Journal of Investigative Dermatology

Fibroproliferative diseases such as systemic sclerosis are complex conditions characterized by chronic skin inflammation and progressive fibrosis, with fibroblast activation as a central feature. While Transforming Growth Factor Beta (TGF-{beta}) signaling is a well-established driver of fibrosis in SSc, inflammatory pathways such as Nuclear Factor Kappa B (NF-{kappa}B) also contribute substantially to disease morbidity. We previously identified CD109 as a TGF-{beta} co-receptor and negative regulator of fibrotic signaling; however, its role in inflammatory signaling remains unknown. Here, we investigate the function of CD109 in regulating inflammatory signaling in skin fibroblasts. We show that, CD109 co-localizes and associates with Toll-like receptors (TLR2, TLR4) and tumor necrosis factor receptors (TNFRI, TNFRII), and that loss of CD109 enhances TNF--induced NF-{kappa}B activation and reprograms cytokine production in human dermal fibroblasts. Furthermore, both global and fibroblast-specific CD109 knockout mice exhibit increased immune cell infiltration and skin inflammation. In parallel, single-cell transcriptomic analyses across a pan-disease fibroblast atlas show that CD109 expression is preferentially maintained in structural and homeostatic fibroblast subtypes, whereas immune-interacting fibroblast subsets consistently display decreased CD109 levels. Pathway-level analyses of fibroblast pseudobulk samples reveal altered activity of canonical inflammatory pathways in SSc compared to healthy skin. Together, these findings identify CD109 as a fibroblast-intrinsic negative regulator of inflammatory signaling and suggest a broader role for CD109 in modulating inflammatory responses in systemic sclerosis. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=102 SRC="FIGDIR/small/736423v1_ufig1.gif" ALT="Figure 1"> View larger version (53K): org.highwire.dtl.DTLVardef@be9e08org.highwire.dtl.DTLVardef@794173org.highwire.dtl.DTLVardef@b81eb5org.highwire.dtl.DTLVardef@1e811f5_HPS_FORMAT_FIGEXP M_FIG Graphical Abstract: CD109 Restrains Fibroblast-Driven Inflammation by Modulating NF-{kappa}B Signaling. Generated using FigureLabs.ai and edited using Adobe Photoshop. C_FIG

Atopic dermatitis (AD), or eczema, is estimated to affect more than 30 million people in the United States, with over 6 million have moderate or severe disease. Chronic pruritus is a common symptom and is one of most difficult to manage. Even though itch is a major component in the pathology of AD, the biological underpinnings are not fully understood. In the present manuscript we identify a role for the neutrophil receptor, Mrgpra2, in the development of AD hyperplasia and chronic itch in the mouse. The role of Mrgprs in the context of itch have provided a huge step in our understanding of pruritus and have led to the development of novel therapeutics. Here we provide new evidence for the involvement of Mrgpra2 in the development of AD. Here we show that genetic deletion of Mrgpra2 significantly reduces scratching behaviors, transepidermal water loss, epidermal thickening, and Tslp expression in AD.

How the cutaneous microenvironment influences early melanomagenesis is poorly understood. Here, we assessed the effects of three immune perturbations on premalignant melanocyte expansion in an autochthonous mouse model of disease. Depletion of regulatory T (Treg) cells markedly accelerated melanoproliferation, an unexpected phenotype that was associated with monocyte and macrophage infiltration, the production of inflammatory and angiogenic factors, and vascular leakage. In line with these observations, single cell transcriptomic analysis of Treg cell deficient skin revealed robust accumulation of monocyte-derived macrophages with tissue remodeling characteristics. Acute UV irradiation and 2,4-dinitrofluorobenzene (DNFB)-induced contact hypersensitivity had analogous effects on both the cellular microenvironment of the skin and the expansion of local premalignant melanocytes. Treatment with the anti-inflammatory agent dexamethasone attenuated DNFB-induced melanocyte expansion and vascular remodeling. Collectively, these results identify a conserved inflammatory axis linked to the early outgrowth of oncogenic melanocytes in the skin.

