Dynamic trends in skin barrier function from birth to age 6 months and infantile atopic dermatitis: A Chinese prospective cohort study

Abstract

Background: Skin barrier functions develop after birth and may be related to skin disorders in infants. We aimed to assess associations between dynamic trends of four skin barrier functional parameters in early life with infant atopic dermatitis (AD). Methods:Based on the prospective cohort MKNFOAD (NCT02889081), we examined transepidermal water loss (TEWL), stratum corneum hydration (SCH), skin pH, and sebum content at five anatomical sites (cheek, forehead, forearm, abdomen, and lower leg) in 418 term infants at birth, 42 days, and 6 months. Trend differences by sex and association with AD at age 1 year were tested using variance analyses. Associations of the parameters with AD risk were tested using discrete time survival analysis, adjusting extensive covariates including parental history of allergy, infant's sex, birth weight (kg), and delivery mode. Odds ratios (ORs) and 95% confidence interval (CIs) were reported.Results: Overall TEWL and SCH appeared trends of increase while skin surface pH and sebum content showed trends of decrease within the first six postnatal months. Sex differences were significant for sebum content only (p < 0.001). After adjustment for parental and children covariates, cheek TEWL at birth (OR = 1.26, 95% CI 1.00-1.57, p = 0.045) and 42 days (OR = 1.52, 95% CI 1.17-1.97, p = 0.002) were significantly associated with increased AD risk. Associations were not observed between SCH, skin pH, and sebum content at birth or 42 days with AD.Conclusions: Skin barrier functions of Chinese term infants varied nonlinearly after birth. Higher postnatal TEWL levels in early life indicate higher risk of early-onset AD.

Trajectory of stratum corneum lipid subclasses in the first year of life and associations with atopic dermatitis: A prospective cohort study

“…Impaired skin barrier function and increased TEWL have been documented as predictors of early-onset infant AD. 1,[8][9][10] Based on a small birth cohort (n = 19 mother-infant pairs), M. Mina mi-Hori et al reported that the total CERs and EOS, EOH, and EOP in diaper-covered buttocks and inner upper thighs skin quickly increase in the first month of life and decline afterward until 1 year old and were in line with the transition in mothers. 13 A recent cross-sectional study in healthy Chinese infants found higher total CER in the upper arms, cheek, and buttocks of infants aged 2-12 months than in those aged 13-24 months.…”

“…A Tewameter TM300 probe was placed on the inner forearm and remained in contact with the skin surface for 20 s. The average of five-second readings within a 0.2 unit variation was recorded. 8 Prior to the assessment, infants were given at least 15 min to acclimatize in a controlled environment. If infants were crying or sweating during the…”

“…test, they were allowed to calm down and become sweat-free before testing. 8 The skin examination was conducted under stable conditions of temperature (23-26°C) and relative humidity (35%-60%). 8…”

“…[4][5][6] Its etiology is not fully understood but is considered to be different in childhood and adults. 7 Transepidermal water loss (TEWL) levels in the cheek and forehead skin of infants during early life have been documented with prospective association with the risk of infant AD 8 and are associated with CER and FFA concentrations as well as the carbon chain length (CCL) of CER and FFA in AD patients. 1,9,10 Two out of 12 CER subclasses (NH and AS) have been observed to increase in the skin of pediatric AD patients (mean age of 44.5 months) and correlate with the disease severity score.…”

Ta-Xi-San Suppresses Atopic Dermatitis Involved in Multitarget Mechanism Using Experimental and Network Pharmacology Analysis

“…It is one of the most common health problems and affects 2.1%–4.9% of human population worldwide [ 2 ]. Meanwhile, the morbidity of atopic dermatitis is high in both developing countries and developed countries [ 3 , 4 ]. Atopic dermatitis is characterized by rash, erythema, edema, hemorrhage, lichenification, and severe itching, and it is always accompanied by destruction in skin barriers [ 5 ].…”