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

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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.

TidsskriftJournal of Allergy and Clinical Immunology
Udgave nummer6
Sider (fra-til)1550-1557.e6
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
The study received financial support from The Leo Foundation , The Lundbeck Foundation , The Novo Nordisk Foundation , Aage Bangs fond, Savværksejer Jeppe Juhl og hustru Ovita Juhls Mindelegat, and Herlev and Gentofte Hospital Research Foundation. The study was conducted independent of these, and they had no influence on study design or data analysis.

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