# Developing a Molecular Map of Atopic Dermatitis Across Ethnicity and Severity Subtypes.

> **NIH NIH U01** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2020 · $224,076

## Abstract

Project Summary
Selection of therapeutics for patients with different AD phenotypes (i.e differing ethnic phenotypes and varying
disease severity) should not be done by serendipity, but should be guided by differences in activation of
immune circuits, and respective barrier alterations. Our overarching hypothesis is that different AD
endotypes (based on ethnicity and severity) have different molecular phenotypes in skin and blood
that may require use of different therapeutic approaches. The sub-hypothesis underlying our first
project is that discrete subtypes/endotypes of AD exist within different ethnic populations. Our first
project aims to define the skin and blood phenotypes of moderate-to-severe AD patients from Africa and Asia,
and determine whether they are similar to those of AA and Asian AD patients in the US, implying global African
and Asian AD phenotypes. The sub-hypothesis underlying our second project is that severe AD may be
considered a systemic disease of the entire skin surface with immune activation extending to non-
lesional skin and circulating cytokines, while mild disease may reflect only focal lesional skin
inflammation without major systemic involvement. This may explain the need for systemic treatments and
the inadequacy of treating only lesional skin with topical agents in severe patients. This study will define an
onset point for systemic inflammation that may necessitate systemic treatments. The aim of the second project
is to define the skin and blood biomarkers associated with increasing disease severity (from mild/limited
through severe/extensive disease). The study will enroll adult AD patients and controls above 18 years old.
SCORAD, EASI, body surface area (BSA), NRS pruritus and sleep loss assessments will be performed. Blood
for CBC, serum (for circulating cytokines and chemokines, IgE and specific IgE levels), and flow cytometry, will
be drawn. PAX RNA (for gene expression) and PAX DNA (for genetic analyses) blood samples will be taken.
4.5 mm lesional/LS and non-lesional/NL punch biopsies will be performed for skin profiling using genomic
(RNAseq and qRT-PCR) and immunohistochemistry approaches. TEWL and swabs for microbiome will be
performed from the same locations prior to biopsies. Exome sequencing will be performed to assess for
genetic ancestry of each ethnicity/severity group. This is the first investigation that provides a system biology
approach for AD, aiming to produce a molecular map of AD across its different ethnic backgrounds and
disease severity sub-groups, which can possibly identify new therapeutics specifically geared towards a
particular ethnic background, or severity. The proposal will set the stage for personalized therapy for AD based
on skin and blood biomarkers (barrier, immune activation, microbiome, genetic risk alleles) related to ethnicity
and severity, and will promote testing and development of innovative pathway-directed therapeutic approaches
for the different ethnic backgroun...

## Key facts

- **NIH application ID:** 9972643
- **Project number:** 1U01AI152036-01
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** Emma Guttman
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $224,076
- **Award type:** 1
- **Project period:** 2020-04-13 → 2027-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9972643

## Citation

> US National Institutes of Health, RePORTER application 9972643, Developing a Molecular Map of Atopic Dermatitis Across Ethnicity and Severity Subtypes. (1U01AI152036-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9972643. Licensed CC0.

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