title: A novel molecular disease classifier for psoriasis and eczema.
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.
authors.affiliation: Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany. natalie.garzorz@tum.de.
authors.forename: Natalie
authors.initials: N
authors.lastname: Garzorz-Stark
authors.affiliation: Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany.
authors.forename: Linda
authors.initials: L
authors.lastname: Krause
authors.affiliation: Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Lauffer
authors.affiliation: 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.
authors.forename: Anne
authors.initials: A
authors.lastname: Atenhan
authors.affiliation: 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.
authors.forename: Jenny
authors.initials: J
authors.lastname: Thomas
authors.affiliation: 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.
authors.forename: Sebastian P
authors.initials: SP
authors.lastname: Stark
authors.affiliation: Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.
authors.forename: Regina
authors.initials: R
authors.lastname: Franz
authors.affiliation: Department of Dermatology, Allergology, and Venereology, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Weidinger
authors.affiliation: Dipartimento di Scienze biomediche avanzate, Università degli Studi di Napoli Federico II, Naples, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Balato
authors.affiliation: Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany.
authors.forename: Nikola S
authors.initials: NS
authors.lastname: Mueller
authors.affiliation: Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany.|Department of Mathematics, Technical University of Munich, Garching, Germany.
authors.forename: Fabian J
authors.initials: FJ
authors.lastname: Theis
authors.affiliation: Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Ring
authors.affiliation: 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.
authors.forename: Carsten B
authors.initials: CB
authors.lastname: Schmidt-Weber
authors.affiliation: Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.
authors.forename: Tilo
authors.initials: T
authors.lastname: Biedermann
authors.affiliation: 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.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Eyerich
authors.affiliation: Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.
authors.forename: Kilian
authors.initials: K
authors.lastname: Eyerich
mesh_terms: D000328:Adult; D000368:Aged; D054425:Chemokine CCL27 / Q000378:metabolism*; D015331:Cohort Studies; D004485:Eczema / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D008297:Male; D008875:Middle Aged; D052247:Nitric Oxide Synthase Type II / Q000378:metabolism*; D011565:Psoriasis / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism
chemical_list: C492276:CCL27 protein, human; D054425:Chemokine CCL27; C496319:NOS2 protein, human; D052247:Nitric Oxide Synthase Type II
keywords: CCL27; NOS2; diagnostic test; inflammatory skin diseases; precision medicine