Q, Hua M, Zhou N, et al. IL-24 promotes atopic dermatitis-like inflammation through driving MRSA-induced allergic responses. Protein Cell. (2024) 16:188–210. doi:  10.1093/procel/pwae030, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 61. Czarnowicki T, He H, Krueger JG, Guttman-Yassky E. Atopic dermatitis endotypes and implications for targeted therapeutics. J Allergy Clin Immunol. (2019) 143:1–11. doi:  10.1016/j.jaci.2018.10.032, PMID: [DOI] [PubMed] [Google Scholar]
  • 62. Kumari S, Bonnet MC, Ulvmar MH, Wolk K, Karagianni N, Witte E, et al. Tumor necrosis factor receptor signaling in keratinocytes triggers interleukin-24-dependent psoriasis-like skin inflammation in mice. Immunity. (2013) 39:899–911. doi:  10.1016/j.immuni.2013.10.009, PMID: [DOI] [PubMed] [Google Scholar]
  • 63. He M, Liang P. IL-24 transgenic mice: in vivo evidence of overlapping functions for IL-20, IL-22, and IL-24 in the epidermis. J Immunol. (2010) 184:1793–8. doi:  10.4049/jimmunol.0901829, PMID: [DOI] [PubMed] [Google Scholar]
  • 64. Senda N, Yanai H, Hibino S, Li L, Mizushima Y, Miyagaki T, et al. HMGB1-mediated chromatin remodeling attenuates Il24 gene expression for the protection from allergic contact dermatitis. Proc Natl Acad Sci USA. (2021) 118. e2022343118 doi:  10.1073/pnas.2022343118, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 65. Wahl C, Müller W, Leithäuser F, Adler G, Oswald F, Reimann J, et al. IL-20 receptor 2 signaling down-regulates antigen-specific T cell responses. J Immunol. (2009) 182:802–10. doi:  10.4049/jimmunol.182.2.802, PMID: [DOI] [PubMed] [Google Scholar]
  • 66. Ran Y, Peng X, Xia Y, Liu Y. IL-24 for bullous pemphigoid severity: A case-control study. J Eur Acad Dermatol Venereol. (2025) 39:e511–3. doi:  10.1111/jdv.20467, PMID: [DOI] [PubMed] [Google Scholar]
  • 67. Bao L, Guerrero-Juarez CF, Li J, Pigors M, Emtenani S, Liu Y, et al. IgG autoantibodies in bullous pemphigoid induce a pathogenic MyD88-dependent pro-inflammatory response in keratinocytes. Nat Commun. (2025) 16:7254. doi:  10.1038/s41467-025-62495-2, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 68. Alkon N, Assen FP, Arnoldner T, Bauer WM, Medjimorec MA, Shaw LE, et al. Single-cell RNA sequencing defines disease-specific differences between chronic nodular prurigo and atopic dermatitis. J Allergy Clin Immunol. (2023) 152:420–35. doi:  10.1016/j.jaci.2023.04.019, PMID: [DOI] [PubMed] [Google Scholar]
  • 69. Zissler UM, Ulrich M, Jakwerth CA, Rothkirch S, Guerth F, Weckmann M, et al. Biomatrix for upper and lower airway biomarkers in patients with allergic asthma. J Allergy Clin Immunol. (2018) 142:1980–3. doi:  10.1016/j.jaci.2018.07.027, PMID: [DOI] [PubMed] [Google Scholar]
  • 70. Zissler UM, Chaker AM, Effner R, Ulrich M, Guerth F, Piontek G, et al. Interleukin-4 and interferon-γ orchestrate an epithelial polarization in the airways. Mucosal Immunol. (2016) 9:917–26. doi:  10.1038/mi.2015.110, PMID: [DOI] [PubMed] [Google Scholar]
  • 71. Thaci D, Laquer V, Lynde C, Reich A, Soong W, Worm M, et al. Targeting IL-22RA1 with temtokibart: A novel approach in atopic dermatitis: Phase 2a monotherapy study results. J Allergy Clin Immunol. (2025) 157:666–76. doi:  10.1016/j.jaci.2025.08.034, PMID: [DOI] [PubMed] [Google Scholar]
  • 72. Thaci D, Simpson EL, Beck LA, Bieber T, Blauvelt A, Papp K, et al. Efficacy and safety of dupilumab in adults with moderate-to-severe atopic dermatitis inadequately controlled by topical treatments: a randomised, placebo-controlled, dose-ranging phase 2b trial. Lancet. (2016) 387:40–52. doi:  10.1016/S0140-6736(15)00388-8, PMID: [DOI] [PubMed] [Google Scholar]
  • 73. Weidinger S, Blauvelt A, Papp KA, Reich A, Lee CH, Worm M, et al. Phase 2b randomized clinical trial of amlitelimab, an anti-OX40 ligand antibody, in patients with moderate-to-severe atopic dermatitis. J Allergy Clin Immunol. (2025) 155:1264–75. doi:  10.1016/j.jaci.2024.10.031, PMID: [DOI] [PubMed] [Google Scholar]
  • 74.NCT05923099. Available online at: http://clinicaltrials.gov/study/NCT05923099. (Accessed September 25, 2025).
  • 75. Weidinger S, Hong CH, Herranz Pinto P, Talia J, Jachiet M, Gkalpakiotis S, et al. (2025). IL-22RA1 antagonism with temtokibart provides significant early and sustained improvements in atopic dermatitis: results from a phase 2b dose-finding trial. In: EADV Congress 2025, Paris, France, September 17–20. [Google Scholar]
  • 76. Del Duca E, Fiedler J, Correa da Rosa J, Pulsinelli J, Estrada Y, Beaziz J, et al.(2025). Temtokibart, an IL-22RA1 Monoclonal Antibody broadly dampens gene expression markers of activated immune pathways in Atopic Dermatitis: Results from a Phase 2b Trial Subgroup Analysis. In: EADV Congress 2025, Paris, France, September 17–20 [Google Scholar]
  • 77. Guttman-Yassky E, Brunner PM, Neumann AU, Khattri S, Pavel AB, Malik K, et al. Efficacy and safety of fezakinumab (an IL-22 monoclonal antibody) in adults with moderate-to-severe atopic dermatitis inadequately controlled by conventional treatments: A randomized, double-blind, phase 2a trial. J Am Acad Dermatol. (2018) 78:872–881.e876. doi:  10.1016/j.jaad.2018.01.016, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 78. Brunner PM, Pavel AB, Khattri S, Leonard A, Malik K, Rose S, et al. Baseline IL-22 expression in patients with atopic dermatitis stratifies tissue responses to fezakinumab. J Allergy Clin Immunol. (2019) 143:142–54. doi:  10.1016/j.jaci.2018.07.028, PMID: [DOI] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Supplementary Figure 1

Analysis of IL-24 expression using the publicly available GSE130588 dataset. Normal skin (n=20), preL, pre-treatment lesional skin (n=51), preNL, pre-treatment non-lesional skin (n=42), postL, post-treatment lesional skin (n=73), postNL, post-treatment non-lesional skin (n=22).

DataSheet1.docx (51.4KB, docx)

Articles from Frontiers in Immunology are provided here courtesy of Frontiers Media SA

RESOURCES