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. 2024 Oct 30;17(11):100983.
doi: 10.1016/j.waojou.2024.100983. eCollection 2024 Nov.

Molecular characteristics of atopic dermatitis patients with clinical remission

Andrés Sánchez  1   2 , Ana Caraballo  1 , Leidy Alvarez  3 , Oscar Valencia  4 , María-Nelly Restrepo  5 , Rodrigo Gaviria  5 , Margarita Velasquez-Lopera  4 , Juan-Ricardo Urrego  2 , Jorge Sánchez  1   5
Affiliations

Molecular characteristics of atopic dermatitis patients with clinical remission

Andrés Sánchez et al. World Allergy Organ J. .

Abstract

Introduction: Atopic dermatitis (AD) is a frequent disease in infants with diverse clinical evolution. Although multiple studies have assessed inflammatory changes in chronic AD, little is known about the molecular transition from symptomatic stage to clinical remission without pharmacotherapy.

Objective: The aim of the study was to evaluate clinical and inflammatory factors and its relationship with AD clinical evolution.

Methods: Three groups of participants older than 10 years of age were recruited; 2 AD groups and 1 non-AD group. The AD-remission group (more than 1 year without AD symptoms and without pharmacotherapy), the AD-persistent group (AD symptoms and pharmacotherapy), and 1 non-AD group. We measured eosinophil peroxidase (EPX), eosinophil cationic protein (ECP), IgE autoantibodies against these antigens, and natural moisturizing factor (NMF).

Results: Different inflammatory profiles within each group were observed: AD-persistent group is characterized by a high frequency of IgE autoantibodies (55.5%), contrasting with the low occurrence in the non-AD group (2%) and a moderate frequency in the AD-remission group (21.4%). A similar distribution was observed for the other type 2 inflammatory biomarkers (Eosinophils, total IgE, EPX, ECP) and NMF.

Conclusion: Patients with AD-remission maintain a minimal T2 inflammation. We identified different potential biomarkers for prognosis of AD evolution. Further studies are necessary to evaluate the mechanisms that allow the coexistence of the inflammatory process without clinical symptoms.

Keywords: Autoantibodies; Autoimmunity; Hypersensitivity; Peroxidase; Remission; Spontaneous.

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Conflict of interest statement

JS, have been advisors and speakers for Novartis, Sanofi, FAES, Galderma, Nettle, Glaxon, Astrazeneca, Thermofhiser. DA has been a consultant and speaker for Novartis and Glaxon. MV-L have been advisor and speaker for Abbvie, Boehringer ingelheim, Galderma, Janssen, Novartis, Pfizer, and Sanofi, RG have been advisors and speakers for Novartis, Sanofi. RG have been advisors and speakers for Novartis, Sanofi. AS, AC, LA, OV, MNR, JRU have not conflict of interest to declare.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
EPX and ECP levels and IgE autoantibodies. A: levels of eosinophils. In non-AD group, the normal high range of eosinophil levels was 227 cells/uL (median + 2SD). B: EPX and ECP levels. C: ant-EPX IgE and anti-ECP levels. D: patients with 1 or both IgE autoantibodies. Eosinophil peroxidase (EPX), and eosinophil cationic protein (ECP). ∗p < 0.05, ∗∗0.01, ∗∗∗<0.001, according to Pearson's χ2 test, Kruskal-Wallis test and Mann-Whitney test
Fig. 2
Fig. 2
Interaction between levels of eosinophil biomarkers. A: Spearman correlation between eosinophils (Eo), EPX, ECP, anti-EPX IgE, anti-ECP IgE, in AD-remission group (ADr), AD-persistence group (ADp) and non-AD group (nonAD). B: SCORAD According to the presence or not of anti-EPX IgE, anti-ECP IgE. ∗p < 0.05, ∗∗0.01, ∗∗∗<0.001
Fig. 3
Fig. 3
Human antigens allergenicity. CD203c expression was measure in each group according to Median and interquartile range. Statistical comparison (∗p < 0.05), was done between AD remission group and AD persistence group. ∗p < 0.05, Kruskal-Wallis test and Mann-Whitney test
Fig. 4
Fig. 4
Natural moisturizing factor (NMF) was the sum of 4 components (histidine, pyrrolidone-5-carbolix acid, cis and trans isomers of urocanic acid) expressed as mmol/g protein. ∗∗∗p < 0.001, according to, Kruskal-Wallis test and Mann-Whitney test
Fig. 5
Fig. 5
Potential predictors of AD evolution. A: Variables evaluated as potential biomarkers in AD groups. B; risk effect of potential biomarkers with p < 0.1 C: ROC curve of the regression model including potential biomarkers with p < 0.1. D: Accuracy evaluation of the regression model. AD-remission group (ADr), AD-persistence group (ADp), AUC: Area under the curve
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