ORGANISED clusters of immune cells within the skin could help sustain inflammation and relapse in atopic dermatitis, new research suggests.
Using spatial transcriptomics, researchers identified distinct immune niches in atopic dermatitis lesions where activated T helper 2 cells were closely associated with mature migratory dendritic cells.
The findings could provide new insight into why inflammation can persist or return despite targeted treatment.
Atopic dermatitis is primarily driven by a Type 2 immune response, involving T helper 2 cells and cytokines including IL-4 and IL-13.
However, less is known about exactly where pathogenic immune cells are positioned within affected skin and how they interact with surrounding cells.
Researchers performed spatial transcriptomics on skin biopsies from six patients with atopic dermatitis, two with psoriasis, and five healthy controls. The analysis was integrated with single-cell RNA sequencing data and supported by imaging mass cytometry and multiplex immunofluorescence.
The approach enabled the team to examine not only which cells and genes were present, but how inflammatory cells were physically organised within tissue.
Atopic dermatitis lesions contained conserved immune aggregates within the superficial dermis, with T cells positioned alongside mature migratory dendritic cells.
A neighbourhood analysis found T-cell-rich regions surrounded by inflammatory fibroblasts and activated keratinocytes.
Researchers also detected signalling patterns suggesting that interactions between dendritic cells and T cells could promote continued recruitment and activation of pathogenic T cells.
These areas displayed characteristics resembling tertiary lymphoid structures: organised immune-cell environments that can develop in tissues affected by chronic inflammation.
Imaging techniques subsequently confirmed the close physical proximity of activated T helper 2 cells and mature migratory dendritic cells.
The findings suggest that inflammation in atopic dermatitis is not simply driven by individual cytokines circulating independently within the skin. Instead, spatially organised networks of immune, stromal, and epithelial cells may help sustain local inflammatory responses.
Importantly, previous research has shown that some pathogenic immune populations can remain in apparently resolved atopic dermatitis skin following treatment.
Targeting the dendritic cell–T cell interaction within these persistent immune niches could therefore offer a future strategy for improving long-term disease control and reducing relapse.
However, the analysis involved a small number of patient samples, and further studies will be required to determine how these niches change during treatment and whether directly disrupting them improves clinical outcomes.
Reference
Gross L. et al. Spatial Transcriptomics Identifies Characteristic Immunological Niches in Atopic Dermatitis. Allergy. 2026.
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