In patients with moderate to severe atopic dermatitis (AD), the skin appears to be the primary source for both the inflammatory and atherosclerosis/cardiovascular signature rather than the blood, according to study results published in the Journal of the American Academy of Dermatology.

A total of 20 adult patients with moderate to severe AD (mean age, 40.6 years) and 28 healthy control patients (mean age, 37 years) were enrolled. The study included only patients who did not use topical therapies for ≥2 weeks prior to enrollment and phototherapy or systemic therapy ≥4 weeks before enrollment. OLINK proteomics, utilizing 10μg/10μL for skin and blood, as well as RNAseq for skin, were used to assess lesional and non-lesional biopsies and blood from patients and healthy control patients. A total of 4 panels were used: inflammation, cardiovascular/cardiovascular disease (CVD) II, and neuro-inflammation (354 markers).

Compared with control patients, significant upregulation of AD skin proteins was observed in lesional and non-lesional skin in both inflammatory markers (MMP12; Th2/IL1RL1/IL-33R, IL-13, CCL17; Th1/ CXCL10; Th17/Th22/PI3, CCL20, S100A12), and cardiovascular-associated proteins (SELE, MMPs, PGF, MPO, FABP4, VEGFA; FDR <0.05). Relative to blood, there were higher and significant upregulations in skin proteins. According to the researchers, this finding indicates that skin may be a source for the inflammatory and cardiovascular profile.

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There was a correlation between mRNA and protein expressions with commonly upregulated inflammatory and cardiovascular risk products in lesional (r=0.410, P <.001) and non-lesional skin (data not reported). This finding suggested protein translation in skin of patients with AD. There was higher protein demonstrated in several atherosclerosis and cardiovascular-related markers than mRNA in lesional vs control skin.


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Study limitations were the inclusion of only 354 markers in the proteomic analysis, as well as the lack of blood mRNA data.

The researchers concluded that “the proteomic skin profile can be valuable for future studies requiring close biomarker monitoring.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Reference

Pavel AB1, Zhou L1, Diaz A, et al. The proteomic skin profile of moderate-to-severe atopic dermatitis patients shows an inflammatory signature [published online October 24, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.10.039