The blood proteomic signature of early-onset pediatric atopic dermatitis shows systemic inflammation and is distinct from adult long-standing disease
Journal of the American Academy of Dermatology, 2019
Brunner P., He H., Pavel A., Czarnowicki T., Lefferdink R., Erickson T., Canter T., Puar N., Rangel S., Malik K., Estrada Y., Krueger J., Guttman-Yassky E., Paller A.
| Disease area | Application area | Sample type | Products |
|---|---|---|---|
Dermatological Diseases | Pathophysiology Patient Stratification | Plasma |  Olink Target 96 |
Abstract
Background
Despite increasing evidence that adults with longstanding atopic dermatitis (AD) have systemic inflammation, little is known about systemic inflammation in recent-onset early pediatric AD.
Objective
To analyze blood inflammatory proteins of early pediatric AD.
Methods
Using high-throughput proteomics (proximity extension assay), we assessed 257 inflammatory and cardiovascular risk proteins in blood of 30 children with moderate-to-severe AD <5 years of age (within 6 months of onset), compared to age-matched pediatric controls and adult AD.ResultsIn pediatric AD blood, Th2 (CCL13, CCL22) and Th17 (PI3/elafin) markers were increased, together with markers of tissue remodelling (MMP3/9/10, uPAR), endothelial activation (E-Selectin), T-cell activation (IL2RA), neutrophil activation (myeloperoxidase), lipid metabolism (FABP4), and growth factors (FGF21, TGF-alpha). Total numbers of dysregulated proteins were smaller (n=22) than in adult AD (n=61). Clinical severity scores were positively correlated with receptors for IL-33 and IL-36, and inversely correlated with some Th1 markers (IFN-γ, CXCL11).LimitationsDifferent baseline expression levels in healthy pediatric vs. adult samples.ConclusionsWithin months of pediatric AD onset, systemic immune activation is present, with Th2/Th17 skewing but otherwise different proteomic patterns from adult AD. Future correlation of proteomic patterns with disease course, comorbidity development, and drug response may yield predictive biomarkers.