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O32 Skin proteome investigation in cutaneous lupus erythematosus (CLE) reveals novel unique disease pathways
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  1. Timothy B Niewold1,
  2. Alexander Meves2,
  3. Julia Lehman2,
  4. Karin Popovic-Silwerfeldt3,
  5. Aleksandra Antovic4,
  6. Jessica M Dorschner5,
  7. Cristine M Charlesworth6,
  8. Ingrid Lundberg4,
  9. Marie Wahren-Herlenius4,
  10. Elisabet Svenungsson4 and
  11. V Oke4
  1. 1Colton Center for Autoimmunity, New York University, New York
  2. 2Dept. of Dermatology, Mayo Clinic, Rochester, USA
  3. 3Dermatology Clinic, Danderyds Hospital, Danderyds, Sweden
  4. 4Rheumatology Unit, Dept. of Medicine, Karolinska Institutet, Stockholm, Sweden; Proteomics Core, Mayo Clinic, Rochester, USA
  5. 5Division of Rheumatology and Dept. of Immunology, Mayo Clinic, Rochester, USA

Abstract

Background Cutaneous Lupus Erythematosus (CLE) is an autoimmune disease. It can be limited to the skin or be one of manifestations of systemic LE (SLE). The typical histopathologic pattern in CLE/SLE is interface dermatitis, which can also be observed in dermatomyositis (DM). While LE may affect any organ system, DM most commonly affect muscles and skin.

The aim of this study was to investigate the whole proteome of skin inflammatory foci in the cohort of CLE and DM patients in a comparative, hypothesis-free manner and identify disease-unique molecular mechanisms.

Methods CLE (n=6), DM (n=5) patients and controls (n=6) were recruited at diagnosis or disease exacerbation. Skin biopsies were acquired, examined by a pathologist and selected inflammatory foci were laser micro-dissected. The total protein content was analyzed by mass-spectrometry, further analysis was performed by string-db.org platform. Certain proteomic findings were confirmed by immunohistochemistry (IHC).

Results CLE infiltrates were more protein rich in comparison to DM lesions. There ratio of 5x upregulated proteins in LE/DM was 60, while ratio for DM/LE was 13. Our results confirmed high abundance of (IFN)-regulated proteins both in CLE and DM, including: IFIT1, IFIT2, IFIT3, MX1, MX2, OAS2, OAS3, STAT1,- STAT2, DDX58, DDX60 and EIF2AK2. Proteins expressed differentially in CLE covered complement proteins (C1b), including membrane attack complex (MAC) (C5, C6, C7, C8A and B) and complement regulators (CFHR1, CFHR2, CFHR5), as well as regulators of coagulation: thrombospondin 2 (THBS2), thrombin (F2), fibrinogen (F12) and annexin A3 (ANXA3). Importantly, we identified interleukin (IL) -16 as the only detectable and highly abundant cytokine in the CLE lesions and confirmed this finding by IHC.

Conclusions Our data confirm evidence on IFN-regulated processes in CLE/SLE. Importantly, we identified IL-16 as a novel cytokine most strongly upregulated locally in the skin lesions. Moreover, we identified activation of MAC, complement regulating proteins as well as involvement of coagulation/fibrinolysis system. The study brings information on novel pathways involved in the inflammatory foci of the skin lesions in CLE patients. Our findings are of interest in further search of new therapeutic targets.

https://doi.org/10.1136/lupus-2020-eurolupus.43

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