Epigenomic Characterization of Fibroblasts in Darier Disease Identifies Cross-cell-type Regulatory Gene Signatures

Authors

  • Nuoqi Wang Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
  • Matthew Hunt Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
  • Monica Torres Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden, DermatoVenereology Clinic, Karolinska University Hospital, Stockholm, Sweden
  • Etty Bachar-Wikstrom Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
  • Jakob D. Wikstrom Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden, and 2DermatoVenereology Clinic, Karolinska University Hospital, Stockholm, Sweden https://orcid.org/0000-0002-9241-6817

DOI:

https://doi.org/10.2340/actadv.v106.adv-2026-0626

Keywords:

Darier disease, methylation, RNA-seq, skin

Abstract

Darier disease is a monogenic acantholytic derma-tosis caused by mutations in ATP2A2 that primarily disrupt keratinocyte calcium homeostasis. Whether dermal fibroblasts harborharbour disease-associated epigenetic alterations remainremains uncharacterized. In this study, we performed genome-wide DNA methy-lation profiling on primary fibroblasts from lesional and non-lesional skin, followed by STRING protein–protein interaction network analysis to identify regulatory hub genes. Hub gene expression was validated by qPCR and cross-referenced with single-cell RNA-seq data from healthy skin and published RNA-seq data from Darier disease keratinocytes. Lesional fibroblasts showed consistent, site-specific hyper- and hypomethylation converging on inter-connected regulatory hubs. Hypomethylated hub genes included transcription factors and signalingsignalling integrators while hypermethylated hub genes comprised growth-regulatory and adhesion-related genes. Methylation direction predicted transcriptional output at 10 of 12 hub genes by qPCR. These hub genes are expressed across both fibroblast and keratinocyte populations in healthy skin, and lesional keratinocyte RNA-seq data showed directionally concordant expression changes, indicating shared transcriptional dysregulation across compartments. These findings suggest that Darier disease involves a stable fibroblast epigenetic state with cross-cell-type transcriptional relevance, potentially contributing to dermal–epidermal regulatory disruption in lesional skin.

Downloads

Download data is not yet available.

References

Zagoras T, Inci R, Kantere D, Holmström P, Broström J, Gillstedt M, et al. Incidence and Prevalence of 73 Different Genodermatoses: A Nationwide Study in Sweden. Acta Derm Venereol 2023; 103: adv12404. DOI: https://doi.org/10.2340/actadv.v103.12404

Labbouz S, Dodiuk-Gad RP. Darier disease: Golden era of discovery and global collaborations. J Eur Acad Dermatol Venereol 2025; 39: 883–884. DOI: https://doi.org/10.1111/jdv.20641

Parfitt E, Burge S, Craddock N, Roberts E, McLean WH, Weissenbach J, et al. The gene for Darier’s disease maps between D12S78 and D12S79. Hum Mol Genet 1994; 3: 35–38. DOI: https://doi.org/10.1093/hmg/3.1.35

Sánchez Martínez EM, Moneva Léniz LM, Gegúndez Hernández H, Mateu Puchades A. Darier Disease: A Case Series of 20 Patients and Review of the Literature. Actas Dermosifiliogr (Engl Ed) 2021: S0001-7310(21)00100-9. DOI: https://doi.org/10.1016/j.adengl.2021.04.002

Ettinger M, Kimeswenger S, Deli I, Traxler J, Altrichter S, Noack P, et al. Darier disease: Current insights and challenges in pathogenesis and management. J Eur Acad Dermatol Venereol 2025; 39: 942–951. DOI: https://doi.org/10.1111/jdv.20448

Celli A, Mackenzie DS, Zhai Y, Tu CL, Bikle DD, Holleran WM, et al. SERCA2-controlled Ca. J Invest Dermatol 2012; 132: 1188–1195. DOI: https://doi.org/10.1038/jid.2011.447

Bachar-Wikström E, Wikström JD. Darier Disease - A Multi-organ Condition? Acta Derm Venereol 2021; 101: adv00430. DOI: https://doi.org/10.2340/00015555-3770

Ashok Kumar P, Paulraj S, Dutta S. Debilitating Darier’s Disease and Its Impact on the Quality of Life. Cureus 2020; 12: e8133. DOI: https://doi.org/10.7759/cureus.8133

Dawson MA, Kouzarides T. Cancer epigenetics: from mechanism to therapy. Cell 2012; 150: 12–27. DOI: https://doi.org/10.1016/j.cell.2012.06.013

Pop S, Enciu AM, Tarcomnicu I, Gille E, Tanase C. Phytochemicals in cancer prevention: modulating epigenetic alterations of DNA methylation. Phytochem Rev 2019; 18: 1005–1024. DOI: https://doi.org/10.1007/s11101-019-09627-x

Botchkarev VA, Gdula MR, Mardaryev AN, Sharov AA, Fessing MY. Epigenetic regulation of gene expression in keratinocytes. J Invest Dermatol 2012; 132: 2505–2521. DOI: https://doi.org/10.1038/jid.2012.182

Rani A, Kaur G, Kumar R, Sachan RSK, Kumar M, Sable H, et al. Role of DNA Methylation in the Pathogenesis of Skin Disorders: Mechanisms, Inhibitors of Methylation-Related Enzyme, and Molecular Docking Studies. Biomed Res Int 2025; 2025: 7002918. DOI: https://doi.org/10.1155/bmri/7002918

Grönniger E, Max H, Lyko F. Skin Rejuvenation by Modulation of DNA Methylation. Exp Dermatol 2024; 33: e70005. DOI: https://doi.org/10.1111/exd.70005

