Seasonal variation in cytokine profiles in atopic dermatitis patients treated with dupilumab.
Seasonal variations can influence immune responses in atopic dermatitis patients, even those treated with dupilumab, highlighting the need for individualized management strategies.
Where it sits
this study against the rest of the thymogen (thymagen) corpusSummary and findings
This study measured seasonal variation in plasma cytokines among adults with atopic dermatitis (AD) treated with dupilumab (N=20), untreated AD patients (N=15), and healthy controls (N=34). Significant winter increases in stimulated cytokines were observed in dupilumab-treated patients. The findings suggest that seasonal factors may influence immune responses in AD patients.
Abstract
Atopic dermatitis (AD) is primarily a T<sub>H</sub>2-driven pathology, yet seasonal factors may activate additional immune pathways. This study examined seasonal variation in plasma cytokines in adults with AD treated with dupilumab (<i>N</i> = 20), AD patients without systemic therapy (<i>N</i> = 15), and healthy controls (<i>N</i> = 34). Cytokines (interleukin [IL]-17A, thymic stromal lymphopoietin (TSLP), interferon (IFN)γ, tumor necrosis factor (TNFα), IL-2, IL-6, IL-12p70, IL-23, and IL-31) were measured during summer and winter under unstimulated and phorbol 12-myristate 13-acetate (PMA)/ionomycin-stimulated conditions. Dupilumab-treated patients showed significant winter increases in stimulated IFNγ, TNFα, IL-2, IL-6, and TSLP, indicating preserved inducible T<sub>H</sub>1/innate and alarmin activity. Untreated AD patients displayed winter elevation of stimulated IL-6 and unstimulated IFNγ, while healthy controls showed broad winter up-regulation of stimulated T<sub>H</sub>1/innate cytokines. Higher winter cytokine levels tended to occur in dupilumab-treated patients with scoring atopic dermatitis (SCORAD) > 10 (evaluation of severity AD - scoring of atopic dermatitis). The findings obtained here suggest that seasonal environmental factors modulate immune responses even under biologic therapy, supporting season-aware, individualized AD management.