Single-cell analysis of psoriasis resolution reveals an inflammatory fibroblast state targeted by IL-23 blockade

This article has been Reviewed by the following groups

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Biologics targeting the IL-23/IL-17 axis have transformed the treatment of psoriasis. However, the early mechanisms of action of these drugs remain poorly understood. Here, we performed longitudinal single-cell RNA-sequencing in affected individuals receiving IL-23 inhibitor therapy. By profiling skin at baseline, day 3 and day 14 of treatment, we demonstrated that IL-23 blockade causes marked gene expression shifts, with fibroblast and myeloid populations displaying the most extensive changes at day 3. We also identified a transient WNT5A+/IL24+ fibroblast state, which was only detectable in lesional skin. In-silico and in-vitro studies indicated that signals stemming from these WNT5A+/IL24+ fibroblasts upregulated multiple inflammatory genes in keratinocytes. Importantly, the abundance of WNT5A+/IL24+ fibroblasts was significantly reduced after treatment. This observation was validated in-silico , by deconvolution of multiple transcriptomic datasets, and experimentally, by RNA in-situ hybridization. These findings demonstrate that the evolution of inflammatory fibroblast states is a key feature of resolving psoriasis skin.

Article activity feed

  1. reduction of WNT5A+/IL24+ fibroblasts as an early eventmediating the resolution of skin inflammation in psoriasis, following systemic or topical treatment

    This is an interesting finding! I imagine that it could be helpful to use this as a potential in screen for new psoriasis treatments if human diseased skin is accessible (with the caveat that this finding was based on samples from males of European descent).

  2. topicalglucocorticoid (halometasone monohydrate 0.05% cream)

    It would be nice to see whether the reduction of WNT5A+/IL24+ fibroblasts also occurred for class V-VII corticosteroids given that the the higher potency corticosteroids are advised for short-term use. I wonder if a reduction in the WNT5A+/IL24+ fibroblast cells would occur as quickly or with the same magnitude when using less potent/strong corticosteroid medications. I’d also be interested to see if Vtama (tapinarof) leads to a WNT5A+/IL24+ fibroblast reduction as well.