Exploring Immune Development in Infants With Moderate to Severe Atopic Dermatitis.

Area of Science:

• Immunology
• Dermatology
• Pediatrics

Background:

• Atopic dermatitis (AD) is a prevalent infant skin condition with complex immune involvement.
• Elevated T helper cell type (Th) 2, Th22, and Th17 serum markers, including CC chemokine ligand (CCL) 17 and CCL22, are linked to AD severity in adults.

Purpose of the Study:

• To explore the association between serum chemokine levels and atopic dermatitis severity in infants.
• To investigate potential immune biomarker profiles in infants with moderate-to-severe AD and elevated immunoglobulin E (IgE).

Main Methods:

• Analysis of serum samples from 41 infants with AD (moderate-to-severe, elevated IgE) from a randomized dietary intervention study.
• Measurement of six chemokines and nine ratios using Luminex, correlated with objective-SCORAD (oSCORAD) scores at baseline and after 4 months.
• Infants received either a hydrolyzed whey formula (control) or the same formula with prebiotics and *Bifidobacterium breve* M-16V (active).

Main Results:

• Median oSCORAD decreased in both groups, indicating overall improvement.
• Changes in Th2 chemokines (CCL17, CCL22), inflammatory chemokine (CCL20), and Th1 chemokine (CXCL9) were observed over time, irrespective of diet.
• CCL17 levels positively correlated with oSCORAD (r=0.446, p<0.01).
• The active dietary intervention group showed higher CXCL9 levels post-intervention and reduced Th2/Th1 chemokine ratios.

Conclusions:

• Serum chemokine profiles, particularly CCL17, show correlation with atopic dermatitis severity in infants.
• Dietary intervention with prebiotics and *Bifidobacterium breve* M-16V may modulate Th2/Th1 chemokine balance.
• Findings contribute to immune biomarker profiling for understanding infant AD.