A newly published study found that reduced levels of protein-bound ceramides in the skin at 6 weeks of age may be associated with an increased risk of atopic dermatitis by 1 year.
In the study, published in the Journal of Allergy and Clinical Immunology, researchers led by Chia-Lun Chang, MSc, of the Allergy and Lung Health Unit at the Centre for Epidemiology and Biostatistics at the Melbourne School of Population and Global Health at the University of Melbourne in Australia, analyzed skin lipid samples from 133 infants using tape strips. They quantified 176 lipid species, including 133 ceramides. The results showed that lower levels of six protein-bound omega-hydroxyl sphingosine (POS) ceramide species with C30 and C32 fatty acids were linked to a higher likelihood of developing atopic dermatitis (AD).
"Reduced levels of POS ceramides are associated with the development of nonatopic AD, suggesting that these lipids may play a role in the pathogenesis of AD and may be useful predictive biomarkers," the study authors said.
In unadjusted models, specific POS ceramides such as PO30:0-C20S had an area under the curve (AUC) of 0.65 (95% confidence interval [CI] = 0.55–0.75) in predicting AD. After adjusting for confounders, PO30:0-C20S remained significantly associated with AD, with an adjusted odds ratio of 0.62 (95% CI = 0.39–0.96 per 1–standard deviation increase). The association was primarily observed in infants with AD without sensitization but not in those with AD with sensitization.
In contrast, free ceramides such as A20:0-C20S were linked to an increased risk of AD with sensitization. The researchers also noted a shift toward shorter-chain ceramide species in infants who later developed AD, a phenomenon previously linked to immune dysregulation.
To evaluate predictive performance, the researchers incorporated POS ceramides into an existing AD risk model. Adding PO30:0-C20S increased the AUC from 0.64 (95% CI = 0.54–0.74) to 0.70 (95% CI = 0.60–0.80), improving prediction accuracy.
The researchers acknowledged limitations, including the study's small sample size, single-site lipid sampling, and potential confounders. Additionally, all infants had a family history of allergic disease, which may have limited generalizability.
The results suggested that interventions aimed at increasing POS ceramides in early life may help prevent AD. Further research is needed to determine clinical applicability.
No conflicts of interest were disclosed.
