Food Sensitization Is Associated With Atopic Dermatitis Severity, Gut-Derived Metabolites and Leaky Gut in Adults

IF 4 2区医学 Q2 ALLERGY

Clinical and Translational Allergy Pub Date : 2025-09-18 DOI:10.1002/clt2.70094

Leszek Blicharz, Emilia Samborowska, Radosław Zagożdżon, Joanna Czuwara, Michał Zych, Aleksander Roszczyk, Michał Zaremba, Michał Dadlez, Zbigniew Samochocki, Małgorzata Olszewska, Lidia Rudnicka

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Abstract

Background

Gut microbiome dysbiosis may cause metabolic dysregulation and intestinal barrier impairment. The latter are hypothesized to provoke food allergy and aggravate cutaneous inflammation. Our objective was to determine the prevalence of food sensitization in adult patients with atopic dermatitis and relate it to the disease severity and the biomarkers of the gut-skin axis.

Methods

50 adult patients with atopic dermatitis and 25 controls were enrolled in this cross-sectional study. Disease severity was determined by using SCORAD and EASI scores. Liquid chromatography-mass spectrometry, Luminex, and Polycheck immunoassays were performed to detect serum concentrations of total IgE, food-specific IgEs, gut-derived metabolites, and leaky gut-related biomarkers.

Results

Food sensitization was significantly more prevalent in patients with atopic dermatitis than in the controls. The severity of atopic dermatitis (EASI, SCORAD) was higher in patients with food sensitization and correlated with the number of positive food-specific IgEs. Higher concentrations of total IgE and higher numbers of positive food-specific IgEs were associated with lower concentrations of short-chain fatty acids and higher concentrations of indoxyl and leaky gut-related biomarkers (LBP, syndecan-4, IL-10, IL-22).

Conclusion

The results suggest a relationship between food sensitization and the severity of atopic dermatitis. This could be partly associated with gut-derived metabolites and intestinal barrier impairment. Fiber-rich diet and restriction of protein could hold potential for upregulating short-chain fatty acids and downregulating indoxyl, which may translate to decreasing the likelihood of food sensitization in atopic dermatitis. Notably, the cross-sectional nature of this exploratory study limits the ability to draw causal inferences, which should be further examined in future prospective research.

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食物致敏与成人特应性皮炎严重程度、肠道衍生代谢物和肠漏有关

背景：肠道微生物群失调可引起代谢失调和肠道屏障损伤。后者被认为会引起食物过敏并加重皮肤炎症。我们的目的是确定成人特应性皮炎患者食物致敏的患病率，并将其与疾病严重程度和肠道-皮肤轴的生物标志物联系起来。方法：50例成人特应性皮炎患者和25例对照者进行横断面研究。采用SCORAD和EASI评分确定疾病严重程度。采用液相色谱-质谱法、Luminex和Polycheck免疫分析法检测血清总IgE、食物特异性IgE、肠道衍生代谢物和漏肠相关生物标志物的浓度。结果：食物致敏在特应性皮炎患者中比在对照组中更为普遍。食物致敏患者的特应性皮炎（EASI， SCORAD）严重程度较高，且与食物特异性IgEs阳性数量相关。较高浓度的总IgE和较高数量的阳性食物特异性IgE与较低浓度的短链脂肪酸和较高浓度的吲哚酚和漏肠相关生物标志物（LBP, syndecan-4, IL-10, IL-22）相关。结论：食物致敏与特应性皮炎的严重程度有关。这可能与肠源性代谢物和肠屏障损伤部分相关。富含纤维的饮食和限制蛋白质可能具有上调短链脂肪酸和下调吲哚酚的潜力，这可能转化为降低特应性皮炎患者食物致敏的可能性。值得注意的是，这项探索性研究的横断面性质限制了得出因果推论的能力，这应该在未来的前瞻性研究中进一步研究。

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来源期刊

Clinical and Translational Allergy Immunology and Microbiology-Immunology

CiteScore

7.50

自引率

4.50%

发文量

117

审稿时长

12 weeks

期刊介绍： Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.