TY - EJOU AU - Xue, Shengjie AU - Ni, Shiyu AU - Lan, Zehao AU - Liao, Jieyue TI - Integrative transcriptomic analysis identifies resistin as a candidate serum marker associated with atopic dermatitis severity T2 - European Cytokine Network PY - 2026 VL - 37 IS - 3 SN - 1952-4005 AB - Background: Atopic dermatitis (AD) is associated with systemic immune dysregulation, but peripheral molecular markers that reliably reflect clinical severity remain insufficiently validated. Using complementary bulk and single-cell transcriptomics, we prioritized peripheral markers and evaluated them in independent clinical cohorts. Methods: Public peripheral blood mononuclear cell (PBMC) transcriptomes were analyzed by differential-expression analysis, weighted gene co-expression network analysis (WGCNA) with power-sensitivity and preservation assessments, immune-cell deconvolution, LASSO, and random forest. Descriptive single-gene receiver operating characteristic (ROC) curves summarized candidate discrimination in the discovery cohort. Selected transcripts were evaluated by RT-qPCR in a PBMC cohort, and serum resistin by ELISA in a separate non-overlapping cohort. Severity associations were examined using multivariable models adjusted for age, sex, and BMI. Results: After correction for multiple module–trait comparisons, WGCNA identified an internally preserved conventional module inversely associated with AD. Power-stable WGCNA-unassigned genes formed an exploratory pool intersected with AD-associated differentially expressed genes. LASSO retained RETN, AZU1, RNASE3, and MS4A3 as computational candidates, and all four genes received relatively high importance rankings in the complementary random-forest analysis. Descriptive within-cohort analyses yielded apparent areas under the curve of 0.750, 0.736, 0.706, and 0.689, respectively, and were not interpreted as independent diagnostic validation. RT-qPCR showed higher RETN, AZU1, and RNASE3 expression in AD PBMC preparations. Deconvolution and single-cell analysis supported a predominantly classical-monocyte-associated expression context for RETN. Serum resistin concentrations were higher in AD and remained positively associated with SCORAD and DLQI after adjustment, although bootstrap analyses indicated uncertainty. Conclusions: Resistin is a candidate peripheral marker associated with AD severity. Its mechanistic significance and clinical utility require functional studies and independent prospective longitudinal validation. KW - Atopic dermatitis; peripheral biomarkers; cytokine; resistin; integrative transcriptomics DO - 10.32604/ecn.2026.086314