Personalized multi-marker panel in the risk assessment of atopic dermatitis phenotypes in children

Introduction
This paper reports the study of a combined genetic and biomarker panel for assessing the risk of development of different phenotypes of atopic dermatitis (AD) in children: alone and combined with other atopic disorders (AtD) – allergic rhinitis/rhino-conjunctivitis (AR/ARC) and bronchial asthma (BA). The aim was to establish a personalized diagnostic multi-marker panel for assessing the developmental risk of different AD phenotypes in children combining single nucleotide polymorphism (SNP) rs_7927894 filaggrin (FLG) genotype variants, serum levels of total immune globulin E (IgE), cutaneous T-cell attracting chemokine (CTACK/CCL27) and thymus and activation regulated chemokine (TARC/CCL17).

Material and methods
The study recruited patients aged 3–18 years old: 39 atopic patients to the main group and 47 non-atopic patients to the control group. All the patients were tested for SNP variants of rs_7927894 FLG and serum concentrations of total IgE, CTACK/CCL27 and TARC/CCL17.

Results
Within AD alone phenotype patients we detected the following significant risk ratios: cytosinethymine (C/T) rs_7927894 FLG [odds ratio (OR) = 4.14, p < 0.05], total IgE > 173 IU/ml (OR = 8.98, p < 0.001), CTACK/ CCL27 > 3658.5 pg/ml (OR = 5.64, p < 0.01). Atopic disorders combined with other AtD phenotype: C/T rs_7927894 FLG (OR = 2.88, p < 0.05), total IgE > 213 IU/ml (OR = 136.7, p < 0.001), CTACK/CCL27 > 4308.8 pg/ml (OR = 7.40, p < 0.001). With AD combined with other AtD collated to AD alone – total IgE > 1001 IU/ml (OR = 16.0, p < 0.001). TARC/CCL17 had no significant differences among main and control groups.

Conclusions
Cytosinethymine rs_7927894 FLG variant combined with cut-off serum IgE and CTACK/CCL27 levels is a novel significant personalized multi-marker panel for assessing the risk of development of the different AD phenotypes in children.