title: Thymic stromal lymphopoietin variation, filaggrin loss of function, and the persistence of atopic dermatitis.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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
  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.
authors.affiliation: Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia 2Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Margolis
authors.affiliation: Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Brian
authors.initials: B
authors.lastname: Kim
authors.affiliation: Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Apter
authors.affiliation: Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Jayanta
authors.initials: J
authors.lastname: Gupta
authors.affiliation: Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Ole
authors.initials: O
authors.lastname: Hoffstad
authors.affiliation: Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Maryte
authors.initials: M
authors.lastname: Papadopoulos
authors.affiliation: Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Nandita
authors.initials: N
authors.lastname: Mitra
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D016207:Cytokines / Q000235:genetics*; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology; D005260:Female; D000091344:Filaggrin Proteins; D020022:Genetic Predisposition to Disease; D006801:Humans; D007381:Intermediate Filament Proteins / Q000235:genetics*; D008297:Male; D009154:Mutation; D016017:Odds Ratio; D020641:Polymorphism, Single Nucleotide; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D018570:Risk Assessment; D012720:Severity of Illness Index; D000094632:Thymic Stromal Lymphopoietin
chemical_list: D016207:Cytokines; C000717249:FLG protein, human; D000091344:Filaggrin Proteins; D007381:Intermediate Filament Proteins; D000094632:Thymic Stromal Lymphopoietin