Early non-lesional filaggrin expression predicts childhood asthma in atopic dermatitis
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Key takeaways:
- Filaggrin expression, a marker of skin barrier function, predicts asthma in school-age children.
- This marker had heightened sensitivity for predicting asthma.
WASHINGTON — Among children with atopic dermatitis, low non-lesional skin filaggrin expression during early ages predicted future asthma, according to data presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting.
In this study, Wan Chi Chang, MS, biostatistician in the division of asthma research at Cincinnati Children’s Hospital Medical Center, and colleagues assessed 96 children with atopic dermatitis aged 7 to 8 years to determine if skin barrier function markers (transepidermal water loss, skin expression filaggrin) and an atopic dermatitis severity marker (SCORing Atopic Dermatitis) aid in asthma prediction vs. parent-reported physician-diagnosed asthma.
According to researchers, pulmonary function testing and/or wheezing and utilization history determined an asthma diagnosis.
Out of the three assessed markers, only skin expression of filaggrin was a significant predictor of school-age asthma in logistic regression. Researchers observed low sensitivity in predicting asthma with transepidermal water loss and SCORing Atopic Dermatitis.
The one significant predictor of asthma was found in the form of low filaggrin expression in non-lesional skin between the ages of 2 and 3 years (OR = 7.2; 95% CI, 2.4-23.7). Researchers noted that this was a significant predictor even after dividing the cohort by Black race.
Specificity in predicting asthma was comparable between non-lesional filaggrin expression and parental-reported physician-diagnosed asthma (0.74 vs. 0.89). In contrast, researchers observed better sensitivity for predicting childhood asthma with use of non-lesional filaggrin expression (0.72 vs. 0.35).
“This work highlights the importance of the skin barrier to asthma development,” Chang said in a press release. “Specifically, filaggrin expression in the normal appearing skin predicts asthma development and is a better predictor than parent-report of physician-diagnosed asthma.”
References:
- Chang WC, et al. J Allergy Clin Immunol. 2024;doi:10.1016/j.jaci.2023.11.782.
- Non-lesional filaggrin expression is predictive of asthma development in children with atopic dermatitis. https://www.aaaai.org/about/news/news/2024/filaggrin. Published Feb. 5, 2024. Accessed Feb. 19, 2024.