ABSTRACT
Background
Atopic dermatitis (AD) commonly occurs in children and can progress into severe phenotypes or atopic march, causing significant impairment in quality of life. It is important to find early biomarkers of future onset of AD before any clinical manifestations.
Objectives
To find early predictors of future onset of AD in skin stratum corneum (SC).
Methods
Skin tape strips (STS) were collected from the forearm of newborns (n=111) with and without family history of atopic diseases at the age of 2 months before any signs of clinical AD. Children were clinically monitored until they reached 2 years of age to ensure the presence or absence of AD. STS were subjected to lipidomic analyses by the LC-MS/MS and cytokine determination by Meso Scale Discovery U-Plex assay.
Results
Overall, 22/74 (29.7%) and 5/37 (13.5%) infants developed AD in the risk group and control group, respectively. In the stratum corneum of future AD children, protein-bound ceramides were decreased (p<0.001), while unsaturated sphingomyelin species (p<0.0001), “short-chain” NS- and AS-ceramides were elevated (p<0.01, 0.05, respectively) as compared to healthy children. Thymic stromal lymphopoietin and interleukin 13 levels were increased in the SC of future AD subjects (by 74.5% and 78.3%, p=0.0022 and p<0.0001, respectively). Multivariable logistic regression analysis revealed strong AD predicting power of the combination of family history, type 2 cytokines, and dysregulated lipids, with an odds ratio reaching 54.0 (95% CI 9.2 – 317.5).
Conclusion
Non-invasive STS analysis at 2 months of age can identify asymptomatic children at risk of future AD development with a high probability.
