Köhlmeier-Degos disease is an interferonopathy characterized by type I and II interferon-driven inflammatory vasculopathy.
Köhlmeier-Degos disease (Degos disease [DD]) is a rare vasculopathy with characteristic skin lesions and life-threatening gastrointestinal and cerebrovascular involvement. Although DD is often viewed as a thrombo-obliterative disorder, its immunopathology remains poorly defined. Here, single-cell RNA and T cell receptor sequencing of skin, blood, and cerebrospinal fluid from DD patients reveal pervasive type I and type II interferon activation, with an interferon-γ-biased program compared with systemic lupus erythematosus. Cytotoxic CD8A+ T cells show interferon-responsive activation and restricted clonotypic diversity, implicating cellular immunity in the DD inflammatory landscape. In a single-patient interventional study, JAK inhibition with ruxolitinib is associated with suppression of interferon-responsive programs, improvement of cutaneous inflammation, and stabilization of neurological disease. These findings support DD as an interferon-driven inflammatory vasculopathy and provide a rationale for further evaluation of interferon-JAK-STAT signaling. This study has been registered at ClinicalTrials.gov (NCT05998395).
Authors
Cudrici Cudrici, Goel Goel, Sakamoto Sakamoto, Jin Jin, Sekiguchi Sekiguchi, Rosing Rosing, Huffstutler Huffstutler, Hammoud Hammoud, Shapiro Shapiro, Schwartz Schwartz, Manohar-Sindhu Manohar-Sindhu, Taylor Taylor, Zhang Zhang, Schaughency Schaughency, Cowen Cowen, Hasni Hasni, Kaplan Kaplan, Kong Kong, Boehm Boehm, Nagao Nagao
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