Exploring Autoimmune Skin Diseases with Immune-Integrated 3D Skin Models

Grantee: Jonathan Brewer, Professor, University of Southern Denmark, Denmark

Amount: DKK 3,992,375

Grant category: Research Grants in open competition

Year: 2024

Geography: Denmark

Jonathan Brewer’s project, conducted in collaboration with Dr. Mike Barnkob, aims to advance skin biology by developing a much-needed human skin model with immune components, enabling detailed study of skin responses to stress and disease. By creating both normal and diseased skin models, with a focus on Cutaneous Lupus Erythematosus (CLE), Jonathan Brewer and his team will investigate the immune processes underlying CLE skin manifestations and provide a platform for developing targeted treatments. These models will also allow Jonathan and the team to study how skin and immune cells respond to UV radiation and mechanical forces, both of which play a significant role in CLE, where such stimuli can exacerbate skin lesions. A key innovation is the use of MERFISH technology, which maps gene activity within individual cells. This will reveal how specific genes are activated or suppressed in response to stimuli, providing insights into how skin adapts over time at the single-cell level. By comparing normal and CLE skin models, they will identify unique pathways involved in disease progression in CLE, offering potential targets for new therapeutic strategies.

The results of the project will be 3D skin models that mimic the structure and environment of human skin, enabling a wide range of experimental applications, including more rapid and ethical drug discovery. The project will also deliver the identification of pathways and molecular regulators involved in CLE and skin responses to UV and mechanical stimuli, supporting targeted treatment development and improved patient outcomes.

ATHENA- Artificial Intelligence Towards Holistic Evaluation of Skin Nanotexture Alterations

Grantee: Edwin En-Te Hwu, Associate Professor, Technical University of Denmark, Denmark

Amount: DKK 3,992,314

Grant category: Research Grants in open competition

Year: 2024

Geography: Denmark

The ATHENA project will explore the untapped potential of stratum corneum nanotexture (SCN, the nanoscale morphology of the outermost skin layer) to advance research and clinical evaluations of challenging-to-diagnose conditions: psoriasis, hand eczema (HE), and actinic keratosis (AK). Edwin En-Te Hwu’s MIDAS group has previously demonstrated that deep learning models could classify atopic dermatitis severity through SCN with high accuracy. Building on these findings, ATHENA aims to identify disease phenotypes across ethnicities and skin phototypes to optimize treatment strategies. ATHENA will: a) collect 1,050 stratum corneum tape strip samples from five countries across four continents, b) build a large dataset of 13,500 SCN images, c) develop self-supervised deep learning models to correlate SCN with skin conditions, and d) explore and identify robust SCN biomarkers for skin diseases. The non-invasive stratum corneum tape strip sampling method is painless and repeatable, causing no tissue damage and allowing frequent monitoring of therapy and disease progression. This method enables patients to collect samples at home for remote analysis, facilitating early detection and intervention to reduce social and economic burden.

Langerhans cells (LC) as main drivers of vitiligo: potential targets for novel therapeutic approaches with chemically enhanced RNA aptamers

Grantee: Julián Valero, Assistant Professor, Aarhus University, Denmark

Amount: DKK 3,999,441

Grant category: Research Grants in open competition

Year: 2024

Geography: Denmark

Early protein biomarkers in childhood atopic dermatitis

Grantee: Ann-Marie Schoos, Clinical Research Associate Professor, Herlev and Gentofte Hospital/COPSAC, Denmark

Amount: DKK 3,501,080

Grant category: Research Grants in open competition

Year: 2024

Geography: Denmark

Ann-Marie Schoos’ project explores atopic dermatitis (AD), which affects about 1 in 5 children. The disease burden of AD varies; some outgrow their disease while others have persistent symptoms. The reasons behind these different outcomes are not well understood and are not addressed by current treatments. Biological markers (biomarkers) can help us understand the disease better and, ideally, help predict, prevent, or treat it more effectively. Proteins can be used as biomarkers and appear in the blood due to secretion or cell damage. While there have been studies identifying such biomarkers (using proteomics) in adults, there is limited research on children, especially in relation to the early stages of AD. To understand the processes involved in early development of AD, Ann-Marie Schoos’ project will explore a novel, large-scale panel of blood-borne proteins measured before and after disease development (at birth, 6 months, 18 months, and 6 years of age) in the well-characterized COPSAC2010 cohort. The children of this cohort have been followed intensely throughout childhood with longitudinal (i.e., over time) measurements of inflammation, allergy, immune data, and genetics among others.

Ann-Marie Schoos’ project hopes to show that a simple blood test in early childhood can predict which children are at high risk of developing AD and who will have a severe and persistent disease course. This could lead to personalized prevention or treatment strategies, improving the quality of life for these children.

Epidemiology and genetics of rosacea and co-morbidities

Grantee: Ole Pedersen, Chief physician, Professor, Zealand University Hospital, Køge

Amount: DKK 2,715,598

Grant category: Research Grants in open competition

Year: 2024

Geography: Denmark

Ole Pedersen’s project aims to determine the genetic basis of rosacea and the causal connection between rosacea and its comorbidities.

