Some Skin Surface Biomarkers Can Help Predict Atopic Dermatitis in Children

Certain skin inflammatory markers and microbial dysbiosis are present before atopic dermatitis presents in children with family history of allergic disease, according to study results presented at the 2023 Annual Meeting of the American Academy of Dermatology (AAD), held from March 17 to 21, 2023, in New Orleans, Louisiana.

After children develop atopic dermatitis, a chronic inflammatory skin disorder, they can develop other allergic disorders such as food allergy, asthma, and allergic rhinitis. Family history of allergic disease is a risk factor for atopic dermatitis in children.

For the study, researchers categorized children into 3 groups: healthy without family history of allergic disease (n=29), healthy with family history of allergic disease (n=101), and diagnosed with atopic dermatitis (n=30). All study participants were White and aged 3 to 48 months. The researchers used noninvasive skin surface measures and collected swabs for 15 biomarkers among the children.

Based on parent report, 11 healthy children with family history of allergic disease were diagnosed with atopic dermatitis within 1 year of the measurements. The researchers noted that the 11 children who developed atopic dermatitis had both microbial dysbiosis and increased concentrations of certain skin inflammatory markers before disease onset. Patients with lesional skin at baseline had higher inflammatory cytokine concentrations, high Staphylococcus aureus, higher transepidermal water loss rates, and reduced skin surface hydration.

Skin assessment of healthy children identified atopic dermatitis lesions but was not able to facilitate prediction. Elastic Net (EN), Support Vector Machine (SVM), Random Forest (RF), and XGBoost (XGB) were trained on atopic dermatitis-lesional tissue vs healthy low-risk and predicting converters vs nonconverters. Overall, the 14 immune markers had higher expression in atopic dermatitis-lesional skin compared with healthy low-risk participants.

“Taken together, these findings demonstrate for the first time that certain skin inflammatory markers are upregulated before the onset of [atopic dermatitis] and have the potential to be used prognostically,” the researchers wrote.

Disclosure: This research was supported by Janssen Research & Development and Johnson & Johnson Santé Beauté France. Please see the original reference for a full list of disclosures.