# Sodium in the Skin and Atopic Dermatitis: The SIS-AD Study

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2024 · $688,519

## Abstract

ABSTRACT
Atopic dermatitis (AD) rates have tripled since the 1950s, and are highest in urban and industrialized areas,
likely due to changing environmental and dietary factors. Atopic dermatitis is now the most burdensome skin
disease globally, and disease course and response to new immunomodulatory treatments remain highly
variable. There is a critical need to identify modifiable factors that could improve patient outcomes. The central
hypothesis of this proposal is that excess dietary sodium (consumed primarily as salt) is concentrated in the
skin as a physiologic response to poor barrier function and water loss, and that high levels of skin sodium
exacerbate the clinical phenotype of atopic dermatitis. The rationale for this project is that the skin serves as an
osmoregulatory organ, storing large amounts of sodium; and that high sodium concentrations trigger
inflammation, including TH2 pathways specific to atopic dermatitis. Our long-term goals are to understand how
skin sodium influences inflammation and to test whether reducing salt intake or storage improves atopic
dermatitis. The first specific aim will focus on reasons for sodium storage in the skin and will evaluate the
impact of dietary sodium intake and skin barrier function on skin sodium concentration. The second specific
aim will focus on the implications of skin sodium and will examine the extent to which skin sodium is associated
with atopic dermatitis severity and persistence. It will also define functional immune profiles associated with
high skin sodium both in skin and in the blood. To achieve these aims, we will perform a longitudinal cohort
study of 90 men and women age > 50 at enrollment. Enrollment will be stratified by sodium intake and atopic
dermatitis status and severity at baseline. Diet will be evaluated using food frequency questionnaires and urine
biomarkers prior to each study visit, and skin sodium concentration will be measured using a novel, non-
invasive sodium MRI technique. Participants will be followed for two years after enrollment. Our
multidisciplinary team combines expertise in clinical and translational research, nutritional and cardiovascular
epidemiology, immunology, and advanced imaging. This proposal is innovative in its application of cutting-edge
techniques to image sodium in the skin and to define immune cell subsets in the skin and blood. It also tests a
new conceptual model that links developments in the understanding of sodium physiology and immune
stimulation with epidemiologic trends in atopic dermatitis. It is significant because the results will be used to
design a clinical trial that would represent a fundamentally new approach to AD management that addresses
disease triggers rather than focusing only on immunosuppression. Moreover, it will improve our understanding
of sodium physiology in ways that could ultimately impact the management of patients with hypertension and
cardiovascular disease.

## Key facts

- **NIH application ID:** 10933427
- **Project number:** 5R01AR082831-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Katrina Elaine Abuabara
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $688,519
- **Award type:** 5
- **Project period:** 2023-09-22 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10933427

## Citation

> US National Institutes of Health, RePORTER application 10933427, Sodium in the Skin and Atopic Dermatitis: The SIS-AD Study (5R01AR082831-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10933427. Licensed CC0.

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