Tape strips might replace biopsy to assess skin biomarkers in kids with atopic dermatitis

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By Megan Brooks

NEW YORK (Reuters Health) - Tape strips may serve as a minimally invasive approach to assess skin biomarkers in children with atopic dermatitis (AD) and also to predict treatment responses, according to a small study.

In the study, tape strips applied several times to the same skin areas proved highly accurate in discriminating between early-onset AD skin and normal skin, including biomarkers pathogenically linked to AD, the study team reports.

The study was published online October 9 in JAMA Dermatology and presented a day later at the European Academy of Dermatology and Venereology (EADV) meeting in Madrid.

"To our knowledge, this is the first study to provide a broad characterization of immune and barrier abnormalities in the skin of children with early-onset (aged <5 years) AD skin using a minimally invasive tape-strip approach," write Dr. Emma Guttman-Yassky of the Icahn School of Medicine at Mount Sinai, in New York City, and colleagues.

"Because tape stripping is painless, nonscarring, and allows repeated sampling, it may be associated with benefits for longitudinal pediatric studies and clinical trials, in which serial measures are needed to identify predictors of response, course, and comorbidities," they add.

For the study, 16 large D-Squame genetic tape strips (from CuDerm Corp.) were serially collected from lesional and nonlesional skin from 21 children with moderate to severe AD and a disease duration of less than six months and from the skin of 30 children without AD. The researchers evaluated gene and protein expression using real-time polymerase chain reaction and immunohistochemistry.

The results were "impressive," Dr. Guttman-Yassky noted in a phone interview with Reuters Health.

Seventy-seven of 79 evaluated immune and barrier gene products were detected (97% gene detection rate) in all but one tape strip (70 of 71, 99% sample detection rate); 53 of the 79 markers differentiated between children with lesional or nonlesional AD from children without AD.

The tape strips were able to define the biomarkers associated with disease, severity, pruritis and transepidermal water loss.

A limitation of the study is that it did not directly compare tape-strip biomarker data against whole skin biopsy biomarker data from the same patients. The researchers plan to determine the correlation between skin biopsy and tape-stripping findings in future studies.

"Being able to non-invasively collect skin in children for this study paves the way for future studies to better understand a wide variety of skin disorders as well as to start identifying markers to predict course, comorbidities, and treatment response in prospective studies," Dr. Guttman-Yassky said in a statement.

She told Reuters Health that eczema is a "heterogeneous disease, particularly in children. In the future, I see what will happen in atopic dermatitis is something similar to cancer where we can define what drug is good for what patient, and for this tape strips will be amazing because you can easily do it in the clinic."

The study was supported by grants from Northwestern University and from Regeneron and Sanofi. Dr. Guttman-Yassky has received grants from the companies.

SOURCE: http://bit.ly/2Oy3B9r

JAMA Dermatol 2019.

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