Low filaggrin (FLG) expression in children aged 2 to 3 may predict of school-age asthma, according to new research slated to be presented at the 2024 American Academy of Allergy, Asthma & Immunology Annual Meeting, in Washington, DC.
In the study, pulmonary function testing (PFT) was conducted in 96 children, aged 7 to 8 years old, with atopic dermatitis from the Mechanisms of Progression from Atopic Dermatitis to Asthma in Children cohort. A child’s asthma diagnosis was defined by PFT, wheezing and utilization history. Logistic regression evaluated the predictability of physician-diagnosed asthma reported by parents, transepidermal water loss (TEWL), SCORing Atopic Dermatitis (SCORAD) and skin expression of FLG for asthma. Research variables were dichotomized to maximize predictive accuracy, while sensitivity and specificity were estimated by the researchers.
Low FLG expression at age 2 to 3 in non-lesional (NL) skin was a significant predictor of school-age asthma among participants, and this remained consistent when stratified for racial groups of Black and non-Black children. Further, NL FLG expression had more than two times higher sensitivity in predicting asthma compared to parental-reported physician-diagnosed asthma, while specificity remained similar for both. SCORAD and transepidermal water loss, however, were not significant predictors of asthma, the study showed.
“This work highlights the importance of the skin barrier to asthma development. Specifically, filaggrin expression in the normal appearing skin predicts asthma development and is a better predictor than parent-report of physician-diagnosed asthma” says lead study author Wan Chi Chang, MS, biostatistician/Epidemiologist II at Cincinnati Children’s Hospital Medical Center, in a news release.
