Non-Lesional Filaggrin Expression is Predictive of Asthma Development in Children with Atopic Dermatitis
February 5, 2024
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Low Filaggrin expression in children aged 2 to 3 years old is a significant predictor of school-age asthma.
MILWAUKEE – Filaggrin (FLG) expression in non-lesional skin and observations of the skin barrier can lead to early diagnosis for children with asthma according to new research being presented at the 2024 American Academy of Allergy, Asthma & Immunology Annual Meeting, in Washington, DC, this month.
“This work highlights the importance of the skin barrier to asthma development. Specifically, filaggrin expression in the normal appearing skin predicts asthma development and is a better predictor than parent-report of physician-diagnosed asthma” says primary author Wan Chi Chang, MS.
Researchers identified markers of skin barrier function and atopic dermatitis severity that could improve childhood asthma prediction. The research states “skin barrier dysfunction is associated with promoting Th2-like sensitization and subsequent asthma, but its role in predicting risk of asthma is unclear.”
In the study, pulmonary function testing (PFT) was conducted in 96 children, aged 7 to 8 years old, with atopic dermatitis from the Mechanisms of Progression from Atopic Dermatitis to Asthma in Children cohort. A child’s asthma diagnosis was defined by PFT, wheezing and utilization history. Logistic regression evaluated the predictability of physician-diagnosed asthma reported by parents, transepidermal water loss (TEWL), SCORing Atopic Dermatitis (SCORAD) and skin expression of FLG for asthma. Research variables were dichotomized to maximize predictive accuracy, while sensitivity and specificity were estimated by the researchers.
The results found that low FLG expression at age 2 to 3 years old in non-lesional (NL) skin was a significant predictor of school-age asthma among participants, and this remained consistent when stratified for racial groups of black and non-black children. Further, NL FLG expression had over two times higher sensitivity in predicting asthma compared to parental-reported physician-diagnosed asthma, while specificity remained similar for both. SCORAD and transepidermal water loss, however, were not significant predictors of asthma.
Early diagnosis of asthma can be a valuable tool in improving patient outcomes, and this research underscores the contribution of the skin barrier to asthma pathogenesis and the need for preventive strategies aimed at skin observations.
Visit aaaai.org to learn more about childhood asthma. Research presented at the 2024 AAAAI Annual Meeting, February 23-26 in Washington, DC, is published in an online supplement to The Journal of Allergy and Clinical Immunology.
The American Academy of Allergy, Asthma & Immunology (AAAAI) is the leading membership organization of more than 7,100 allergists, asthma specialists, clinical immunologists, allied health professionals and other professionals with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has more than 7,100 members in the United States, Canada and 72 other countries and is the go-to resource for patients living with allergies, asthma and immune deficiency disorders.