Skin TARC/CCL17 increase precedes the development of childhood atopic dermatitis

Anne-Sofie Halling, Maria Rasmussen Rinnov, Iben Frier Ruge, Trine Gerner, Nina Haarup Ravn, Mette Hjorslev Knudgaard, Simon Trautner, Nikolai Loft, Lone Skov, Simon F Thomsen, Alexander Egeberg, Emma Guttman-Yassky, Aske L L Rosted, Troels Petersen, Ivone Jakasa, Sanja Kezic, Jacob P Thyssen


BACKGROUND: It is unknown whether skin biomarkers collected in infancy can predict the onset of atopic dermatitis (AD) and be used in future prevention trials to identify children at risk.

OBJECTIVES: This study sought to examine whether skin biomarkers can predict AD during the first 2 years of life.

METHODS: This study enrolled 300 term and 150 preterm children at birth and followed for AD until the age of 2 years. Skin tape strips were collected at 0 to 3 days and 2 months of age and analyzed for selected immune and barrier biomarkers. Hazard ratio (HR) with 95% confidence interval (CI) using Cox regression was calculated for the risk of AD.

RESULTS: The 2-year prevalence of AD was 34.6% (99 of 286) and 21.2% (25 of 118) among term and preterm children, respectively. Skin biomarkers collected at birth did not predict AD. Elevated thymus- and activation-regulated chemokine/C-C motif chemokine ligand 17 -levels collected at 2 months of age increased the overall risk of AD (HR: 2.11; 95% CI: 1.36-3.26; P = .0008) and moderate-to-severe AD (HR: 4.97; 95% CI: 2.09-11.80; P = .0003). IL-8 and IL-18 predicted moderate-to-severe AD. Low filaggrin degradation product levels increased the risk of AD (HR: 2.04; 95% CI: 1.32-3.15; P = .001). Elevated biomarker levels at 2 months predicted AD at other skin sites and many months after collection.

CONCLUSIONS: This study showed that noninvasively collected skin biomarkers of barrier and immune pathways can precede the onset of AD.

Original languageEnglish
JournalThe Journal of allergy and clinical immunology
Pages (from-to)epub
Publication statusE-pub ahead of print - 23 Dec 2022


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