The adult atopic dermatitis (AD) profile varies with age, according to a recent investigation. While TH1/TH17-skewing decreases in both AD and controls, AD shows unique decreases in TH2/TH22 polarization, and normalization of epithelial abnormalities. Thus, age-specific treatment approaches may be beneficial for AD. Researchers evaluated age-specific changes in lesional and non-lesional tissues and blood from moderate-to-severe AD patients (n=246) and age-matched controls (n=72) in a cross-sectional study. Patients were analyzed using age-groups (18-40, 41-60, and ≥61 years). They found:
- While disease severity/SCORAD was similar across AD age-groups (mean: ∼60), dendritic cell infiltrates decreased with age.
- TH2 measures (IL-5, IL-13, CCL13, CCL18, CCL26) significantly decreased with age in AD, despite increasing with age in controls.
- Consistent with TH2 axis decreases, serum IgE and eosinophils negatively correlated with age in AD.
- TH22-secreted IL-22 also decreased with age uniquely in AD.
- TH1- and TH17-related markers increased with age in both AD and controls.
Zhou L, Leonard A, Pavel AB, et al. Age-specific changes in the molecular phenotype of patients with moderate-to-severe atopic dermatitis. [Published online ahead of print January 24, 2019]. J Allergy Clin Immunol. doi:10.1016/j.jaci.2019.01.015.