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Utility of Blood Biomarkers for Assessing Atopic Dermatitis Severity in Infants Aged < 2 Years
Sumire Seki1, Misako Kinoshita1, Noriko Takahata1
1Department of Pediatrics, Jikei University Katsushika Medical Center, Tokyo, Japan.
Insights
Thymus and activation-regulated chemokine (TARC) and squamous cell carcinoma antigen 2 (SCCA2) show promise in assessing infant atopic dermatitis (AD) severity, outperforming total IgE and eosinophils. Biomarker selection may aid early diagnosis and targeted therapy for AD.
Area of Science:
- Pediatric Dermatology
- Immunology
- Biomarker Discovery
Background:
- Atopic dermatitis (AD) is a prevalent inflammatory skin condition with increasing incidence in infants.
- Severe infantile AD can lead to significant morbidity.
- Thymus and activation-regulated chemokine (TARC) and squamous cell carcinoma antigen 2 (SCCA2) are potential biomarkers for AD severity.
Purpose of the Study:
- To evaluate the correlation between AD severity, defined by the Patient-Oriented Eczema Measure (POEM) score, and biomarkers including TARC, SCCA2, total immunoglobulin E (IgE), and eosinophil counts in infants (<2 years).
- To compare the diagnostic performance of these biomarkers in classifying AD severity.
- To examine the association of each biomarker with individual POEM items.
Main Methods:
- Retrospective analysis of 50 infants (<2 years) with newly diagnosed AD.
- Classification of patients into mild or moderate-to-severe AD based on POEM scores.
- Receiver operating characteristic (ROC) analyses to determine sensitivity and specificity; Spearman correlations to assess biomarker association with POEM items.
Main Results:
- SCCA2 demonstrated the highest diagnostic accuracy for mild AD (AUC=0.708).
- TARC exhibited the best performance for moderate AD (AUC=0.717).
- Total IgE and eosinophil counts showed limited diagnostic value (AUC≈0.5). TARC correlated more strongly with bleeding and flaking than SCCA2.
Conclusions:
- TARC and SCCA2 are superior to total IgE and eosinophils for assessing AD severity in infants (<2 years).
- These biomarkers are valuable tools for evaluating AD severity.
- Tailored biomarker selection could enable earlier diagnosis and more effective, targeted therapies for infantile AD.
Background:
Atopic dermatitis (AD) is an increasingly common skin disease that can lead to serious morbidity in a subset of more severely affected infants. Thymus and activation-regulated chemokine (TARC) and squamous cell carcinoma antigen 2 (SCCA2) are biomarkers. This study examined how severity, defined by Patient-Oriented Eczema Measure (POEM) score, correlates with TARC, SCCA2, total immunoglobulin E (IgE), and eosinophil counts in infantile AD (< 2 years), comparing their diagnostic performance and examining each biomarker's association with individual POEM items.
Methods:
This retrospective study included 50 children aged < 2 years with newly diagnosed AD (March 2023-November 2024). Patients were categorized as mild or moderate-to-severe disease based on POEM scores. Receiver operating characteristic (ROC) analyses were used to assess each biomarker's sensitivity and specificity for severity classification, and correlations with POEM's seven items were evaluated using Spearman correlations.
Results:
SCCA2 had the highest diagnostic accuracy for mild AD (area under the curve [AUC] = 0.708), while TARC had the best performance (AUC = 0.717) for moderate AD. Total IgE and eosinophil counts had AUC values at approximately 0.5. TARC showed stronger correlations (Spearman's rank correlation coefficient [rs] ≥ 0.4) with bleeding and flaking compared with SCCA2.
Conclusions:
In children aged < 2 years with AD, TARC and SCCA2 were superior to total IgE or eosinophils in assessing severity. Both TARC and SCCA2 appear valuable for evaluating AD severity; a symptom-specific biomarker selection may facilitate earlier diagnosis and targeted therapy. Larger prospective studies are needed to confirm these findings.
