Published online: July 21, 2020
Atopic dermatitis (AD) and psoriasis are some of the most common inflammatory skin disorders with overlapping but distinct immune and barrier abnormalities that have been investigated with skin biopsies. However, biopsies are associated with pain, scarring, and increased risk of infection, limited their utility in large clinical trials and longitudinal studies. Tape-strips, which are serial adhesive films used to sample the outermost layers of skin, may constitute a less invasive, non-scarring approach to analyze molecular abnormalities in these diseases.
In a recent study published in The Journal of Allergy and Clinical Immunology (JACI), He et al evaluated tape-strips obtained from 20 adults with moderate-to-severe AD, 20 with moderate-to-severe psoriasis, and from 20 healthy individuals. Twenty serial tapes were collected from both lesions and clinically unaffected skin of all subjects and were subjected to global molecular profiling for identification of disease-related biomarkers.
This study successfully captured genes related to immune and epidermal barrier function that were dysregulated in AD and/or psoriasis, and that distinguished the diseases from each other. For example, tape-strips from AD patients strongly expressed markers related to T-helper 2 (Th2) inflammation, while psoriasis patients displayed much higher Th17 and Th1 inflammation. Moreover, He et al identified a single gene, NOS2, which differentiated AD from psoriasis with perfect accuracy. The molecular phenotypes described this study were notably in accord with previous reports from skin biopsy studies, and with the current mechanistic understanding of both diseases.
This study represents the most comprehensive tape-strip molecular profile that compares AD with psoriasis. He et al showed that tape-strips are able to accurately detect the distinct immune and barrier signatures of AD and psoriasis. These findings suggest future applications of tape-strips in monitoring disease activity and therapeutic response in clinical trials, longitudinal studies, and everyday clinical settings in the context of AD, psoriasis, and other inflammatory skin diseases.
The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.