Atopic Dermatitis In Early Childhood Research Articles

T-cell receptor diversity and allergen sensitivity in childhood asthma and atopic dermatitis.

Childhood allergies of asthma and atopic dermatitis (AD) involve an overactive T-cell immune response triggered by allergens. However, the impact of T-cell receptor (TCR) repertoires on allergen sensitization and their role in mediating different phenotypes of asthma and AD in early childhood remains unclear. A total of 78 children, comprising 26 with asthma alone, 26 with AD alone, and 26 healthy controls (HC), were enrolled. TCR repertoire profiles were determined using a unique molecular identifier system for next-generation sequencing. Integrative analyses of their associations with allergen-specific IgE levels and allergies were performed. The diversity in TCR alpha variable region (TRAV) genes of TCR repertoires and complementarity determining region 3 (CDR3) clonality in TRAV/TRBV (beta) genes were significantly higher in children with AD compared with those with asthma and HC (p < .05). Compared with HC, the expression of TRAV13-1 and TRAV4 genes was significantly higher in both asthma and AD (p < .05), with a significant positive correlation with mite-specific IgE levels (p < .01). In contrast, TRBV7-9 gene expression was significantly lower in both asthma and AD (p < .01), with this gene showing a significant negative correlation with mite-specific IgE levels (p < .01). Furthermore, significantly higher TRAV8-3 gene expression, positively correlated with food-specific IgE levels, was found in children with AD compared with those with asthma (p < .05). Integrated TCR repertoires analysis provides clinical insights into the diverse TCR genes linked to antigen specificity, offering potential for precision immunotherapy in childhood allergies.

Vitamin D level is inversely related to allergen sensitization for risking atopic dermatitis in early childhood

BackgroundThere are few studies concerning the impact of serum vitamin D status on the risk of allergen sensitization and atopic dermatitis (AD) during early childhood. MethodChildren with AD and age-matched healthy controls (HC) were prospectively enrolled at age 0.5, 2, and 4 years. Serum 25-hydroxyvitamin D (25[OH]D) level was measured using Elecsys Vitamin D Total assay. The study utilized the ImmunoCAP assay to analyze specific IgE for food and inhalant allergens, along with total serum IgE levels. It explored the connection between vitamin D levels and allergen sensitization, as well as their influence on AD at different ages. ResultsA total of 222 children including 95 (59 AD and 36 HC), 66 (37 AD and 29 HC), and 61 (32 AD and 29 HC) children were classified at age 0.5, 2, and 4 years, respectively. In children with AD, there was a significantly lower vitamin D level at age 2 and 4, but a significantly higher prevalence of food and mite sensitization at all ages in comparison with HC (P < 0.001). Vitamin D level was found to be inversely related to the prevalence of allergen sensitization at age 4 (P < 0.05). However, vitamin D level appeared to have high importance for allergen sensitization at all ages and AD at age 2 and 4 years. ConclusionVitamin D deficiency is strongly associated with heightened prevalence of allergen sensitization, potentially increasing the susceptibility to AD in early childhood.

Atopic Dermatitis in Early Childhood and Risk of Inflammatory Bowel Disease: A Scandinavian Birth Cohort Study

ObjectiveTo examine the association between early-life atopic manifestations and later risk of inflammatory bowel disease (IBD), for which prospective data are scarce. Study designThe population-based All Babies in Southeast Sweden (ABIS) and Norwegian Mother, Father, and Child (MoBa) cohorts follow children from birth (ABIS 1997–1999; MoBa 2000–2009) to the end of 2021. Based on validated questionnaires, parents prospectively reported information on asthma, food-related allergic symptoms, atopic dermatitis, and allergic rhinitis by age 3. IBD was defined by ≥2 diagnostic records in the national health registries. Cox regression estimated hazard ratios adjusted (aHR) for parental IBD, atopy, education level, smoking habits, and national origin. Cohort-specific estimates were pooled using a random-effects model. ResultsWe compiled data on 83,311 children (ABIS, n=9,041; MoBa, n=74,270). In over 1,174,756 person-years of follow-up, 301 participants were diagnosed with IBD. Children with atopic dermatitis at age 3 had an increased risk of IBD (pooled aHR=1.46 [95% confidence interval [CI]=1.13-1.88]), Crohn’s disease (pooled aHR=1.53 [95%CI=1.04-2.26]), and ulcerative colitis (pooled aHR=1.78 [95%CI=1.15-2.75]). Conversely, any atopic manifestation by age 3 was not associated with IBD (pooled aHR=1.20 [95%CI=0.95-1.52]), nor were analyses specifically focused on early-life food-related allergic symptoms, asthma, and allergic rhinitis. ConclusionWhile atopic manifestations in early childhood were overall not associated with IBD, children with atopic dermatitis specifically were at increased risk of developing IBD, suggesting shared etiological traits; these findings might be useful in identifying at-risk individuals for IBD.

