The Asian atopic dermatitis phenotype combines features of atopic dermatitis and psoriasis with increased TH17 polarization

Shinji Noda, Mayte Suárez-Fariñas, Benjamin Ungar, Soo Jung Kim, Cristina De Guzman Strong, Hui Xu, Xiangyu Peng, Yeriel D. Estrada, Saeko Nakajima, Tetsuya Honda, Jung U. Shin, Hemin Lee, James G. Krueger, Kwanghoon Lee, Kenji Kabashima, Emma Guttman-Yassky

Research output: Contribution to journalArticle

135 Citations (Scopus)

Abstract

Background Atopic dermatitis (AD) shows very high prevalence in Asia, with a large unmet need for effective therapeutics. Direct comparisons between European American (EA) and Asian patients with AD are unavailable, but earlier blood studies detected increased IL-17+-producing cell counts in Asian patients with AD. Objective We sought to characterize the Asian AD skin phenotype and compare it with the EA AD skin phenotype. Methods We performed genomic profiling (real-time PCR) and immunohistochemistry on lesional and nonlesional biopsy specimens from 52 patients with AD (25 EAs and 27 Asians), 10 patients with psoriasis (all EAs), and 27 healthy subjects (12 EAs and 15 Asians). Results Although disease severity/SCORAD scores were similar between the AD groups (58.0 vs 56.7, P =.77), greater acanthosis, higher Ki67 counts, and frequent parakeratosis were characteristics of lesional epidermis from Asian patients with AD (P <.05). Most (24/27) Asian patients had high IgE levels. A principal component analysis using real-time PCR data clustered the Asian AD phenotype between the EA AD and psoriasis phenotypes. TH2 skewing characterized both Asian and EA patients with AD but not patients with psoriasis. Significantly higher TH17 and TH22 (IL17A, IL19, and S100A12 in lesional and IL-22 in nonlesional skin; P <.05) and lower TH1/interferon (CXCL9, CXCL10, MX1, and IFNG in nonlesional skin; P <.05) gene induction typified AD skin in Asian patients. Conclusion The Asian AD phenotype presents (even in the presence of increased IgE levels) a blended phenotype between that of EA patients with AD and those with psoriasis, including increased hyperplasia, parakeratosis, higher TH17 activation, and a strong TH2 component. The relative pathogenic contributions of the TH17 and TH2 axes in creating the Asian AD phenotype need to be tested in future clinical trials with appropriate targeted therapeutics.

Original languageEnglish
Pages (from-to)1254-1264
Number of pages11
JournalJournal of Allergy and Clinical Immunology
Volume136
Issue number5
DOIs
Publication statusPublished - 2015 Jul 9

Fingerprint

Atopic Dermatitis
Psoriasis
Phenotype
Skin
Parakeratosis
Asian Americans
Immunoglobulin E
Real-Time Polymerase Chain Reaction
Interleukin-17
Principal Component Analysis
Epidermis
Interferons
Hyperplasia
Healthy Volunteers

