Biomarkers to Differentiate Atopic Dermatitis Endotypes

NJH ID: #19-01

Background
Atopic Dermatitis (AD) is the most common inflammatory skin disease in children affecting nearly 20%.  AD patients with multiple allergen sensitization could progress from AD to food allergy (FA) and respiratory allergy. FA only affects one-third of children with AD, with allergy to peanuts, egg, and milk as the predominant food allergies.

There is great interest in identifying the different endotypes and skin biomarkers which result in various clinical phenotypes of AD in hopes that this will translate into personalized treatments which could improve outcomes.

Although blood biomarkers can correlate with AD disease activity, their interpretation is limited by potential contribution within the circulation from other allergic co-morbidities such as asthma, allergic rhinitis, and FA. Skin biopsies cannot be performed with routine exams because they are invasive and not accepted by most patients.

Skin barrier dysfunction is believed to be a contributor to the development of both AD and FA.  Preliminary studies by this group found that nonlesional skin from patients with AD had different characteristics depending on whether the patient also had FA.

 

Technology
Dr. Leung and his research group have performed a comprehensive study on 62 children which purpose was to use a novel skin tape strip sampling method and a multi-omics approach to comprehensively determine whether children with AD and FA (AD FA+) have stratum corneum abnormalities which distinguish them from AD without FA and non-atopic controls.  

This study revealed that several biomarkers, particularly keratin 5 and 14, and filaggrin breakdown products, were the most important independent predictors of AD FA+.

 

Potential Applications
Diagnostic assay predictive of AD and FA development, and targeted preventive therapeutic intervention by improving skin barrier functions.

 

State of Development
Additional skin tape stripping studies in a larger cohort of infants will be needed to validate these biomarkers as predictors of AD endotypes.

 

Publications

  • Leung, DYM, et al. The Non-Lesional Skin Surface Distinguishes Atopic Dermatitis with Food Allergy as a Unique Endotype, Science Translational Medicine; Vol. 11, Issue 480, eaav2685 - PMID: 30787169

 

Patent Status
Patent Pending

 

Inventors
Donald Leung, MD, PhD, Elena Goleva, Ph.D. and Evgeny Berdyshev, Ph.D.

 

Licensing Status
This technology is available for licensing.

 

For Further Information, Contact:
Emmanuel Hilaire, PhD
Director
Technology Transfer Office
National Jewish Health
1400 Jackson Street, Room M206b
Denver, CO 80206
Voice: 303.398.1262
HilaireE@njhealth.org