Atopic Dermatitis and Eczema Association Between Early Life Antibiotic Exposure and Development of Early Childhood Atopic Dermatitis.

Atopic Dermatitis and Eczema Association Between Early Life Antibiotic Exposure and Development of Early Childhood Atopic Dermatitis.

Exploring Longitudinal Gut Microbiome towards Metabolic Functional Changes Associated in Atopic Dermatitis in Early Childhood.

Atopic dermatitis (AD) is a prevalent inflammatory skin disease that has been associated with changes in gut microbial composition in early life. However, there are limited longitudinal studies examining the gut microbiome in AD. This study aimed to explore taxonomy and metabolic functions across longitudinal gut microbiomes associated with AD in early childhood from 9 to 30 months of age using integrative data analysis within the Thai population. Our analysis revealed that gut microbiome diversity was not different between healthy and AD groups; however, significant taxonomic differences were observed. Key gut bacteria with short-chain fatty acids (SCFAs) production potentials, such as Anaerostipes, Butyricicoccus, Ruminococcus, and Lactobacillus species, showed a higher abundance in the AD group. In addition, metabolic alterations between the healthy and AD groups associated with vitamin production and host immune response, such as biosynthesis of menaquinol, succinate, and (Kdo)2-lipid A, were observed. This study serves as the first framework for monitoring longitudinal microbial imbalances and metabolic functions associated with allergic diseases in Thai children during early childhood.

Cognitive Function and Academic Achievement in Children with Early Childhood Atopic Dermatitis

Cognitive Function and Academic Achievement in Children with Early Childhood Atopic Dermatitis

Introduction of Egg White and Yolk to Infant Diets and Early Childhood Atopic Dermatitis

This study investigated whether the introduction of allergenic foods in infancy is associated with atopic dermatitis (AD) in early childhood. Information regarding parental allergic histories, the introduction of six possible allergenic foods (fruits, egg white, egg yolk, fish, shellfish, and peanuts), and physician-diagnosed AD was obtained using age-specific questionnaires (0-2 years). Immunoglobulin E, specific to 20 food allergens, was also quantified at 12 months of age. Logistic regression analyses were used to determine the association between individual food introduction and the outcomes of food sensitization and AD. We found AD development by 2 years of age was significantly related to a parental history of allergy (adjusted odds ratio (aOR) = 1.29) and not being introduced to egg white and yolk during infancy (aORs = 2.27 and 1.97, respectively). Stratified analyses revealed that the introduction of both egg white and yolk was negatively associated with AD by 2 years of age, especially for those children where both parents had allergic diseases (aOR = 0.10). In summary, the introduction of egg white and yolk to an infant's diet may be a modifiable factor in reducing the risk of physician-diagnosed AD by 2 years of age, which may be particularly important for infants where both parents have allergies.

Mode of delivery and offspring atopic dermatitis in a Swedish nationwide study.

Atopic dermatitis is a common chronic childhood disease associated with significant morbidity and healthcare costs. There is a known association between caesarean section and asthma, but the relationship between caesarean section and offspring atopic dermatitis remains uncertain. We conducted a register-based nationwide cohort study including children born in Sweden between January 2006 and December 2018. Data on health and socioeconomic variables were extracted from the national registers for children aged ≤5 years. Time-to-event analyses were used to calculate hazard ratios (HR) with 95% confidence intervals (CI) adjusting for confounders and familial factors. 1,399,406 children were included (6,029,542 person-years at risk). Atopic dermatitis was observed in 17.2% of the 1,150,896 children born by vaginal delivery and 18.3% of the 248,510 born by caesarean section. The mean age of onset of atopic dermatitis was 2.72 years (SD 1.8). Birth by caesarean section was associated with a higher risk of atopic dermatitis (adj-HR 1.12, 95% CI: 1.10-1.14). A higher risk of atopic dermatitis was found in children born by instrumental vaginal delivery (adj-HR 1.10, 1.07-1.13); emergency caesarean section (adj-HR 1.12, 1.10-1.15), and elective caesarean section (adj-HR 1.13, 1.10-1.16) than uncomplicated vaginal delivery in children <1year of age. Similar hazards were observed in those ≥1year of age. In sibling control analysis, greater risks remained in children aged <1year but not in age ≥1year. In our study population, it was observed that children born by caesarean section or instrumental vaginal delivery were at higher risk of early childhood atopic dermatitis. Although familial confounding attenuates the risk in children aged ≥1year, this was not observed in the first year of life.

