Researchers have found a way to evaluate the cutaneous biomarkers of atopic dermatitis via a minimally invasive method using tape strips, which may offer insight into tracking pediatric treatment responses in the future, according to recent findings published in JAMA Dermatology.
“We are constantly seeking a minimally invasive means to get to the [atopic dermatitis] phenotype in children,” study author Emma Guttman-Yassky, MD, PhD, of the department of dermatology and laboratory for inflammatory skin diseases, Icahn School of Medicine at Mount Sinai Medical Center, told Healio Dermatology. “It’s even more important because many clinical trials which have been successful in adults are now moving into children. We have therapeutic development moving into children, and we also need biomarkers to understand treatment responses in children. Up until now, we couldn’t do anything because you can’t take biopsies in children. No one would even consider it.”
The study included 51 children aged younger than 5 years with moderate to severe early-onset AD or without AD. Sixteen tapes were collected from the lesional and nonlesional skin of 21 children with AD for less than 6 months and from the normal skin of 30 children without AD. Nonlesional skin samples came from nearby skin on the same arm.
Seventy-seven of 79 immune and barrier gene products were detected, for a gene detection rate of 97%, in 70 of 71 tape strips, for a sample detection rate of 99%, according to the study.“We are happy about the data for several reasons, one being that we managed to identify the phenotype in children with tape strips,” Guttman-Yassky said. “We found similar phenotypes to what we have found in biopsies, which is the gold standard.”
Fifty-three of the 79 markers differentiated children with AD with or without lesions from those without AD. With the exception of CD83 and CD11c, most cellular markers had significant differences in lesional AD skin and non-AD skin.
“We found that many of the genes that are the hallmark of eczema [were] upregulated in children with eczema in lesional and non-lesional skin,” Guttman-Yassky said.
Among these were many genes currently being targeted by therapeutic drugs such as interleukin 4, IL-13, IL-22 and IL-17C.
Additionally, one gene, the epidermal negative regulator cytokine IL-34, was the best single-gene classifier and able to separate the children with AD from the ones without with 100% accuracy, according to Guttman-Yassky.
“We believe that such a gene can be helpful in longitudinal studies from the ones that outgrow eczema. We are very excited about this data,” she said.
Guttman-Yassky foresees additional application for tape strips in other inflammatory skin diseases in children and beyond.
“For dermatology, using tape strips is not hard, but it is time-consuming in the lab. I think it’s worthwhile because you can get biomarkers in children, babies and early on in other diseases,” she said. – by Abigail Sutton
Disclosures: Gutman-Yassky reports receiving grants from Regeneron during the conduct of the study; grants from AbbVie, Asana Biosciences, Celgene, Dermavant, DS Biopharma, Lilly, Galderma, Glenmark Pharmaceuticals, Innovaderm Research, Janssen Biotech, Kyowa Kirin, Leo Pharma, Novan, Novartis, Pfizer, Ralexar Therapeutics, Regeneron, Sanofi and Union Therapeutics; and personal fees from AbbVie, Allergan, Amgen, Asana BioSciences, Celgene, Concert Pharmaceuticals, DBV Technologies, Dermira, DS Biopharma, Lilly, EMD Serono, Escalier, RAPT Therapeutics, Galderma, Glenmark Pharmaceuticals, Kyowa Kirin, Leo Pharma, Mitsubishi Tanabe, Novartis, Pfizer, Regeneron, Sanofi and Union Therapeutics. Please see the study for all other authors’ relevant financial disclosures.