Transcriptomic evaluation of skin tape-strips in children with allergic asthma uncovers epidermal barrier dysfunction and asthma-associated biomarkers abnormalities

Tape-strips were obtained from skin of 18 pediatric patients with moderate allergic asthma (MAA) (n=11), severe allergic asthma (SAA) (n=9), and from healthy children (n=12) and analyzed with bulk RNA-sequencing (RNA-seq). Differential expression was defined as |fold change|≥2 and false discovery rate<0.05. MAA and SAA shared downregulation of G-protein-coupled receptor- (GPCR), mitochondria-, and Wnt-signaling-related genes. Terminal differentiation (FLG/filaggrin), cell adhesion (CDH19, JAM2), lipid biosynthesis/metabolism (ACOT2, LOXL2) markers were significantly downregulated in MAA and SAA (FDR<0.05). Many of these markers additionally correlated with metrics of asthma severity (e.g. exacerbation rate per year, forced expiratory volume in 1 second [FEV1] [% predicted], impulse oscillometry [IOS] R5-20 Hz, fractional excretion of nitric oxide [FeNO]).