Prenatal Maternal Risk Factors Contributing to Atopic Dermatitis: A Systematic Review and Meta-Analysis of Cohort Studies.

The gestational risk factors predispose to the manifestation of early childhood atopic dermatitis (AD). We evaluated the association between modifiable and non-modifiable gestational and prenatal risk factors that affect the AD prevalence in children. We performed the systematic review and meta-analysis of cohort studies (n=27) in PubMed and EMBASE (2000~2021). A meta-analysis was performed using random-effects models to estimate pooled odds ratios (OR) or hazard ratio (HR). We performed a systematic review according to Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines and summarized cohort studies investigating gestational and prenatal risk factor those predispose to AD in off spring. Leading modifiable and non-modifiable were identified through ORs. Meta-analysis using the random effect model was also conducted to provide an overall estimate for several significant factors. Among the non-modifiable risk factors gestational diabetes (7.2, 95% confidence interval [CI]: 1.4~34.5), maternal history of allergy (2.14, 95% CI: 1.54~2.97) and prenatal history of eczema (2.46, 95% CI: 1.0~5.8) were found as major determining risk factors in early manifestation of AD in children. Further, maternal exposure to industrial products (1.89, 95% CI: 1.10~3.16), exposure to antibiotics during pregnancy (3.59, 95% CI: 1.19~10.85) and passive smoking during pregnancy (2.60, 95% CI: 1.11~6.1) are leading causes of early AD manifestation. Conclusively, both genetic and environmental factors play a pivotal role in early manifestation of AD. The better managing the environmental factors during gestational phase to the least can help curtail the prevalence of AD in children.

Association between early life antibiotic exposure and development of early childhood atopic dermatitis

Atopic dermatitis (AD) is a chronic, inflammatory skin disease commonly onset during infancy. We examine the association between pre-and postnatal antibiotic exposure and the development of AD. A retrospective, observational study analyzed 4106 infants at the University of Florida from June 2011 to April 2017. Antibiotic exposure during the first year of life was associated with a lower risk of AD. The association was strongest for exposure during the first month of life. There were no significant differences in the rates of AD in infants with or without exposure to antibiotics in months 2 through 12, when examined by month. Antibiotic exposure during week 2 of life was associated with lower risk of AD, with weeks 1, 3, and 4 demonstrating a similar trend. Retrospective data collection from a single center, use of electronic medical record, patient compliance with prescribed medication, and variable follow-up. Early life exposures, such as antibiotics, may lead to long-term changes in immunity. Murine models of atopic dermatitis demonstrate a "critical window" for the development of immune tolerance to cutaneous microbes. Our findings suggest that there may also be a "critical window" for immune tolerance in human infants, influenced by antibiotic exposure.

A Child Girl Has Severe Case of Pediatric Atopic Dermatitis: Treatment with Terbinafine Hydrochloride

Atopic dermatitis in early childhood accounts for 20% of all atopic dermatitis occurrences, with similar atopic dermatitis symptomology of red pustules or scales characteristic. The potential causation of atopic dermatitis varies, may be hereditary in some cases. Combination topical therapies are used to treat patients with a compromised skin barrier. There are few safe and regulated pharmacotherapeutic atopic dermatitis therapies for pediatric use, and current treatment satisfaction is low. Here we provide details of the successful treatment of a pediatric patient with pustular atopic dermatitis using topical application of terbinafine hydrochloride in tandem with maternal diet control on July 22, 2020 at AYA Medical Center in Sydney, Australia. After a six-month follow-up, the patient's symptoms had fully recovered. Thus, Terbinafine hydrochloride may be useful in the treatment of atopic dermatitis in children.

Munich atopy prediction study (MAPS): protocol for a prospective birth cohort addressing clinical and molecular risk factors for atopic dermatitis in early childhood

IntroductionThe pathogenesis of atopic diseases is highly complex, and the exact mechanisms leading to atopic dermatitis (AD) onset in infants remain mostly enigmatic. In addition to an interdependent network of...

Human milk oligosaccharide profiles and child atopic dermatitis up to 2years of age: The Ulm SPATZ Health Study.

