A clinical trial for psoriasis with novel single-cell genomic techniques to understand regulatory immunity behind long-term disease remission off drug induced by short-term IL-23 inhibition

尽管高效，但针对IL-23/Th17轴的生物制剂应持续注射到 抑制牛皮癣的复发。我的长期目标是治愈牛皮癣而不复发 个人免疫耐受性。本申请的总体目标是：(I)确定监管免疫 抗IL-23p19抗体在银屑病患者皮肤中诱导的细胞相互作用 被清除而不会复发以及(Ii)为牛皮癣患者开发治疗前预测模型 预测短期注射抗IL-23p19抗体后的疾病复发。中心假设是 抑制IL-23p19促进银屑病患者病情好转的调节性免疫细胞 无复发，治疗前的单细胞免疫特征与患者不同 他的病会复发。这个项目的基本原理是免疫耐受的分子证据 抑制IL-23p19在人类皮肤中的诱导可能提供一个强大的临床框架，使新的 可以制定预防慢性炎症性疾病复发的策略。中心假说 将通过追求两个具体目标进行测试：1)测试调节性免疫细胞 短期应用抗IL-23p19抗体可促进银屑病患者皮肤的相互作用 谁的疾病变得明确而不会复发；以及2)通过预处理开发预测模型 皮肤活检单细胞基因组数据预测药物治疗后长期疾病清除 短期应用抗IL-23p19抗体。为了实现特定的目标，我们最近开发了 两种创新的互补单细胞方法获取异质性基因表达谱 来自牛皮癣的免疫细胞和对照皮肤，无需酶消化。第一个单细胞实验 方法是微流控分离培养48小时后的人皮肤移行细胞 在没有酶消化的培养液中，这使得单细胞转录图谱 体外培养条件下，异质免疫细胞和角质形成细胞分布于不同层次的表皮。 第二种单细胞实验方法是组合索引RNA测序，由 该提案的共同指导者，使联合分析转录组和单细胞染色质的可及性成为可能。 在拟议的研究完成后，我们的预期结果是拥有新的单细胞 研究人体皮肤免疫细胞相互作用的基因组技术，定义了单细胞基因特征 在银屑病皮肤中，由抗IL-23p19抗体促进的调节性免疫细胞， 以及阐明病理免疫是如何在单细胞水平上被高度有效地抑制的能力 生物制品。我们还希望有可以预测长期疾病清除的治疗前生物标记物。 停药后短期给予抗IL-23p19抗体。

Although highly effective, biologics targeting IL-23/Th17 axis should be continuously injected to suppress recurrence of psoriasis. My long-term goal is to cure psoriasis without recurrence guided by personal immune tolerance. The overall objectives in this application are to (i) identify regulatory immune cell interactions induced by anti-IL-23p19 antibody administration in the skin of patients whose psoriasis is cleared without recurrence and (ii) develop pre-treatment predictive models for psoriasis patients that anticipate disease recurrence after short-term anti-IL-23p19 antibody injection. The central hypothesis is that IL-23p19 inhibition promotes regulatory immune cells in psoriasis patients whose disease is cleared without recurrence, and their pre-treatment single-cell immune signatures are different from those of patients whose disease recurs. The rationale for this project is that molecular evidence of immune tolerance induction by IL-23p19 inhibition in human skin is likely to offer a strong clinical framework whereby new strategies to prevent recurrence of chronic inflammatory diseases can be developed. The central hypothesis will be tested by pursuing two specific aims: 1) Testing the hypothesis that regulatory immune cell interactions are promoted by short-term anti-IL-23p19 antibody administration in the skin of psoriasis patients whose disease becomes clear without recurrence; and 2) Developing predictive models with pretreatment skin biopsy single-cell genomic data that anticipate long-term disease clearance off drug after short-term anti-IL-23p19 antibody administration. To achieve the specific aims, we have recently developed two innovative complementary single-cell approaches to obtain gene expression profiles of heterogeneous immune cells from psoriasis and control skin without enzyme digestion. The first single-cell experimental approach is microfluidic partitioning of emigrating cells from human skin after 48-hour incubation in culture medium without enzyme digestion, which empowers single-cell transcriptomic profiling of heterogeneous immune cells and keratinocytes in different layers of epidermis under ex vivo condition. The second single-cell experimental approach is Combinatorial indexing RNA sequencing, developed by the co-mentor of the proposal, which enables co-profiling transcriptome and single-cell chromatin accessibility. At the completion of the proposed research, our expected outcomes are to have novel single-cell genomic techniques to study immune cell interactions in human skin, defined single-cell gene signatures of regulatory immune cells that are promoted by anti-IL-23p19 antibody administration in psoriasis skin, and the ability to elucidate how pathologic immunity is suppressed at the single-cell level by highly effective biologics. We also expect to have pre-treatment biomarkers that can predict long-term disease clearance off drugs after short-term anti-IL-23p19 antibody administration.