In this issue of JAMA Dermatology, Margolis et al1 report the association of a thymic stromal lymphopoietin (TSLP) variant with disease remission in children with atopic dermatitis (AD), particularly in those carrying filaggrin gene (FLG) mutations. Thymic stromal lymphopoietin, an epithelial cell-derived cytokine, is a master initiator of helper T cell type 2 (TH2) differentiation and allergic manifestations.2 These results suggest that TSLP could be a possible dual factor in AD, capable of modulating the effects of FLG mutations in triggering allergic manifestations. Alternatively, this single-nucleotide polymorphism (SNP) variant could be in linkage disequilibrium, with a causative variant to be identified, localized within or outside TSLP. Functional and expression studies of this TSLP SNP variant will be instrumental to assess its role(s) in the disease.
Duchatelet S, Hovnanian A. Genetics of Atopic DermatitisBeyond Filaggrin—the Role of Thymic Stromal Lymphopoietin in Disease Persistence. JAMA Dermatol. 2014;150(3):248-250. doi:10.1001/jamadermatol.2013.7994