Hailey-Hailey disease (HHD) is a genetic skin blistering disorder lacking approved treatments despite linkage to ATP2C1 variants 25 years ago. Since knockout mice did not replicate HHD, we ablated ATP2C1 in human keratinocytes or chemically inhibited its encoded Golgi calcium pump SPCA1. In organotypic epidermis, SPCA1 deficiency or inhibition reproduced HHD pathology, disrupting desmosomal cadherins and severing cell-cell junctions, termed acantholysis. RNA sequencing of heterozygous cells identified dysregulation of actin and Rho GTPases along with EGF receptor signaling as potential pathogenic drivers. Accordingly, SPCA1-depleted organotypic epidermis and HHD biopsies exhibited cortical actin disorganization and hyper-phosphorylation of the Rho kinase (ROCK) target, myosin light chain. Rho activation was sufficient to induce acantholysis, while ROCK inhibition partially restored heterozygous keratinocyte cohesion. A fluorescent biosensor demonstrated ERK hyper-activation in heterozygous cells along with desmosomal cadherin mis-localization. Importantly, treating SPCA1-deficient keratinocyte sheets with MEK and ROCK inhibitors together fully restored their integrity. Our results show HHD blistering is driven by desmosome and cortical actin dysfunction that was mitigated by targeting MEK and ROCK with repurposed drugs, offering a viable treatment strategy. Moreover, our model provides a blueprint for replicating genetic epidermal disorders to delineate pathogenic mechanisms and vet therapeutics for other orphan skin diseases. GRAPHICAL ABSTRACT O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=199 SRC="FIGDIR/small/726679v1_ufig1.gif" ALT="Figure 1"> View larger version (57K): org.highwire.dtl.DTLVardef@b2de6aorg.highwire.dtl.DTLVardef@128411borg.highwire.dtl.DTLVardef@1ca760forg.highwire.dtl.DTLVardef@10cd6c7_HPS_FORMAT_FIGEXP M_FIG C_FIG

Skin pigmentation relies on the coordinated regulation of melanin production and dendritic morphology to ensure effective pigment distribution. While staurosporine is widely used as a proapoptotic agent in malignant cells, its effects on normal human melanocytes have not been fully characterized. Here, we investigated the impact of staurosporine on melanocyte biology and identify it as a potent inducer of non-canonical melanocyte maturation at sub-cytotoxic concentrations. In primary human neonatal melanocytes, staurosporine treatment enhances melanogenesis and promotes pronounced dendritic remodeling, leading to functional maturation distinct from its apoptotic effects in melanoma cells. Phenotypic analyses demonstrate increased pigment production and expanded dendritic networks that support efficient pigmentation. Molecular characterization indicates that these effects are associated with coordinated activation of {beta}-catenin signaling and actin-dependent cytoskeletal remodeling. The physiological relevance of these findings was further examined in vivo. Topical application of staurosporine to normal guinea pig skin increased baseline pigmentation without detectable inflammation. In addition, staurosporine accelerated repigmentation in a rhododendrol-induced leukoderma model by restoring functionally mature melanocyte populations and enhancing nuclear localization of {beta}-catenin. Together, these results identify staurosporine as a non-canonical modulator of melanocyte maturation and highlight the coordinated regulation of pigment production and dendritic remodeling as a key process supporting pigmentation in acquired hypopigmentary conditions. SummaryO_LIStaurosporine promotes non-canonical maturation of human melanocytes at sub-cytotoxic concentrations. C_LIO_LITreatment enhances both melanogenesis and dendritic remodeling, supporting functional pigmentation. C_LIO_LIStaurosporine increases baseline skin pigmentation in vivo without inducing inflammation. C_LIO_LIRepigmentation is accelerated in a rhododendrol-induced leukoderma model through restoration of mature melanocyte populations. C_LIO_LIThese findings highlight coordinated regulation of pigment production and dendritic morphology as a potential strategy to promote pigmentation in acquired hypopigmentary conditions. C_LI SignificanceLoss of melanocyte dendricity and functional maturation is a shared feature of multiple acquired hypopigmentary disorders, including vitiligo and chemical-induced leukoderma. This study demonstrates that staurosporine promotes dendritic remodeling and pigmentation in normal human melanocytes and enhances repigmentation in vivo. By identifying a melanocyte-intrinsic, ultraviolet-independent maturation program, our findings provide a biological framework for strategies aimed at restoring functional melanocytes in depigmented skin.

