Skin TARC/CCL17 increase precedes the development of childhood atopic dermatitis
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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.
Original language | English |
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Journal | Journal of Allergy and Clinical Immunology |
Volume | 151 |
Issue number | 6 |
Pages (from-to) | 1550-1557.e6 |
ISSN | 0091-6749 |
DOIs | |
Publication status | Published - 2023 |
Bibliographical note
Publisher Copyright:
© 2022 The Authors
- Atopic dermatitis, birth cohort, immune biomarkers, predictive biomarkers, skin barrier biomarkers
Research areas
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