Reduced Skin Microbiome Diversity in Infancy Is Associated with Increased Risk of Atopic Dermatitis in High-Risk Children

Abstract

It is currently unknown whether alterations in the skin microbiome exist prior to development of atopic dermatitis (AD). In this prospective Danish birth cohort of 300 children, we examined whether skin microbiome alterations during the first 2 months of life were associated with an increased risk of AD in the first 2 years, and its severity, following adjustment for environmental factors and selected skin chemokine and natural moisturizing factor levels. We found no overall association between the skin microbiome at birth and 2 months of age and AD during the first 2 years of life. However, when restricting the analysis to children with at least one parent with atopy, a lower alpha diversity at 2 months of age was associated with an increased risk of AD (adjusted hazard ratio [HR] 1.7, 95% confidence interval [CI] 1.1-2.6). We observed a stronger association in children where both parents had atopy (HR 4.4 [1.1-18.2]). The putative pathogenic role of changes in the skin microbiome on AD risk remains uncertain but may play a role in those with an atopic predisposition.