Background: Monitoring the effects of biologic therapies in skin diseases will benefit from alternative nonivasive skin sampling techniques to examine immune pathways in diseased tissue early and longitudinally.
Objective: To establish minimally invasive profiling of skin cytokines for diagnosis, therapeutic response monitoring and clinical research in atopic dermatitis (AD) and other skin diseases, particularly in pediatric cohorts.
Methods: We developed a novel method for cytokine profiling in the epidermis using skin tape strips (STS) in a setting designed to maximize the efficiency of protein extraction from STS. This method was applied to analyze STS protein extracts from lesional skin of AD children (n=41) and normal healthy controls (n=22). Twenty cytokines were probed with ultra sensitive Mesoscale multiplex cytokine assay.
Results: A significant increase in IL-1b, IL-18, IL-8 and a decrease in IL-1a in the stratum corneum of AD lesional skin was found. Concurrently, an increase in markers associated with type 2 inflammatory response was readily detectable in AD lesional skin, including CCL22, CCL17 and TSLP. Levels of IL-1b, IL-18 and TSLP exhibited positive correlations with AD severity index (SCORAD) and skin transepidermal water loss (TEWL), while an inverse correlation between IL-1a and SCORAD, IL-1a and TEWL was found. Levels of CCL17, CCL22, TSLP, IL-22 and IL-17a correlated with skin TEWL measurements.
Conclusion: Using minimally invasive STS analysis we identified cytokine profiles easily sampled in AD lesional skin. The expression of these markers correlated with disease severity and reflected changes in TEWL in lesional skin. These markers suggest new response assessment targets for AD skin.
Keywords: atopic dermatitis; cytokines; skin.