Parental History Of Atopic Dermatitis Research Articles

Enhancing the skin barrier by emollients in neonates to prevent atopic dermatitis.

The importance of the skin barrier for the pathogenesis of atopic dermatitis (AD) is now well accepted. A degraded skin barrier allows the immune system inappropriate access to environmental allergens, leading to sensitization and the initiation of atopic dermatitis.1, 2 Bland creams and ointments may heal or ameliorate atopic dermatitis and may help in preventing relapses of the disease. Therefore, the idea developed that enhancing the skin barrier in babies by emollients may prevent atopic sensitization. Simpson et al., and Horimukai et al., in 2014 in well-remarked studies showed that emollient use in neonates prevents the development of AD.3, 4 In most of several subsequent studies, these results were not confirmed. In line with these studies, Kottner et al., in this issue of the JEADV, did not find that regular emollient application during the first year of life prevents AD.5 However, in some of the studies, a positive trend for preventing AD or improving the symptoms was shown. Also, Kottner et al. found that if AD developed it was more severe in the control group. Even more, a recent study from Ireland presented by Chaoimh et al.6 found a statistically significant 33% reduction of AD in the intervention group, confirming the 32% and 50% reduction in the first studies published in 2014. Chaoimh et al. explained their success because of early intervention immediately after birth. They had shown that trans-epidermal water loss (TEWL) increased from birth to 2 months but stabilized thereafter, suggesting beginning of intervention as soon as possible after birth and a need for a shorter intervention period, only. In two of the failed studies, interventions began at a median age of 11 days or 2 weeks. In addition, in some of the failed studies petrolatum and paraffin-based emollient formulations were used, while Chaoimh and Hormukai used more refined emulsion-type moisturizers consisting of cetearyl alcohols, fatty acids, and glycerin, and ceramide-3, claimed to specifically target at improving the skin barrier, or a hypoallergenic moisturizer milk for sensitive skin prone to dryness, respectively. Further basic and applied research may be necessary to create emollients which specifically improve the skin barrier in babies against epidermal ingress of allergens. Recently, the term emollient plus has been created, which refers to topical formulations with vehicle plus additional active, non-medicated substances. A previous study published in the JEADV with an emollient containing ceramide and filaggrin-associated amino acids showed a trend for preventing AD.7 Until now, it is only known in part which ceramides, which filaggrin-associated amino acids or additional compounds in emollients are best for improving skin barrier. Some ingredients, for example some plant oils, may have an opposite effect, may irritate the skin, worsen the skin barrier and enhance allergen penetration. Also, it would be very important to know which allergens are the most dangerous for atopic sensitization and how to prevent penetration. In addition, it would be important to better classify the group of babies where intervention is advisable. Intervention does not seem to work in babies without a risk for AD. Chaoimh et al. were successful with term infants at high risk of AD, parental history of AD, asthma or allergic rhinitis; further subgroups may be possible. In summary, though several studies failed to show a significant effect, some of the studies using very early intervention in babies at high risk and with specialized emollients targeted at improving the skin barrier showed a significant or a trend in reduction in AD. Further improvements in emollients and very early intervention in neonates may successfully reduce AD. Open Access funding enabled and organized by Projekt DEAL. No conflict of interest. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

Parental History of Atopic Diseases and Presence of Allergic Rhinitis and Asthma in Children with Atopic Dermatitis

Objective − To assess the prevalence of allergic rhinitis and asthma in children with and without parental history of atopic dermatitis (AD) as well as to explore the association between parental history of atopic diseases and presence of allergic rhinitis or asthma in children diagnosed with AD. Methods − From January to June 2014, we recruited a total of 98 children with AD and their parents who presented at the Clinic of Dermatovenereology, Clinical Center of Serbia, Belgrade, Serbia. The parents filled in a questionnaire. The severity of AD was assessed using the SCORing Atopic Dermatitis (SCORAD) Index. Results − Of 98 parents, 33 (33.7%) reported having history of AD. In children with parental history of AD, the prevalence of allergic rhinitis and asthma was 18.2% and 24.2%, respectively. In children without parental history of AD, the prevalence of allergic rhinitis and asthma was 12.3% and 23.1%, respectively. Adjusted logistic regression analyses showed that: neither mothers’ nor fathers’ history AD were associated with presence of allergic rhinitis or asthma; fathers’ history of asthma was associated with presence of asthma and mothers’ history of asthma was associated with presence of allergic rhinitis. Fathers’ history of allergic rhinitis was associated with presence of allergic rhinitis and mothers’ history of allergic rhinitis was associated with presence of asthma. Conclusion − Our findings suggest that, compared to parental history of AD, parental history of asthma and allergic rhinitis were stronger contributors to the presence of atopic comorbid disorders in children with AD.

