Comparison of Skin Transcriptome between Responder and Non-Responder Vitiligo Lesions to Cell Transplantation: A Clinical Trial Study

Document Type : Original Article

Authors

1 Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran

2 Department of Molecular and Cellular Biology, Faculty of Basic Sciences and Advanced Technologies in Biology, University of Science and Culture, ACECR, Tehran, Iran

3 Department of Regenerative Biomedicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran

4 Skin and Stem Cell Research Center, Tehran University of medical Sciences, Tehran, Iran

5 Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran

6 Department of Regenerative Biomedicine and Cell Terapy, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran

Abstract

Objective: Autologous transplantation of epidermal cells has been used increasingly to treat vitiligo patients and is a simple, safe, and relatively efficient method. However, the outcome is not always satisfactory, and some patients show less or no response to this treatment. This study was evaluated to identify genes expressed differently among responders and non-responders to cell transplantation to find potential markers that could predict 'patients' responses to this type of cell therapy.
Materials and Methods: Eleven stable vitiligo patients who received autologous epidermal cell transplantation were included in this clinical trial study. Before cell transplantation, skin samples were obtained from the recipient’s vitiligo lesions. After epidermal cell transplantation, patients were followed for at least six months to assess the response to epidermal cell injection. RNA sequencing was used to determine potential gene expression profile differences between responder and non-responder vitiligo patients.
Results: The RNA sequencing results showed differences in expression levels of 470 genes between the skin specimens of responder versus non-responder patients. There were 269 up-regulated genes and 201 down-regulated
genes. Upregulated genes were involved in processes, such as Fatty Acid Omega Oxidation. Down-regulated genes
were related to PPAR signaling pathway, and estrogen signaling pathway. Among the most differentially expressed genes (DEGs) with the most altered RNA expression levels in responders versus non-responder patients, we selected three genes (up-regulated genes KRTAP10-11 and down-regulated genes IP6K2 and C9) as potential biomarkers, which are involved in associated pathways.
Conclusion: Based on our findings, it is estimated that proposed genes might predict the response of vitiligo patients to cell therapy. However, further studies are required to clarify the role of these genes in pathogenesis and to characterize gene expression in a larger number of vitiligo patients in the context of epidermal cell transplantation therapy (registration number: IRCT201508201031N16).

