Dupilumab-Associated Head and Neck Dermatitis Shows a Pronounced Type 22 Immune Signature Mediated by Oligoclonally Expanded T Cells
Author Type(s)
Student
Document Type
Article
Publication Date
4-2-2024
Journal Title
Nature Communications
Abstract
Dupilumab, an IL4R-blocking antibody, has shown clinical efficacy for atopic dermatitis (AD) treatment. In addition to conjunctivitis/blepharitis, the de novo appearance of head/neck dermatitis is now recognized as a distinct side effect, occurring in up to 10% of patients. Histopathological features distinct from AD suggest a drug effect, but exact underlying mechanisms remain unknown. We profiled punch biopsies from dupilumab-associated head and neck dermatitis (DAHND) by using single-cell RNA sequencing and compared data with untreated AD and healthy control skin. We show that dupilumab treatment was accompanied by normalization of IL-4/IL-13 downstream activity markers such as CCL13, CCL17, CCL18 and CCL26. By contrast, we found strong increases in type 22-associated markers (IL22, AHR) especially in oligoclonally expanded T cells, accompanied by enhanced keratinocyte activation and IL-22 receptor upregulation. Taken together, we demonstrate that dupilumab effectively dampens conventional type 2 inflammation in DAHND lesions, with concomitant hyperactivation of IL22-associated responses.
Recommended Citation
Bangert, C., Alkon, N., Chennareddy, S., Arnoldner, T., Levine, J., Pilz, M., Medjimorec, M., Ruggiero, J., Cohenour, E., Jonak, C., Damsky, W., Griss, J., & Brunner, P. (2024). Dupilumab-Associated Head and Neck Dermatitis Shows a Pronounced Type 22 Immune Signature Mediated by Oligoclonally Expanded T Cells. Nature Communications, 15 (1), 2839-2839. https://doi.org/10.1038/s41467-024-46540-0
