Tape-strip profiling identifies unique immune and lipid dysregulation in patients with seborrheic dermatitis

Background: Seborrheic dermatitis (SD) is a common, chronic inflammatory skin disease with limited understanding of its pathophysiology. Molecular profiling has been limited by invasiveness of sampling methods. Objective: To analyze the molecular skin profile of adult patients with SD using tape strips. Methods: Tape-strips obtained from facial lesions of 26 adult SD patients and 18 demographically matched healthy controls were evaluated with RNA sequencing. Results: SD molecular skin fingerprint was characterized by strong and significant upregulation of IL23/Th17 and Th22 (i.e. IL23A, IL22, PI3, LL37, S100A8, S100A12), some Th1 skewing (OASL, STAT1, CXCL9), and limited Th2 modulation. A parallel downregulation of barrier markers (CLDN1/8, FA2H, ELOVL3) was also observed. Limitations: Limited representation of mild and severe SD patients. Conclusion: These data deepen our understanding of SD suggesting that it has robust Th17/Th22, some Th1 skewing, and minimal Th2 activation, and associated skin barrier alterations. This provides rationale for novel immunomodulatory treatment approaches for SD patients targeting IL23/Th17 and/or Th22 pathways.背景：脂溢性皮炎（Seborrheic dermatitis, SD）是一种常见的慢性炎症性皮肤病，目前对其病理生理学的认知仍较为有限。此前因采样方法具有侵入性，其分子谱分析的开展受到了制约。 研究目的：采用胶带采样法，分析成人脂溢性皮炎患者的皮肤分子谱。 研究方法：采集26名成人脂溢性皮炎患者面部皮损与18名人口学特征匹配的健康对照者的胶带采样样本，通过RNA测序开展评估。 研究结果：脂溢性皮炎的皮肤分子特征谱表现为IL23/Th17及Th22通路相关基因（即IL23A、IL22、PI3、LL37、S100A8、S100A12）显著上调，存在轻度Th1极化倾向（OASL、STAT1、CXCL9），而Th2通路调控变化较为有限。同时还观察到皮肤屏障相关标志物（CLDN1/8、FA2H、ELOVL3）的表达呈显著下调趋势。 研究局限性：本研究纳入的轻度与重度脂溢性皮炎患者样本代表性不足。 研究结论：本研究数据加深了我们对脂溢性皮炎的认知，提示该病以显著的Th17/Th22通路激活、轻度Th1极化及极弱的Th2激活为特征，并伴随皮肤屏障功能改变。上述发现为针对IL23/Th17和/或Th22通路的新型免疫调节治疗方案应用于脂溢性皮炎患者提供了理论依据。