Relationship between atopic dermatitis and children's mental and behavioral health: The Hokkaido Study

Objectives Atopic dermatitis (AD) is a common childhood disease with an increasing prevalence, affecting the quality of life of afflicted children. The onset of AD at an early age may disrupt normal sleep patterns, behavior, and relationships. Increased behavioral and discipline problems associated with AD have been documented. However, there are insufficient studies on AD at early ages, especially in Japan. This study aimed to examine the association between AD and the mental and behavioral health of children of preschool age.Methods This study was a part of a prospective cohort study (n=20,926), and children born after April 2008 (n=7,386) were the target population of this study. Those who answered the Japanese version of the International Study of Asthma and Allergies in Childhood (ISAAC) at 4 years of age (n=4,228) and answered the Strength and Difficulties Questionnaire (SDQ) at 5 years of age were included in this study (n=3,862). The subscale scores of SDQ, namely, emotional symptoms, conduct problems, peer relationship problems, and hyperactivity/inattention, along with the sum of these 4 subscale scores, (total difficulties score (TDS), were investigated in relation to the prevalence of AD. SDQ scores were treated as continuous values for linear regression analysis and as dichotomized values for logistic regression analysis. The parental history of AD was adjusted in the final models.Results The prevalence of AD at 4 years of age was 20.7% (n=799). The mean scores of emotional symptoms, conduct problems, and TDS were significantly higher among children with AD than among those without AD. Linear regression analysis revealed increased scores for emotional symptoms, conduct problems, and TDS in association with AD. Logistic regression analysis revealed a significantly increased risk for conduct problems in children with AD.Conclusion This study found associations between AD at 4 years of age and emotional symptoms, conduct problems and TDS at 5 years of age. Further studies to assess the severity of AD and children's mental and behavioral problems at older ages are essential.

The Prevalence and Risk Factors of Atopic Dermatitis and Clinical Characteristics according to Disease Onset in 19-Year-Old Korean Male Subjects.

BackgroundThe natural course of atopic dermatitis (AD) in infancy, childhood, and adolescence is not yet completely known.ObjectiveTo investigate the prevalence and risk factors of atopic dermatits among 19-year-old Korean male subjects.MethodsAll 19-year-old Korean males must undergo medical examination for conscription. We precisely evaluated the prevalence of AD in three Korean provinces using the information from this physical checkup. AD was diagnosed by experienced dermatologists according to the Hanifin and Rajka criteria. The disease severity was assessed by the scoring of atopic dermatitis (SCORAD) index. In order to investigate the risk factors for AD, a questionnaire was administered to all subjects regarding parental atopic history, geographical characteristics of past habitation, past economic status, number of siblings, parental occupation, etc.ResultsThe point prevalence in the Korean provinces ranged from 1.15% to 1.44%. In multivariable analysis, a parental history of AD was a significant risk factor in all 3 disease-onset groups (infancy, childhood, and adolescent onset). In the infancy-onset group, low economic status was also a significant risk factor for AD. The SCORAD index was significantly higher in AD subjects with early onset and those living in small-sized habitations. Moreover, erythema, edema, lichenification, dryness of skin, and sleep loss appeared to be more severe in early-onset cases.ConclusionThe younger the age of disease onset, the more severe the clinical outcomes in 19-year-old male subjects. In addition, active AD treatment at younger ages might affect the prevalence and the severity of AD in adulthood.

Home Remodeling and Food Allergy Interact Synergistically to Increase the Risk of Atopic Dermatitis

Purpose The purpose of this study was to investigate the effects of home remodeling and food allergy (FA) on the development of atopic dermatitis (AD) in children. Methods The Modified International Study of Asthma and Allergies in Childhood questionnaire was used to survey 4,111 children recruited from 3 kindergartens and 6 elementary schools from Seongnam, Korea. Participants' parents agreed for them to participate in physical examinations, skin prick tests, and blood tests. Results Home remodeling in the past 12 months (adjusted odds ratio [aOR] 3.40, P = 0.006), lifetime diagnosis of FA (aOR 3.95, P < 0.001), parental history of AD (aOR 2.67, P = 0.001), and FA (aOR 2.35, P = 0.004) were independent risk factors for lifetime diagnosis of AD ever. When history of home remodeling and FA were combined, the risk for moderate-to-severe AD by scoring atopic dermatitis (SCORAD) score increased (aOR, 7.19, P = 0.011, P for interaction = 0.034). Conclusion Home remodeling, lifetime diagnosis of FA, parental history of AD, and parental history of FA were independent risk factors for AD. In addition, we observed a synergistic interaction between home remodeling and FA in the risk of moderate-to-severe AD.