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology

Cite this

Noda, S., Suárez-Fariñas, M., Ungar, B., Kim, S. J., De Guzman Strong, C., Xu, H., ... Guttman-Yassky, E. (2015). The Asian atopic dermatitis phenotype combines features of atopic dermatitis and psoriasis with increased TH17 polarization. Journal of Allergy and Clinical Immunology, 136(5), 1254-1264. https://doi.org/10.1016/j.jaci.2015.08.015
Noda, Shinji ; Suárez-Fariñas, Mayte ; Ungar, Benjamin ; Kim, Soo Jung ; De Guzman Strong, Cristina ; Xu, Hui ; Peng, Xiangyu ; Estrada, Yeriel D. ; Nakajima, Saeko ; Honda, Tetsuya ; Shin, Jung U. ; Lee, Hemin ; Krueger, James G. ; Lee, Kwanghoon ; Kabashima, Kenji ; Guttman-Yassky, Emma. / The Asian atopic dermatitis phenotype combines features of atopic dermatitis and psoriasis with increased TH17 polarization. In: Journal of Allergy and Clinical Immunology. 2015 ; Vol. 136, No. 5. pp. 1254-1264.
@article{62741180bd4b4ee7860bc22cb30b206b,
title = "The Asian atopic dermatitis phenotype combines features of atopic dermatitis and psoriasis with increased TH17 polarization",
abstract = "Background Atopic dermatitis (AD) shows very high prevalence in Asia, with a large unmet need for effective therapeutics. Direct comparisons between European American (EA) and Asian patients with AD are unavailable, but earlier blood studies detected increased IL-17+-producing cell counts in Asian patients with AD. Objective We sought to characterize the Asian AD skin phenotype and compare it with the EA AD skin phenotype. Methods We performed genomic profiling (real-time PCR) and immunohistochemistry on lesional and nonlesional biopsy specimens from 52 patients with AD (25 EAs and 27 Asians), 10 patients with psoriasis (all EAs), and 27 healthy subjects (12 EAs and 15 Asians). Results Although disease severity/SCORAD scores were similar between the AD groups (58.0 vs 56.7, P =.77), greater acanthosis, higher Ki67 counts, and frequent parakeratosis were characteristics of lesional epidermis from Asian patients with AD (P <.05). Most (24/27) Asian patients had high IgE levels. A principal component analysis using real-time PCR data clustered the Asian AD phenotype between the EA AD and psoriasis phenotypes. TH2 skewing characterized both Asian and EA patients with AD but not patients with psoriasis. Significantly higher TH17 and TH22 (IL17A, IL19, and S100A12 in lesional and IL-22 in nonlesional skin; P <.05) and lower TH1/interferon (CXCL9, CXCL10, MX1, and IFNG in nonlesional skin; P <.05) gene induction typified AD skin in Asian patients. Conclusion The Asian AD phenotype presents (even in the presence of increased IgE levels) a blended phenotype between that of EA patients with AD and those with psoriasis, including increased hyperplasia, parakeratosis, higher TH17 activation, and a strong TH2 component. The relative pathogenic contributions of the TH17 and TH2 axes in creating the Asian AD phenotype need to be tested in future clinical trials with appropriate targeted therapeutics.",
author = "Shinji Noda and Mayte Su{\'a}rez-Fari{\~n}as and Benjamin Ungar and Kim, {Soo Jung} and {De Guzman Strong}, Cristina and Hui Xu and Xiangyu Peng and Estrada, {Yeriel D.} and Saeko Nakajima and Tetsuya Honda and Shin, {Jung U.} and Hemin Lee and Krueger, {James G.} and Kwanghoon Lee and Kenji Kabashima and Emma Guttman-Yassky",
year = "2015",
month = "7",
day = "9",
doi = "10.1016/j.jaci.2015.08.015",
language = "English",
volume = "136",
pages = "1254--1264",
journal = "Journal of Allergy and Clinical Immunology",
issn = "0091-6749",
publisher = "Mosby Inc.",
number = "5",

}

Noda, S, Suárez-Fariñas, M, Ungar, B, Kim, SJ, De Guzman Strong, C, Xu, H, Peng, X, Estrada, YD, Nakajima, S, Honda, T, Shin, JU, Lee, H, Krueger, JG, Lee, K, Kabashima, K & Guttman-Yassky, E 2015, 'The Asian atopic dermatitis phenotype combines features of atopic dermatitis and psoriasis with increased TH17 polarization', Journal of Allergy and Clinical Immunology, vol. 136, no. 5, pp. 1254-1264. https://doi.org/10.1016/j.jaci.2015.08.015

The Asian atopic dermatitis phenotype combines features of atopic dermatitis and psoriasis with increased TH17 polarization. / Noda, Shinji; Suárez-Fariñas, Mayte; Ungar, Benjamin; Kim, Soo Jung; De Guzman Strong, Cristina; Xu, Hui; Peng, Xiangyu; Estrada, Yeriel D.; Nakajima, Saeko; Honda, Tetsuya; Shin, Jung U.; Lee, Hemin; Krueger, James G.; Lee, Kwanghoon; Kabashima, Kenji; Guttman-Yassky, Emma.

In: Journal of Allergy and Clinical Immunology, Vol. 136, No. 5, 09.07.2015, p. 1254-1264.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Asian atopic dermatitis phenotype combines features of atopic dermatitis and psoriasis with increased TH17 polarization

AU - Noda, Shinji

AU - Suárez-Fariñas, Mayte

AU - Ungar, Benjamin

AU - Kim, Soo Jung

AU - De Guzman Strong, Cristina

AU - Xu, Hui

AU - Peng, Xiangyu

AU - Estrada, Yeriel D.

