Author:
Wongvibulsin Shannon,Sutaria Nishadh,Kannan Suraj,Alphonse Martin Prince,Belzberg Micah,Williams Kyle A.,Brown Isabelle D.,Choi Justin,Roh Youkyung Sophie,Pritchard Thomas,Khanna Raveena,Eseonu Amarachi C.,Jedrych Jaroslaw,Dillen Carly,Kwatra Madan M.,Chien Anna L.,Archer Nathan,Garza Luis A.,Dong Xinzhong,Kang Sewon,Kwatra Shawn G.
Abstract
AbstractAtopic dermatitis (AD) often presents more severely in African Americans (AAs) and with greater involvement of extensor areas. To investigate immune signatures of AD in AAs with moderate to severe pruritus, lesional and non-lesional punch biopsies were taken from AA patients along with age-, race-, and sex-matched controls. Histology of lesional skin showed psoriasiform dermatitis and spongiotic dermatitis, suggesting both Th2 and Th17 activity. Gene Set Variation Analysis showed upregulation of Th2 and Th17 pathways in both lesional versus non-lesional and lesional versus control (p < 0.01), while Th1 and Th22 upregulation were observed in lesional versus control (p < 0.05). Evidence for a broad immune signature also was supported by upregulated Th1 and Th22 pathways, and clinically may represent greater severity of AD in AA. Furthermore, population-level analysis of data from TriNetX, a global federated health research network, revealed that AA AD patients had higher values for CRP, ferritin, and blood eosinophils compared to age-, sex-, and race-matched controls as well as white AD patients, suggesting broad systemic inflammation. Therefore, AA AD patients may feature broader immune activation than previously thought and may derive benefit from systemic immunomodulating therapies that modulate key drivers of multiple immune pathways.
Funder
National Institutes of Health
Dermatology Foundation Medical Dermatology Career Development Award
Skin of Color Society
Publisher
Springer Science and Business Media LLC
Cited by
31 articles.
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