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Lupus dermal fibroblasts are proinflammatory and exhibit a profibrotic phenotype in scarring skin disease
Suzanne K. Shoffner-Beck, … , Lam C. Tsoi, J. Michelle Kahlenberg
Suzanne K. Shoffner-Beck, … , Lam C. Tsoi, J. Michelle Kahlenberg
Published February 15, 2024
Citation Information: JCI Insight. 2024;9(6):e173437. https://doi.org/10.1172/jci.insight.173437.
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Research Article Dermatology

Lupus dermal fibroblasts are proinflammatory and exhibit a profibrotic phenotype in scarring skin disease

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Abstract

Fibroblasts are stromal cells known to regulate local immune responses important for wound healing and scar formation; however, the cellular mechanisms driving damage and scarring in patients with cutaneous lupus erythematosus (CLE) remain poorly understood. Dermal fibroblasts in patients with systemic lupus erythematosus (SLE) experience increased cytokine signaling in vivo, but the effect of inflammatory mediators on fibroblast responses in nonscarring versus scarring CLE subtypes is unclear. Here, we examined responses to cytokines in dermal fibroblasts from nonlesional skin of 22 patients with SLE and CLE and 34 individuals acting as healthy controls. Notably, inflammatory cytokine responses were exaggerated in SLE fibroblasts compared with those from individuals acting as healthy controls. In lesional CLE biopsies, these same inflammatory profiles were reflected in single-cell RNA-Seq of SFRP2+ and inflammatory fibroblast subsets, and TGF-β was identified as a critical upstream regulator for inflammatory fibroblasts in scarring discoid lupus lesions. In vitro cytokine stimulation of nonlesional fibroblasts from patients who scar from CLE identified an upregulation of collagens, particularly in response to TGF-β, whereas inflammatory pathways were more prominent in nonscarring patients. Our study revealed that SLE fibroblasts are poised to hyperrespond to inflammation, with differential responses among patients with scarring versus nonscarring disease, providing a potential skin-specific target for mitigating damage.

Authors

Suzanne K. Shoffner-Beck, Lisa Abernathy-Close, Stephanie Lazar, Feiyang Ma, Mehrnaz Gharaee-Kermani, Amy Hurst, Craig Dobry, Deepika Pandian, Rachael Wasikowski, Amanda Victory, Kelly Arnold, Johann E. Gudjonsson, Lam C. Tsoi, J. Michelle Kahlenberg

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Figure 1

Schematic of fibroblast isolation, culture, and differential gene expression analysis workflow.

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Schematic of fibroblast isolation, culture, and differential gene expres...
(A) Two parallel studies were performed: one study compared nonlesional biopsies from individuals acting as healthy controls and patients with lupus, and another study that subdivided the patients with lupus into patients with damaged or scarring skin disease and patients with nondamaged or nonscarring skin disease and examined their fibroblasts from nonlesional biopsies. Fibroblasts were subjected to RNA-Seq at baseline (no cytokine stimulation) and stimulated with IFN-γ (IFNG), IFN-α (IFNA), TNF-α (TNFA), TGF-β (TGFB), and IL-1β (IL1B). After sequencing, gene expression fold change was determined for the stimulated versus unstimulated state. Effect size (ES) is plotted and calculated by taking the difference in fold change across disease groups. Pathway analysis was performed to identify pathways shared across cytokine stimulations and unique to individual stimulations. The genes in those pathways were plotted in heatmaps for all conditions. (B and C) The number of differentially expressed genes across stimulations in (B) healthy individuals and patients with lupus and (C) nonscarring and scarring patients.

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