A recent study has revealed the existence of 6 distinct subphenotypes of atopic dermatitis (AD) in children. This discovery not only further indicates the complexity of the condition, but may also help guide future treatment initiatives for AD based on disease trajectory.AD is a common disease with variable natural history. To further evaluate the prevalence of AD, the researchers evaluated data on 9894 children from the UK (ALSPAC) and 3652 from the Netherlands (PIAMA).
The researchers defined AD as a parent-reported typical itchy and/or flexural rash. Patterns of AD from birth to age 11 to 16 years was assessed via longitudinal latent class analysis. Also examined were associations with known AD risk factors, including filaggrin gene (FLG) null mutations, 23 other established AD-genetic risk variants, and atopic comorbidity.
As a result of the study, the researchers identified 6 latent classes or subphenotypes of AD. According to the researchers, the consistency between the 2 cohorts had been remarkable. They found that early-onset-resolving AD, which was associated with male gender, had been the most common class. Additionally, they identified 2 classes of persistent AD (early-onset-persistent and early-onset-late-resolving AD), which had been most significantly associated with the AD-genetic risk score and personal and parental history of atopic disease.
Furthermore, the researchers also identified a class of mid-onset-resolving AD, which until now had been unrecognized. They noted that this class was strongly associated with asthma but not with FLG mutations.
“Atopic dermatitis ranges from a transient condition to lifelong morbidity,” the researchers concluded. “This study has identified distinct subphenotypes of atopic dermatitis in children, which could indicate the importance of a stratified approach to management of this complex disease.”
—Christina Vogt
Reference:
Patemoster L, Savenije OEM, Heron J, et al. Identification of atopic dermatitis subgroups in children from two longitudinal birth cohorts. J Allergy Clin Immunol. 2017;6749(17):31739-6. doi:10.1016/j.jaci.2017.09.044.
