Emerging Biomarkers May Improve Precision Diagnosis and Personalized Treatment in Atopic Dermatitis

Emerging immunoassay-based biomarkers may improve disease assessment and support personalized treatment strategies for patients with atopic dermatitis (AD), according to a narrative review examining their clinical validity and potential integration into laboratory diagnostics.

AD affects approximately 204 million people worldwide, with prevalence rates of 11.1% among children and 6.3% among adults. The chronic inflammatory condition is characterized by pruritus, skin barrier dysfunction, and Th2-driven immune dysregulation, contributing to substantial health care costs and reduced quality of life.

The authors emphasized the need to identify reliable biomarkers that complement conventional severity assessments, including the SCORing Atopic Dermatitis index and Eczema Area and Severity Index, across diverse AD phenotypes and endotypes.

The review evaluated several emerging biomarkers, including TARC/CCL17, IL-13, IL-22, IL-31, SCCA1/SCCA2, and periostin. Assessment methods included enzyme-linked immunosorbent assays, bead-based multiplexing, proximity extension assays, and highly sensitive digital technologies.

Biomarkers were evaluated using serum, plasma, and skin samples collected through tape stripping and microneedle techniques.

Analytical validation considerations included detection limits, precision, linearity, interference, calibration, and external quality standards. Clinical performance was assessed using measures such as area under the curve, likelihood ratios, and decision thresholds.

“Conventional biomarkers, including total IgE, peripheral eosinophil count, and tryptase, show less clinical utility than new biomarkers,” the authors reported.

However, implementation challenges remain. The review identified standardized skin sample collection, population-specific reference intervals, interplatform harmonization, and clinically meaningful cutoff values as essential requirements for reliable testing.

The authors outlined an “evidence-based plan for incorporating reliable AD biomarker tests into current diagnostic methods” to support precision medicine.

Reference
Orayj K, Samuel VP, Saleem S, et al. Immunoassay-based biomarkers in atopic dermatitis. Clin Chim Acta. 2026;579:120634. doi:10.1016/j.cca.2025.120634