Biomarkers may predict future atopic dermatitis development in infants
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An immune and lipid profile on the surface of infants’ skin may predict the future development of atopic dermatitis months before the condition’s chronic onset, according to a study.
AD often occurs early in childhood, with 20% to 30% of children affected worldwide. This study indicates that preventative detection is possible.
“Abnormalities of the skin can be detected in children predisposed to eczema or atopic dermatitis up to 1 year before clinical rash is observed,” Donald Y.M. Leung, MD, PhD, division head of pediatric allergy and clinical immunology at National Jewish Health and senior study author, told Healio.
To find early predictors of future AD in skin stratum corneum (SC), the authors collected and analyzed skin tape strips (STS) from the forearms of 111 newborns aged 2 months. Although none of the newborns displayed any AD development, those who had family members with AD or allergic diseases were placed in a risk group (n = 74) whereas the rest were placed in a control group (n = 37).
After 2 years of follow-up, results showed that 22 (29.7%) infants in the risk group developed AD compared with five (13.5%) in the control group.
An STS analysis revealed that the SC of children with vs. without future AD contained decreased levels of protein-bound ceramides (P < .001) and increased levels of unsaturated sphingomyelin species (P < .0001), “short-chain” NS ceramides (P < .01) and “short-chain” AS ceramides (P < .05).
Children with future AD also experienced a 74.5% (P = .0022) increase in thymic stromal lymphopoietin and a 78.3% (P < .0001) increase in interleukin-13 levels in their SC.
As a result, a multivariable logistic regression analysis revealed that the combined evaluation of family history, type 2 cytokines and dysregulated lipids had strong AD predicting power (OR = 54; 95% CI, 9.2-317.5).
According to the authors, these findings support the high probability of non-invasive STS analysis when infants are aged 2 months to identify those asymptomatic children at risk for developing future AD.
“This observation suggests that new interventions can be introduced to prevent the development of eczema or atopic dermatitis,” Leung told Healio. “These interventions include skin creams that strengthen the skin barrier as well as anti-allergic medications introduced in this group of infants at high risk for atopic dermatitis.