2018
DOI: 10.1016/j.jaci.2018.02.040
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Early-onset pediatric atopic dermatitis is characterized by TH2/TH17/TH22-centered inflammation and lipid alterations

Abstract: Skin samples from children and adult patients with AD share lipid metabolism and tight junction alterations, but epidermal differentiation complex defects are only present in adult AD, potentially resulting from chronic immune aberration that is not yet present in early-onset disease.

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Cited by 197 publications
(271 citation statements)
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References 99 publications
(132 reference statements)
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“…In this study, we elucidated the molecular and cellular characteristics of DN, along with its relationship with respect to CMN and MM, using a rigorous statistical method that has previously been successfully applied to the study of many cutaneous diseases, including psoriasis, alopecia areata, atopic dermatitis and skin cancers . Studies investigating the molecular profiles of melanocytic lesions that include DN are limited.…”
Section: Discussionmentioning
confidence: 99%
“…In this study, we elucidated the molecular and cellular characteristics of DN, along with its relationship with respect to CMN and MM, using a rigorous statistical method that has previously been successfully applied to the study of many cutaneous diseases, including psoriasis, alopecia areata, atopic dermatitis and skin cancers . Studies investigating the molecular profiles of melanocytic lesions that include DN are limited.…”
Section: Discussionmentioning
confidence: 99%
“…Acute AD lesions are characterized by the enhanced expression of Th2 (interleukin [IL]‐4, IL‐13, IL‐31)/Th22 (IL‐22) cytokines, while progression to chronic AD is associated with intensification of Th2/Th22 and significant increases in Th1‐related products like interferon (IFN)‐γ, C‐X‐C motif chemokine (CXCL)9 and CXCL10 . Especially, lesions of adult patients with long‐standing AD reveal extremely enhanced expression of Th1‐associated mediators (CXCL9, CXCL10, signal transducer and activator of transcription 1, IL‐12RB2), which is not seen in the lesions of pediatric AD patients with early onset . The enhanced Th1 activity may be related to the decreased expression of epidermal differentiation complex like filaggrin, and of ceramides with long‐chain fatty acids in the stratum corneum in chronic adult AD lesions .…”
Section: Discussionmentioning
confidence: 99%
“…The skin transcriptome of 19 young children (with no known FLG mutations) with early‐onset AD was compared to that of age‐matched healthy controls, as well as to adult AD patients/controls. In common for both child and adult AD patients were alterations in lipid metabolism and tight junction associated genes as well as Th2‐mediated inflammation . In addition, the pediatric patients displayed significant Th17/Th22 polarization, but neither Th1 activation nor downregulation of epidermal differentiation complex genes, which are characteristic features of adult AD.…”
Section: From Disease Understanding To Biomarkers Endotypes and Tarmentioning
confidence: 99%
“…The effect of ethnicity on AD has been shown in Asian (Japanese and Korean) patients, who in general display a more psoriasiform AD phenotype and significantly higher Th17/Th22 activation as assessed by cytokine expression (IL‐17A, IL‐19, IL‐22, S100A12), compared to European American AD patients . This can have implications for the choice of treatment, as the selective blockade of IL‐17/IL‐22 pathways could be indicated in the Asian, ‘psoriasis‐like’ immune phenotype.…”
Section: From Disease Understanding To Biomarkers Endotypes and Tarmentioning
confidence: 99%