A novel molecular disease classifier for psoriasis and eczema
A novel molecular disease classifier for psoriasis and eczema
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DOI：
10.1111/exd.13077
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发表时间：
2016-10-01
影响因子：
3.6
通讯作者：
Eyerich, Kilian
中科院分区：
文献类型：
--
作者：
Garzorz-Stark, Natalie;Krause, Linda;Eyerich, Kilian
治疗牛皮癣和湿疹的新的特效疗法已经开发出来，它们标志着这些复杂的炎症性皮肤病的治疗进入了一个新纪元。然而，在广泛的临床谱内，牛皮癣和湿疹的表型重叠，使得在特殊情况下不可能做出准确的诊断，更不用说预测单个患者的临床结果了。在这里，我们提出了一种新的强大的分子分类器(MC)，由NOS2和CCL27基因组成，在129例患者中诊断银屑病和湿疹的灵敏度和特异度为95%，这些患者患有(I)经典类型；(Ii)亚型；(Iii)临床和组织学上不明显的牛皮癣和湿疹变异体。NOS2和CCL27以一种相互拮抗的方式与银屑病和湿疹的临床和组织学特征相关，从而突出了它们的生物学相关性。与此相一致，MC可以转移到石蜡切片上iNOS和CCL27蛋白免疫荧光染色的水平，在这种水平上，患者诊断的敏感性和特异性为88%。我们的MC被证明优于目前区分银屑病和湿疹的金标准方法，因此可能为建立现场个性化药物所需的慢性炎症性皮肤病的分子诊断奠定基础。
Novel specific therapies for psoriasis and eczema have been developed, and they mark a new era in the treatment of these complex inflammatory skin diseases. However, within their broad clinical spectrum, psoriasis and eczema phenotypes overlap making an accurate diagnosis impossible in special cases, not to speak about predicting the clinical outcome of an individual patient. Here, we present a novel robust molecular classifier (MC) consisting of NOS2 and CCL27 gene that diagnosed psoriasis and eczema with a sensitivity and specificity of >95% in a cohort of 129 patients suffering from (i) classical forms; (ii) subtypes; and (iii) clinically and histologically indistinct variants of psoriasis and eczema. NOS2 and CCL27 correlated with clinical and histological hallmarks of psoriasis and eczema in a mutually antagonistic way, thus highlighting their biological relevance. In line with this, the MC could be transferred to the level of immunofluorescence stainings for iNOS and CCL27 protein on paraffin-embedded sections, where patients were diagnosed with sensitivity and specificity >88%. Our MC proved superiority over current gold standard methods to distinguish psoriasis and eczema and may therefore build the basis for molecular diagnosis of chronic inflammatory skin diseases required to establish personalized medicine in the field.