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IL18-containing 5-gene signature distinguishes histologically identical dermatomyositis and lupus erythematosus skin lesions
Lam C. Tsoi, … , Johann E. Gudjonsson, J. Michelle Kahlenberg
Lam C. Tsoi, … , Johann E. Gudjonsson, J. Michelle Kahlenberg
Published July 9, 2020
Citation Information: JCI Insight. 2020;5(16):e139558. https://doi.org/10.1172/jci.insight.139558.
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Research Article Dermatology

IL18-containing 5-gene signature distinguishes histologically identical dermatomyositis and lupus erythematosus skin lesions

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Abstract

Skin lesions in dermatomyositis (DM) are common, are frequently refractory, and have prognostic significance. Histologically, DM lesions appear similar to cutaneous lupus erythematosus (CLE) lesions and frequently cannot be differentiated. We thus compared the transcriptional profile of DM biopsies with CLE lesions to identify unique features. Type I IFN signaling, including IFN-κ upregulation, was a common pathway in both DM and CLE; however, CLE also exhibited other inflammatory pathways. Notably, DM lesions could be distinguished from CLE by a 5-gene biomarker panel that included IL18 upregulation. Using single-cell RNA-sequencing, we further identified keratinocytes as the main source of increased IL-18 in DM skin. This study identifies a potentially novel molecular signature, with significant clinical implications for differentiating DM from CLE lesions, and highlights the potential role for IL-18 in the pathophysiology of DM skin disease.

Authors

Lam C. Tsoi, Mehrnaz Gharaee-Kermani, Celine C. Berthier, Tori Nault, Grace A. Hile, Shannon N. Estadt, Matthew T. Patrick, Rachael Wasikowski, Allison C. Billi, Lori Lowe, Tamra J. Reed, Johann E. Gudjonsson, J. Michelle Kahlenberg

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Figure 1

DM skin lesions demonstrate a strong IFN signature.

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DM skin lesions demonstrate a strong IFN signature.
(A) Principal compon...
(A) Principal components analysis of differentially expressed genes (DEGs) between lesional DM biopsies and healthy control skin. (B) IPA identifying key pathways in the DM DEG list. (C) Graphical representation of log2 mRNA expression values of IFN genes from DM lesional skin microarrays. Bars depict SD. (D) IFN score comparison between DM and healthy control biopsies. The box plots depict the minimum and maximum values (whiskers), the upper and lower quartiles, and the median. The length of the box represents the interquartile range.

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