Epidermal differentiation complex genetic variation in atopic dermatitis and peanut allergy

Michelle F. Huffaker, Kanika Kanchan, Henry T. Bahnson, Ingo Ruczinski, Gautam Shankar, Donald Y.M. Leung, Carolyn Baloh, George Du Toit, Gideon Lack, Gerald T. Nepom, Rasika A. Mathias

Research output: Contribution to journalArticlepeer-review


Background: Deleterious variation in the epidermal differentiation complex (EDC) on chromosome 1 is a well-known genetic determinant of atopic dermatitis (AD) and has been associated with risk of peanut allergy (PA) in population-based studies. Objective: Our aim was to determine the effect of genetic variation in the EDC on AD trajectory and risk of PA in early life. Methods: Genome sequencing was used to measure genetic variation in the EDC in the Learning Early about Peanut Allergy (LEAP) study participants. Association tests were done to identify gene- and variant-level predicted deleterious variation associated with AD severity by using the Scoring Atopic Dermatitis (SCORAD) tool (n = 559) at baseline and each follow-up visit, as well as PA and food allergy in peanut avoiders (n = 275). Predicted deleterious variants included missense variants that were frameshift insertions, frameshift deletions, stop-gain mutations, or stop-loss mutations. Associations between variant load, SCORAD score, and PA were tested by using linear and generalized linear regression models. Results: The genes FLG, FLG2, HRNR, and TCHH1 harbored the most predicted deleterious variation (30, 6, 3, and 1 variant, respectively). FLG variants were associated with SCORAD score at all time points; 4 variants (R1798X, R501X, S126X, and S761fs) drove the association with SCORAD score at each time point, and higher variant load was associated with greater AD severity over time. There was an association between these variants and PA, which remained significant independent of baseline AD severity (odds ratio = 2.63 [95% CI = 1.11-6.01] [P = .02]). Conclusions: Variation in FLG predicted to be deleterious is associated with AD severity at baseline and longitudinally and has an association with PA independent of baseline severity.

Original languageEnglish (US)
Pages (from-to)1137-1142.e4
JournalJournal of Allergy and Clinical Immunology
Issue number4
StatePublished - Apr 2023


  • Atopic dermatitis
  • eczema
  • epidermal differentiation complex
  • filaggrin
  • genetics
  • peanut allergy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


Dive into the research topics of 'Epidermal differentiation complex genetic variation in atopic dermatitis and peanut allergy'. Together they form a unique fingerprint.

Cite this