RUNX1 is Expressed in a Subpopulation of Dermal Fibroblasts and Higher RUNX1 Levels are Associated with the Severity of Systemic Sclerosis

The activation of Runt-related transcription factor 1 (RUNX1) in fibroblasts has been implicated in wound healing and fibrosis; however, the role of RUNX1 in the fibrotic progression of the autoimmune disease systemic sclerosis (SSc) is not known. Through gene expression analysis, we have demonstrated an association between the severity of dermal fibrosis and the expression levels of RUNX1 in the skin of patients with SSc. Additionally, we identified hypomethylated CpG sites proximal to the RUNX1 gene, implicating their potential role in the increased expression of RUNX1. Analysis of single-cell RNA-seq data from skin biopsies of individuals with SSc revealed that RUNX1 is higher in subpopulations of fibroblasts enriched in SSc, which are believed to contribute to fibrosis. Lastly, modulation of RUNX1 activity using an inhibitor caused a reduction in fibroblast contraction and proliferation rates. Altogether, this study is the first to demonstrate a potential role for RUNX1 in the pathogenesis of systemic sclerosis dermal fibrosis. ### Competing Interest Statement MLW has received consulting and research funding from Bristol-Myers Squibb, Boehringer Ingelheim, Corbus Pharmaceuticals, Celdara Medical, LLC, and UCB Biopharma for systemic sclerosis research. All other authors declare no competing interests.