Association of parental eczema, hayfever, and asthma with atopic dermatitis in infancy: birth cohort study

Abstract

Objective: To evaluate the association of parental history of atopic disease with childhood atopic dermatitis, and to examine the relative strength of associations with maternal and paternal disease. Design: Mothers were recruited to the Avon longitudinal study of parents and children (ALSPAC) from the eighth week of pregnancy. Before parturition, both parents were asked, separately, to report their lifetime history of eczema, asthma, and hayfever. Parents reported symptoms of atopic dermatitis in their children at ages 6, 18, 30, and 42 months. Results: Of 8530 children with complete information on rash at ages 6, 18, 30, and 42 months, 7969 had complete information on maternal atopic disease and 5658 on maternal and paternal atopic disease. There was a strong association between parental eczema and childhood atopic dermatitis: odds ratio 1.69 (95% confidence interval, 1.47 to 1.95) for maternal eczema only, 1.74 (1.44 to 2.09) for paternal eczema only, and 2.72 (2.09 to 3.53) for eczema in both parents. Associations with parental asthma or hayfever were attenuated after controlling for parental eczema. There was no evidence that associations with maternal atopy were stronger than with paternal. Conclusions: Associations between parents' atopic disease and the risk of atopic dermatitis in offspring vary according to the type of atopic disease in the parents, but not according to parental sex. These results are at variance with previous studies reporting stronger associations with maternal than paternal atopy, and suggest that there is no ''parent-of-origin'' effect in atopic dermatitis. Parental eczema may be a better marker than parental asthma/hayfever in predisposing to childhood eczema.A topic dermatitis is an inflammatory skin disease that is characterised by itching, redness, and scaling of the skin, predominantly in the skin creases. Although the causes of atopic dermatitis are unclear, the familial aggregation of the disease is well established through many family studies of atopic dermatitis, asthma, and allergic rhinitis.

Association between Maternal Allergic Rhinitis and Asthma on the Prevalence of Atopic Disease in Offspring

“…AR is an atopic condition similar to atopic dermatitis and has been shown to cluster among families [9]. The risk of children developing allergic disease increases by up to 4-fold if either parent has an atopic condition, particularly the mother [10,11,12,13,14,15,16,17]. Presently there are few reports describing the association between maternal AR and asthma in the context of atopy developing in the offspring, despite extensive studies examining maternal history of asthma or atopy.…”

Asthma in patients with atopic dermatitis

“…Also the relationship between IgE and SCORAD in AD patients shows that IgE can be used as a severity index of AD in patients and this correlation is stronger in patients with asthma. Some studies revealed that male sex, increasing age and family history of allergic disease contributed to an increased risk of each allergic disease 14,16,25 and family history of allergy was associated with a high risk of developing asthma. 6 There was a significant association between disease severity and eosinophil count.…”

The genetics of atopic dermatitis

“…In epidemiologic terms higher IgE antibody levels also appear to be associated with a more severe disease phenotype and worse long-term prognoses. 18 Maternal transmission of AD Parent-of-origin effects are thought to play an important role in the cause of AD (and other atopic conditions) because infant disease risk is often, 8,19,20 although not always, 9,21 found to be more closely related to maternal than paternal disease status. This observation might be related to a number of underlying mechanisms, including genomic imprinting, mitochondrial transmission, and gene-environment interactions involving the in utero environment and/or exposure to the immunologic and nutritional properties of breast milk.…”

“…This is supported by the observation that parental history of AD represents a more potent risk factor for AD in a child than either asthma or allergic rhinitis. 8,9 Current evidence indicates that AD is strongly genetic, with enhanced levels of phenotype concordance reported in monozygotic relative to dizygotic twin pairs (0.72-0.77 vs 0.15-0.23). 2,3 The individual genetic factors or genes that contribute to the trait's cause are relative to other complex genetic diseases proving amenable to identification.…”