Dermitzakis I, Kyriakoudi SA, Chatzianagnosti S, Chatzi D, Vakirlis E, Meditskou S, et al. Epigenetics in Skin Homeostasis and Ageing. Epigenomes 2025; 9: 3. DOI: https://doi.org/10.3390/epigenomes9010003

Dopytalska K, Ciechanowicz P, Wiszniewski K, Szymańska E, Walecka I. The Role of Epigenetic Factors in Psoriasis. Int J Mol Sci 2021; 22: 9294. DOI: https://doi.org/10.3390/ijms22179294

Schmidt AD, de Guzman Strong C. Current understanding of epigenetics in atopic dermatitis. Exp Dermatol 2021; 30: 1150–1155. DOI: https://doi.org/10.1111/exd.14392

Pacella G, Capell BC. Epigenetic and metabolic interplay in cutaneous squamous cell carcinoma. Exp Dermatol 2021; 30: 1115–1125. DOI: https://doi.org/10.1111/exd.14354

Haber RN, Dib NG. Management of Darier disease: A review of the literature and update. Indian J Dermatol Venereol Leprol 2021; 87: 14–21. DOI: https://doi.org/10.25259/IJDVL_963_19

Hunt M, Wang N, Pupinyo N, Curman P, Torres M, Jebril W, et al. Dantrolene corrects cellular disease features of Darier disease and may be a novel treatment. EMBO Mol Med 2024; 16: 1986–2001. DOI: https://doi.org/10.1038/s44321-024-00104-3

Schnabel CA, Selleri L, Jacobs Y, Warnke R, Cleary ML. Expression of Pbx1b during mammalian organogenesis. Mech Dev 2001; 100: 131–135. DOI: https://doi.org/10.1016/S0925-4773(00)00516-5

Mascharak S, desJardins-Park HE, Davitt MF, Griffin M, Borrelli MR, Moore AL, et al. Preventing Engrailed-1 activation in fibroblasts yields wound regeneration without scarring. Science 2021; 372: eaba2374. DOI: https://doi.org/10.1126/science.aba2374

Flockhart RJ, Diffey BL, Farr PM, Lloyd J, Reynolds NJ. NFAT regulates induction of COX-2 and apoptosis of keratinocytes in response to ultraviolet radiation exposure. FASEB J 2008; 22: 4218–4227. DOI: https://doi.org/10.1096/fj.08-113076

Wong PP, Pickard A, McCance DJ. p300 alters keratinocyte cell growth and differentiation through regulation of p21(Waf1/CIP1). PLoS ONE 2010; 5: e8369. DOI: https://doi.org/10.1371/journal.pone.0008369

Bai R, Guo Y, Liu W, Song Y, Yu Z, Ma X. The Roles of WNT Signaling Pathways in Skin Development and Mechanical-Stretch-Induced Skin Regeneration. Biomolecules 2023; 13: 1702.

D’Arcy C, Kiel C. Cell Adhesion Molecules in Normal Skin and Melanoma. Biomolecules 2021; 11: 1213. DOI: https://doi.org/10.3390/biom11081213

Yu X, Zhao H, Wang R, Chen Y, Ouyang X, Li W, et al. Cancer epigenetics: from laboratory studies and clinical trials to precision medicine. Cell Death Discov 2024; 10: 28. DOI: https://doi.org/10.1038/s41420-024-01803-z

Marella S, Plikus MV, Gudjonsson JE. Skin fibroblasts in health and disease: From extracellular matrix remodeling to immune regulation. J Invest Dermatol 2026; 146: 1473–1485. DOI: https://doi.org/10.1016/j.jid.2025.12.002

Manabe T, Park H, Minami T. Calcineurin-nuclear factor for activated T cells (NFAT) signaling in pathophysiology of wound healing. Inflamm Regen 2021; 41: 26. DOI: https://doi.org/10.1186/s41232-021-00176-5

Bai R, Guo Y, Liu W, Song Y, Yu Z, Ma X. The Roles of WNT Signaling Pathways in Skin Development and Mechanical-Stretch-Induced Skin Regeneration. Biomolecules 2023; 13: 1702. DOI: https://doi.org/10.3390/biom13121702

Widelitz RB. Wnt signaling in skin organogenesis. Organogenesis 2008; 4: 123–133. DOI: https://doi.org/10.4161/org.4.2.5859

Lim X, Tan SH, Koh WLC, Chau RMW, Yan KS, Kuo CJ, et al. Interfollicular epidermal stem cells self-renew via autocrine Wnt signaling. Science 2013; 342: 1226–1230. DOI: https://doi.org/10.1126/science.1239730

Ding X, Bloch W, Iden S, Rüegg MA, Hall MN, Leptin M, et al. mTORC1 and mTORC2 regulate skin morphogenesis and epidermal barrier formation. Nat Commun 2016; 7: 13226. DOI: https://doi.org/10.1038/ncomms13226

Jevtić M, Löwa A, Nováčková A, Kováčik A, Kaessmeyer S, Erdmann G, et al. Impact of intercellular crosstalk between epidermal keratinocytes and dermal fibroblasts on skin homeostasis. Biochim Biophys Acta Mol Cell Res 2020; 1867: 118722. DOI: https://doi.org/10.1016/j.bbamcr.2020.118722

Published

2026-10-28

How to Cite

Wang, N., Hunt, M., Torres, M., Bachar-Wikstrom, E., & Wikstrom, J. D. (2026). Epigenomic Characterization of Fibroblasts in Darier Disease Identifies Cross-cell-type Regulatory Gene Signatures. Acta Dermato-Venereologica, 106, adv–2026. https://doi.org/10.2340/actadv.v106.adv-2026-0626