Lipidomics and Metabolomics in Infant Atopic Dermatitis: What’s the Correlation with Early Nutrition?

Abstract

To date, the complex picture of atopic dermatitis (AD) has not yet been fully clarified, despite the important prevalence of this disease in the pediatric population (20%) and the possibility of persistence into adulthood, with important implications for the quality of life of those affected, as well as significant social and financial costs. The most recent scientific evidence suggests a new interpretation of AD, highlighting the important role of the environment, particularly that of nutrition in the early stages of development. In fact, the new indications seem to point out the harmful effect of elimination diets, except in rare cases, the uselessness of chrono-insertions during complementary feeding and some benefits, albeit weak, of breastfeeding in those at greater risk. In this context, metabolomics and lipidomics can be necessary for a more in-depth knowledge of the complex metabolic network underlying this pathology. In fact, an alteration of the metabolic contents in children with AD has been highlighted, especially in correlation to the intestinal microbiota. While preliminary lipidomic studies showed the usefulness of a more in-depth knowledge of the alterations of the skin barrier to improve the development of baby skin care products. Therefore, investigating the response of different allergic phenotypes could be useful for better patient management and understanding, thus providing an early intervention on dysbiosis necessary to regulate the immune response from the earliest stages of development.

Integrative Multiomics Approach to Skin: The Sinergy between Individualised Medicine and Futuristic Precision Skin Care?

“…Nonetheless, a microbial imbalance at the skin level can represent a significant issue not only in the case of local skin pathologies but also in the presence of other systemic inflammatory diseases, such as food allergies. In fact, the production of microbial metabolites at the skin level can have repercussions on the entire organism [ 23 , 24 , 25 ]. Specifically, as regards food allergies (FA), the presence of specific IgE towards egg whites in children suffering from AD was significantly correlated with the detection of specific IgE towards staphylococcal toxins [ 24 , 25 ].…”

“…In fact, the production of microbial metabolites at the skin level can have repercussions on the entire organism [ 23 , 24 , 25 ]. Specifically, as regards food allergies (FA), the presence of specific IgE towards egg whites in children suffering from AD was significantly correlated with the detection of specific IgE towards staphylococcal toxins [ 24 , 25 ]. This may be due to the presence of a cutaneous pathway of sensitization to IgE, which emerged thanks to studies conducted with tape stripping, which mimics the alteration of the AD-related skin barrier.…”

“…This may be due to the presence of a cutaneous pathway of sensitization to IgE, which emerged thanks to studies conducted with tape stripping, which mimics the alteration of the AD-related skin barrier. Such research has in fact found that in eczematous skin exposed to allergens, there is an increase in the same epidermal alarmins involved in the immune dysregulation that characterizes AD, responsible for the hyperactivation of the Th-2 immune response [ 24 , 25 ]. Furthermore, exposure to particular non-pathogenic bacteria typical of rural environments, such as Acinetobacter , or to mothers’ germs during spontaneous childbirth, also seem to represent a protective agent against allergies, providing solid evidence of the ability of the symbiosis of the skin microbiota to control the systemic immune response of the entire organism [ 23 ].…”

Metabolomics in Children Cow’s Milk Protein Allergy: Possible Contribution from a System Biology Approach?

“…In fact, in the case of AD, FA is only one of the possible triggers in about one-third of patients, and the most recent indications suggest that in such individuals, only after establishing optimal skin treatment is it appropriate to proceed with allergy testing. Where this proves positive, together with a clinical reactivity clearly attributed to the food, one can proceed with an elimination diet that is well tailored and appropriate to improve the severity of AD itself [17,18].…”