Severe Eczema in Infancy Can Predict Asthma Development. A Prospective Study to the Age of 10 Years

Ekbäck, Marie; Tedner, Michaela; Devenney, Irene; Oldæus, Göran; Norrman, Gunilla; Strömberg, Leif; Fälth‐Magnusson, Karin

doi:10.1371/journal.pone.0099609

Cited by 28 publications

(17 citation statements)

References 45 publications

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“…Similarly, the Consortium of Food Allergy Research Observational Study reported that children with history of atopic dermatitis had higher peanut sensitization when exposed to peanut and the sensitization rates was further increased in those with severe atopic dermatitis [ 25 , 26 ]. Other studies reported the association between eczema severity and asthma [ 29 , 30 ], which we did not observe in our cohort.…”

Section: Discussioncontrasting

confidence: 93%

Clinical phenotype and allergen sensitization in the first 2 years as predictors of atopic disorders at age 5 years

Quah

Lee

Kuo

et al. 2015

World Allergy Organization Journal

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IntroductionFrom a birth cohort of at-risk Asian infants, we prospectively investigated the role of early onset allergen sensitization and clinical phenotypes as risk factors for atopic disorders at the age of 5 years.Methods and materialsThe study recruited 253 families with a history of allergic disease in a first degree relative from an antenatal clinic in Singapore. The children were followed prospectively to assess clinical outcomes and skin prick test was performed at 2 and 5 years of age.ResultsAllergen sensitization (food and/or house dust mites) alone at 2 years of age was not associated with increased risk of wheeze and eczema at 5 years. However, the clinical phenotype (eczema and wheeze) with or without the presence of concomitant allergen sensitization at 2 years increased this risk. For eczema, eczema alone at year 2 increased the risk of eczema at year 5 (adjOR = 7.1; 95 % CI: 1.8–27.8) and this was further increased by the presence of allergen sensitization (adjOR = 25.4; 95 % CI: 4.7–138.5) and the concomitant presence of both wheeze and allergen sensitization (adjOR = 64.9; 95 % CI: 4.7–900.0). For wheeze, wheeze alone at 2 years (adjOR = 4.5; 95 % CI: 1.4 -14.8), and wheeze with concomitant allergen sensitization and eczema (adjOR = 13.9; 95 % CI: 1.2–168.5) increased the risk of wheeze at 5 years. The exception was rhinitis, where allergen sensitization alone at 2 years (adjOR = 5.6; 95 % CI: 1.1–29.2) increased the risk of rhinitis at 5 years. Early onset of eczema at 2 years also increased the risk of rhinitis (adjOR = 6.8; 95 % CI: 2.0–23.1).ConclusionIn this Asian birth cohort, the clinical phenotype (eczema and wheeze) with or without concomitant allergen sensitization in the first 2 years of life were strong predictors of atopic disorders at 5 years.

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Section: Discussioncontrasting

confidence: 93%

Clinical phenotype and allergen sensitization in the first 2 years as predictors of atopic disorders at age 5 years

Quah

Lee

Kuo

et al. 2015

World Allergy Organization Journal

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“…Finally, in a prospective Swedish study of a cohort of 115 children with AD aged under 2 years, AD severity was not only associated with a higher risk of asthma at 10 years ( P = .01), but also with a higher risk of allergic rhinitis ( P = .01) …”

Section: Methodsmentioning

confidence: 96%

New insights into the phenotypes of atopic dermatitis linked with allergies and asthma in children: An overview

Amat

Soria

Tallon

et al. 2018

Clin Experimental Allergy

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Atopic dermatitis (AD) is a complex disease with multiple causes and complex mechanistic pathways according to age of onset, severity of the illness, ethnic modifiers, response to therapy and triggers. A group of difficult-to-manage patients characterized by early-onset AD and severe lifelong disease associated with allergic asthma and/or food allergy (FA) has been identified. In this study, we focus on these severe phenotypes, analysing their links with other atopic comorbidities, and taking into account the results from recent cohort studies and meta-analyses. The main hypothesis that is currently proposed to explain the onset of allergic diseases is an epithelial barrier defect. Thus, the atopic march could correspond to an epithelial dysfunction, self-sustained by a secondary allergenic sensitization, explaining the transition from AD to allergic asthma. Furthermore, AD severity seems to be a risk factor for associated FA. Results from population-based, birth and patient cohorts show that early-onset and severe AD, male gender, parental history of asthma, and early and multiple sensitizations are risk factors leading to the atopic march and the development of asthma. The importance of environmental factors should be recognized in these high-risk children and prevention programs adapted accordingly. Effective targeted therapies to restore both barrier function and to control inflammation are necessary; early emollient therapy is an important approach to prevent AD in high-risk children. Clinicians should also keep in mind the specific risk of atopic comorbidities in case of filaggrin loss-of-function mutations and the rare phenotypes of orphan syndromes due to heritable mutations in skin barrier components.

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“…Ekbäck et al 20 showed that infantile eczema with high scoring atopic dermatitis (SCORAD) points (scoring of AD severity) was associated with an increased risk of asthma at 10 years of age. Children with eczema and wheezing episodes during infancy are more likely to develop asthma than infants with eczema alone.…”

Section: Infantile Eczema and Its Association With Development Of Atomentioning

confidence: 99%

Dual Factors May Be Necessary for Development of Atopic March in Early Infancy

Taniuchi

Soejima²,

Hatano³

et al. 2018

J Nippon Med Sch

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The incidence of atopic diseases, including atopic dermatitis (AD), food allergies, allergic rhinitis, and asthma, has increased in recent decades, and currently affects approximately 20% of the population. Atopic march is the development of AD in infancy and subsequent food allergies, allergic rhinitis, and asthma in later childhood. Patients with infantile eczema may develop typical symptoms of AD, allergic rhinitis, and asthma at certain ages. Some patients' symptoms persist for several years, whereas others may have resolution with aging. Development of these diseases is strongly influenced by the following two factors: skin dysfunction caused by filaggrin mutations and development of colonization of microflora in early infancy. Filaggrin mutations predisposing to asthma, allergic rhinitis, and allergic sensitization, only in the presence of AD, strongly support the role of filaggrin in the pathogenesis of AD and in subsequent progression of the atopic march. Several studies have shown that development of colonization of microflora in early infancy might affect development of allergic disease or food desensitization. Therefore, massive allergen exposure to genetic skin dysfunction in early infancy and an imbalance of microflora might be necessary for development of atopic march.

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Severe Eczema in Infancy Can Predict Asthma Development. A Prospective Study to the Age of 10 Years

Cited by 28 publications

References 45 publications

Clinical phenotype and allergen sensitization in the first 2 years as predictors of atopic disorders at age 5 years

Clinical phenotype and allergen sensitization in the first 2 years as predictors of atopic disorders at age 5 years

New insights into the phenotypes of atopic dermatitis linked with allergies and asthma in children: An overview

Dual Factors May Be Necessary for Development of Atopic March in Early Infancy

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