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James Mackay is the Founder, President, and CEO of Aristea Therapeutics, a San Diego-based company that is applying its insights on neutrophils to develop a treatment for a rare inflammatory skin condition known as palmoplantar pustulosis, PPP. Most of the people who get this disease are postmenopausal females, and 90%+ of the patients either are current cigarette smokers or have a history of cigarette smoking. 

James explains, "So neutrophils are cells that are part of the immune system. They sit in the bone marrow, and then when there's either an infection or an inflammatory response in the body, the neutrophils are attracted out of the bone marrow to the site of infection or inflammation. In inflammatory diseases, what you often see is extremely large numbers of neutrophils accumulating at the site of the inflammation, which obviously causes some challenges for the patients."

"And in our particular case, we have a drug, it's called RIST4721, which is a CXCR2 antagonist which actually blocks the neutrophils moving from the bone marrow to the site of inflammation. And we believe that this is potentially a way to treat a whole range of serious inflammatory diseases."

"So there's definitely a direct link to cigarette smoking. There's not much basic research been done on PPP, so the exact reason for that is not clear, but we believe, based on some of the research, that it's due to the nicotine receptor in the sweat ducts on the palms of the hands and the soles of the feet. And the sweat ducts on the hands and the feet are different structures from those elsewhere in the body, which is why this disease probably just affects the palms of the hands and the soles of the feet."

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