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Inflammasome activation drives inflammation in hidradenitis suppurativa skin

ABSTRACT: Treatment for the debilitating, chronic skin disease hidradenitis suppurativa (HS) is grossly inadequate. A better understanding of its pathogenesis is required to design new therapeutic strategies. Despite an incidence of approximately 1 in 200, HS is underrecognized and underdiagnosed, with a high morbidity and poor quality of life, which may last decades. In this study we first employed single cell RNA sequencing to analyse gene expression in immune cells isolated from HS lesions compared with healthy control skin. We identified 30 unique immune cell clusters, with a significant enrichment in the frequency of plasma cells, Th17 cells and a subset of dendritic cells (DC) in HS skin. These findings were validated by flow cytometry, which revealed a significant increase in infiltrating immune cells in HS skin, including T cells, B cells, neutrophils, dermal macrophages and DC. The sequencing analysis revealed that the immune transcriptome in HS skin was distinct and much more heterogenous, when compared with healthy skin. Genes and pathways associated with Th17 cells and IL-17, IL-1β, and the NLRP3 inflammasome were enhanced in HS skin, particularly in samples with a high inflammatory load. Inflammasome constituent genes principally mapped to Langerhans cells and a subpopulation of DC. A skin explant model showed that culture of HS skin with an NLRP3 inflammasome inhibitor reduced the inflammatory response, with significant reduction of IL-1β and IL-17A as well as other key mediators of inflammation. These data provide a rationale for targeting the IL-17 pathway in HS, particularly upstream at the NLRP3 inflammasome.

ORGANISM(S): Homo sapiens

PROVIDER: GSE212721 | GEO | 2023/10/01

REPOSITORIES: GEO

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Project description:BACKGROUND: Cryopyrin-Associated Periodic Syndrome (CAPS) is an autoinflammatory condition consequence of monoallelic variants in the NLRP3 gene that exacerbate IL-1β production. These variants are gain-of-function, but the exact regulatory mechanism of the NLRP3 CAPS-inflammasome is not well yet understood. It is considered as a hypersensitive inflammasome triggered by cell priming, but patients with CAPS and animal disease models present inflammatory flares in the absence of external triggers.OBJECTIVES: To study the regulation and activation of the NLRP3 inflammasome in CAPS.METHODS: CAPS derived blood samples and genetically modified macrophages expressing different NLRP3 CAPS-associated variants were used to assess NLRP3 function dissociated from cell priming and cell metabolism.RESULTS: We found that CAPS-associated variants constitutively result in active NLRP3 inflammasomes, that induce a basal cleavage of gasdermin D, IL-18 release and pyroptosis. The constitutive active NLRP3 inflammasome was blocked by MCC950 and was dependent on NLRP3 expression level, being further regulated by deubiquitination. We also showed that activation of NF-κB with lipopolysaccharide or other endogenous host-derived molecules (palmitate, S100A9 or IL-6) further modulated the activation of the NLRP3 CAPS inflammasome and expanded the repertoire of molecules secreted from CAPS macrophages to IL-1β, IL-1α, HMGB1, cystatin B and the P2X7 receptor, identifying novel proteins involved in CAPS pathogenesis. NLRP3 inflammasomes with CAPS associated variants affected the immunometabolism of the myeloid compartment and impaired glycolysis.CONCLUSIONS: These findings demonstrate that NLRP3 CAPS-associated variants form a constitutive active inflammasome that induce basal pyroptosis and IL-18 release without cell priming, suggesting a priming-independent mechanism for the initiation of CAPS flares characterized with a profound affection in the immunometabolism.

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Inflammasome activation drives inflammation in hidradenitis suppurativa skin

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