Spatial mapping of Ethiopian cutaneous leishmaniasis lesions reveals patient-defined immune signatures

To characterise the local immune response in Ethiopian CL, we performed spatial transcriptomics (Visium, 10x Genomics) on paired (lesional and non lesional) skin punch biopsies from five Ethiopian CL patients.

We used reference-free deconvolution, morphology-guided regional analyses, and immunohistochemistry to identify five5 dominant patient-defined immunopathological responses: i) epithelial hyperplasia with interferon-stimulated keratinocytes, ii) cytotoxicity with tertiary lymphoid structures, iii) granulomatous inflammation with proinflammatory response iv) granulomatous inflammation with M2-polarised myeloid cell responses , and v) fibrotic remodelling with active collagen synthesis.