Single-Cell Transcriptomes and Immune Repertoires Reveal the Cell State and Molecular Changes in Pemphigus Vulgaris

Shumin Duan, Qionghua Li, Fei Wang, Wenjing Kuang, Yunmei Dong, Dan Liu, Jiongke Wang, Wei Li, Qianming Chen, Xin Zeng, Taiwen Li
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Abstract The etiology and pathogenesis of pemphigus vulgaris (PV) entail intricate interactions between immune cells and epithelial cells. However, the specific subtypes of immune cells involved in PV, along with their respective roles, remain elusive. Likewise, the precise functions and mechanisms by which glucocorticoids affect cell types within the disease context require further elucidation. To address these knowledge gaps, we performed 5′ single-cell RNA sequencing, combined with V(D)J enrichment on buccal mucosal lesions and peripheral blood samples from treatment-naive patients with PV, in conjunction with post-treatment peripheral blood samples obtained after oral prednisone treatment. Our findings suggest that the IL-1α signaling pathway, myeloid APCs, inflammatory CD8+ resident memory T cells, and dysfunctional CD4+ regulatory T cells are involved in the pathogenesis of PV. Part of these findings were validated by immunohistochemical assays and multiplex immunofluorescence assays. Furthermore, our results highlight the significant impact of prednisone treatment on monocytes and mucosal-associated invariant T cells while revealing a limited effect on CD4+ regulatory T cells. Additionally, we present the CDR3 amino acid sequence of BCR related to PV disease and investigate the characteristics of TCR/BCR clonotypes. In conclusion, our study provides a comprehensive understanding of PV, particularly focusing on the mucosal-dominant type, and sheds light on the effects of glucocorticoids within the PV context. These insights hold promise for the development of new therapeutic strategies in this autoimmune disorder.
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单细胞转录组和免疫反应揭示丘疹性荨麻疹的细胞状态和分子变化
摘要 丘疹性荨麻疹(PV)的病因和发病机制涉及免疫细胞和上皮细胞之间错综复杂的相互作用。然而,参与丘疹性荨麻疹的免疫细胞的具体亚型及其各自的作用仍然难以确定。同样,糖皮质激素在疾病背景下影响细胞类型的确切功能和机制也需要进一步阐明。为了填补这些知识空白,我们结合 V(D)J 富集技术,对未经治疗的鼻咽癌患者的口腔黏膜病变和外周血样本进行了 5′单细胞 RNA 测序,同时还检测了口服泼尼松治疗后获得的外周血样本。我们的研究结果表明,IL-1α 信号通路、骨髓 APCs、炎症性 CD8+ 常驻记忆 T 细胞和功能失调的 CD4+ 调节性 T 细胞参与了 PV 的发病机制。部分研究结果通过免疫组化检测和多重免疫荧光检测得到了验证。此外,我们的研究结果突显了泼尼松治疗对单核细胞和粘膜相关不变性 T 细胞的重大影响,而对 CD4+ 调节性 T 细胞的影响有限。此外,我们还提出了与 PV 疾病相关的 BCR 的 CDR3 氨基酸序列,并研究了 TCR/BCR 克隆型的特征。总之,我们的研究提供了对真性红斑狼疮的全面认识,尤其是对粘膜主导型真性红斑狼疮的认识,并揭示了糖皮质激素在真性红斑狼疮中的作用。这些见解为开发治疗这种自身免疫性疾病的新策略带来了希望。
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