Rosacea is a common chronic inflammatory skin disease of the face, which may manifest as a bulbous nose, central erythema, flushing, inflammatory papules/pustules, or broken vessels in addition to diverse eye involvement. Severe rosacea has a large impact on the patients’ quality of life, social and psychological well-being and has been linked to many systemic comorbidities including cardiovascular, psychiatric, neurological, and cancer diseases.

Ole Pedersen’s project aims to identify the genetic pathways of rosacea and determine the causal connection and modifiable risk factors to previously reported systemic comorbidities. He has recently developed a rosacea classification tool and applied it to a deep phenotyped cohort of ~55,000 Danes allowing for detailed analysis of association between rosacea, risk factors and co-morbidities. In addition, Ole Pedersen has facilitated genotyping of 500,000 Danes that can be used for genome wide association study meta-analysis with other genetic cohorts from Iceland, Finland, UK and USA to perform the so far largest genetic study on rosacea. Based on this analysis, his project will determine the genetic correlations and perform Mendelian randomization analysis of the causation between rosacea and comorbidities.

Ole Pedersen’s project may provide new understanding of disease pathogenesis and the link to systemic comorbidities, paving the way for developing new treatments and early targeted interventions.

Structural dissection and dynamic insights into the molecular switch of mast cells and basophils: a blueprint for novel urticaria therapies

Grantee: Rosaria Gandini, Assistant Professor, Aarhus University

Amount: DKK 3,462,144

Grant category: Research Grants in open competition

Year: 2024

Geography: Denmark

Rosaria Gandini’s project investigates the molecular details of the IgE-FceRI complex and its functioning on mast cells and basophils in order to improve treatment opportunities for urticaria.

Urticaria, a common inflammatory skin disorder characterized by itchy wheals, angioedema, or both, manifests in acute (AU) and chronic (CU) forms. It significantly impairs patients’ quality of life, causing sleep disturbances due to pruritus, fatigue, and anxiety. The symptoms arise from the activation of skin mast cells and basophils, leading to the release of histamine and other inflammatory mediators. This activation is initiated by cross-linking and clustering of the complexes between immunoglobulin E (IgE) and its high-affinity receptor, FceRI, which is expressed on the surface of these cells.

The FceRI-IgE complex hence acts as a powerful molecular switch, which initiates the inflammatory cascade and thus provides an attractive target for drug intervention. The structural basis of this activity, however, remains open.

Rosaria Gandini’s project aims to determine the structure of the FceRI-IgE membrane complex using state of the art Cryo Electron Microscopy (cryo-EM).

Successful elucidation of the molecular details of the entire complex and its conformations will allow identification of specific regions on FceRI for targeted intervention. This knowledge will deepen the understanding of the interaction of antibodies with Fc receptors in general and may pave the way for the development of specific and effective treatment of urticaria and related disorders.

Protein stability and misfolding in keratin disorders

Grantee: Rasmus Hartmann-Petersen, Professor, University of Copenhagen

Amount: DKK 2,600,678

Grant category: Research Grants in open competition

Year: 2024

Geography: Denmark

Rasmus Hartmann-Petersen’s project aims to characterize all possible missense variants (changes in genes which introduce a different amino acid in the resulting protein) in human keratins and investigate the importance of these variants in associated diseases.

Keratins are intermediate filament proteins that form a cytoskeletal network within cells. They are expressed in a tissue-specific fashion and form heterodimers, which then further oligomerize into filaments. Variants in several keratin encoding genes are linked to a range of hereditary disorders, including several epidermal skin diseases. On the molecular level, some pathogenic keratin variants appear to cause aggregation of the keratins.

In Rasmus Hartmann-Petersen’s project it is hypothesized that most keratin-disorders are protein misfolding diseases, i.e. diseases where the underlying genetic variants cause misfolding of the encoding protein. Rasmus and his team aim to explore this hypothesis by using computational tools, including large language models (a specific form of AI). They will test the validity of the computational predictions through focused cellular studies on selected keratins and identify components regulating keratin turnover.

The results will highlight the underlying molecular mechanisms for keratin-linked human disorders and provide predictions on the severity of all possible (both known and yet unobserved) coding variants in human keratin genes. The results could be of diagnostic value, but may also highlight the cellular protein folding and protein quality control machinery as potential therapeutic targets.

Architecture of the Herpes simplex replication machinery and its inhibitors

Grantee: Eva Kummer, Associate Professor, Copenhagen University

Amount: DKK 4,902,307

Grant category: Research Grants in open competition

Year: 2024

Geography: Denmark

Eva Kummer’s project targets to improve our understanding of the replication machinery of the skin-infecting herpes simplex virus (HSV) in order to improve and expand treatment opportunities.

HSV is one of the most widespread viral infections. The virus persists lifelong in the nerve system of the host and causes recurrent infections with mild to severe symptoms.

