Single-cell RNA-seq reveals abnormal differentiation of keratinocytes and increased inflammatory differentiated keratinocytes in atopic dermatitis

BackgroundAtopic dermatitis (AD) is a chronic and recurrent inflammatory skin disease characterized by severe pruritus and eczematous lesions. Heterogeneity of AD has been reported among different racial groups according to clinical, molecular and genetic differences. ObjectiveThis study aimed to conduct an in-depth transcriptome analysis of AD in Chinese population. MethodsWe performed single-cell RNA sequencing (scRNA-seq) analysis of skin biopsies from five Chinese adult patients with chronic AD and from four healthy controls, combined with multiplexed immunohistochemical analysis in whole-tissue skin biopsies. We explored the functions of IL19 in vitro. ResultsScRNA-seq analysis was able to profile a total of 87,853 cells, with keratinocytes (KCs) in AD manifesting highly expressed keratinocyte activation and pro-inflammatory genes. KCs demonstrated a novel IL19(+)IGFL1(+) subpopulation that increased in AD lesions. Inflammatory cytokines IFNG, IL13, IL26 and IL22 were highly expressed in AD lesions. In vitro, IL19 directly downregulated KRT10 and LOR in HaCaT cells and activated HaCaT cells to produce TSLP. ConclusionAbnormal proliferation and differentiation of keratinocytes contribute immensely to the pathogenesis of AD, whereas AD chronic lesions have witnessed significant presence of IL19(+)IGFL1(+)KCs, which may be involved in the disruption of the skin barrier, the connection and magnification of Th2 and Th17 inflammatory responses, and mediation of skin pruritus. Furthermore, progressive activation of multiple immune axes dominated by Type 2 inflammatory reaction occur in AD chronic lesions.

Automated summary

This study conducted an in-depth transcriptome analysis of atopic dermatitis (AD) in the Chinese population, revealing heterogeneity and highly expressed keratinocyte activation and pro-inflammatory genes. The study also identified an increased IL19(+)IGFL1(+) subpopulation in AD lesions, which may be associated with disruption of the skin barrier, amplified Th2 and Th17 inflammatory responses, and mediation of skin pruritus. Additionally, progressive activation of multiple immune axes dominated by Type 2 inflammatory reaction occurred in AD chronic lesions.