Understanding the heterogeneity of atopic dermatitis in childhood
File(s)caci_v31_n3_a3.pdf (868.61 KB) Accepted manuscripts.docx (136.72 KB)
Published version
Accepted version
Author(s)
Nakamura, Toshinori
Haider, Sadia
Custovic, Adnan
Type
Journal Article
Abstract
No universally accepted definition of atopic dermatitis (AD) exists in epidemiological studies, and no objective test that can unequivocally confirm the diagnosis. The heterogeneity of AD is now broadly accepted, but there is no consensus on what the best approach is to disaggregate this complex condition, and how best to identify different AD endotypes. One approach is to use data-driven techniques to uncover the unobserved (ie latent) structure in the data set(s) to identify homogenous groups of individuals in the heterogeneous AD population. Since AD usually starts early in life, and its clinical features may progress, remit or relapse over time, analyses assessing trajectories related to their presence or absence over time may help us understand AD heterogeneity. However, studies that used unsupervised methods such as latent class analysis to discover AD ‘phenotypes’ have reported inconsistent findings. If we are to use data-driven analyses to uncover patterns of AD with different long-term consequences, then the discovered ‘phenotypes’ must be consistent and reproducible. We therefore need to understand the reasons for the inconsistencies between different studies. We suggest that in addition to capturing a simple presence or absence of symptoms, more detailed clinical features, such as the severity and medication used, should be assessed in longitudinal studies. Ultimately, the objective is to move from ‘deep phenotyping’ to more informative genetic studies, followed by functional studies to understand mechanisms. In this way, the identification of novel therapeutic targets could be facilitated.
Date Issued
2018-09-01
Date Acceptance
2018-09-01
Citation
Current Allergy and Clinical Immunology, 2018, 31 (3), pp.124-130
ISSN
1609-3607
Publisher
Allergy Society of South Africa
Start Page
124
End Page
130
Journal / Book Title
Current Allergy and Clinical Immunology
Volume
31
Issue
3
Copyright Statement
© 2018 Allergy Society of South Africa.
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000443446700003&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Allergy
OF-FUNCTION VARIANTS
1ST 6 YEARS
BIRTH COHORT
PRECISION MEDICINE
SKIN BARRIER
RISK-FACTORS
ASTHMA
ECZEMA
POPULATION
PREVALENCE
Publication Status
Published