NCRC supported researchers in Department of Clinical Medicine, Trinity College Dublin and the Department of Dermatology, Children’s Health Ireland, Crumlin have shown that topical corticosteroid therapy can normalise systemic immune dysregulation in children with eczema.
Eczema, also known as Atopic Dermatitis, is the most common persistent inflammatory disease of early childhood. 60% of cases of eczema begin during the first year of life while 85% begin before 5 years of age. Eczema is caused by a combination of genetic and environmental factors, but the exact mechanisms underlying the development and progression of the disease are not fully understood.
Increased local (within the skin) and systemic (within the peripheral blood circulation) inflammation is evident in infants with eczema but it is not clear what effect standard treatment with topical corticosteroids (creams, gels, ointments containing corticosteroids) has on inflammation within this patient group.
In their study, NCRC supported researchers Dr. Maeve McAleer and Prof. Alan Irvine, and colleagues set out to investigate responses to first-line corticosteroid treatments in infants with eczema and examine the effect of corticosteroid therapy on skin and blood biomarkers of inflammation
They recruited 74 treatment naïve infants (< 12 months of age) with moderate to severe eczema, through the Atopic Dermatitis clinic at Children’s Health Ireland, Crumlin. Using minimally invasive skin tape stripping, skin samples were collected before and after a 6-week course of treatment with topical corticosteroids. Blood samples were also collected at both time points. Skin and blood biomarkers of inflammation (e.g. inflammatory cytokines) were measured by multiplexed immunoassay.
As expected, they found that topical corticosteroid therapy led to an improvement in disease severity, but treatment also normalised systemic immune dysregulation in infants with eczema. Following treatment, altered skin and blood cytokine profiles approached levels seen in children without eczema. The effect of topical treatment on cytokine profiles within the peripheral circulation suggests that local inflammation within the skin is responsible for dysregulated systemic cytokine profiles in infants with eczema.
On publication of the study results, Prof. Alan Irvine said “Our study shows that inflammatory signals from the skin of children with eczema leak into the system and are circulating widely. Treating the skin inflammation reduces the levels of these inflammatory signals in the blood. These findings help shape our understanding of the systemic (all of body) effects of eczema”.
This study was published in the British Journal of Dermatology. The complete publication can be found through the following link.
MA McAleer, I Jakasa, N Stefanovic, WHI McLean, S Kezic, AD Irvine. Topical Corticosteroids Normalize both Skin and Systemic Inflammatory Markers in Infant Atopic Dermatitis. British Journal of Dermatology. https://doi.org/10.1111/bjd.19703
This study was supported by the NCRC and Wellcome.