Molecular characteristics of atopic dermatitis patients with clinical remission

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

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.