Deficiency of the Interleukin-36 Receptor antagonist (DITRA) is a rare autoinflammatory condition which commonly manifests as severe, recurrent episodes of Generalized Pustular Psoriasis (GPP). Loss-of-function mutations in the IL36RN gene result in unopposed IL-36 cytokine signalling leading to severe psoriatic inflammation, which can be successfully treated with Anti-IL-36 receptor (IL-36R) monoclonal antibodies. Despite such advances, there remain some key questions concerning how loss of a functional IL-36R antagonist predisposes to GPP, including identifying the potential impacts of IL36RN mutations on skin homeostasis. To address this question, we investigated the consequences of IL-36Ra deficiency using Il36rn-/- mice, which recapitulate the severe psoriatic inflammation observed in DITRA patients. Here, we demonstrate, that in overtly healthy Il36rn-/- mice, prior to disease onset, there is disrupted dermal immune homeostasis, characterised by decreased expression of the chemokine CCL27. Altered skin homeostasis occurred in association with dysbiosis of the skin microbiome, characterised by a significant outgrowth of the commensal bacteria, Cutibacterium acnes. Importantly, intradermal administration of recombinant CCL27, prior to disease induction, significantly reduced the enhanced severity of psoriasiform inflammation, demonstrating a central role for this chemokine in regulating predisposition to increased severity. Transcriptomic analysis of GPP patients skin also revealed decreased CCL27 expression in non-lesional, as well as lesional, compared to healthy skin, indicating that this chemokine may also play a key instructive role among DITRA patients. Together, these data identify a novel mechanism through which IL-36Ra deficiency alters dermal homeostasis and predisposes to increased severity of psoriatic disease observed in DITRA patients.

ObjectiveTo determine whether pyroptosis-related transcription in systemic sclerosis skin forms a translayer spatial architecture rather than a single coextensive inflammatory program. MethodsWe reanalyzed public Visium formalin-fixed paraffin-embedded skin sections (4 healthy controls, 9 systemic sclerosis) from a discovery cohort and tested prespecified endpoints in 10 independent systemic sclerosis sections. The tissue section was the inferential unit. Epidermal versus dermal contrasts within each section were evaluated for inflammasome-related and gasdermin genes, followed by cell2location spatial deconvolution and partial correlation adjusted for endothelial context in the dermis. ResultsNLRP1, PYCARD, and CASP4 displayed epidermal bias in all 13 discovery sections, whereas GSDMD displayed dermal bias in all 13. This spatial separation was detectable in healthy skin and appeared stronger in systemic sclerosis. A tier 1 triad captured the epidermal signal better than broader composites (dilution 35.5%; P = 0.0002). In an independent systemic sclerosis cohort, the dermal gasdermin endpoint retained its direction in 8 of 10 sections and the epidermal inflammasome-related endpoint in 10 of 10. Spatial deconvolution indicated that dermal GSDMD associated most strongly with estimated endothelial abundance in both healthy and systemic sclerosis skin. The IFN{gamma}-GSDMD association remained positive after endothelial adjustment across sections, compatible with an additional IFN{gamma} component. ConclusionSystemic sclerosis skin harbors a reproducible translayer pyroptosis-related transcriptional architecture in which upstream epidermal inflammasome-related transcription and dermal GSDMD expression are spatially dissociated. This organization, detectable in healthy skin and often stronger in SSc, may warrant future mechanistic and therapeutic interrogation by compartment.

