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A novel molecular disease classifier for psoriasis and eczema
Authors:Natalie Garzorz‐Stark  Felix Lauffer  Anne Atenhan  Jenny Thomas  Sebastian P. Stark  Regina Franz  Stephan Weidinger  Anna Balato  Nikola S. Mueller  Fabian J. Theis  Johannes Ring  Carsten B. Schmidt‐Weber  Tilo Biedermann  Stefanie Eyerich  Kilian Eyerich
Affiliation:1. Department of Dermatology and Allergy, Technical University of Munich, Munich, GermanyN.G. and L.K. contributed equally to this work.;2. Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany;3. ZAUM – Center of Allergy and Environment, Technical University of Munich and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Germany;4. Department of Dermatology, Allergology, and Venereology, University Hospital Schleswig‐Holstein, Kiel, Germany;5. Dipartimento di Scienze biomediche avanzate, Università degli Studi di Napoli Federico II, Naples, Italy;6. Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany;7. Department of Mathematics, Technical University of Munich, Garching, Germany
Abstract:Novel specific therapies for psoriasis and eczema have been developed, and they mark a new era in the treatment of these complex inflammatory skin diseases. However, within their broad clinical spectrum, psoriasis and eczema phenotypes overlap making an accurate diagnosis impossible in special cases, not to speak about predicting the clinical outcome of an individual patient. Here, we present a novel robust molecular classifier (MC) consisting of NOS2 and CCL27 gene that diagnosed psoriasis and eczema with a sensitivity and specificity of >95% in a cohort of 129 patients suffering from (i) classical forms; (ii) subtypes; and (iii) clinically and histologically indistinct variants of psoriasis and eczema. NOS2 and CCL27 correlated with clinical and histological hallmarks of psoriasis and eczema in a mutually antagonistic way, thus highlighting their biological relevance. In line with this, the MC could be transferred to the level of immunofluorescence stainings for iNOS and CCL27 protein on paraffin‐embedded sections, where patients were diagnosed with sensitivity and specificity >88%. Our MC proved superiority over current gold standard methods to distinguish psoriasis and eczema and may therefore build the basis for molecular diagnosis of chronic inflammatory skin diseases required to establish personalized medicine in the field.
Keywords:CCL27  diagnostic test  inflammatory skin diseases  NOS2  precision medicine
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