Fehr Danielle, Huynh-Tran Van Hung, Maintz Laura, Niederseer David, Ameri Milad, Dreher Anita, Study Group Ck-Care, Akdis Cezmi A, Lauener Roger, Rhyner Claudio, Traidl-Hoffmann Claudia, Schmid-Grendelmeier Peter, Bieber Thomas, Brüggen Marie-Charlotte
Allergy Unit, Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
Faculty of Medicine, University of Zurich, Zurich, Switzerland.
Allergy. 2025 Aug;80(8):2187-2200. doi: 10.1111/all.16588. Epub 2025 May 19.
There are conflicting data on a potential association between atopic dermatitis (AD) and cardiovascular diseases (CVD). The aim of this study was to further explore this connection and whether there are biomarkers indicating the risk for CVD in AD patients.
We included 677 AD patients and 79 nonatopic controls from an observational multicenter case-control study (ProRaD: Prospective longitudinal study investigating the remission phase in patients with atopic dermatitis and other allergy-associated diseases). AD severity and atopic, metabolic, and cardiovascular conditions as well as risk factors were assessed. Serum samples were analyzed with targeted proteomics (cardiometabolics panel, Olink).
We did not find an overall association between AD and CVD. However, AD patients without atopic comorbidities (pure AD) showed a significantly higher CVD prevalence than AD patients with atopic comorbidities (ADAC) (28.2% [37/131] vs. 14.7% [80/546], p < 0.001). Yet, this association could not be confirmed when controlling for cardiovascular risk factors. In pure AD, patients with CVD showed a more severe AD than those without CVD (median EASI [Eczema Area and Severity Index] 12.9 vs. 4.0, p < 0.001). In this subgroup of patients, EASI remained a significant predictor of CVD even in the adjusted model (adjusted odds ratio [aOR] = 1.05, p = 0.040). Forty serum cardiometabolic proteins were upregulated in AD patients compared with nonatopic controls. CC-chemokine ligand 18 (CCL18) was upregulated in both AD (p < 0.001) and CVD (p < 0.001) and its increase correlated with AD severity.
Our study does not suggest an overall association between AD and CVD, but a more complex relation between the two conditions. Disease severity may be a risk factor for CVD in pure AD patients, but not in those with atopic comorbidities. CCL18 may be a biomarker for CVD.
关于特应性皮炎（AD）与心血管疾病（CVD）之间潜在关联的数据存在矛盾。本研究的目的是进一步探讨这种联系，以及是否存在表明AD患者发生CVD风险的生物标志物。
我们纳入了一项观察性多中心病例对照研究（ProRaD：前瞻性纵向研究，调查特应性皮炎和其他过敏相关疾病患者的缓解期）中的677例AD患者和79例非特应性对照。评估了AD严重程度、特应性、代谢和心血管状况以及危险因素。采用靶向蛋白质组学（心脏代谢组学面板，Olink）分析血清样本。
我们未发现AD与CVD之间存在总体关联。然而，无特应性合并症的AD患者（单纯AD）的CVD患病率显著高于有特应性合并症的AD患者（ADAC）（28.2%[37/131]对14.7%[80/546]，p<0.001）。然而，在控制心血管危险因素后，这种关联无法得到证实。在单纯AD中，患有CVD的患者的AD比未患有CVD的患者更严重（湿疹面积和严重程度指数[EASI]中位数12.9对4.0，p<0.001）。在该患者亚组中，即使在调整模型中，EASI仍然是CVD的显著预测因子（调整优势比[aOR]=1.05，p=0.040）。与非特应性对照相比，AD患者中有40种血清心脏代谢蛋白上调。CC趋化因子配体18（CCL18）在AD（p<0.001）和CVD（p<0.001）中均上调，其升高与AD严重程度相关。
我们的研究未提示AD与CVD之间存在总体关联，但提示这两种疾病之间存在更复杂的关系。疾病严重程度可能是单纯AD患者发生CVD的危险因素，但在有特应性合并症的患者中并非如此。CCL18可能是CVD的生物标志物。
