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Updated: Jul 11, 2025

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Association between skin barrier development and early-onset atopic dermatitis: A longitudinal birth cohort study

John Chittock1, Linda Kay1, Kirsty Brown1

  • 1Sheffield Dermatology Research, Division of Clinical Medicine, University of Sheffield Medical School, Sheffield, United Kingdom.

The Journal of Allergy and Clinical Immunology
|November 5, 2023
PubMed

Insights

Infant skin barrier development shows subtle differences, but genetic factors and early biomarkers like reduced natural moisturizing factor are key indicators for atopic dermatitis (AD) risk. This study highlights potential for improved early AD risk assessment.

Area of Science:

  • Dermatology
  • Genetics
  • Pediatrics

Background:

  • Atopic dermatitis (AD) is a common infant diagnosis, but the role of skin barrier development in its onset is unclear.
  • Understanding early skin barrier maturation is crucial for identifying infants at risk of developing AD.

Purpose of the Study:

  • To assess the feasibility of remote skin testing from birth.
  • To monitor skin barrier maturation and its association with AD diagnosis by 12 months.
  • To investigate genetic predispositions and early biomarkers for AD.

Main Methods:

  • Biophysical testing and infrared spectroscopy were performed in homes and maternity wards.
  • Tape stripping analyzed desquamatory protease and natural moisturizing factor (NMF).
  • Screening for common European filaggrin risk alleles was conducted.

Main Results:

  • Subtle differences in skin barrier development were observed between infant subgroups.
  • Filaggrin risk alleles strongly correlated with early-onset AD, reducing NMF and water content.
  • Reduced NMF, higher lipid/protein ratio, and lower protease activity at birth, along with family history, predicted AD.

Conclusions:

  • Skin barrier dysfunction in AD appears inherent rather than acquired.
  • A combination of tests at birth can potentially improve early AD risk evaluation.
  • Remote monitoring and a portfolio of tests show promise for community-based AD risk assessment.
Abstract

Keywords:
Atopic dermatitisinfant skin barrierinfrared spectroscopyremote skin testing

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