Immune checkpoint inhibitor-induced lichen planus (ICI-LP) is a cutaneous immune related adverse event (irAE) that shares key clinicopathologic features with spontaneous lichen planus (LP) but differs histologically and in the sex distribution of its incidence, and may therefore reflect a distinct tissue inflammatory state. To define the cellular programs that distinguish ICI-LP from LP, we profiled lesional skin by single cell and spatial transcriptomic approaches. We found few differences in the T cell and keratinocyte compartments between ICI-LP and LP, which shared similar inflammatory signatures. Rather, the dominant transcriptional features differentiating these two eruptions occurred within the fibroblast and myeloid cell compartments. Fibroblasts in ICI-LP were enriched for IGF1, FGF7, and androgen-response-associated programs, whereas myeloid cells exhibited amplified JAK-STAT and interferon-responsive states spanning both type I and type II interferon signatures. The potential role of androgen response in shaping lichenoid inflammation was supported by a striking loss of androgen receptor expression in lesional keratinocytes by immunohistochemistry. Furthermore, using spatial RNA and transcriptomic approaches, we identified anatomically segregated IFNG, IL17A, and IL13 niches within lesional skin, suggesting that regional immune compartmentalization with differences in local immunoregulation may explain the mixed inflammatory features reported in both ICI-LP and LP. Collectively, these data indicate that ICI-LP is not simply a more inflamed form of LP, but a distinct form of the disease with more prominent inflammatory perturbations within stromal and innate immune cell populations.

Basal keratinocytes in the skin are essential for epidermal homeostasis and repair; however, how intrinsic alterations in these cells contribute to inflammatory skin pathology remains poorly understood. In this study, we employed a tamoxifen-inducible mouse model to express the human RUNX1-ETO fusion gene, a well-established oncogenic driver of acute myeloid leukemia, in epidermal basal keratinocytes. RUNX1-ETO induction in keratinocytes resulted in progressive skin inflammation in vivo, accompanied by splenomegaly, epidermal hyperplasia, increased cytokine production, and alterations in epidermal stem cell composition. Inflammatory lesions were prominent in the tail, ear, and plantar epidermis, whereas hair-bearing dorsal skin remained largely unaffected. RNA-seq analysis of FACS-isolated RUNX1-ETO+ basal keratinocytes revealed global changes in gene expression, characterized by the suppression of epidermal homeostatic and metabolic programs and the activation of inflammatory signaling pathways. In particular, RUNX1-ETO expression was associated with increased TNF/NF-{kappa}B and IL-6-STAT signaling, as well as interferon-associated inflammatory pathways, together with the induction of neutrophil-attracting chemokines and epithelial inflammatory mediators. Together, these findings indicate that RUNX1-ETO-mediated transcriptional dysregulation in basal keratinocytes promotes a pro-inflammatory cellular state that drives progressive skin inflammation.

Psoriasis is a chronic autoimmune skin disorder marked by IL-17-producing {gamma}{delta} T cell ({gamma}{delta}T17) and pruritus, but immunoregulatory roles of itch-inducing neurons in this context remain unclear. This study addressed whether non-peptidergic (NP) afferents bearing the Mas-related G protein-coupled receptor D (MrgprD/NP1) and MrgprA3/NP2 subsets had differential effects on psoriasiform immunopathology. Data show human NP1 and NP2 neurons basally expressed an array of pattern recognition and cytokine receptor genes, and psoriatic human skin had a profound dysregulation of neuropeptides and their receptors. In mice, imiquimod (IMQ) application reduced the density of MrgprD+ skin afferents, whereas NP1 neuron ablation exacerbated IMQ-induced disease. Strikingly, NP1 activation using either optogenetics or {beta}-alanine before IMQ exposure significantly reduced epidermal thickness, psoriatic clinical score, and {gamma}{delta}T17 cell accumulation. In stark contrast, NP2 activation increased the numbers of {gamma}{delta}T17 cells that co-expressed amphiregulin (Areg) and exacerbated IMQ-driven skin pathology. Instead, pre-emptive NP1 stimulation shifted {gamma}{delta} T cell profiles away from being IL-17 and Areg dominant to IL-13+ {gamma}{delta} T cells expressing the transcription factor GATA3 accompanied by IL-10 secretion. Importantly, IL-10 signaling blockade reversed NP1-mediated suppression of IMQ-induced dermatitis. These data show that sensory neuron subsets can distinctly modulate inflammatory skin disease.

