Age-Dependent Blood Protein Changes in Patients With Atopic Dermatitis

A recent study published in the Journal of the American Academy of Dermatology shed light on the intricate age-specific changes in blood proteins among individuals with atopic dermatitis (AD). The research, conducted using the advanced Olink high-throughput proteomic platform, has illuminated the unique proteomic characteristics that evolve as patients transition from infancy to adulthood, providing valuable insights into the systemic biomarker dysregulation associated with AD.

The researchers aimed to decipher the distinctive proteomic signatures within different age groups of patients with AD compared to age-appropriate controls. The research encompassed a wide spectrum of ages, including 20 infants (age 0–5 years), 39 children (age 6–11 years), 21 adolescents (age 12–17 years), and 20 adults (age ≥18 years), all with moderate to severe AD. These groups were contrasted with 83 age-matched controls.

In the results, each age group showcased a unique systemic proteomic signature. Among the infants, AD was associated with an elevation of Th2-related proteins, including interleukin 4, CCL13, and CCL17, which progressively intensified through adolescence and into adulthood. In contrast, the Th1 axis, which was initially downregulated in infants with AD, exhibited a gradual reversal to increased Th1 products, such as interferon γ, CXCL9, CXCL10, and CCL2, as patients advanced from childhood to adulthood.

Significantly, even in infants with a short disease duration, evidence of systemic inflammation was evident. This was underscored by substantial upregulation of proteins associated with innate immunity (IL-17C and IL-1RN), T-cell activation/migration (CCL19), Th2 (CCL13 and CCL17), and Th17 (PI3) pathways.

The study's findings also revealed a unique upregulation of cardiovascular proteins linked to coagulation and diabetes in adults with AD. This highlights the multifaceted impact of AD on the body, beyond the skin.

“Systemic immune signatures of AD are age-specific beyond the shared Th2 immune activation,” concluded the study authors. “These data advocate for precision medicine approaches based on age-specific AD profiles.”

Reference
Del Duca E, Renert-Yuval Y, Pavel AB, et al. Proteomic characterization of atopic dermatitis blood from infancy to adulthood. J Am Acad Dermatol. 2023;88(5):1083-1093. doi:10.1016/j.jaad.2022.12.050