Human milk oligosaccharides (HMOs) have several biological functions. Yet, very few studies have investigated the effect of HMOs on the development of allergies and even fewer on their specific associations with atopic dermatitis (AD) during early childhood. This study investigated whether individual HMO concentrations, measured at two time points of lactation, were associated with reported diagnosis of AD in children up to twoyears of age. Outcome data were available for HMOs measured in human milk samples collected at 6weeks (n=534) and 6months (n=356) of lactation. Associations of HMOs with AD, ascertained from parents and pediatricians at ages one and two years, were assessed in crude and adjusted logistic regression models. Few associations were statistically significant at the conventional level (p<.05), for example, 6-week Lacto-N-neotetraose with 2-year AD [OR 95%CI: 0.82 (0.66, 1.00)] and 6-month 3'-sialyllactose among non-secretor mothers with 1-year AD [2.59 (1.53, 6.81)]. Importantly, accounting for multiple testing, these and all further associations were not statistically significant (all p>.0031, which is the threshold for statistical significance after correction for multiple testing). Our findings suggest that the intake of different levels (or even absence) of the individual HMOs measured at 6weeks and 6months of lactation, in the current study, is not significantly associated with the development of AD in early childhood. Given the exploratory nature of our study and the limited sample size, these results should be interpreted with caution. The specific HMOs for which we show plausible associations at conventional level may warrant further research and investigation.

Phenotypes of atopic dermatitis up to 36 months of age by latent class analysis and associated factors in Japan.

BackgroundAtopic dermatitis (AD) in early childhood is the first allergic manifestation in the atopic march. Recently, latent class analysis (LCA) has revealed the presence of AD subgroups in childhood.ObjectiveThis study aimed to elucidate different AD phenotypes up to 36 months of age and identify factors associated with a particular AD phenotype in early childhood.MethodsPediatric allergists or dermatologists examined children who visited local public health centers in Chiba or Yokohama city at 4, 18, and 36 months of age for regular health checkups between 2003 and 2005. LCA was used to identify AD subtypes on the basis of the course of skin symptoms and comorbidity of other allergic diseases. After LCA, the association between genetic and environmental factors and AD phenotypes was assessed.ResultsA total of 1,378 children who underwent the 3 checkups were included. Complete data were available for 515 children up to 36 months of age. Of 515 children, 183 were diagnosed with AD at least at one out of the 3 time points. The LCA model of these children with AD separated 4 AD phenotypes: early-persistent (EP), early-transient (ET), late-onset (LO), and variable (V). Antibiotic use by 4 months of age was significantly higher in EP group than in other 3 groups. Mother’s allergy was significantly higher in EP and LO groups than in other 2 groups. Passive smoking at 18 months of age was higher in LO group than in other groups. Furthermore, >80% of V group was born in spring–summer.ConclusionWe identified 4 AD phenotypes using LCA on the basis of the onset/course of AD and comorbidity of other allergic diseases and also identified several factors related to the particular phenotypes, which may be useful markers for the prediction of prognosis of AD in early childhood.

Serum 25-Hydroxyvitamin D Concentrations and Atopic Dermatitis in Early Childhood: Findings from the Japan Environment and Children’s Study

Vitamin D (VitD) may affect immune system modulation and result in the development of atopic dermatitis (AD). However, published findings have remained controversial. We investigated the association between early-life 25-hydroxyvitamin D (25(OH)D) levels and AD risk at childhood with a birth cohort. The data were obtained from “the Japan Environment and Children’s Study (JECS)” and “the Sub-Cohort study of JECS” performed with children aged 2 years. “Liquid chromatography-tandem mass spectrometry” was used to measure VitD. The information on AD was obtained from parents’ answers to a questionnaire when their children were aged 3 years. In order to explain the seasonal effects on VitD levels, a deseasonalized continuous variable was further calculated. The logistic regression models were fitted to evaluate the effect of VitD on childhood AD. The study included 4378 children with complete data on VitD and AD. The results from models indicated that low VitD at 2 years was not a risk factor for the development of AD at 3 years, after adjusting for potential confounders. Moreover, there was no U-shape relationship between deseasonalized VitD and childhood AD. Overall, early-life 25(OH)D levels were not link to the increased risk of developing childhood AD.

Medical algorithm: Diagnosis of atopic dermatitis in early childhood (part I).

Atopic dermatitis (AD, atopic eczema) is a chronic, relapsing, pruritic, non-communicable inflammatory skin disease that affects children and adults1 . It almost always has its debut in early life2,3 , therefore this medical algorithm focuses on diagnosis (part I) and therapy (part II4 ) of AD in early childhood, which is defined by UNESCO as 'the period from birth to eight years old'.

