from Trinity College Dublin and Children’s Health Ireland, Crumlin, offers hope for the improved treatment of infants with eczema. The research showed that corticosteroid treatments reduced disease severity and normalised immune dysregulation.
The scientists, supported by NCRC, have recently published their research in the British Journal of Dermatology.
Eczema, also known as atopic dermatitis, is the most common persistent inflammatory disease of early childhood. Sixty per cent of cases of eczema begin during the first year of life, while 85 per cent begin before a child reaches five 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 the recently published study, a team led by Dr Maeve McAleer and Prof Alan Irvine from Trinity’s School of Medicine 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 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 six-week course of treatment with topical corticosteroids. Blood samples were also collected at both time points.
The scientists 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. Moreover, the results suggest that local inflammation within the skin is responsible for immune dysregulation in infants with eczema.
Prof 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. Collectively, these findings help to shape our understanding of the systemic effects of eczema.”