To investigate early disease biomarkers for atopic dermatitis (AD) we investigated epidermal cytokine levels and skin microbial profiles. We performed minimally invasive biosampling in a prospective cohort of 50 neonates at high risk for developing AD including tape strips and skin swabs from antecubital fossa, volar forearm and cheek at 3, 6, 12, 18 and 24 months after birth. 26% of the included new-borns developed AD until month 24. Multiplex ELISA analysis showed a significant increase of pro-inflammatory cytokines in the epidermis at AD onset (i.e. IL-1b, log2 foldchange 0.995 (p= 0.00025); IL-31, log2 foldchange 0.447 (p= 0.0017)), whereas TNFb (p= 0.022) and VEGFa (p= 0.013) were significantly elevated directly after birth in children that later developed AD. 16S rRNA sequencing analysis showed a non-significant trend towards a less diverse and less stable skin bacterial community (defined by variance) in children that developed AD within 24 months. AD onset was characterized by decreased correlation between pro-inflammatory epidermal cytokine levels and disease-associated bacterial abundances (i.e. Staphylococcus epidermidis to IL22 and TSLP, change in spearman correlation: -0.87 and -0.91 respectively) in comparison to healthy state. Our observations demonstrate a significant increase in expression of epidermal pro-inflammatory cytokines and a reduction of correlation between cytokine levels and bacterial abundances at AD manifestation, indicating a decoupling of host-microbiome interactions. Overexpression of TNFb and VEGFa, a decreased microbial diversity and an unstable composition of amplicon sequence variances appear to be early predictors for disease manifestation. To our knowledge, this study provides the first characterisation of molecular and microbial parameters at the time point of first manifestation of AD in infants using minimally invasive methods.

ESDR390 - Identification of early epidermal biomarkers in infants at risk of developing atopic dermatitis using minimally invasive methods

The scientific meeting of the European Society for Dermatological Research (ESDR) is held yearly, usually in September. With an international attendance of more than 1000 skin scientists from around the globe, the four-day event includes short oral presentations from peer-reviewed abstracts, keynote lectures from international experts, sponsored symposia, satellite programs, educational events as well as an important focus on posters, networking and building collaborations amongst scientists. For more information about this year’s meeting visit our website.