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. 2024 Jan;79(1):80-92.
doi: 10.1111/all.15845. Epub 2023 Aug 14.

Intrapatient comparison of atopic dermatitis skin transcriptome shows differences between tape-strips and biopsies

Ester Del Duca  1   2 , Helen He  1 , Ying Liu  1 , Angel D Pagan  1 , Eden David  1 , Julia Cheng  1 , Britta Carroll  1 , Yael Renert-Yuval  1   3 , Jonathan Bar  1 , Yeriel D Estrada  1 , Catherine Maari  4 , Etienne Saint-Cyr Proulx  4 , James G Krueger  3 , Robert Bissonnette  4 , Emma Guttman-Yassky  1
Affiliations

Intrapatient comparison of atopic dermatitis skin transcriptome shows differences between tape-strips and biopsies

Ester Del Duca et al. Allergy. 2024 Jan.

Abstract

Background: Our knowledge of etiopathogenesis of atopic dermatitis (AD) is largely derived from skin biopsies, which are associated with pain, scarring and infection. In contrast, tape-stripping is a minimally invasive, nonscarring technique to collect skin samples.

Methods: To construct a global AD skin transcriptomic profile comparing tape-strips to whole-skin biopsies, we performed RNA-seq on tape-strips and biopsies taken from the lesional skin of 20 moderate-to-severe AD patients and the skin of 20 controls. Differentially expressed genes (DEGs) were defined by fold-change (FCH) ≥2.0 and false discovery rate <0.05.

Results: We detected 4104 (2513 Up; 1591 Down) and 1273 (546 Up; 727 Down) DEGs in AD versus controls, in tape-strips and biopsies, respectively. Although both techniques captured dysregulation of key immune genes, tape-strips showed higher FCHs for innate immunity (IL-1B, IL-8), dendritic cell (ITGAX/CD11C, FCER1A), Th2 (IL-13, CCL17, TNFRSF4/OX40), and Th17 (CCL20, CXCL1) products, while biopsies showed higher upregulation of Th22 associated genes (IL-22, S100As) and dermal cytokines (IFN-γ, CCL26). Itch-related genes (IL-31, TRPV3) were preferentially captured by tape-strips. Epidermal barrier abnormalities were detected in both techniques, with terminal differentiation defects (FLG2, PSORS1C2) better represented by tape-strips and epidermal hyperplasia changes (KRT16, MKI67) better detected by biopsies.

Conclusions: Tape-strips and biopsies capture overlapping but distinct features of the AD molecular signature, suggesting their respective utility for monitoring specific AD-related immune, itch, and barrier abnormalities in clinical trials and longitudinal studies.

Keywords: atopic dermatitis; biopsies; immune; pruritus; tape-strips.

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References

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