TY - JOUR

T1 - Skin TARC/CCL17 increase precedes the development of childhood atopic dermatitis

AU - Halling, Anne-Sofie

AU - Rinnov, Maria Rasmussen

AU - Ruge, Iben Frier

AU - Gerner, Trine

AU - Ravn, Nina Haarup

AU - Knudgaard, Mette Hjorslev

AU - Trautner, Simon

AU - Loft, Nikolai

AU - Skov, Lone

AU - Thomsen, Simon F.

AU - Egeberg, Alexander

AU - Guttman-Yassky, Emma

AU - Rosted, Aske L. L.

AU - Petersen, Troels

AU - Jakasa, Ivone

AU - Kezic, Sanja

AU - Thyssen, Jacob P.

N1 - Publisher Copyright: © 2022 The Authors

PY - 2023

Y1 - 2023

N2 - Background: It is unknown whether skin biomarkers collected in infancy can predict the onset of atopic dermatitis (AD) and be used in future prevention trials to identify children at risk. Objectives: This study sought to examine whether skin biomarkers can predict AD during the first 2 years of life. Methods: This study enrolled 300 term and 150 preterm children at birth and followed for AD until the age of 2 years. Skin tape strips were collected at 0 to 3 days and 2 months of age and analyzed for selected immune and barrier biomarkers. Hazard ratio (HR) with 95% confidence interval (CI) using Cox regression was calculated for the risk of AD. Results: The 2-year prevalence of AD was 34.6% (99 of 286) and 21.2% (25 of 118) among term and preterm children, respectively. Skin biomarkers collected at birth did not predict AD. Elevated thymus- and activation-regulated chemokine/C-C motif chemokine ligand 17 -levels collected at 2 months of age increased the overall risk of AD (HR: 2.11; 95% CI: 1.36-3.26; P = .0008) and moderate-to-severe AD (HR: 4.97; 95% CI: 2.09-11.80; P = .0003). IL-8 and IL-18 predicted moderate-to-severe AD. Low filaggrin degradation product levels increased the risk of AD (HR: 2.04; 95% CI: 1.32-3.15; P = .001). Elevated biomarker levels at 2 months predicted AD at other skin sites and many months after collection. Conclusions: This study showed that noninvasively collected skin biomarkers of barrier and immune pathways can precede the onset of AD.

AB - Background: It is unknown whether skin biomarkers collected in infancy can predict the onset of atopic dermatitis (AD) and be used in future prevention trials to identify children at risk. Objectives: This study sought to examine whether skin biomarkers can predict AD during the first 2 years of life. Methods: This study enrolled 300 term and 150 preterm children at birth and followed for AD until the age of 2 years. Skin tape strips were collected at 0 to 3 days and 2 months of age and analyzed for selected immune and barrier biomarkers. Hazard ratio (HR) with 95% confidence interval (CI) using Cox regression was calculated for the risk of AD. Results: The 2-year prevalence of AD was 34.6% (99 of 286) and 21.2% (25 of 118) among term and preterm children, respectively. Skin biomarkers collected at birth did not predict AD. Elevated thymus- and activation-regulated chemokine/C-C motif chemokine ligand 17 -levels collected at 2 months of age increased the overall risk of AD (HR: 2.11; 95% CI: 1.36-3.26; P = .0008) and moderate-to-severe AD (HR: 4.97; 95% CI: 2.09-11.80; P = .0003). IL-8 and IL-18 predicted moderate-to-severe AD. Low filaggrin degradation product levels increased the risk of AD (HR: 2.04; 95% CI: 1.32-3.15; P = .001). Elevated biomarker levels at 2 months predicted AD at other skin sites and many months after collection. Conclusions: This study showed that noninvasively collected skin biomarkers of barrier and immune pathways can precede the onset of AD.

KW - Atopic dermatitis

KW - birth cohort

KW - immune biomarkers

KW - predictive biomarkers

KW - skin barrier biomarkers

U2 - 10.1016/j.jaci.2022.11.023

DO - 10.1016/j.jaci.2022.11.023

M3 - Journal article

C2 - 36572354

AN - SCOPUS:85146905809

VL - 151

SP - 1550-1557.e6

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

SN - 0091-6749

IS - 6

ER -