Cutaneous squamous cell carcinoma (cSCC) represents a growing public health burden, with incidence projected to increase 23-29% over the coming decade. Topical immunoprevention strategies targeting the PD-L1/PD-1 and TLR4 axes have demonstrated preclinical efficacy, yet optimal intervention timing in humans remains undefined. To address this gap, single-cell RNA sequencing was performed on matched sun-protected (SP), sun-damaged (SD), and actinic keratosis (AK) biopsies from the same individuals, along with independent cSCC cases. Immune checkpoint and innate inflammatory signals were detectable as early as SD skin, prior to histologically confirmed dysplasia. Monotonically increasing expression of CD274 (PD-L1), CTLA4, PDCD1, CD27, and STAT1, alongside progressive TLR4-MYD88 innate immune signaling, was revealed through pseudobulk data analysis, with earliest upregulation at the SD stage. Fuzzy c-means trajectory clustering identified cell-typespecific programs across dendritic cells, macrophages, T cells, fibroblasts, endothelial cells, and keratinocytes. Dendritic cells shifted from early inflammatory antigen-presenting programs toward late PD-L1/IFN-regulatory states; macrophages showed monotonically increasing TLR4-associated myeloid activation; and T cells defined a "hot but exhausted" microenvironment in established cSCC. These findings identify SD and AK as biologically active stages for topical immunoprevention and provide a cellular roadmap for PD-L1/PD-1 and TLR4 blockade strategies.

Pigmentation is a critical protective mechanism that safeguards the skin against UV-induced damage, whereas dysregulated pigmentation predisposes to pigmentary disorders and skin malignancies. Although calcium signaling has emerged as an important regulator of melanogenesis, the identity of the calcium-handling proteins and the molecular mechanisms linking calcium dynamics to pigmentation remain poorly understood. Here, we identify the ER calcium pump SERCA2b as a negative regulator of pigmentation through modulation of ER stress and mitochondrial calcium uptake. We demonstrate that SERCA2b expression inversely correlates with pigmentation levels, and gain- and loss-of-function studies establish SERCA2b as a suppressor of melanogenesis. Mechanistically, SERCA2b depletion induces adaptive ER stress, enhances ER-mitochondrial proximity, and promotes mitochondrial calcium uptake. Notably, mutations in SERCA2b are associated with Darier disease, a condition characterized by hyperpigmented skin lesions, although the underlying mechanism remains unknown. To address this, we generated SERCA2b mutants corresponding to variants identified in Indian Dariers disease patients and examined their effects on pigmentation, ER stress, and mitochondrial calcium dynamics. The mutant phenotypes closely recapitulated SERCA2b loss-of-function effects, demonstrating that adaptive ER stress and enhanced mitochondrial calcium signaling underlie hyperpigmentation associated with Dariers disease. Importantly, treatment with 4-phenylbutyrate (4-PBA), an FDA-approved ER stress alleviator, rescued mutant-induced hyperpigmentation, reduced ER stress, and normalized mitochondrial calcium uptake. Collectively, our findings uncover a previously unrecognized role of SERCA2b in skin pigmentation, establish a mechanistic link between SERCA2b mutations and hyperpigmentation, and identify adaptive ER stress pathways as potential therapeutic target for pigmentary disorders.

