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Skin biomarkers predict development of atopic dermatitis in infancy
Maria Rasmussen Rinnov1, Anne-Sofie Halling1,2, Trine Gerner1
1Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Insights
Infant lipid alterations, including lower phytosphingosine, predict atopic dermatitis (AD) risk. Specific sphingoid base chain lengths and higher TARC/CCL17 also indicate future AD development.
Area of Science:
- Dermatology
- Biochemistry
- Pediatrics
Background:
- Pediatric atopic dermatitis (AD) lacks predictive biomarkers for early onset.
- Understanding early skin barrier differences is crucial for predicting AD.
Purpose of the Study:
- To identify early biomarkers predicting the onset of pediatric atopic dermatitis (AD).
- To investigate skin barrier components in infants before AD manifestation.
Main Methods:
- Analysis of tape strips from infants at 2 months of age.
- Measurement of Natural moisturizing factor (NMF), corneocyte surface, cytokines, free sphingoid bases (SBs), and ceramides.
- Utilized liquid chromatography, atomic force microscopy, and mass spectrometry.
Main Results:
- Significantly lower phytosphingosine ([P]) levels observed in infants who developed AD (240 pmol/mg vs. 540 pmol/mg).
- Differences noted in sphingoid base chain lengths (C17, C18, C20) between groups.
- Phytosphingosine achieved 75.6% prediction accuracy; a lipid ratio combination reached 89.4%.
Conclusions:
- Altered lipid levels and sphingoid base chain lengths in infants are associated with later AD development.
- Elevated TARC/CCL17 levels were also observed in infants who developed AD.
- These findings offer potential biomarkers for predicting pediatric atopic dermatitis.
Background:
There is currently no insight into biomarkers that can predict the onset of pediatric atopic dermatitis (AD).
Methods:
Nested in a prospective birth cohort study that examined the occurrence of physician-diagnosed AD in 300 children, 44 random children with onset of AD in the first year of life were matched on sex and season of birth with 44 children who did not develop AD. Natural moisturizing factor (NMF), corneocyte surface protrusions, cytokines, free sphingoid bases (SBs) of different chain lengths and their ceramides were analyzed from tape strips collected at 2 months of age before onset of AD using liquid chromatography, atomic force microscopy, multiplex immunoassay, and liquid chromatography mass spectrometry, respectively.
Results:
Significant alterations were observed for four lipid markers, with phytosphingosine ([P]) levels being significantly lower in children who developed AD compared with children who did not (median 240 pmol/mg vs. 540 pmol/mg, p < 0.001). The two groups of children differed in the relative amounts of SB of different chain lengths (C17, C18 and C20). Thymus- and activation-regulated chemokine (TARC/CCL17) was slightly higher in children who developed AD, whereas NMF and corneocyte surface texture were similar. AD severity assessed by the eczema area and severity index (EASI) at disease onset was 4.2 (2.0;7.2). [P] had the highest prediction accuracy among the biomarkers (75.6%), whereas the combination of 5 lipid ratios gave an accuracy of 89.4%.
Conclusion:
This study showed that levels and SB chain length were altered in infants who later developed AD, and that TARC/CCL17 levels were higher.
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