Awareness of Atopic Dermatitis and Attitudes toward Different Types of Medical Institutions for Its Treatment among Adult Patients and the Parents of Pediatric Patients: A Survey of 500 Participants.

BackgroundPhysicians can play a crucial role in the knowledge that patients have about a disease and its prognosis. Recently, patients with atopic dermatitis (AD) are increasingly turning from western medicine to oriental herbal medicine. However, their awareness of AD and attitude toward Western medicine and oriental herbal medicine clinics are scarcely reported.ObjectiveThe aim of this study was to determine the understanding of AD among patients and their parents and to identify their awareness of and attitude toward Western medicine and oriental herbal medicine as treatments for AD.MethodsAn online questionnaire was administered to 500 consenting respondents with AD (age, 16~49 years) and parents of children with AD (age, 0~15 years).ResultsThe mean percentage of correct answers to questions about AD was 52.54%. A parental history of AD was independently associated with higher respondent’s knowledge about the disease and its treatment. The satisfaction with treatment outcomes was highest among patients treated at private clinic of dermatology specialists (49.4%), while lowest among those treated at oriental herbal medicine clinics (38.4%). Many participants were aware that oriental herbal medicine requires a longer treatment period for a cure and does not burden the skin, while steroid phobia was seen in most of participants.ConclusionPhysicians need to educate AD patients and their parents about the disease and its treatment. Misconceptions for Western medicine and oriental herbal medicine among AD patients and parents should be corrected to improve their prognosis.

Perinatal factors and the risk of atopic dermatitis: A cohort study

To analyze the effects of pregnancy and early events in the newborn on the risk of subsequent atopic dermatitis (AD) during the first year of life. This is a prospective multicenter cohort study of newborns during the first year of life. Newborns identified on random days in three obstetrics departments in the area of Bergamo, Lombardy, Northern Italy, were eligible. At baseline, the mothers were interviewed by medical staff during their stay in hospital after delivery. At 6 and 12 months after delivery, a postal questionnaire was sent to the parents. Relative risks were calculated with and without adjustment by multiple regression analysis. A total of 1081 newborns entered the study: 796 (74%) parents answered the 12-month questionnaire. Hundred and thirty-eight (17%) reported a diagnosis of AD at 6 months and 222 (28%) at 12 months. Parental history of AD and/or asthma was associated with an increased risk of AD (RR 1.5, 95%CI 1.1-2.0). Birth weight was slightly associated with an increased risk of AD: RR 1.04, 95%CI 1.001-1.08 (continuous variable, increment of 100 grams). No association emerged between breast feeding, smoking, and risk of AD. This study in an Italian offspring cohort points to family history of atopic diseases and body weight at birth as relevant risk factors. The study was unable to document associations with other perinatal factors particularly breast feeding and parental smoking in the perinatal period.

Gene-environment interaction between Toll-like receptor 4 and mold exposure in the development of atopic dermatitis in preschool children

Purpose: Genetic factors and environmental exposures are recognized as important risk factors for atopic dermatitis (AD) in children. Inflammatory responses by molds can be mediated via Toll-like receptor 4 (TLR4). The aims of this study were to investigate mold as risk factor of AD and gene-environment interaction on AD in preschool children. Methods: We undertook a cross-sectional survey with 986 preschool children. We investigated five mold exposure measures (dampness stain, dampness damage, visible mold, mold odor, and house repair). The TLR4 polymorphism (rs1927911) was genotyped by TaqMan assay. Results: The prevalence of AD was as follows: AD diagnosis by questionnaire, 35.1%; current AD (lifetime diagnosis together with symptoms in the last 12 months), 21.5%. When children with parental history of AD were exposed to mold odor during infancy and house repair during the last 12 months, the risk for current AD (adjusted odds ratio [aOR], 6.826; 95% confidence interval [CI], 2.511 to 18.554 vs. aOR, 6.143; 95% CI, 2.348 to 16.074) was further increased than only with parental history of AD. In children with the CC genotype of TLR4 polymorphism, the risk of AD was increased by mold exposure. Conclusion: This investigation identified that mold exposure is potential risk factor for AD in preschool children. Parental history of AD and mold exposure during infancy and the last 12 months had synergistic effect on high prevalence of AD. We identified that mold exposure and TLR4 polymorphism have an effect on the development of atopic dermatitis. (Allergy Asthma Respir Dis 2013;1:129-137)

