NLRP1 inflammasome activation in skin equivalents reveals mechanistic insights into the roles of keratinocytes in psoriasis

Psoriasis is a major inflammatory skin disease for which a causal therapy is still not available. The pro-inflammatory cytokines interleukin(IL)-1β and IL-36γ are key drivers of the disease phenotype, but the mechanisms underlying their regulation in psoriasis remain poorly understood. Generation of IL-1β activity is regulated by protein complexes, termed inflammasomes. We activated the NLRP1 inflammasome in human keratinocytes cultivated in three-dimensional skin equivalents. NLRP1 activation induced histological and molecular features that are highly reminiscent of psoriasis. Mechanistically, the phenotype was dependent on IL-1, which triggered a pro-inflammatory epidermal-dermal crosstalk. This included induction of expression of IL-36γ, which, together with IL-1β, was released from keratinocytes through NLRP1-induced gasdermin D pores. The in vivo relevance of these findings is reflected by the expression of the NLRP1 sensor and signs of inflammasome activation in lesional skin of psoriatic patients. Finally, we discovered endogenous cytoplasmic double stranded (ds) RNA, recently associated with cellular perturbations in psoriasis, as a novel activator of the NLRP1 inflammasome in human keratinocytes. Our results identify a novel endogenous double-stranded RNA-mediated NLRP1-IL-1-IL-36γ signaling axis relevant in psoriasis and suggest targeting of this pathway as a promising treatment strategy.