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2014 ; 150
(3
): 254-9
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Thymic stromal lymphopoietin variation, filaggrin loss of function, and the
persistence of atopic dermatitis
#MMPMID24401911
Margolis DJ
; Kim B
; Apter AJ
; Gupta J
; Hoffstad O
; Papadopoulos M
; Mitra N
JAMA Dermatol
2014[Mar]; 150
(3
): 254-9
PMID24401911
show ga
IMPORTANCE: Atopic dermatitis (AD) is a common chronic illness of childhood.
OBJECTIVE: To evaluate the association between thymic stromal lymphopoietin
(TSLP) variation and the persistence of skin symptoms of AD. DESIGN, SETTING, AND
PARTICIPANTS: A prospective cohort study was conducted in the general community.
Participants included 796 children enrolled in the Pediatric Eczema Elective
Registry. EXPOSURE Evaluation of TSLP variation. MAIN OUTCOMES AND MEASURES:
Self-reported outcome of whether a child's skin had no symptoms of AD and
required no medications for 6 months at 6-month intervals. RESULTS: We evaluated
14 variants of TSLP. The variant rs1898671 was significantly associated with the
outcome in white children (P =?.01). As measured by overlapping CIs, similar odds
ratios (ORs) were noted among whites (OR, 1.72; 95% CI, 1.11-2.66) and African
Americans (1.33; 0.52-3.45). Further within the subcohort of individuals with a
filaggrin protein (FLG) loss-of-function mutation, those with TSLP variation were
more likely to have less-persistent disease (OR, 4.92; 95% CI, 2.04-11.86).
CONCLUSIONS AND RELEVANCE: The TSLP variation is associated with less persistent
AD. Therefore, TSLP may be a potential therapeutic target for the treatment of
AD, especially in individuals with diminished barrier function due to FLG
mutations. This is an attractive hypothesis that can be tested in clinical
trials.