Fellow
Angel Pagan
Ponce Health Sciences University
Mentor
Emma Guttman-Yassky, MD, PhD
Ichan School of Medicine at Mount Sinai
Overview
Up to 11% of United States children are affected by atopic dermatitis (AD) and one-third of these suffer from moderate-to-severe disease. The negative impact of AD in children include feelings of isolation from peers due to disease-related lifestyle restrictions, embarrassment, and bullying. There’s also a large burden of disease on families, with parents of children with AD reporting lower total sleep time and higher frequency of missed workdays. Despite a worldwide increase in the incidence of pediatric AD, the development of effective long-term treatments has been slow.
Our objective is to investigate the role of age, race and ethnicity in response to immunomodulating agents in children with moderate to severe atopic dermatitis. Our central hypothesis is formulated on the basis that TH17-cell–generated products such as IL-17A and IL-17F, important for skin antimicrobial and barrier functions, recently showed the greatest upregulations in infant (0-5 years old) AD, which could show a different frequency of adverse events such as Staphylococcus aureus skin infections and ocular manifestations, compared to children (6-11 years old). If this hypothesis is correct, efforts can be directed towards maximing effectiveness during infancy and applying strategies proven successful in the older age group to directly address dupilumab adverse events in pediatric AD. Our long-term is to disseminate knowledge at the clinical level that reduce the burden of AD in affected families. By pursuing the following specific aims, we will gather data essential to help direct future interventions.
Aim 1: Compare differences in the incidence of skin infections and injection-site reactions in multiple dose treatment with dupilumab in infants compared to children.
Aim 2: Compare differences in the incidence of treatment‐emergent adverse events such as nasopharyngitis, conjunctivitis, and anaphylactic reactions in multiple dose treatment with dupilumab in infants compared to children.
Aim 3: Compare differences in the incidence of adverse events between African American, Hispanic, Asian, and European American children in multiple dose treatment with dupilumab.
Status
This project was funded through a 2021 PeDRA Research Fellowship Grant.