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Single-cell profiling reveals distinct adaptive immune hallmarks in MDA5+ dermatomyositis with therapeutic implications.


ABSTRACT: Anti-melanoma differentiation-associated gene 5-positive dermatomyositis (MDA5+ DM) is an autoimmune condition associated with rapidly progressive interstitial lung disease and high mortality. The aetiology and pathogenesis of MDA5+ DM are still largely unknown. Here we describe the immune signatures of MDA5+ DM via single-cell RNA sequencing, flow cytometry and multiplex immunohistochemistry in peripheral B and T cells and in affected lung tissue samples from one patient. We find strong peripheral antibody-secreting cell and CD8+ T cell responses as cellular immune hallmarks, and over-stimulated type I interferon signaling and associated metabolic reprogramming as molecular immune signature in MDA5+ DM. High frequency of circulating ISG15+ CD8+ T cells at baseline predicts poor one-year survival in MDA5+ DM patients. In affected lungs, we find profuse immune cells infiltration, which likely contributes to the pro-fibrotic response via type I interferon production. The importance of type I interferons in MDA5+ DM pathology is further emphasized by our observation in a retrospective cohort of MDA5+ DM patients that combined calcineurin and Janus kinase inhibitor therapy show superior efficacy to calcineurin inhibitor monotherapy. In summary, this study reveals key immune-pathogenic features of MDA5+ DM and provides a potential basis for future tailored therapies.

SUBMITTER: Ye Y 

PROVIDER: S-EPMC9617246 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Single-cell profiling reveals distinct adaptive immune hallmarks in MDA5+ dermatomyositis with therapeutic implications.

Ye Yan Y   Chen Zechuan Z   Jiang Shan S   Jia Fengyun F   Li Teng T   Lu Xia X   Xue Jing J   Lian Xinyue X   Ma Jiaqiang J   Hao Pei P   Lu Liangjing L   Ye Shuang S   Shen Nan N   Bao Chunde C   Fu Qiong Q   Zhang Xiaoming X  

Nature communications 20221029 1


Anti-melanoma differentiation-associated gene 5-positive dermatomyositis (MDA5<sup>+</sup> DM) is an autoimmune condition associated with rapidly progressive interstitial lung disease and high mortality. The aetiology and pathogenesis of MDA5<sup>+</sup> DM are still largely unknown. Here we describe the immune signatures of MDA5<sup>+</sup> DM via single-cell RNA sequencing, flow cytometry and multiplex immunohistochemistry in peripheral B and T cells and in affected lung tissue samples from on  ...[more]

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