BackgroundNon-segmental vitiligo(NSV) shows marked heterogeneity in activity, progression, and treatment response. Reliable clinical markers that predict prognosis and patient-reported outcomes are lacking. ObjectivesTo identify clinicodemographic and clinical predictors of disease extent, progression, repigmentation, treatment dependency, noticeability, and psychosocial impact in NSV. MethodsIn this prospective cohort study, 275 patients with NSV were followed for 12 months. Sixteen baseline variables, including demographic features, autoimmune history, and clinical markers (koebnerization, confetti and trichrome patterns, leukotrichia, mucosal, acral, and periorificial involvement), were recorded. Outcomes included body surface area(BSA), progression, repigmentation, treatment dependency, Vitiligo Noticeability Scale(VNS), and quality-of-life indices(VIS-22, DLQI, C-DLQI, F-VIS). Multivariable analyses and cluster analysis were performed at 6 and 12 months. ResultsMarkers of disease activity leukotrichia, trichrome and confetti lesions, koebnerization, and mucosal, acral, and periorificial involvement were strongly associated with greater BSA, poor repigmentation, higher noticeability, and treatment dependency. Leukotrichia was consistent predictor of poor repigmentation and high VNS. Family history of autoimmunity predicted progression and treatment dependency. Early-onset vitiligo showed lower disease extent but greater family-related psychosocial burden. Cluster analysis identified severe, intermediate, and mild phenotypes with distinct therapeutic responses. ConclusionsSimple clinical markers can stratify NSV patients into prognostic subgroups, enabling individualized treatment and counseling. Plain Language SummaryVitiligo behave variably in different people, some people may have slow-spreading course, while others develop widespread or persistent patches. In this study, we followed 275 people with non-segmental vitiligo for one year to find signs on the skin that could predict how the disease would behave and how it would affect daily life. We found that features such as white hair within patches (leukotrichia), speckled (confetti) or three-colored lesions (trichrome), new patches appearing after injury (koebnerization), and involvement of the lips, mouth, hands, feet were linked to more severe disease, poorer response to treatment, and greater cosmetic concern. A family history of autoimmune disease increased the risk of worsening vitiligo. Patients who developed vitiligo early in life had less skin involvement but greater emotional and family-related impact. These easily recognized signs can help doctors and patients plan treatment and set realistic expectations. Significance of the studyNon-segmental vitiligo (NSV) has a heterogeneous and unpredictable clinical course with variable progression and response to therapy. However, robust prospective data linking these markers with long-term outcomes and patient-reported measures remain limited. In our prospective cohort of 275 patients, clinical markers such as leukotrichia, trichrome and confetti lesions, koebnerization, and acral/mucosal/periorificial involvement, were strongly associated with greater disease extent, poorer repigmentation, higher treatment dependency, and increased noticeability. Leukotrichia consistently predicted poor repigmentation. Thereby, prognostic stratification can also improve patient counselling regarding expected repigmentation, treatment duration, and psychosocial burden.

Kindlin-1, encoded by FERMT1, is an essential integrin co-activator that regulates cell-extracellular matrix (ECM) adhesion, tissue architecture, and microenvironment signalling. Loss-of-function mutations in FERMT1 cause Kindler epidermolysis bullosa, which is strongly associated with aggressive cutaneous squamous cell carcinoma (cSCC). Although Kindlin-1 deficiency promotes hypoxia and invasion, the impacts on ECM-vascular organisation and oxygen homeostasis are not known. Here, using genetic deletion of Kindlin-1 in a murine model of cSCC across 2D cultures, 3D spheroids, and in vivo tumours, combined with collagen and vascular imaging and spatial mixed-effects modelling, we show that Kindlin-1 loss uncouples ECM-vascular regulation, driving hypoxia and tumour progression. Tumours in which Kindlin-1 was deleted displayed a dense but dysfunctional vascular network, with reduced tissue-to-vessel and inter-bifurcation distances, increased vessel alignment, and persistent hypoxia despite increased vascular density. Collagen deposition was reduced and fibres were straighter, indicating a simplified, invasion-permissive matrix. Hypoxia increased Vegfa and Angpt1 expression while reducing Col1a1, and hypoxia-responsive spheroids confirmed greater hypoxia and invasiveness in Kindlin-1-deficient cells. Transcriptomic analysis revealed enrichment of ECM degradation and vascular dysfunction pathways, including upregulation of matrix-remodelling and vascular permeability genes such as Mmp13, Mmp3, and Ptgs2, alongside reduced collagen-associated and vascular homeostasis genes. Spatial modelling further showed disrupted collagen-vascular coupling and an association between hypoxia and reduced vessel diameter, consistent with dysfunctional angiogenesis rather than improved perfusion. These changes arose early and independently of tumour size, establishing impaired integrin activation as a central mechanism linking ECM degradation, vascular dysfunction, and sustained hypoxia in aggressive cSCC.

