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Predicting persistence of atopic dermatitis in children using clinical attributes and serum proteins.
Allergy 76, 1158–1172 (2021)
Publ. Version/Full Text
Research data
DOI
PMC
Background Atopic dermatitis (AD) is the most common inflammatory skin disease in children, with 30% of all those diagnosed developing chronic or relapsing disease by adolescence. Such disease persistence cannot yet be predicted. The aim of the present study was to predict the natural course of AD using clinical parameters and serum proteins. Methods Sera of 144 children with AD (age 0-3 years) were analyzed for IgE and 33 cytokines, chemokines, and growth factors. Patient disease course until the age of 7 years was assessed retrospectively. Unsupervised k-means clustering was performed to define disease endotypes. Identified factors associated with AD persistence at the age of 7 years were validated in children with AD in an independent cohort (LISA Munich; n = 168). Logistic regression and XGBoosting methods followed by cross-validation were applied to predict individual disease outcomes. Results Three distinct endotypes were found in infancy, characterized by a unique inflammatory signature. Factors associated with disease persistence were disease score (SCORAD), involvement of the limbs, flexural lesion distribution at the age of 3 years, allergic comorbidities, and disease exacerbation by the trigger factors stress, pollen exposure, and change in weather. Persistence was predicted with a sensitivity of 81.8% and a specificity of 82.4%. Factors with a high impact on the prediction of persistence were SCORAD at the age of 3 years, trigger factors, and low VEGF serum levels. Conclusion Atopic dermatitis in infancy comprises three immunological endotypes. Disease persistence can be predicted using serum cytokines and clinical variables.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Atopic Dermatitis ; Atopic Eczema ; Endotype ; Predictive Biomarker; Endothelial Growth-factor; Tissue Inhibitors; Disease Severity; Adult Patients; T-cells; Eczema; Skin; Biomarkers; Symptoms; Weather
ISSN (print) / ISBN
0105-4538
e-ISSN
1398-9995
Journal
Allergy
Quellenangaben
Volume: 76,
Pages: 1158–1172
Publisher
Wiley
Publishing Place
111 River St, Hoboken 07030-5774, Nj Usa
Non-patent literature
Publications
Reviewing status
Peer reviewed
Grants
Deutsche Forschungsgemeinschaft (DFG)