Early-life risk factors for occurrence of atopic dermatitis during the first year
Early-life risk factors for occurrence of atopic dermatitis during the first year
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DOI：
10.1542/peds.2006-0893
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发表时间：
2007-03-01
期刊：
影响因子：
8
通讯作者：
Morikawa, Akihiro
中科院分区：
文献类型：
--
作者：
Sugiyama, Mikio;Arakawa, Hirokazu;Morikawa, Akihiro
OBJECTIVE.在一项前瞻性出生队列研究中，我们试图确定围产期发生特应性皮炎在生命的第一年的预测。分析家族史、妊娠期感染、脐带血细胞因子浓度和皮肤功能参数与特应性皮炎的关系。用阻抗计测量角质层水合作用，直到分娩后5天，并在1个月时再次测量。获得了213名婴儿的完整数据，其中27名在第一年内被医生诊断为特应性皮炎，26名在第一个月内被诊断为婴儿湿疹。出生后第一年发生特应性皮炎的风险与母体特应性皮炎、脐带血中巨噬细胞炎性蛋白-1 β浓度较低以及1个月龄时前额和脸颊表面和角质层皮肤水分较多有关，但与妊娠或哺乳期间的病毒或细菌感染无关。父亲花粉热与特应性皮炎的发生呈负相关。高浓度的白细胞介素-5、白细胞介素-17和巨噬细胞趋化蛋白-1以及仅脸颊表面潮湿与婴儿湿疹的发病风险相关。婴儿期特应性皮炎与新生儿巨噬细胞炎性蛋白-1 β水平降低的相关性表明与出生时不成熟的免疫反应有关。特应性皮炎的角质层屏障破坏可能涉及皮肤对子宫外生活的适应性受损。大多数危险因素对婴儿湿疹和特应性皮炎有不同的影响，表明不同的原因。
OBJECTIVE. In a prospective birth cohort study, we sought to identify perinatal predictors of the occurrence of atopic dermatitis in the first year of life.METHODS. Associations of family history, infection during pregnancy, cord blood cytokine concentrations, and skin function parameters with atopic dermatitis were analyzed. Stratum corneum hydration was measured with an impedance meter until 5 days after delivery and again at 1 month.RESULTS. Complete data were obtained for 213 infants, including 27 diagnosed by a physician as having atopic dermatitis during their first year and 26 diagnosed as having infantile eczema during their first month. The risk of atopic dermatitis during the first year of life was related to maternal atopic dermatitis, lower concentrations of macrophage inflammatory protein-1 beta in cord blood, and greater skin moisture in the surface and stratum corneum of the forehead and cheek at 1 month of age but not to viral or bacterial infection during pregnancy or breast-feeding. Paternal hay fever was associated negatively with the development of atopic dermatitis. High concentrations of interleukin- 5, interleukin- 17, and macrophage chemotactic protein-1 and only surface moisture in the cheek were associated with greater risk of infantile eczema in the first month.CONCLUSIONS. The association of atopic dermatitis in infancy with reduced neonatal macrophage inflammatory protein-1 beta levels suggests a link with immature immune responses at birth. Stratum corneum barrier disruption in atopic dermatitis may involve impairment of cutaneous adaptation to extrauterine life. The majority of risk factors had different effects on infant eczema and atopic dermatitis, indicating different causes.