BackgroundCutaneous squamous cell carcinoma (cSCC) is among the most common human cancers, yet the cellular identity and molecular programs of its preinvasive precursor, actinic keratosis (AK), remains poorly defined. MethodsWe applied CITE-seq to patient-matched AK, UV-exposed normal skin, and non-UV-exposed normal skin (n=5 patients, 12 biopsies) and performed spatial whole-transcriptome profiling in an independent cohort (n=4) to map pre-invasive keratinocyte states at single-cell resolution. ResultsWe identify AK-specific keratinocytes (ASK), a discrete population localized to the dysplastic basal epidermis and characterized by UV-associated mutational signatures (SBS7b), high mutational burden, and recurrent copy number alterations including 9p loss and 8q gain. ASK occupies a basal-like undifferentiated state sustained by a {Delta}Np63/PITX1 regulatory module that attenuates Notch/HES1-driven differentiation and activates glycolytic metabolism. Comparison with published cSCC data reveals that ASK share core tumor-propagating gene networks with tumor-specific keratinocytes (TSK), including IGFBP6, IGFBP2, and ITGA6, but lack invasion effectors MMP1, MMP10, and PTHLH. Functional experiments identify IGFBP6 as a pro-proliferative factor in AK-derived keratinocytes. The AK microenvironment shows expansion of inflammatory basal keratinocytes, barrier disruption, and early immunosuppressive T cell remodeling. ConclusionsThese findings define the molecular identity of a pre-invasive malignant keratinocyte population governed by p63/PITX1 and distinguish early oncogenic programs shared with invasive cSCC from later-acquired invasion effectors, identifying candidate targets for prevention or treatment of squamous cell carcinoma.

The interfollicular epidermis is maintained by spatially organized basal cell populations with distinct molecular signatures and division kinetics; however, the markers that define these populations remain poorly defined. In this study, we identified Il1r2, which encodes the IL-1 decoy receptor IL-1R2, as a marker of the slow-cycling basal population in the epidermis. Single-cell RNA-seq analysis of epidermal and hair follicle basal populations in the murine tail skin revealed that Il1r2 is preferentially expressed in the slow-cycling epidermal basal population, and immunofluorescence staining confirmed its protein localization in tissues. To enable fate mapping of this population, we generated an Il1r2-CreERT2 knock-in mouse line using a CRISPR-Cas9-based PITCh method. Tamoxifen induction in Il1r2-CreERT2/Rosa-tdTomato mice exhibited selective labeling of basal cells localized to the slow-cycling interscale region of the tail epidermis. Because the CreERT2 cassette was inserted into the Il1r2 coding sequence, homozygous Il1r2-CreERT2 knock-in mice can also serve as an Il1r2 knockout model through targeted gene ablation. Thus, the Il1r2-CreERT2 mouse line provides a dual genetic tool for lineage tracing of the slow-cycling epidermal basal population and for functional modulation of IL-1 signaling in vivo.

An autocrine pro-adhesive/pro-contractile signaling loop, through the mechanosensitive transcriptional cofactor YAP, promotes fibrosis. The CCN family of matricellular proteins modify adhesive signaling. Of these, CCN3 is antifibrotic. We show that BLR-200, a CCN3-derived peptide, has anti-fibrotic properties in the bleomycin-induced model of scleroderma skin fibrosis. In vitro, BLR-200 delayed, but did not abolish, fibroblast adhesion to collagen and nuclear YAP localization. In vivo, BLR-200 prevented/treated bleomycin-induced skin fibrosis, and reduced bleomycin-induced expression of profibrotic genes including alpha-smooth muscle actin, CCN1 and CCN2. Lineage tracing and scRNA-seq analyses revealed that the myofibroblasts in this model were quantitatively derived from collagen-lineage Pi16+/Col15+ve fibroblasts. BLR-200 prevented myofibroblast differentiation in this model and trajectory of fibroblasts toward a Sfrp2-positive subset, a cell type associated with poor clinical outcome. BLR-200 impairs YAP activation in vitro and appearance of translationally-relevant fibroblast subtypes in vivo and is a novel anti-fibrotic agent for SSc skin fibrosis.

