Proteomic characterization of atopic dermatitis blood from infancy to adulthood

Ester Del Duca, Yael Renert-Yuval, Ana B. Pavel, Daniela Mikhaylov, Jianni Wu, Rachel Lefferdink, Milie Fang, Anjani Sheth, Alli Blumstein, Paola Facheris, Yeriel D. Estrada, Stephanie M. Rangel, James G. Krueger, Amy S. Paller, Emma Guttman-Yassky

Research output: Contribution to journalArticlepeer-review


Background: Patients with atopic dermatitis (AD) have systemic biomarker dysregulation that differs by age group; however, the proteomic characteristics of these age-based changes are unknown. Objective: To profile blood proteins of patients with AD across different age groups versus age-appropriate controls. Methods: Using the Olink high-throughput proteomic platform, we profiled 375 serum proteins of 20 infants (age, 0-5 years), 39 children (age, 6-11 years), 21 adolescents (age, 12-17 years), and 20 adults (age, ≥18 years) with moderate-to-severe AD and 83 age-appropriate controls. Results: Each group presented a distinct systemic proteomic signature. Th2-related proteins were increased in infant AD and further intensified with age through adolescence and adulthood (interleukin 4/CCL13/CCL17). In contrast, Th1 axis down-regulation was detected in infants with AD and gradually reversed to increased Th1 products (interferon γ/CXCL9/CXCL10/CCL2) in patients with AD from childhood to adulthood. Despite their short disease duration, infants already had evidence of systemic inflammation, with significant upregulation of innate immunity (interleukin 17C/ interleukin-1RN), T-cell activation/migration (CCL19), Th2 (CCL13/CCL17), and Th17 (PI3) proteins. Adults with AD present unique upregulation of cardiovascular proteins related to coagulation and diabetes. Limitations: Cross-sectional observational study with a single time point. Conclusion: Systemic immune signatures of AD are age-specific beyond the shared Th2 immune activation. These data advocate for precision medicine approaches based on age-specific AD profiles.

Original languageEnglish
Pages (from-to)1083-1093
Number of pages11
JournalJournal of the American Academy of Dermatology
Issue number5
StatePublished - May 2023


  • Olink
  • atopic dermatitis
  • pediatric
  • proteomic


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