Eczema is an inflammatory skin condition that usually affects infants as young as one to 2 months. Amongst the varied kinds of eczema seen in infants, early-onset atopic dermatitis (AD), characterised by psychological stress and sleep disorders, is especially concerning. Studies have, in truth, identified that if left untreated, AD can increase the chance of allergic diseases corresponding to food allergies and asthma-;a progression also often called the “atopic march”. Early diagnosis and intervention of early-onset AD is required to make sure the infant’s psychological and physical health.

Nevertheless, it may possibly be difficult to make a diagnosis of AD in infants as young as one or two months. Besides parents’ reluctance to hunt medical advice and the infant’s inability to specific their symptoms, the diagnosis of AD could also be influenced by the doctor’s subjectivity and experience. Furthermore, the usage of accurate yet invasive diagnostic procedures for AD, corresponding to skin biopsies, is difficult in infants. There may be, thus, a necessity for brand spanking new methods of diagnosing AD which might be objective and non-invasive.

In an earlier study led by Project Leader Takayoshi Inoue from the Biological Science Research division at Kao Corporation, a few of these researchers had identified that sebum comprises measurable levels of human mRNA molecules. They hypothesized that analyzing the genetic expression of such RNA-containing sebum samples could reveal the molecular features of AD, and its underlying pathogenesis. Based on this discovery, the researchers developed a novel analytical method called “RNA monitoring” that permits human skin transcriptome evaluation of the mRNA in sebum (skin surface lipids) collected from the skin using an easy oil-blotting film.

On this study published within the Journal of the European Academy of Dermatology and Venereology on March 10, 2023, the researchers verified the usefulness of this novel RNA monitoring method. This study was conducted in collaboration with Kiwako Yamamoto-Hanada and Yukihiro Ohya of the National Center for Allergy Research on the National Center for Child Health and Development, Japan. The important objective of this study was to find out if sebum RNA could provide reliable biomarkers for the detection of early-onset AD in infants.

The study population comprised a prospective cohort of 98 one- and two-month-old infants. In a few of these infants, a diagnosis of AD was made in keeping with the UK Working Party’s criteria. The researchers first collected sebum from the facial skin of all participating infants using a single oil-blotting film, in a non-invasive and simple procedure. Next, mRNA in skin surface lipids (SSLs) were extracted for performing transcriptome evaluation, and lastly, subjected to data evaluation for identifying their underlying molecular features of early-onset AD in infants.

The evaluation revealed several genes with different expression between infants with and without AD. Specifically, the researchers observed that one-month-old infants with AD had lower expression of genes related to lipid metabolism and synthesis, tight junctions, antimicrobial peptides, and keratinization, and better expression of genes related to Th2-, Th17- and Th22-type immune responses. These molecular changes in barrier function and inflammatory markers characterizing AD weren’t reported in earlier literature, especially in one-month old infants, largely owing to the invasiveness of common diagnostic procedures.

Most significantly, the team observed that via changes in the degrees of those markers, sebum RNA may very well be used to detect the onset of AD well upfront. Explains Dr. Yamamoto-Hanada, Chief of the Allergy Center, “Our results confirm that the RNA monitoring method is helpful for the early detection of AD in infants and may additionally be used for his or her treatment monitoring in the long run.”

Hopefully, the supply of this straightforward, objective, and non-invasive diagnostic option for AD will encourage parents of infants with AD to go for early consultation and therapeutical intervention of the condition.

Infants often have multiple eczemas and experience repeated exacerbations and remissions. With our method, the timely treatment of early-onset AD might be realized, enabling an improvement in the standard of life for infants with AD and their families.”

Dr. Kiwako Yamamoto-Hanada, Chief of the Allergy Center

We are able to only hope that the outcomes of this research lessen the suffering of infants and their families and convey our society one step closer to being allergy-free!

Source:

Journal reference:

Yamamoto-Hanada, K., et al. (2023) mRNAs in skin surface lipids unveiled atopic dermatitis at 1 month. Journal of the European Academy of Dermatology and Venereology. doi.org/10.1111/jdv.19017.