Atopic dermatitis displays stable and dynamic skin transcriptome signatures

To gain a deeper understanding of the atopic dermatitis (AD) skin transcriptome and the effects of systemic treatment with dupilumab and cyclosporine, we conducted a gene expression study of AD using mRNA-Seq data generated from lesional and non-lesional skin biopsies collected from patients included in the TREATgermany registry. We are able to provide deep characterisation of AD skin transcriptomic signatures by using an assortment of bioinformatic approaches such as differential expression, co-expression network and pathway enrichment analysis. We performed mRNA sequencing of 166 skin transcriptomes obtained from 57 patients with moderate to severe AD recruited in the TREATgermany registry between July 2017 and February 2019 at six out of 17 study centres which agreed to participate in the additional and optional bioanalytics module. Intrapersonal lesional (AL) and non-lesional (AN) skin biopsies (4 mm) were collected from 57 patients prior to the initiation of a systemic therapy. Follow-up biopsies 3 months after the initiation of systemic treatment were available from 21 (dupilumab) and 8 (cyclosporine) patients. Non-lesional samples were taken at least 5 cm from the active lesion.