The stratum corneum transcriptome in atopic dermatitis can be assessed by tape stripping

Background: Skin biopsies represent a gold standard in skin immunology and pathology but can cause pain and induce scarring. Non-invasive techniques will facilitate study recruitment of e.g. patients with pediatric atopic dermatitis (AD), hand eczema or facial dermatitis. Objective: By RNA sequencing, we examined whether the stratum corneum transcriptome in AD skin can be assessed by tape stripping, as compared to the epidermal transcriptome of AD in skin biopsies. To make the procedure clinically relevant tape strips were stored and shipped at room temperature for up to 3 days. Methods: Nine adult Caucasian AD patients and three healthy volunteers were included. Tape samples were collected from non-lesional and lesional skin. Biopsies were collected from lesional skin and were split into epidermis and dermis. Total RNA was extracted, and shotgun sequencing was performed. Results: Shotgun sequencing could be performed on skin cells obtained from two consecutive tape strips which had been stored and shipped at room temperature for up to three days. The most prominent differences between the tape strip and biopsy derived transcriptome were due to structural genes, while established molecular markers of AD, including CCL17, CCL22, IL17A and S100A7-S100A9, were also identified in tape strip samples. Furthermore, the tape strip derived transcriptome showed promise in also analysing the skin microbiome. Conclusion: Our study shows that the stratum corneum (SC) transcriptome of AD can be assessed by tape stripping the skin, supporting that this method may be central in future skin biomarker research. Overall design: 9 patients with atopic dermatitis and 3 healthy subjects were included. Biopsy samples was collected from lesional and healthy skin areas (healthy subjects only). Tape samples was obtained from lesional and non-lesional skin sites and from healthy skin areas (healthy subjects only).

背景：皮肤活检是皮肤免疫学与病理学研究的金标准，但会引发疼痛并遗留瘢痕。非侵入性采样技术将有助于拓展研究受试者招募范围，例如儿童特应性皮炎（atopic dermatitis，AD）、手部湿疹或面部皮炎患者。目的：本研究通过RNA测序，探究相较于皮肤活检获取的特应性皮炎表皮转录组，能否通过胶带剥离采样（tape stripping）评估特应性皮炎皮肤的角质层转录组。为使该操作具备临床实用性，胶带样本需在室温下储存并运输长达3天。方法：本研究纳入9名成年白人特应性皮炎患者与3名健康志愿者。从非病变皮肤与病变皮肤区域采集胶带剥离样本；从病变皮肤区域采集活检样本，并将其分离为表皮层与真皮层。提取总RNA后进行鸟枪测序（shotgun sequencing）。结果：对室温储存、运输长达3天的连续两次胶带剥离样本中获取的皮肤细胞，可成功完成鸟枪测序。胶带样本与活检样本来源的转录组之间最显著的差异源于结构基因；而包括CCL17、CCL22、IL17A及S100A7-S100A9在内的已确立的特应性皮炎分子标志物，在胶带样本中也可被检测到。此外，胶带样本来源的转录组在皮肤微生物组分析方面也展现出应用潜力。结论：本研究证实，可通过胶带剥离采样评估特应性皮炎皮肤的角质层（stratum corneum，SC）转录组，表明该方法有望成为未来皮肤生物标志物研究的核心手段。整体实验设计：纳入9名特应性皮炎患者与3名健康志愿者。从病变皮肤与健康皮肤区域（仅健康志愿者）采集活检样本；从病变皮肤、非病变皮肤区域及健康皮肤区域（仅健康志愿者）采集胶带剥离样本。