Early changes in the cheek skin barrier may predict the onset of atopic dermatitis (AD) before any clinical symptoms appear, according to a new study out of National Jewish Health in Denver, CO.
This research, published in The Journal of Allergy and Clinical Immunology: In Practice, opens the door to earlier interventions and potential preventive strategies for infants at risk of developing AD.
The research team analyzed skin samples from infants within their first month of life and again at three months, using minimally invasive skin tape to evaluate the stratum corneum. The study focused on 18 mother-infant pairs enrolled during the COVID-19 pandemic, eight of whom developed AD by one year of age.
The cheek showed biomarker changes before those seen in previous studies of the forearm.
“These results suggest that the foundation for atopic dermatitis is already being laid within the first month of life, particularly in the cheek area,” says Jessica Hui, MD, the lead investigator on the study and a Pediatric Allergist and Immunologist at National Jewish Health. “By identifying these early-life skin biomarkers, we hope to develop strategies to prevent the condition before symptoms ever develop.”
The study also highlights the role of maternal and environmental influences, suggesting that exposures during pregnancy may impact the infant’s skin barrier development.
With 83% of the infants in the cohort having a family history of AD, the findings underscore the importance of early identification in high-risk populations.
“This groundbreaking work reinforces the importance of studying cheek skin specifically, due to its delayed maturation, frequent exposure to food allergens, and status as a common site of infantile AD,” adds Donald Leung, MD, PhD, senior author on the study and the Head of the Division of Pediatric Allergy and Immunology at National Jewish Health. “The study is the first to demonstrate such early changes in this region, potentially redefining the timeline for AD risk assessment.”
