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Published on: January 28, 2014
The atopic dermatitis blood signature is characterized by increases in inflammatory and cardiovascular risk proteins
Patrick M Brunner1, Mayte Suárez-Fariñas2,3,4, Helen He2
1The Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA.
Insights
Atopic dermatitis (AD) is a systemic disease with increased cardiovascular risk. Proteomic analysis revealed distinct inflammatory and cardiovascular markers in AD serum compared to psoriasis, confirming its systemic nature.
Area of Science:
- Immunology
- Dermatology
- Cardiovascular Medicine
Background:
- Atopic dermatitis (AD) is increasingly recognized as a systemic disease, extending beyond its atopic comorbidities.
- There is growing evidence linking AD to an increased risk of cardiovascular disease.
- Understanding the specific protein signatures in AD serum is crucial for defining its systemic nature and associated risks.
Purpose of the Study:
- To define the serum inflammatory and cardiovascular risk protein profiles in moderate-to-severe atopic dermatitis (AD).
- To compare the proteomic signature of AD with psoriasis and healthy controls.
- To investigate the relationship between serum markers, disease severity (SCORAD), and skin inflammation.
Main Methods:
- Utilized OLINK high-throughput proteomic assay to analyze serum samples from patients with moderate-to-severe AD (n=59), psoriasis (n=22), and healthy controls (n=18).
- Compared protein expression levels between disease groups and controls.
- Correlated specific serum protein levels with clinical parameters like SCORAD and BMI, and with skin inflammation markers.
Main Results:
- 10 proteins, including Th1 and Th17 markers, were elevated in both AD and psoriasis compared to controls.
- 48 proteins were uniquely upregulated in AD and 48 in psoriasis.
- AD serum showed distinct upregulation of Th2, Th1, and Th1/Th17/Th22 response markers, alongside novel markers for atherosclerosis, T-cell activation, and angiogenesis.
- Several atherosclerosis mediators and inflammatory markers in AD serum correlated with SCORAD and/or skin inflammation.
Conclusions:
- The serum proteomic signature of AD is significantly different from psoriasis, highlighting its distinct systemic inflammatory profile.
- Elevated levels of cardiovascular risk markers and inflammatory proteins in AD serum support its classification as a systemic disease.
- These findings underscore the need to consider cardiovascular risk in the management of AD patients.
Abstract:
Beyond classic "allergic"/atopic comorbidities, atopic dermatitis (AD) emerges as systemic disease with increased cardiovascular risk. To better define serum inflammatory and cardiovascular risk proteins, we used an OLINK high-throughput proteomic assay to analyze moderate-to-severe AD (n = 59) compared to psoriasis (n = 22) and healthy controls (n = 18). Compared to controls, 10 proteins were increased in serum of both diseases, including Th1 (IFN-γ, CXCL9, TNF-β) and Th17 (CCL20) markers. 48 proteins each were uniquely upregulated in AD and psoriasis. Consistent with skin expression, AD serum showed up-regulation of Th2 (IL-13, CCL17, eotaxin-1/CCL11, CCL13, CCL4, IL-10), Th1 (CXCL10, CXCL11) and Th1/Th17/Th22 (IL-12/IL-23p40) responses. Surprisingly, some markers of atherosclerosis (fractalkine/CX3CL1, CCL8, M-CSF, HGF), T-cell development/activation (CD40L, IL-7, CCL25, IL-2RB, IL-15RA, CD6) and angiogenesis (VEGF-A) were significantly increased only in AD. Multiple inflammatory pathways showed stronger enrichment in AD than psoriasis. Several atherosclerosis mediators in serum (e.g. E-selectin, PI3/elafin, CCL7, IL-16) correlated with SCORAD, but not BMI. Also, AD inflammatory mediators (e.g. MMP12, IL-12/IL-23p40, CXCL9, CCL22, PI3/Elafin) correlated between blood and lesional as well as non-lesional skin. Overall, the AD blood signature was largely different compared to psoriasis, with dysregulation of inflammatory and cardiovascular risk markers, strongly supporting its systemic nature beyond atopic/allergic association.
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