Keywords


1. Grimes PE. New insights and new therapies in vitiligo. JAMA. 2005; 293(6): 730-735.
2. Whitton ME, Ashcroft DM, González U. Therapeutic interventions for vitiligo. J Am Acad Dermatol. 2008; 59(4): 713-717.
3. Falabella R. Surgical approaches for stable vitiligo. Dermatol Surg. 2005; 31(10): 1277-1284.
4. Passeron T. Medical and maintenance treatments for vitiligo. Dermatol Clin. 2017; 35(2): 163-170.
5. Nijsten TE, Stern RS. The increased risk of skin cancer is persistent after discontinuation of psoralen+ultraviolet A: a cohort study. J Invest Dermatol. 2003; 121(2): 252-258.
6. Valejo Coelho MM, Matos TR, Apetato M. The dark side of the light: mechanisms of photocarcinogenesis. Clin Dermatol. 2016; 34(5): 563-570.
7. Rodrigues M. Skin cancer risk (nonmelanoma skin cancers/melanoma) in vitiligo patients. Dermatol Clin. 2017; 35(2): 129-134.
8. Bae JM, Ju HJ, Lee RW, Oh SH, Shin JH, Kang HY, et al. evaluation for skin cancer and precancer in patients with vitiligo treated with long-term narrowband UV-B phototherapy. JAMA Dermatol. 2020; 156(5): 529-537.
9. Gauthier Y, Surleve-Bazeille JE. Autologous grafting with noncultured melanocytes: a simplified method for treatment of depigmented lesions. J Am Acad Dermatol. 1992; 26(2 Pt 1): 191-194.
10. Orouji Z, Bajouri A, Ghasemi M, Mohammadi P, Fallah N, Shahbazi A, et al. A single-arm open-label clinical trial of autologous epidermal cell transplantation for stable vitiligo: a 30-month follow-up. J Dermatol Sci. 2018; 89(1): 52-59.
11. Khodadadi L, Shafieyan S, Sotoudeh M, Dizaj AV, Shahverdi A, Aghdami N, et al. Intraepidermal injection of dissociated epidermal cell suspension improves vitiligo. Arch Dermatol Res. 2010; 302(8): 593-599.
12. Kuleshov MV, Jones MR, Rouillard AD, Fernandez NF, Duan Q, Wang Z, et al. Enrichr: a comprehensive gene set enrichment analysis web server 2016 update. Nucleic Acids Res. 2016; 44(W1): W90-W97. 13. Strimbu K, Tavel JA. What are biomarkers? Curr Opin HIV AIDS. 2010; 5(6): 463-466.
14. Wang Z, Gerstein M, Snyder M. RNA-Seq: a revolutionary tool for transcriptomics. Nat Rev Genet. 2009; 10(1): 57-63.
15. Dillies MA, Rau A, Aubert J, Hennequet-Antier C, Jeanmougin M, Servant N, et al. A comprehensive evaluation of normalization methods for Illumina high-throughput RNA sequencing data analysis. Brief Bioinform. 2013; 14(6): 671-683.
16. Wright HL, Cox T, Moots RJ, Edwards SW. Neutrophil biomarkers predict response to therapy with tumor necrosis factor inhibitors in rheumatoid arthritis. J Leukoc Biol. 2017; 101(3): 785-795.
17. Moreno-Torres I, González-García C, Marconi M, García-Grande A, Rodríguez-Esparragoza L, Elvira V, et al. immunophenotype and transcriptome profile of patients with multiple sclerosis treated with fingolimod: setting up a model for prediction of response in a 2-year translational study. Front Immunol. 2018; 9: 1693.
18. Ando H, Watabe H, Valencia JC, Yasumoto K, Furumura M, Funasaka Y, et al. Fatty acids regulate pigmentation via proteasomal degradation of tyrosinase: a new aspect of ubiquitin-proteasome function. J Biol Chem. 2004; 279(15): 15427-15433.
19. Sertznig P, Seifert M, Tilgen W, Reichrath J. Peroxisome proliferator- activated receptors (PPARs) and the human skin: importance of PPARs in skin physiology and dermatologic diseases. Am J Clin Dermatol. 2008; 9(1): 15-31.
20. Gao J, Liu Q, Xu Y, Gong X, Zhang R, Zhou C, et al. PPARα induces cell apoptosis by destructing Bcl2. Oncotarget. 2015; 6(42): 44635-44642.
21. Lee AY, Youm YH, Kim NH, Yang H, Choi WI. Keratinocytes in the depigmented epidermis of vitiligo are more vulnerable to trauma (suction) than keratinocytes in the normally pigmented epidermis, resulting in their apoptosis. Br J Dermatol. 2004; 151(5): 995-1003.
22. Schallreuter KU, Chiuchiarelli G, Cemeli E, Elwary SM, Gillbro JM, Spencer JD, et al. Estrogens can contribute to hydrogen peroxide generation and quinone-mediated DNA damage in peripheral blood lymphocytes from patients with vitiligo. J Invest Dermatol. 2006; 126(5): 1036-1042.
23. Schallreuter KU, Moore J, Wood JM, Beazley WD, Gaze DC, Tobin DJ, et al. In vivo and in vitro evidence for hydrogen peroxide (H2O2) accumulation in the epidermis of patients with vitiligo and its successful
removal by a UVB-activated pseudocatalase. J Investig Dermatol Symp Proc. 1999; 4(1): 91-96.
24. Shalbaf M, Gibbons NC, Wood JM, Maitland DJ, Rokos H, Elwary SM, et al. Presence of epidermal allantoin further  supports oxidative stress in vitiligo. Exp Dermatol. 2008; 17(9): 761-770.
25. Arican O, Kurutas EB. Oxidative stress in the blood of patients with active localized vitiligo. Acta Dermatovenerol Alp Pannonica Adriat. 2008; 17(1): 12-6.
26. Kartasova T, Roop DR, Holbrook KA, Yuspa SH. Mouse differentiation- specific keratins 1 and 10 require a preexisting keratin scaffold to form a filament network. J Cell Biol. 1993; 120(5): 1251-1261.
27. Ivanyi D, Ansink A, Groeneveld E, Hageman PC, Mooi WJ, Heintz AP. New monoclonal antibodies recognizing epidermal differentiation- associated keratins in formalin-fixed, paraffin-embedded tissue. Keratin 10 expression in carcinoma of the vulva. J Pathol. 1989; 159(1): 7-12.
28. Saiardi A, Sciambi C, McCaffery JM, Wendland B, Snyder SH. Inositol pyrophosphates regulate endocytic trafficking. Proc Natl Acad Sci U S A. 2002; 99(22): 14206-14211.
29. Illies C, Gromada J, Fiume R, Leibiger B, Yu J, Juhl K, et al. Requirement of inositol pyrophosphates for full exocytotic capacity in pancreatic beta cells. Science. 2007; 318(5854): 1299-1302.
30. Morrison BH, Bauer JA, Kalvakolanu DV, Lindner DJ. Inositol hexakisphosphate kinase 2 mediates growth suppressive and apoptotic effects of interferon-beta in ovarian carcinoma cells. J Biol Chem. 2001; 276(27): 24965-24970.
31. Koldobskiy MA, Chakraborty A, Werner JK Jr, Snowman AM, Juluri KR, Vandiver MS, et al. p53-mediated apoptosis requires inositol hexakisphosphate kinase-2. Proc Natl Acad Sci USA. 2010; 107(49): 20947-20951.
32. Dudkina NV, Spicer BA, Reboul CF, Conroy PJ, Lukoyanova N, Elmlund H, et al. Structure of the poly-C9 component of the complement membrane attack complex. Nat Commun. 2016; 7: 10588.
33. Norris DA, Kissinger RM, Naughton GM, Bystryn JC. Evidence for immunologic mechanisms in human vitiligo: patients’ sera induce damage to human melanocytes in vitro by complement-mediated damage and antibody-dependent cellular cytotoxicity. J Invest Dermatol. 1988; 90(6): 783-789.