AU - Nakajima, Saeko

AU - Honda, Tetsuya

AU - Shin, Jung U.

AU - Lee, Hemin

AU - Krueger, James G.

AU - Lee, Kwanghoon

AU - Kabashima, Kenji

AU - Guttman-Yassky, Emma

PY - 2015/7/9

Y1 - 2015/7/9

N2 - Background Atopic dermatitis (AD) shows very high prevalence in Asia, with a large unmet need for effective therapeutics. Direct comparisons between European American (EA) and Asian patients with AD are unavailable, but earlier blood studies detected increased IL-17+-producing cell counts in Asian patients with AD. Objective We sought to characterize the Asian AD skin phenotype and compare it with the EA AD skin phenotype. Methods We performed genomic profiling (real-time PCR) and immunohistochemistry on lesional and nonlesional biopsy specimens from 52 patients with AD (25 EAs and 27 Asians), 10 patients with psoriasis (all EAs), and 27 healthy subjects (12 EAs and 15 Asians). Results Although disease severity/SCORAD scores were similar between the AD groups (58.0 vs 56.7, P =.77), greater acanthosis, higher Ki67 counts, and frequent parakeratosis were characteristics of lesional epidermis from Asian patients with AD (P <.05). Most (24/27) Asian patients had high IgE levels. A principal component analysis using real-time PCR data clustered the Asian AD phenotype between the EA AD and psoriasis phenotypes. TH2 skewing characterized both Asian and EA patients with AD but not patients with psoriasis. Significantly higher TH17 and TH22 (IL17A, IL19, and S100A12 in lesional and IL-22 in nonlesional skin; P <.05) and lower TH1/interferon (CXCL9, CXCL10, MX1, and IFNG in nonlesional skin; P <.05) gene induction typified AD skin in Asian patients. Conclusion The Asian AD phenotype presents (even in the presence of increased IgE levels) a blended phenotype between that of EA patients with AD and those with psoriasis, including increased hyperplasia, parakeratosis, higher TH17 activation, and a strong TH2 component. The relative pathogenic contributions of the TH17 and TH2 axes in creating the Asian AD phenotype need to be tested in future clinical trials with appropriate targeted therapeutics.

AB - Background Atopic dermatitis (AD) shows very high prevalence in Asia, with a large unmet need for effective therapeutics. Direct comparisons between European American (EA) and Asian patients with AD are unavailable, but earlier blood studies detected increased IL-17+-producing cell counts in Asian patients with AD. Objective We sought to characterize the Asian AD skin phenotype and compare it with the EA AD skin phenotype. Methods We performed genomic profiling (real-time PCR) and immunohistochemistry on lesional and nonlesional biopsy specimens from 52 patients with AD (25 EAs and 27 Asians), 10 patients with psoriasis (all EAs), and 27 healthy subjects (12 EAs and 15 Asians). Results Although disease severity/SCORAD scores were similar between the AD groups (58.0 vs 56.7, P =.77), greater acanthosis, higher Ki67 counts, and frequent parakeratosis were characteristics of lesional epidermis from Asian patients with AD (P <.05). Most (24/27) Asian patients had high IgE levels. A principal component analysis using real-time PCR data clustered the Asian AD phenotype between the EA AD and psoriasis phenotypes. TH2 skewing characterized both Asian and EA patients with AD but not patients with psoriasis. Significantly higher TH17 and TH22 (IL17A, IL19, and S100A12 in lesional and IL-22 in nonlesional skin; P <.05) and lower TH1/interferon (CXCL9, CXCL10, MX1, and IFNG in nonlesional skin; P <.05) gene induction typified AD skin in Asian patients. Conclusion The Asian AD phenotype presents (even in the presence of increased IgE levels) a blended phenotype between that of EA patients with AD and those with psoriasis, including increased hyperplasia, parakeratosis, higher TH17 activation, and a strong TH2 component. The relative pathogenic contributions of the TH17 and TH2 axes in creating the Asian AD phenotype need to be tested in future clinical trials with appropriate targeted therapeutics.

UR - http://www.scopus.com/inward/record.url?scp=84956603674&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84956603674&partnerID=8YFLogxK

U2 - 10.1016/j.jaci.2015.08.015

DO - 10.1016/j.jaci.2015.08.015

M3 - Article

VL - 136

SP - 1254

EP - 1264

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

SN - 0091-6749

IS - 5

ER -