Cross-species transcriptomic evidence for peripheral-central immune crosstalk in atopic dermatitis

Atopic dermatitis (AD) is characterized by peripheral inflammation and intense pruritus. While itch-induced brain activation in AD is documented, our previous work revealed aberrant resting-state activation in the left superior frontal gyrus (LSFG). However, whether this central dysfunction is linked to peripheral immune status remains unclear.

We integrated neuroimaging transcriptomics based on resting-state functional MRI data from AD patients (n=19) and healthy controls (n=36) with transcriptomic profiling and experimental validation in MC903-induced AD mouse models. Imaging transcriptomics was applied to identify genes associated with abnormal left superior frontal gyrus (LSFG) activation. T follicular helper 13-conditional knockout (Tfh13-cKO) mice were used to investigate whether dampening peripheral inflammation affects CNS neuroinflammation. RNA sequencing, flow cytometry, histology, and RT-qPCR were employed for mechanistic validation.

Neuroimaging transcriptomics revealed that the spatial pattern of aberrant LSFG activation in AD patients was significantly correlated with the expression maps of astrocyte- and microglia-related genes, enhanced inflammatory signaling and dysregulation of dopaminergic and GABAergic neurotransmission according to Allen Human Brain Atlas. Interleukin family members (IL13RA1, IL17RD, IL33) also showed strong positive correlations with LSFG imaging phenotypes. In AD mice, the prefrontal cortex exhibited a pronounced neuroinflammatory phenotype with elevated glial markers (Gfap, Aif1) and pro-inflammatory mediators (Tnf, Il6, Cxcl10), accompanied by transcriptomic signatures indicative of impaired synaptic plasticity. Notably, Tfh13-cKO AD mice with attenuated peripheral inflammation (reduced IgE, decreased effector T cells and germinal center B cells) displayed significantly alleviated central neuroinflammation, downregulated interferon-alpha response, and restored expression of synaptic plasticity-related genes.

These findings suggest that chronic peripheral inflammation may be associated with neuroinflammation and neurotransmitter imbalance centered in the LSFG and prefrontal cortex, contributing to specific brain activation patterns in AD patients. This study uncovers a novel peripheral-central immune interaction mechanism in AD and provides new insights for developing neuroimmune-targeted therapeutic strategies.