Abstract
Background:Atopic dermatitis is a highly heterogeneous skin disease, mainly affecting children. Introduction of biological therapies has urged the development of biomarkers to facilitate personalized therapy. Stratum corneum biomarkers emerged as a promising non-invasive alternative to skin biopsy, yet validation of spatial and biological variability is essential for their application in clinical research.Objective:To assess spatial and biological variability of stratum corneum biomarkers for atopic dermatitis.Methods:Stratum corneum was collected from 17 atopic dermatitis patients by consecutive application of eight adhesive tapes to a lesional skin site and 2 cm and 4 cm from the lesion. Two non-lesional sites at a 2 cm distance from the same lesion were collected to determine biological variability. Filaggrin degradation products (NMF) were determined by liquid chromatography and thirteen cytokines (IL-4, IL-13, IL-18, IL-31, IL-33, CCL17, CCL22, CCL27, CXCL8, IL-1α, IL-RA, IL-18, IL-22) by multiplex immunoassay.Results:Biomarker levels showed gradual changes from lesional to non-lesional skin sites at 2 cm and 4 cm; magnitude and direction of change were biomarker-specific. Intra-subject variability ranged from 17.3% (NMF) to 85.1% (CXCL8). Biomarker levels from two stratum corneum depths were highly correlated; several biomarkers showed significant depth dependence.Conclusion:Stratum corneum enables non-invasive collection of relevant immune and epidermal biomarkers, but biomarker-specific spatial and biological variability emphasizes the importance of standardized procedures for stratum corneum collection.
Highlights
Atopic Dermatitis (AD) is a common inflammatory skin disease affecting up to 20% of children and 7-10% of adults [1, 2]
Intra-subject variability ranged from 17.3% (NMF) to 85.1% (CXCL8)
Stratum corneum enables non-invasive collection of relevant immune and epidermal biomarkers, but biomarker-specific spatial and biological variability emphasizes the importance of standardized procedures for stratum corneum collection
Summary
Atopic Dermatitis (AD) is a common inflammatory skin disease affecting up to 20% of children and 7-10% of adults [1, 2]. The disease is characterized by the impaired skin barrier and aberrant immune response, and clinically manifests through recurrent dermatitis, dry and inflamed skin, severe itch. SC can and non-invasively be collected using adhesive tapes, a technique that has evidenced its potential for the study of various inflammatory skin diseases such as AD, psoriasis and contact dermatitis. Atopic dermatitis is a highly heterogeneous skin disease, mainly affecting children. Stratum corneum biomarkers emerged as a promising non-invasive alternative to skin biopsy, yet validation of spatial and biological variability is essential for their application in clinical research
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