Since decades, treatment of herpes infections has exclusively targeted the viral replicative DNA polymerase (an enzyme that copies the viral DNA) using nucleoside analogs. However, resistance to current nucleoside analogs is emerging necessitating the search for alternative targets.

A major caveat in developing anti-herpetic compounds is a lack of structural information of other components of the herpes simplex replication system, which are likely strong candidates for targeted drug development. Eva Kummer and her team will use cryo-electron microscopy to visualize the architecture and working principles of the protein complexes that drive herpes simplex replication. They will also aim to clarify how novel anti-herpetic drugs block the viral replication machinery and why naturally occurring resistance mutations inhibit their action.

Overall, the project will generate structural and functional insights of the HSV replication strategy and potentially improve and accelerate anti-viral drug design.

Phage therapy to treat group A Streptococcus in Necrotizing Soft Tissue Infection

Grantee: Thomas Sicheritz-Pontén, Professor, University of Copenhagen

Amount: DKK 3,988,469

Grant category: Research Grants in open competition

Year: 2023

Geography: Denmark

The project led by Thomas Sicheritz-Pontén from the Globe Institute at the University of Copenhagen, aims to carry out the fundamental work needed to develop targeted phage therapy (using bacteria-infecting viruses) to counter Necrotizing Soft Tissue Infections (NSTI).  This innovative treatment approach necessitates an in-depth understanding of the causative organisms, which will be achieved through sequencing these organisms and employing machine learning algorithms to predict their susceptibility to specific phages.

Necrotizing Soft Tissue Infections (NSTI), also known as “flesh-eating disease”, are rapidly escalating globally, posing a deadly bacterial threat that necessitates innovative therapeutic strategies due to its profound impact on human health. NSTI is characterized by aggressive skin manifestations primarily caused by Group A Streptococcus (Strep A). Although prompt surgery and antibiotics serve as the first-line treatment, infections often progress to necrosis, rendering antibiotics ineffective and often necessitating amputation and in worst case death.

Bacteriophages, or simply phages, offer a promising avenue to address this severe skin and soft tissue infection. Phages are viruses that selectively infect and eliminate bacteria, including antibiotic-resistant strains, without harming human cells.

Thomas Sicheritz-Pontén and team will do the fundamental work needed to identify prototype tailored phage therapies targeting Strep A. Along with his team, comprised of chief physicians from three different Danish hospitals, the UK Centre for Phage Research and the University of Copenhagen, Thomas Sicheritz-Pontén intends to identify phages capable of rapidly eradicating the bacteria, harness bacterial enzymes (endolysins), and employ phage satellites (mobile genetic elements that parasitize phages) for gene delivery.

By collaborating across research hubs, the team will decode Strep A’s genetic makeup, thereby facilitating the creation of precise phage cocktails and develop a novel molecular typing system to predict bacterial susceptibility, streamlining targeted phage treatments.

If successful, Thomas Sicheritz-Pontén’s project may greatly aid the battle against deadly NSTI infections through innovative development of phage therapy.

The ribotoxic stress response in inflammatory skin disease

Grantee: Simon Bekker-Jensen, Professor, University of Copenhagen, Center for Healthy Aging

Amount: DKK 3,823,440

Grant category: Research Grants in open competition

Year: 2023

Geography: Denmark

Simon Bekker-Jensen’s project investigates the potential role of the NLRP1 (Nucleotide-Binding Oligomerization Domain, Leucine Rich Repeat and Pyrin Domain Containing 1) inflammasome in combination with the upstream activator Ribotoxic Stress Response (RSR) in AD and psoriasis.

Inflammatory and hyperproliferative skin diseases, including atopic dermatitis (AD) and psoriasis, are associated with cascades of inflammatory events. A key player in innate skin immunity is the NLRP1 inflammasome, which mediates inflammation and cell death in response to a wide array of stress insults. In human keratinocytes, NLRP1 was recently shown by Simon Bekker-Jensen’s team and others to be activated by the Ribotoxic Stress Response (RSR) upon exposure to UV-B irradiation and a range of bacterial toxins.

Based on their preliminary data demonstrating that the RSR also mediates inflammation and keratinocyte hyperproliferation in vivo, the team hypothesize that these pathways have broader implications for the pathogenesis of inflammatory skin diseases.

In Simon Bekker-Jensen’s project, the validity of the RSR as a therapeutic target in the common inflammatory skin diseases psoriasis and AD will be explored. By genetic deletion and pharmacological inhibition of the RSR, the team will interrogate this pathway in several mouse models of inflammatory skin diseases. In addition, they will generate a humanized NLRP1 mouse model to study the RSR-NLRP1 signaling axis in vivo. Finally, by using 3D organotypic skin models and skin biopsies from patients, they aim to firmly establish the role of the RSR in psoriasis and AD.

The long-term goal is to leverage this insight to develop new therapeutic options for the management and treatment of inflammatory skin diseases.