Medical algorithm: Treatment of atopic dermatitis in early childhood (part II).

Medical algorithm: Treatment of atopic dermatitis in early childhood (part II).

Symptom burden of atopic dermatitis in early childhood assessed from daily monitoring of symptoms and topical steroid use

To our knowledge, diseaseburden of atopic dermatitis (AD) as number of days with symptoms and medical treatment has never been studied as measure of severity. To investigate risk factors for AD burden in the first 3years of life. The Copenhagen Prospective Studies on Asthma in Childhood2010 included 700 children. AD burden was assessed by daily diary entries with information on AD and steroid days measuring 18 possible heritable, prenatal, and postnatal environmental exposures. The children with AD had a median (interquartile range) of 136 symptom days (61-294days) and 72 steroid days (27-145days) during the first 3years of life, with the highest disease burden in the second year of life. The multivariable risk factor analysis showed that maternal AD and childhood allergic sensitization were associated with a higher number of AD days and maternal AD, filaggrin mutation, and allergic sensitization were associated with a higher number of steroid days. Participants with a personal interest in atopic diseases could be more likely to participate. Children's burden of AD, assessed quantitatively as AD and steroid days, demonstrated positive associations with maternal AD, filaggrin mutation, and early-life allergic sensitization, with the highest disease burden in the second year of life.

466 The relationship between atopic dermatitis and childhood symptoms of attention deficit/hyperactivity disorder: A longitudinal cohort study

The rise in atopic dermatitis (AD) has been paralleled by rising prevalence of attention deficit/hyperactivity disorder (ADHD) in the past few decades, especially in developed and Western countries. Previous research shows a possible association between AD and ADHD, but data have been mixed, likely due to poorly defined phenotypes and heterogeneity in measuring AD and ADHD. Furthermore, most studies have been limited by cross-sectional designs. To test our hypothesis that active and more severe early childhood AD is associated with clinician-diagnosed ADHD at age 7, and hyperactive symptoms as measured by the Strengths and Difficulties Questionnaire (SDQ) at ages 7, 10, 13, and 16 years, we analyzed data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a large population-based birth cohort from the UK. Using logistic regression models, we found that AD (defined as at least two reports of flexural dermatitis from a standardized and validated questionnaire) was not associated with clinician-diagnosed ADHD at age 7 based on the Development and Wellbeing Assessment (Odds Ratio 1.07, 95% CI 0.64-1.78, adjusted for potential confounders including maternal stress during pregnancy, maternal age at delivery, maternal smoking during pregnancy, socioeconomic status, and maternal smoking). We found a trend toward higher effect estimates in younger ages, though this was not statistically significant, and we found no evidence of an interaction with parental-reported sleep quantity. Additionally, we did not find any significant cross-sectional associations between active AD and symptoms of hyperactivity based on the SDQ at four subsequent assessments between ages 7 and 16. Our results do not provide evidence to support an association between AD and ADHD in a large cohort of children followed from birth. Our research challenges the current paradigm that AD is strongly associated with ADHD.

Jaundiced Neonates Receiving Phototherapy and Risk of Atopic Dermatitis in the First 2 Years of Life: A Case-Control Study

Background Only alimited number of studies have evaluated the association between phototherapy-treated neonatal jaundice and the development of atopic dermatitis (AD) in the early childhood. In this context, the present study is aimed to assess the relationship between the AD development in the childhood and the history of phototherapy in the case of neonatal jaundice. Materials and Methods 92 children younger than two years of age who were admitted in Besat hospital and Imam Khomeini clinic (Hamadan, Iran) were enrolled in this case-control study. The subjects were classified into the case (children with AD, n=43), and control (children without AD, n=49) groups. AD was diagnosed by an allergist according to the AD diagnostic criteria. The history of neonatal jaundice treatment with phototherapy as well as the medical records of all the recruited subjects was investigated. The data were collected by physician according to clinical manifestations and medical records. The association between phototherapy-treated jaundiced neonates and developing AD was examined. Results 92 children were recruited.The mean age of the participants in the case and control groups was 10.56 and 9.89 months, respectively. About 74% (n=14) of the phototherapy-treated neonatal jaundice patients developed AD in their early childhood. Logistic regression analysis was used to evaluate the effect of jaundice treatment with phototherapy on the AD development in the early childhood. The prevalence of AD was higher in the patients with positive history of jaundice treatment with phototherapy (p < 0.05, OR=4.24, 95% CI: 1.38-13.06). Conclusion Based on the results, atopic dermatitis in early childhood was significantly associated with neonatal jaundice treatment by phototherapy.