RUNX1-ETO expression in epidermal keratinocytes induces progressive skin inflammation in vivo

Basal keratinocytes in the skin are essential for epidermal homeostasis and repair; however, how intrinsic alterations in these cells contribute to inflammatory skin pathology remains poorly understood. In this study, we employed a tamoxifen-inducible mouse model to express the human RUNX1-ETO fusion gene, a well-established oncogenic driver of acute myeloid leukemia, in epidermal basal keratinocytes. RUNX1-ETO induction in keratinocytes resulted in progressive skin inflammation in vivo , accompanied by splenomegaly, epidermal hyperplasia, increased cytokine production, and alterations in epidermal stem cell composition. Inflammatory lesions were prominent in the tail, ear, and plantar epidermis, whereas hair-bearing dorsal skin remained largely unaffected. RNA-seq analysis of FACS-isolated RUNX1-ETO ⁺ basal keratinocytes revealed global changes in gene expression, characterized by the suppression of epidermal homeostatic and metabolic programs and the activation of inflammatory signaling pathways. In particular, RUNX1-ETO expression was associated with increased TNF/NF-κB and IL-6–STAT signaling, as well as interferon-associated inflammatory pathways, together with the induction of neutrophil-attracting chemokines and epithelial inflammatory mediators. Together, these findings indicate that RUNX1-ETO-mediated transcriptional dysregulation in basal keratinocytes promotes a pro-inflammatory cellular state that drives progressive skin inflammation.