On the biological underpinnings of the atopic march, also called the atopic triad, and what people with eczema need to know.
Published On: Dec 1, 2015
Last Updated On: Jul 15, 2021
Adam Freidman, M.D., FAAD is an associate professor of dermatology and serves as residency program director and director of translational research in the Department of Dermatology at The George Washington University School of Medicine & Health Sciences.
Biomarkers are reproducible and measurable indicators that can allow one to examine or follow biological activity or function over time. Biomarkers can be categorized into different types depending on their specific characteristics. They can be used to identify the risk of developing a disease, to diagnose a disease, predict disease progression, mark a particular response to an intervention (i.e. lifestyle change such as exercise, moisturizer use, diet), and for monitoring disease activity and clinical response to medication.
This has huge implications in medicine, as identifying biomarkers can not only help us better understand how diseases develop, but also improve our ability to diagnosis a condition, follow its activity and severity, and monitor whether a medication is working or not working. In sum, biomarkers allow for a personalized approach, or what has become known in some respects as “personalized medicine.”
Biomarkers can be used for many different purposes, including providing an objective evaluation of disease severity, confirmation of clinical diagnosis and to predict response to a particular eczema treatment. More importantly, understanding the importance of a biomarker in disease progression and severity could help identify new treatments based on said biomarker.
Eczema even today remains a clinical diagnosis without an objective approach for confirmation. Not all eczema is created equal, and while exceedingly common, for many years it was almost like an orphan disease given the limited advances made in treatment and management. This is all changing and biomarkers are central to this exponentially growing field of study. Identifying biomarkers will no doubt play an important role in research and personalized medical approach given the variation in disease severity from person to person. The use of biomarkers will enhance the success of treatment by creating therapies that target the patient’s specific biological signature as well as help the physician predict and follow response to medications. Many biomarkers — derived from different sources such as blood and saliva — are being studied to develop the best and most accurate way to evaluate patients with eczema.
The same enthusiasm and drive to better understand and treat psoriasis over the past 20 to 30 years is now focused on eczema. Teams of researchers from different universities are working together to identify panels of biomarkers which can be used to identify differences in eczema among age ranges, genders, you name it. This in turn, will help us select the best treatment for a particular eczema patient’s situation.
As of right now, the use of biomarkers to characterize and monitor eczema is still in the early stages. No question, advancing this science is of the utmost importance for everyone and therefore this is a team effort. People with eczema and their families should get involved with the National Eczema Association, to increase awareness, fundraise for research grants, participate in research studies and petition both state and federal government to make this work a priority. We are all in this together: patient, physician and scientist.