Cord Blood Biomarkers and TEWL Predict Atopic Dermatitis in Infants

A prospective study reports that elevated levels of CCL17 and IL-31 in cord blood, along with increased transepidermal water loss (TEWL) at the anterior cubital fossa, could help identify infants at higher risk of developing atopic dermatitis (AD) within their first year of life.

The study, conducted in Pisa, Italy, followed 40 full-term newborns for 12 months. The researchers measured TEWL and hydration rates at the anterior cubital fossa and knee at 1, 6, and 12 months of age. Cord blood samples were analyzed for serological biomarkers, including CCL17, IL-31, CCL18, CCL22, CCL27, and thymus stromal lymphopoietin.

At 6 months, 16 infants exhibited signs of AD, and these infants consistently demonstrated significantly higher TEWL values at the anterior cubital fossa compared to the non-AD group, according to the results of the analysis. TEWL measurements at the anterior part of the knee did not show significant differences between the two groups.

Serological analysis revealed that newborns who developed AD had higher levels of CCL17 and IL-31 at birth. The data showed that CCL17 levels were nearly twice as high in the AD group compared to the non-AD group (716 pg/mL vs. 419 pg/mL, P = 0.003). Similarly, IL-31 levels were significantly elevated in the AD group (212 pg/mL vs. 97 pg/mL, P = 0.04). Other cytokines, including CCL18, CCL22, CCL27, and thymus stromal lymphopoietin, did not show statistically significant differences.

"In this observational study, the analysis of TEWL at the anterior cubital fossa area occurred prior to and correlated with the clinical signs of AD," the authors wrote. "Quantification of cytokines indicated that assessing cord blood serum levels of CCL17 and IL-31 could offer new perspectives in identifying newborns who might be susceptible to AD. Larger studies are needed to validate these findings."

Source: Massimiliano A, et al. JAMA Dermatology. Doi:10.1001/jamadermatol.2024.3178