engleski

Stratum corneum biomarkers of skin barrier and immune response in atopic dermatitis children with different skin types ; an explorative study

Atopic dermatitis (AD) affects children of all skin types. The wide variety of clinical symptoms and signs provide complexity in individualised approach in therapy and management. Biomarkers can aid in stratification, but the young age of children provides limitations in obtaining blood samples or skin biopsies, and detailed data of skin samples are lacking. A validated minimally invasive method to detect biomarkers would provide an important tool in dissection of childhood AD into disease endotypes. To explore the suitability of stratum corneum (SC) samples obtained by tape stripping in determining skin barrier and immune response biomarkers in AD children with different skin types. SC samples were collected with adhesive tapes from lesional and visibly non-lesional forearm skin of 53 AD children and 50 healthy children. We analysed a panel of 28 immunomodulatory mediators analysed by multiplex technique, as well as natural moisturizing factors (NMF) levels and corneocyte morphology with atomic force microscopy (dermal texture index (DTI)) as markers for skin barrier. Epidermal cytokines (IL 1β, and IL-18) and chemokines (CCL2, CCL22, CCL17) were significantly (p<0.001) higher in lesional AD skin as compared to non-lesional AD skin, while IL-1 α showed the opposite trend. The biomarkers IL8, CCL2, CCL17 showed the best correlation with AD severity (oSCORAD). Healthy skin showed highest NMF levels, with a gradual decrease in non-lesional and lesional AD skin. Children with skin type II also showed gradually decreasing NMF levels from healthy skin to non-lesional and lesional AD skin, but in skin type VI no differences in NMF levels were found between healthy skin, non-lesional and lesional AD skin. AD children with skin type VI showed higher NMF levels in both non-lesional and lesional AD skin compared to skin type II. DTI showed significant differences between lesional AD skin and both non-lesional AD skin and healthy skin. The minimally invasive method of collecting SC samples is suitable for determination of inflammatory and skin barrier biomarkers in AD children. This explorative study shows differences between AD children with skin type II and skin type VI in NMF levels, suggesting that some aspects of pathomechanisms may differ in AD children with light vs dark skin types.

biomarkers, cytokines, atopic dermatitis, NMF

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