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Updated: Jul 1, 2025

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Atopic dermatitis phenotype affects expression of atopic diseases despite similar mononuclear cell cytokine response

Mohamed H Taki1, Kristine E Lee2, Ronald Gangnon2

  • 1Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.

The Journal of Allergy and Clinical Immunology
|March 4, 2024
PubMed

Insights

Atopic dermatitis (AD) phenotype influences the development of other allergic diseases. However, immune dysregulation in the blood does not appear to drive this atopic march, suggesting localized immune responses.

Area of Science:

  • Pediatric Allergy and Immunology
  • Immunology
  • Dermatology

Background:

  • The atopic march describes the progression of allergic diseases in childhood, often starting with atopic dermatitis (AD).
  • Understanding the factors influencing the atopic march is crucial for early intervention and management of childhood allergic diseases.

Purpose of the Study:

  • To investigate if atopic dermatitis (AD) phenotype modifies the risk of developing subsequent atopic diseases.
  • To explore whether underlying cytokine signaling dysregulation contributes to these observed differences.

Main Methods:

  • Prospective follow-up of 285 children from the Childhood Origins of Asthma (COAST) birth cohort from birth to 18 years.
  • Assessment of atopic dermatitis (AD), food allergy, allergic rhinitis, and asthma rates.
  • Analysis of associations between AD phenotype and allergic outcomes, including sensitization and lung function, alongside peripheral blood mononuclear cell cytokine responses.

Main Results:

  • Early-onset atopic dermatitis (AD) at year 1 was linked to a higher risk of food allergy.
  • Persistent and late-onset AD were associated with increased risks of asthma, allergic rhinitis, elevated IgE, and exhaled nitric oxide.
  • No consistent differences in peripheral blood cytokine responses were found among different AD phenotypes.

Conclusions:

  • Atopic dermatitis (AD) phenotype is associated with distinct patterns of other atopic disease development.
  • Peripheral blood cytokine dysregulation does not appear to be the primary mechanism driving the atopic march.
  • Immune dysregulation in the atopic march may occur at mucosal surfaces or secondary lymphoid organs.
Abstract

Keywords:
Atopic dermatitisallergic sensitizationatopic dermatitis phenotypesatopic marchprogression of atopic disease

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