- About 223 million people globally have atopic dermatitis, with 43 million children ages 1 to 4.
- About 60% of all people with eczema will develop it in the first year of life.
- Researchers from National Jewish Health have discovered specific biomarkers on the skin that can predict whether a baby will develop eczema.
In 2022, there were an estimated 223 million people around the world living with the skin condition eczema, clinically known as atopic dermatitis.
Of that number, 43 million were children between the ages of 1 and 4.
About 60% of people who have atopic dermatitis — for which there is currently no cure — develop it as a baby during their first year of life.
Now, researchers from National Jewish Health have discovered specific biomarkers on the skin that can predict whether a baby will develop eczema months before the onset of illness.
Scientists say this finding will help in the development of targeted therapies for the condition.
Their study was recently published in the Journal of Allergy and Clinical Immunology.
What is atopic dermatitis?
Atopic dermatitis is an inflammatory skin condition.
A number of factors contribute to the development and exacerbation of eczema, including:
- genetics — a family history of atopic dermatitis or major allergies.
- an overactive immune system.
- environmental irritants, such as air pollution, smoke, and harsh cleansers and fabrics.
General symptoms of eczema — usually known as flare-ups — include:
- dry, scaly skin
- skin that looks red
- itchy skin
- skin rash
- bumps on the skin
- swelling
In babies, atopic dermatitis normally begins with very dry, itchy skin on the scalp and cheeks.
As a child gets older, eczema symptoms may form in a number of places in the body, including:
- the outside of or creases of the knees and elbows
- other areas of the face, including around the mouth
- hands and/or feet
- wrists and/or ankles
- outside of the ears
Eczema flare-ups can be triggered by a variety of things, including:
- stress
- dry weather
- allergens such as dust and pollen
- irritating fabrics, soaps, and/or detergents
- pollutants
- food allergies
- cosmetics and/or skin care products
There is currently no cure for atopic dermatitis.
Doctors treat the condition through medications, including topical corticosteroids and antihistamines.
A doctor may also suggest phototherapy as a treatment option.
Predicting eczema
According to Dr. Donald Leung, the division head of Pediatric Allergy and Clinical Immunology at National Jewish Health and a senior author of this study, it is important to have a way to predict if an infant will develop atopic dermatitis.
“Not all babies develop atopic dermatitis — 20% of babies develop atopic dermatitis,” he told Medical News Today. “It is important to identify the subset of babies prone to atopic dermatitis so we can selectively target treatment to that group of babies.”
“The holy grail to deal with atopic dermatitis is to prevent it,” Leung added. “It tends to come back when you treat it, so we really have to examine how to avoid getting it.”
Looking for eczema biomarkers
For this study, Leung and his team worked in conjunction with scientists from South Korea.
Those doctors used a non-invasive skin tape to collect skin cell samples from infants at 2 months of age when they did not show any clinical signs of eczema. The infants included those with and without a family history of atopic dermatitis.
The babies were clinically monitored from birth until the age of 2. Additional skin cell samples were taken at designated points during that time.
At the conclusion of the study, the research team reported that 22 of the 74 babies in the risk group developed atopic dermatitis. Upon analysis of their skin cells, scientists said that two specific skin biomarkers — thymic stromal lymphopoietin (TSLP) and interleukin‐13 (IL-13) — were increased by 75% in infants who went on to develop atopic dermatitis.
“The biomarkers IL-13 and TSLP are molecules that promote allergy,” Leung explained. “Finding these biomarkers in the skin of atopic dermatitis patients (is) abnormal and predicts that such patients are prone to develop atopic dermatitis in the future. Treatments that can antagonize the activity of IL13 and TSLP would prevent the onset of atopic dermatitis.”
Therapy targets for atopic dermatitis
Leung said their findings suggest skin abnormalities occur prior to the onset of skin rash and the use of preventive measures prior to the onset of skin rash can help.
“In order for us to introduce an effective preventative therapy, we must know the skin abnormalities before patients develop clinical rash,” Leung said in a press release. “Now that we’ve discovered the biomarkers IL-13 and TSLP, we can find ways to prevent eczema by using targeted therapies, such as emollients or other biologics. The disease begins because the skin barrier is leaky and allows allergens to come in through the skin. An abnormal skin barrier doesn’t protect a patient from environmental hazards.”
As for the next steps in this research, Leung said their observation that the allergic pathway is already activated at 2 months means that the disease activation switch was turned on prior to that age.
“We are now tracing the pathway backward to determine what turned the allergic pathway on and when this occurred,” he continued. “We want to determine if it could even have occurred in utero as that might completely change our approach to (the) prevention of allergic disease.”
Exciting study data
Medical News Today also spoke with Dr. Emma Guttman, a professor and system chair in The Kimberly and Eric J. Waldman Department of Dermatology as well as the director of the Center of Excellence in Eczema and director of Laboratory of Inflammatory Skin Diseases at Icahn School of Medicine at Mount Sinai in New York, about this research.
She said as a physician-scientist who treats patients with atopic dermatitis and also performs many biomarker studies — including prediction biomarkers — the study data was exciting.
“The study shows that based on early immune and barrier biomarkers in (the) skin using the tape stripping technique we can predict who are the children that may develop atopic dermatitis later on,” Guttman said. “This study adds to a bulk of evidence showing early disease biomarkers in infants with atopic dermatitis from my group, as well as Jacob Thyssen’s group. It also introduces the idea that it may be possible to prevent atopic dermatitis early in susceptible children.”
Source: Read Full Article