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Multiomic single-cell sequencing defines tissue-specific responses in Stevens-Johnson syndrome and toxic epidermal necrolysis
Journal article   Open access   Peer reviewed

Multiomic single-cell sequencing defines tissue-specific responses in Stevens-Johnson syndrome and toxic epidermal necrolysis

Andrew Gibson, Ramesh Ram, Rama Gangula, Yueran Li, Eric Mukherjee, Amy M Palubinsky, Chelsea N Campbell, Michael Thorne, Katherine C Konvinse, Phuti Choshi, …
Nature communications, Vol.15(1), 8722
2024
PMCID: PMC11461852
PMID: 39379371
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Published (Version of Record)CC BY V4.0 Open Access

Abstract

Antigen presentation Antigens Blistering CD27 antigen CD8 antigen Cell proliferation Cell surface Cytotoxicity Granzyme B Histocompatibility antigen HLA Immune response Immune system Immunopathogenesis Keratinocytes Lymphocytes Lymphocytes T Macrophages Perforin Populations Proteomes Skin Stevens-Johnson syndrome T cell receptors Therapeutic targets Toxic epidermal necrolysis Transcriptomes
Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) is a rare but life-threatening cutaneous drug reaction mediated by human leukocyte antigen (HLA) class I-restricted CD8+ T cells. For unbiased assessment of cellular immunopathogenesis, here we perform single-cell (sc) transcriptome, surface proteome, and T cell receptor (TCR) sequencing on unaffected skin, affected skin, and blister fluid from 15 SJS/TEN patients. From 109,888 cells, we identify 15 scRNA-defined subsets. Keratinocytes express markers indicating HLA class I-restricted antigen presentation and appear to trigger the proliferation of and killing by cytotoxic CD8+ tissue-resident T cells that express granulysin, granzyme B, perforin, LAG3, CD27, and LINC01871, and signal through the PKM, MIF, TGFβ, and JAK-STAT pathways. In affected tissue, cytotoxic CD8+ T cells express private expanded and unexpanded TCRαβ that are absent or unexpanded in unaffected skin, and mixed populations of macrophages and fibroblasts express pro-inflammatory markers or those favoring repair. This data identifies putative cytotoxic TCRs and therapeutic targets.

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