Allergic Airways Responses Are Associated With A Late-phase Systemic Inflammatory Response In An Environmental Allergen Challenge Model

FEBRUARY 2012 AB6 Abstracts S A T U R D A Y 21 Cord Blood Cellular Proliferative Response as a Predictive Factor For Atopic Dermatitis At 6 Months of Age H. Kim, J. Seo, H. Kim, J. Kwon, B. Kim, J. Shim, W. Kim, D. Song, S. Lee, S. Lee, G. Jang, K. Kim, K. Ahn, Y. Shin, J. Yu, M. Kang, K. Lee, S. Hong; Inje University Sanggye Paik Hospital, Seoul, REPUBLIC OF KOREA, University of Ulsan College of Medicine, Seoul, REPUBLIC OF KOREA, Seoul National University Bundang Hospital, Seongnam, REPUBLIC OF KOREA, Inje University Haeundae Paik Hospital, Pusan, REPUBLIC OF KOREA, Sungkyunkwan University School of Medicine, Seoul, REPUBLIC OF KOREA, Inje University Seoul Paik Hospital, Seoul, REPUBLIC OF KOREA, College of Medicine, Korea University, Seoul, REPUBLIC OF KOREA, Hallym University College of Medicine, Seoul, REPUBLIC OF KOREA, Ajou University School of Medicine, Suwon, REPUBLIC OF KOREA, National Health Insurance Corporation Ilsan Hospital, Ilsan, REPUBLIC OF KOREA, Yonsei University, Seoul, REPUBLIC OF KOREA, CHA University School of Medicine, Seoul, REPUBLIC OF KOREA. RATIONALE: When a person exposed to allergens earlier as fetal period, the risk to develop allergic diseases increase. Therefore immunologic status of fetus may be associated with the development of allergic disease. We evaluated the factors that could have an effect on the development of atopic dermatitis (AD) at 6 months with cord blood mononuclear cells (CBMCs). METHODS: We constructed Cohort for Childhood Origin of Asthma and Allergic Diseases (COCOA) in general population from 2007 and diagnosed AD by allergy specialists in 371 infants. Cord blood was collected from them and measured cell count and total IgE. When CBMCs were extracted, ovalbumin (OVA) 100 ug/mL and phytohaemagglutinin (PHA) 10 ug/mL were stimulated and cellular proliferative response (CPR) and cytokine levels (IL-13 and IFN-g) were measured. RESULTS: The risk to develop AD at 6 months is increased in boys (OR 3.04, 95% CI 1.64-5.65) and when maternal education level was high (OR 1.97, 95% CI 1.07-3.61). Parental history of AD increased the risk of AD diagnosis (OR 2.39, 95% CI 1.18-4.81). With PHA stimulation, CPR was increased in AD-diagnosed group compared to infants without AD (P50.013), but with OVA stimulation, there was no difference between the two groups (P50.180). In addition, there was no significant difference in IFN-g/IL-13 ratio to PHA stimulation. CONCLUSIONS: The independent risk factors for the development of AD at 6 months were male, high maternal education level, and parental history of AD. Increased CPR with PHA stimulation may predict the development of AD at 6 months.

Real Time Pcr Detection Of Aspergllus Fumigatus, Aspergillus Flavus And Aspergillus Niger Based On Polyketide Synthase Gene