Palmoplantar pustulosis (PPP) and dyshidrotic eczema (DE) are chronic vesiculopustular dermatoses with overlapping clinical presentations but distinct underlying biology. Although comparative transcriptomic and proteomic analyses between PPP and DE have been reported, they remain limited in number and scope, with no comprehensive understanding of their distinct molecular signatures. Moreover, their molecular mechanisms remain unclear, and currently available therapeutic options are limited. To clarify disease-specific epidermal programs underlying vesicle formation, we conducted Visium HD spatial transcriptomic analysis of FFPE lesional skin samples obtained from patients with PPP and DE, followed by immunohistochemical validation against normal palmoplantar skin controls. Spatial clustering identified a keratinocyte subpopulation adjacent to vesicles that exhibited distinct transcriptional programs in the two diseases. In PPP, vesicle-associated keratinocytes demonstrated marked downregulation of aquaporin-3 (AQP3) and E-cadherin, together with strong, spatially localized activation of JAK-STAT3 signaling. Conversely, DE exhibited diffuse AQP3 expression and more homogeneous activation of JAK-STAT3 signaling throughout the epidermis. These results indicate that, although PPP and DE share inflammatory pathways, they differ substantially in their spatial molecular architecture. Reduced AQP3 expression and localized STAT3 activation may contribute to vesicle formation in PPP, supporting our previous hypothesis that implicates intraepidermal sweat leakage as a pathogenic mechanism in PPP. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=130 SRC="FIGDIR/small/723901v1_ufig1.gif" ALT="Figure 1"> View larger version (48K): org.highwire.dtl.DTLVardef@19c7591org.highwire.dtl.DTLVardef@eab29aorg.highwire.dtl.DTLVardef@73c2e2org.highwire.dtl.DTLVardef@1ffc02f_HPS_FORMAT_FIGEXP M_FIG C_FIG

Inflammatory skin diseases (ISDs) affect up to 25% of the global population. Yet, large-scale comparative single-cell RNA-sequencing (scRNA-seq) analyses between ISDs are still missing. Here, we integrated scRNA-seq datasets spanning 27 skin diseases from 50 studies, comprising over 2 million cells from 441 samples. Using the healthy skin cell atlas as reference, we could build a robust ISD atlas that enabled us to differentiate universal inflammatory signatures and disease-specific ones. This highlighted, for example, a shared gene program between keratinocytes in atopic dermatitis and parapsoriasis, not present in cutaneous T-cell lymphoma, confirms the plasticity of Th17 cells throughout ISDs, defines specific macrophage signatures in acne, and reveals a yet undescribed role of mural cells in ISDs. This demonstrates the power of the ISD atlas as a resource to resolve disease-specific immune mechanisms. The complete atlas is available through an interactive online portal at https://isd-atlas.derma.meduniwien.ac.at.

Resident dermal macrophages (DMs) play essential roles in maintaining skin homeostasis and initiating inflammatory responses during tissue injury and against infectious agents. However, studies of their cellular mechanisms have been limited by their low abundance in steady-state skin and by technical challenges in isolating resident DMs. Here, we describe the generation and characterization of a novel DM cell line, termed SB89. F4/80+ skin-resident DMs were sorted and immortalized using J2 retroviral transduction. SB89 cells display a stable, homogeneous macrophage phenotype and distinct surface markers compared with Langerhans cells and alveolar macrophages. Functionally, SB89 cells efficiently phagocytose methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli, zymosan particles, and apoptotic cells, and effectively kill MRSA. Importantly, SB89 cells respond to LPS, as evidenced by production of IL-6, TNF, and IL-10, and by MRSA-induced production of inflammatory cytokines, chemokines, and eicosanoids. RNA-seq and gene ontology analyses revealed that SB89 cells elicit stronger responses in innate immunity, cell signaling, and epigenetic regulation than immortalized bone marrow-derived macrophages. SB89 cells are genetically tractable, amenable to gene silencing via RNAi and gene introduction via plasmid transfection. Overall, SB89 cells provide a renewable, dermis-imprinted macrophage model that preserves key functional and transcriptional features of resident DMs while reducing reliance on primary cells and animal models. This cell line represents a powerful platform for mechanistic, genetic, and translational studies in skin immunobiology.