Patients with co-existing psoriasis and eczema: key to understand the pathogenesis of chronic inflammatory skin diseases

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Chronic inflammatory skin diseases such as psoriasis or eczema challenge modern medicine, as they are frequent, mean a devastating life quality for affected patients and come with a high socio-economic burden. Those complex diseases are based on individual predisposition, modulating environmental factors, and altered immune responses. While a lot of progress was made elucidating the pathogenesis of chronic inflammatory skin diseases, basic questions remain unanswered: "what are primary triggers of the disease?" or "What leads to chronic course of the disease?". A reason for those unresolved riddles is the heterogeneity of both psoriasis and eczema. To achieve a substantial progress, a model is needed that enables to distinguish the individual genetic code from molecular expression changes in lesional skin. Such a model is the basis of this application: patients with co-existing psoriasis and eczema.This interdisciplinary approach will compare molecular events in lesional skin in patients affected by both psoriasis and eczema at the same time. In these patients, it is possible to observe expression changes of different diseases at the same genetic background. This is important, as so far only expression changes can be modulated therapeutically. Factors that are regulated specifically in one inflammatory skin condition represent highly promising diagnostic and therapeutic targets. In pilot studies, we identified NOS2 and CCL27 as specifically and highly regulated markers in psoriasis or eczema, respectively. Here, we will validate and functionally characterize those two markers. Furthermore, systematic computational biology approaches will identify further candidate targets.