Abstract
Background
Monitoring the effects of biologic therapies in skin diseases will benefit from alternative
noninvasive skin sampling techniques to evaluate immune pathways in diseased tissue
early and longitudinally.
Objective
To establish a minimally invasive profiling of skin cytokines for diagnosis, therapeutic
response monitoring, and clinical research in atopic dermatitis (AD) and other skin
diseases, particularly in pediatric cohorts.
Methods
We developed a novel method for cytokine profiling in the epidermis using skin tape
strips (STSs) in a setting designed to maximize the efficiency of protein extraction
from STSs. This method was applied to analyze STS protein extracts from the lesional
skin of children having AD (n = 41) and normal, healthy controls (n = 22). A total
of 20 cytokines were probed with the ultrasensitive Mesoscale multiplex cytokine assay.
Results
A significant increase in interleukin (IL)-1b (P < .01), IL-18 (P < .001), and IL-8 (P < .001) with a decrease in IL-1a (P < .001) in the stratum corneum of AD lesional skin was found. Concurrently, an increase
in markers associated with type 2 inflammatory response was readily detectable in
AD lesional skin, including C-C motif chemokine ligand (CCL) 22, CCL 17, and thymic
stromal lymphopoietin (TSLP). The levels of IL-1b, IL-18, and TSLP exhibited positive
correlations with the AD severity index (Scoring AD index) and skin transepidermal
water loss (TEWL), whereas an inverse correlation between IL-1a and Scoring AD index
and IL-1a and TEWL was found. The levels of CCL17, CCL22, TSLP, IL-22, and IL-17a
correlated with skin TEWL measurements.
Conclusion
Using minimally invasive STS analysis, we identified cytokine profiles easily sampled
in AD lesional skin. The expression of these markers correlated with disease severity
and reflected changes in TEWL in lesional skin. These markers suggest new response
assessment targets for AD skin.
Trial Registration
ClinicalTrials.gov Identifier: NCT03168113.
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Article Info
Publication History
Published online: September 04, 2020
Accepted:
August 31,
2020
Received in revised form:
August 27,
2020
Received:
July 29,
2020
Footnotes
Disclosures: The authors have no conflicts of interest to report.
Funding: This work was supported by the Atopic Dermatitis Research Network grant numbers U19AI117673 and UM2AI117870 from the National Institute of Allergy and Infectious Diseases of the National Institutes of Health .
Identification
Copyright
© 2020 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
