Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Clin Exp Allergy. 2021 May;51(5):666-673. doi: 10.1111/cea.13866. Epub 2021 Mar 21.
Children with atopic dermatitis (AD) are often sensitized to food and aeroallergens, but sensitization patterns have not been analysed with biologic measures of disease pathogenicity.
We sought to define allergen sensitization grouping(s) using unbiased machine learning and determine their associations with skin filaggrin (FLG) and transepidermal water loss (TEWL) (assesses skin barrier integrity), S100A8 and S100A9 expression (assesses skin inflammation) and AD severity.
We studied 400 children with AD in the Mechanisms of Progression from Atopic Dermatitis to Asthma in Children (MPAACH) cohort to identify groupings of food and aeroallergen sensitizations. MPAACH is a paediatric AD cohort, aged 1-2, recruited through hospital/community settings between 2016 and 2018. We analysed these groupings' associations with AD biomarkers: skin FLG, S100A8 and S100A9 expression, total IgE, TEWL and AD severity.
An unbiased machine learning approach revealed five allergen clusters. The most common cluster (N = 131), SPT had sensitization to peanut, egg and/or pets. Three low prevalence clusters, which included children with allergen sensitization other than peanut, egg or pets, were combined into SPT . SPT included children with no sensitization(s). SPT children had higher median non-lesional TEWL (16.9 g/m /h) and IgE (90 kU/L) compared with SPT (8.8 g/m /h and 24 kU/L; p = .01 and p < .001) and SPT (9 g/m /h and 26 kU/L; p = .003 and p < .001). SPT children had lower median lesional (0.70) and non-lesional (1.09) FLG expression compared with SPT (lesional: 0.9; p = .047, non-lesional: 1.78; p = .01) and SPT (lesional: 1.47; p < .001, non-lesional: 2.21; p < .001). There were no differences among groupings in S100A8 or S100A9 expression.
In this largely clinic-based cohort of young children with AD, allergic sensitization to peanut, egg, cat or dog was associated with more severe disease and skin barrier function but not markers of cutaneous inflammation. These data need replicating in a population-based cohort but may have important implications for understanding the interaction between AD and allergic sensitization.
患有特应性皮炎（AD）的儿童通常对食物和空气过敏原敏感，但尚未用疾病发病机制的生物标志物分析过敏敏感模式。
我们试图使用无偏机器学习定义过敏原致敏分组，并确定它们与皮肤丝聚蛋白（FLG）和经表皮水分流失（TEWL）（评估皮肤屏障完整性）、S100A8 和 S100A9 表达（评估皮肤炎症）和 AD 严重程度的关系。
我们研究了 400 名患有 AD 的儿童，这些儿童来自儿童特应性皮炎向哮喘进展的机制（MPAACH）队列，以确定食物和空气过敏原致敏的分组。MPAACH 是一个儿科 AD 队列，年龄在 1-2 岁之间，通过医院/社区环境于 2016 年至 2018 年招募。我们分析了这些分组与 AD 生物标志物的关系：皮肤 FLG、S100A8 和 S100A9 表达、总 IgE、TEWL 和 AD 严重程度。
一种无偏机器学习方法揭示了五个过敏原群。最常见的群集（N=131）SPT 对花生、鸡蛋和/或宠物有过敏反应。三个低流行率的群集，包括对花生、鸡蛋或宠物以外的过敏原过敏的儿童，被合并为 SPT。SPT 包括没有过敏反应的儿童。与 SPT（16.9 g/m /h 和 90 kU/L）相比，SPT 儿童的中位非病变 TEWL（16.9 g/m /h）和 IgE（90 kU/L）更高（p=0.01 和 p<0.001）和 SPT（8.8 g/m /h 和 24 kU/L；p=0.003 和 p<0.001）。与 SPT（病变：0.9；p=0.047，非病变：1.78；p=0.01）和 SPT（病变：1.47；p<0.001，非病变：2.21；p<0.001）相比，SPT 儿童的中位病变（0.70）和非病变（1.09）FLG 表达较低。各组之间 S100A8 或 S100A9 表达无差异。
在这个主要基于诊所的年轻 AD 儿童队列中，对花生、鸡蛋、猫或狗的过敏反应与更严重的疾病和皮肤屏障功能有关，但与皮肤炎症标志物无关。这些数据需要在基于人群的队列中进行复制，但可能对理解 AD 与过敏敏感之间的相互作用具有重要意义。
