Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr;76(4):1158-1172.
doi: 10.1111/all.14557. Epub 2020 Sep 1.

Predicting persistence of atopic dermatitis in children using clinical attributes and serum proteins

Felix Lauffer  1 , Veronika Baghin  1 , Marie Standl  2 , Sebastian P Stark  3 , Manja Jargosch  1 , Julius Wehrle  4   5   6 , Jenny Thomas  3 , Carsten B Schmidt-Weber  3 , Tilo Biedermann  1 , Stefanie Eyerich  3 , Kilian Eyerich  1   7 , Natalie Garzorz-Stark  1   7
Affiliations

Predicting persistence of atopic dermatitis in children using clinical attributes and serum proteins

Felix Lauffer et al. Allergy. 2021 Apr.

Abstract

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.

Keywords: atopic dermatitis; atopic eczema; endotype; predictive biomarker.

PubMed Disclaimer

References

REFERENCES

    1. Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387(10023):1109-1122.
    1. Garmhausen D, Hagemann T, Bieber T, et al. Characterization of different courses of atopic dermatitis in adolescent and adult patients. Allergy. 2013;68(4):498-506.
    1. Illi S, von Mutius E, Lau S, et al. The natural course of atopic dermatitis from birth to age 7 years and the association with asthma. J Allergy Clin Immunol. 2004;113(5):925-931.
    1. Davidson WF, Leung DYM, Beck LA, et al. Report from the National Institute of allergy and infectious diseases workshop on "atopic dermatitis and the atopic march: mechanisms and interventions". J Allergy Clin Immunol. 2019;143(3):894-913.
    1. von Kobyletzki L, Svensson A, Apfelbacher C, Schmitt J. Factors that predict remission of infant atopic dermatitis: a systematic review. Acta Derm Venereol. 2015;95(4):389-394.

Publication types

LinkOut - more resources