Uzun, G. | bioRxiv Science

bioRxiv2026

A transcriptional continuum from clinically normal to lesional skin: Single-cell trajectory analysis of psoriasis

Psoriasis is a chronic inflammatory skin disease characterized by immune dysregulation and complex cellular interactions involving keratinocytes (KCs), T cells, and endothelial cells. Single-cell studies have mapped the cellular diversity of psoriatic plaques, yet most analyses treat skin as either healthy or diseased and therefore overlook the graded changes that precede a visible lesion. We asked whether psoriasis instead progresses along a transcriptional continuum and whether clinically normal skin from patients already carries a measurable disease signature. Using single-cell RNA sequencing (scRNA-seq) of healthy skin (NS), clinically normal skin adjacent to lesions (PN), and lesional skin (PP), we combined two complementary designs: a complete set spanning all three states and a within-patient paired set of matched PN and PP skin biopsies that removes inter-individual variability. Trajectory analysis using a novel pseudotime approach reveals transcriptional changes within cell populations and dynamic cellular states underlying psoriatic pathology. To distinguish lesion-driven effects from disease-associated transcriptional changes, we applied a differential expression strategy comparing PP and PN psoriatic tissue with NS and integrating these contrasts. This approach enabled the identification of disease-specific gene signatures while minimizing lesion-specific bias. As a result, we identified a coherent, cell-type-resolved continuum of transcriptional states in which endothelial cells, IL20+ keratinocytes (KCs: IL20), and KGF+ keratinocytes (KCs: KGF) undergo trajectory-dependent state transitions. These trajectories converge on features including epidermal thickening, barrier dysfunction, and plaque maintenance. Endothelial cells transition from an inflamed, angiogenic state to a mature, barrier-stabilized phenotype, while KCs: IL20 and KCs: KGF shift from PN states toward hyperproliferative, stress-adapted lesional phenotypes. These findings reframe psoriasis as a dynamic, multicellular continuum and identify candidate temporal windows for early intervention.

bioinformatics↗

bioRxiv2022

Platelet phosphatidylserine is the critical mediator of thrombosis in heparin-induced thrombocytopenia

Heparin-induced thrombocytopenia (HIT) is a severe immune-mediated prothrombotic disorder caused by antibodies reactive to complexes of platelet factor 4 and heparin. Platelets (PLTs) and their interaction with different immune cells contribute to prothrombotic conditions in HIT. However, the exact mechanisms and the role of different PLT subpopulations to this prothrombotic enviroment remain poorly understood. In this study, we observed that HIT patient antibodies (Abs) induce relevant changes in PLT phenotype, with the key features being increased P-Selectin expression and procoagulant phosphatidylserine (PS) externalization. Formation of procoagulant PLTs was dependent on engagement of PLT Fc-gamma-RIIA by HIT Abs and resulted in significant increase of thrombin generation on the PLT surface. Using an ex vivo thrombosis model and multi-parameter assessment of thrombus formation, we observed that HIT Ab-induced procoagulant PLTs propagated formation of large PLT aggregates, leukocyte recruitment and most importantly, fibrin network generation. These prothrombotic conditions were prevented via the upregulation of PLTs intracellular cAMP with Iloprost, a clinically approved prostacyclin analogue. Additionally, the functional relevance of high P-Selectin and PS levels on procoagulant PLTs was dissected. While inhibition of P-Selectin did not affect thrombus formation, the specific blockade of PS with Lactadherin prevented HIT Ab-mediated thrombin generation and most importantly procoagulant PLT-mediated thrombus formation ex vivo. Taken together, our findings indicate that procoagulant PLTs are critical mediators of prothrombotic conditions in HIT. Upregulation of cAMP with Iloprost or PS targeting specifc therapeutics could be a promising approach to prevent thromboembolic events in HIT patients. Key points- HIT immune complexes drive procoagulant platelet formation - Phosphatidylserine blockade prevents HIT antibody-induced thrombus formation

immunology↗