Fondation Jean Dausset-Centre d'Etude du Polymorphisme Humain (CEPH), Paris, France.
INSERM U976, Hôpital Saint-Louis, Paris, France.
Blood Adv. 2022 May 10;6(9):2805-2811. doi: 10.1182/bloodadvances.2021004707.
Cutaneous involvement of chronic graft-versus-host disease (cGVHD) has a wide range of manifestations including a lichenoid form with a currently assumed mixed Th1/Th17 signature and a sclerotic form with Th1 signature. Despite substantial heterogeneity of innate and adaptive immune cells recruited to the skin and of the different clinical manifestations, treatment depends mainly on the severity of the skin involvement and relies on systemic, high-dose glucocorticoids alone or in combination with a calcineurin inhibitor. We performed the first study using RNA sequencing to profile and compare the transcriptome of lichen planus cGVHD (n = 8), morphea cGVHD (n = 5), and healthy controls (n = 6). Our findings revealed shared and unique inflammatory pathways to each cGVHD subtype that are both pathogenic and targetable. In particular, the deregulation of IFN signaling pathway was strongly associated with cutaneous cGVHD, whereas the triggering receptor expressed on myeloid cells 1 pathway was found to be specific of lichen planus and likely contributes to its pathogenesis. The results were confirmed at a protein level by performing immunohistochemistry staining and at a transcriptomic level using real-time quantitative polymerase chain reaction.
慢性移植物抗宿主病(cGVHD)的皮肤受累表现广泛,包括目前假定为混合 Th1/Th17 特征的苔藓样形式和 Th1 特征的硬化形式。尽管招募到皮肤的先天和适应性免疫细胞以及不同的临床表现存在很大的异质性,但治疗主要取决于皮肤受累的严重程度,并依赖于全身性、大剂量糖皮质激素单独或与钙调神经磷酸酶抑制剂联合使用。我们进行了第一项使用 RNA 测序来分析和比较扁平苔藓 cGVHD(n = 8)、硬皮病 cGVHD(n = 5)和健康对照(n = 6)的转录组的研究。我们的发现揭示了每种 cGVHD 亚型的共同和独特的炎症途径,这些途径既是致病的,也是可靶向的。特别是 IFN 信号通路的失调与皮肤 cGVHD 强烈相关,而髓样细胞表达的触发受体 1 通路被发现是扁平苔藓特有的,可能有助于其发病机制。通过进行免疫组织化学染色和实时定量聚合酶链反应在转录组水平上证实了这些结果。
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