Skin Tape Proteomics Identifies Pathways Associated With Transepidermal Water Loss and Allergen Polysensitization in Atopic Dermatitis

Abstract Background Atopic dermatitis (AD) and food allergy (FA) are associated with skin barrier dysfunction. Objective Skin biomarkers are needed for skin barrier interventions studies. Methods In this study skin tape strip (STS) samples were collected from non-lesional skin of 62 AD FA+, AD FA- and nonatopic (NA) children for mass spectrometry proteomic analysis. TEWL and allergic sensitization were assessed. STS proteomic analysis results were validated in an independent cohort of 41 adults with AD with and without FA versus NA controls. Results A group of 45 proteins was identified as a principal component 1 (PC1) with the highest expression in AD FA+ STS. This novel set of STS proteins was highly correlative to skin transepidermal water loss (TEWL) and allergic sensitization. PC1 proteins included keratin (KRT) intermediate filaments; proteins associated with inflammatory responses (S100 proteins, alarmins, protease inhibitors); glycolysis and anti-oxidant defense enzymes. Analysis of PC1 proteins expression in an independent adult AD cohort validated differential expression of STS PC1 proteins in the skin of adult AD patients with the history of clinical reactions to peanut. Conclusion STS analysis of non-lesional skin of AD children identified a cluster of proteins with the highest expression in AD FA+ children. The differential expression of STS PC1 proteins was confirmed in a replicate cohort of adult AD patients with FA to peanut, suggesting a unique STS proteomic endotype for AD FA+ that persists into adulthood. Collectively, PC1 proteins are associated with abnormalities in skin barrier integrity and may increase the risk of epicutaneous sensitization to food allergens. Clinical Implications Skin tape proteomics analysis identified abnormalities in barrier function of atopic dermatitis children and adults with and without food allergy that can be noninvasively assessed using skin tape strips.