Skin barrier dysfunction may serve as a biomarker for pediatric eosinophilic esophagitis (EoE), according to a new study out of the National Jewish Health in Denver, CO.
Specifically, the skin of children with EoE but without atopic dermatitis (AD) show significant deficits in long-chain and ultralong-chain ceramides compared to healthy controls.
“This research provides the first evidence that skin barrier lipid abnormalities exist in EoE, even in the absence of visible skin disease,” says study author Elena Goleva, PhD, a Professor at National Jewish Health. “Our findings support the idea of a unified epithelial barrier dysfunction underlying allergic diseases of both the skin and the esophagus.”
EoE is often seen in patients with other allergic conditions such as eczema and food allergies, but no reliable surrogate non-invasive markers currently existed for identifying EoE risk—particularly in children without overt skin symptoms—until now.
“This study paves the way for using non-invasive skin tape stripping as a potential diagnostic or screening tool for EoE—eliminating the need for endoscopy,” says Donald Y. Leung, MD, PhD, a Distinguished Professor of Pediatrics, Allergist, and Immunologist at National Jewish Health. “By analyzing skin lipid profiles, we may be able to detect epithelial vulnerability before symptoms appear. If validated, this simple skin test could revolutionize how we diagnose and monitor eosinophilic esophagitis.”
The research team used advanced lipidomics analysis via liquid chromatography with tandem mass spectrometry on skin samples collected via tape strips from the forearms of study participants.
The results underscore the possibility that EoE and eczema share a common origin in defective lipid metabolism and epithelial barrier dysfunction.
The study appears in the Journal of Allergy and Clinical Immunology.