FEBRUARY 2012 AB6 Abstracts S A T U R D A Y 21 Cord Blood Cellular Proliferative Response as a Predictive Factor For Atopic Dermatitis At 6 Months of Age H. Kim, J. Seo, H. Kim, J. Kwon, B. Kim, J. Shim, W. Kim, D. Song, S. Lee, S. Lee, G. Jang, K. Kim, K. Ahn, Y. Shin, J. Yu, M. Kang, K. Lee, S. Hong; Inje University Sanggye Paik Hospital, Seoul, REPUBLIC OF KOREA, University of Ulsan College of Medicine, Seoul, REPUBLIC OF KOREA, Seoul National University Bundang Hospital, Seongnam, REPUBLIC OF KOREA, Inje University Haeundae Paik Hospital, Pusan, REPUBLIC OF KOREA, Sungkyunkwan University School of Medicine, Seoul, REPUBLIC OF KOREA, Inje University Seoul Paik Hospital, Seoul, REPUBLIC OF KOREA, College of Medicine, Korea University, Seoul, REPUBLIC OF KOREA, Hallym University College of Medicine, Seoul, REPUBLIC OF KOREA, Ajou University School of Medicine, Suwon, REPUBLIC OF KOREA, National Health Insurance Corporation Ilsan Hospital, Ilsan, REPUBLIC OF KOREA, Yonsei University, Seoul, REPUBLIC OF KOREA, CHA University School of Medicine, Seoul, REPUBLIC OF KOREA. RATIONALE: When a person exposed to allergens earlier as fetal period, the risk to develop allergic diseases increase. Therefore immunologic status of fetus may be associated with the development of allergic disease. We evaluated the factors that could have an effect on the development of atopic dermatitis (AD) at 6 months with cord blood mononuclear cells (CBMCs). METHODS: We constructed Cohort for Childhood Origin of Asthma and Allergic Diseases (COCOA) in general population from 2007 and diagnosed AD by allergy specialists in 371 infants. Cord blood was collected from them and measured cell count and total IgE. When CBMCs were extracted, ovalbumin (OVA) 100 ug/mL and phytohaemagglutinin (PHA) 10 ug/mL were stimulated and cellular proliferative response (CPR) and cytokine levels (IL-13 and IFN-g) were measured. RESULTS: The risk to develop AD at 6 months is increased in boys (OR 3.04, 95% CI 1.64-5.65) and when maternal education level was high (OR 1.97, 95% CI 1.07-3.61). Parental history of AD increased the risk of AD diagnosis (OR 2.39, 95% CI 1.18-4.81). With PHA stimulation, CPR was increased in AD-diagnosed group compared to infants without AD (P50.013), but with OVA stimulation, there was no difference between the two groups (P50.180). In addition, there was no significant difference in IFN-g/IL-13 ratio to PHA stimulation. CONCLUSIONS: The independent risk factors for the development of AD at 6 months were male, high maternal education level, and parental history of AD. Increased CPR with PHA stimulation may predict the development of AD at 6 months.

Cord Blood Cellular Proliferative Response as a Predictive Factor for Atopic Dermatitis at 12 Months

Since the risk of developing allergic disease increases in individuals exposed to allergens previously, even during the neonatal period, the immunologic status of a fetus may be important in the subsequent development of allergy. We evaluated the fetal factors to predict atopic dermatitis (AD) at 12 months in 412 infants of a COhort for Childhood Origin of Asthma and Allergic Diseases (COCOA) in the general Korean population. Cord blood mononuclear cells (CBMCs) were stimulated with ovalbumin and phytohemagglutinin and cellular proliferative response and concentrations of interleukin-13 and interferon-γ, were measured. The risk of developing AD was greater in boys than girls (OR 1.97, 95% CI 1.26-3.09), infants delivered by cesarean section than vaginally (OR 1.93, 95% CI 1.14-3.26) and infants with than without parental history of AD (OR 2.34, 95% CI 1.29-4.24). The CBMC proliferative response to phytohemagglutinin stimulation was higher in infants with than without AD (P = 0.048), but no difference was observed in ovalbumin-stimulated cells (P = 0.771). Risk factors for the development of AD at 12 months include male gender, delivery by cesarean section and parental history of AD. Increased CBMC proliferative response to phytohemagglutinin stimulation may predict the development of AD at 12 months.

Is atopic dermatitis predictable?

Atopic dermatitis (AD) is a common skin disease which affects 10 to 20% of the population, usually with onset during infancy. The frequency of AD appears to have increased over the past three decades. Attempts to identify parameters predictive of the development of AD have been made by many investigators during the last decades. Although genetic factors remain unmodifiable, avoidance of relevant trigger factors could modify the development of AD. This paper reviews and discusses findings of the last several years and outlines recent advances in genetic studies of AD. In spite of decades of intensive research and newly developed technology, the parental history of AD appears to be the most valuable predictive parameter. However, the predictive capacity is not sufficient to recommend it as screening instrument. At this time, a perinatal screening with the objective of primary prevention of AD does not seem feasible.