Biomarkers associated with the development of comorbidities in patients with atopic dermatitis: A systematic review

Abstract

Biomarkers associated with the development of comorbidities in atopic dermatitis (AD) patients have been reported, but have not yet been systematically reviewed.Seven electronic databases were searched, from database inception to September 2021. English language randomized controlled trials, prospective and retrospective cohort, and case-control studies that investigated the association between a biomarker and the development of comorbidities in AD patients were included. Two authors independently screened the records for eligibility, one extracted all data, and critically appraised the quality of studies and risk of bias. Fifty six articles met the inclusion criteria, evaluating 146 candidate biomarkers. The most frequently reported biomarkers were filaggrin mutations and allergen specific-IgE. Promising biomarkers include specific-IgE and/or skin prick tests predicting the development of asthma, and genetic polymorphisms predicting the occurrence of eczema herpeticum. The identified studies and biomarkers were highly heterogeneous, and associated with predominately moderate-to-high risk of bias across multiple domains. Overall, findings were inconsistent. High-quality studies assessing biomarkers associated with the development of comorbidities in people with AD are lacking. Harmonized datasets and independent validation studies are urgently needed.

Maternal prepregnancy body mass index, gestational weight gain, and allergic diseases in children: A systematic review and meta‐analysis

“…Abnormal GWG may lead to alternations in the metabolic and hormonal environment of the developing fetus, along with increased concentrations of inflammatory cytokines 46 . The evidence that prepregnancy BMI is negatively associated with the level of cord‐blood IgE, 27 an important biomarker in eczema, 47 indicates that prepregnancy BMI is negatively related to the risk of childhood eczema. Moreover, the 2009 IOM GWG guideline recommends a higher weight gain for pregnant women with prepregnancy underweight and a lower weight gain for pregnant women with prepregnancy overweight and obesity.…”

“…Abnormal GWG may lead to alternations in the metabolic and hormonal environment of the developing fetus, along with increased concentrations of inflammatory cytokines. 46 The evidence that prepregnancy BMI is negatively associated with the level of cordblood IgE, 27 an important biomarker in eczema, 47 indicates that prepregnancy BMI is negatively related to the risk of childhood eczema.…”

A concept for integrated care pathways for atopic dermatitis—A GA2LEN ADCARE initiative

“…Despite its complex pathophysiology and variable clinical phenotype, AD is often considered a single disease and treated with a uniform approach. More tailored prevention and therapeutic strategies are being explored, such as by the BIOMAP Consortium, aiming to stratify AD patients according to their phenotype and endotype with the support of new biomarkers 85,86 . Such a personalised approach may help to assign available and newly emerging drugs to those patients with the best benefit/risk ratio 22 .…”

The origins and longevity of IgE responses as indicated by serological and cellular studies in mice and humans

“…A systemic IgE priming may also occur by exposing tape‐strip damaged epidermis to allergen, 96 with the exposure to allergens through eczematous skin lesions or a damaged epithelial barrier, such as occurs with filaggrin loss‐of‐function mutations that render individuals prone to atopic diseases, 97,98 potentially underlying sensitization, setting the epitopes that are recognized by IgE in allergic individuals 71 . Damage to epithelial barriers caused by detergents and environmental pollutants is a tenet of the “epithelial barrier” hypothesis, seen as a major cause of multiple diseases, including those mediated by type 2 immunity and associated with IgE 99–101 .…”