The following is a summary of “Gene Expression Signatures in Inflammatory and Sclerotic Morphea Skin and Sera Distinguish Morphea from Systemic Sclerosis,” published in the October 2023  issue of Investigative Dermatology by Chen, et al.

People have said that morphea is a lot like systemic sclerosis (SSc) because it causes inflammation and scarring on the skin. Researchers wanted to look at the molecular picture of morphea by looking at gene expression in lesional skin and blood biomarkers. They then compared these gene expression profiles with those from nonlesional skin with the same size and type as the lesions and SSc lesional skin. 

The Researchers discovered that most of the morphea transcriptome is made up of IFN-γ–mediated T helper 1 immune dysfunction pathways, while fibrosis pathways aren’t very common. In particular, the expression profiles of morphea skin were similar to those of the SSc inflammatory subset but different from those of the SSc fibroproliferative subset. Morphea skin that wasn’t affected was also different from SSc skin that wasn’t affected because it didn’t show any signs of abnormal gene expression. When they looked at the downstream IFN-γ-mediated chemokines CXCL9 and CXCL10, they saw that their transcription was higher in the skin but not in the blood. Unlike transcriptional activity, CXCL9 levels were high in the serum and were linked to active, broad skin involvement. 

These data show that morphea is a process that happens in the skin and is characterized by T helper 1 immune-mediated disorder. This is different from SSc, which is marked by fibrotic signs and changes in gene patterns throughout the body. The fact that morphea and the inflammatory subset of SSc are similar in RNA profiling suggests that treatments being worked on for this subset of SSc could also be used to treat morphea.

Source: sciencedirect.com/science/article/abs/pii/S0022202X23019541