Clinical onset of atopic eczema: Results from 2 nationally representative British birth cohorts followed through midlife
Clinical onset of atopic eczema: Results from 2 nationally representative British birth cohorts followed through midlife
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DOI：
10.1016/j.jaci.2019.05.040
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发表时间：
2019-09-01
影响因子：
14.2
通讯作者：
Langan, Sinead M.
中科院分区：
文献类型：
--
作者：
Abuabara, Katrina;Ye, Morgan;Langan, Sinead M.
背景：特应性湿疹主要在儿童早期发病，而成人发病的频率和特征仍存在争议。
目的：我们试图确定从出生到中年报告特应性湿疹症状的受试者比例，并研究与症状发作时期相关的人口统计学、免疫学和遗传因素。
方法：我们利用来自英国两个具有全国代表性的社区出生队列的数据进行了一项纵向研究：1958年和1970年英国出生队列研究。受试者从出生开始被随访至42至50岁。主要结局是基于每次调查中自我报告特应性湿疹的重复测量所确定的自我报告特应性湿疹症状发作的年龄阶段。
结果：在两个各有超过17000名参与者从出生到中年被随访的队列中，特应性湿疹的年期间患病率在5%到15%之间。患病率没有明显的年龄趋势，并且在某一年报告患有活动性特应性湿疹的成年人中，只有38%的人报告症状在儿童期发作。与儿童期开始患湿疹的受试者相比，成人发病者更可能是女性，来自苏格兰或英格兰北部，儿童时期社会经济地位较低，成年后吸烟，且患哮喘的可能性较小。仅使用1958年队列数据进行的亚组分析中，先前与特应性湿疹相关的基因突变，包括丝聚蛋白缺失突变，以及过敏原特异性IgE在儿童期发病者中更为常见。
结论：自我报告的特应性湿疹在儿童期之后患病率仍然较高，且成人发病的特应性湿疹与儿童期发病的湿疹具有不同的危险因素关联。
Background: Atopic eczema onset is described primarily in early childhood, and the frequency and characteristics of adult onset disease remain controversial.Objective: We sought to determine the proportion of subjects who report atopic eczema symptoms between birth and midadulthood and to examine demographic, immunologic, and genetic factors associated with period of symptom onset.Methods: We conducted a longitudinal study using data from 2 nationally representative community-based birth cohorts from the United Kingdom: the British Cohort Studies 1958 and 1970. Subjects were followed from birth through age 42 to 50 years. The primary outcome was the age period of self-reported atopic eczema symptom onset based on repeated measures of self reported atopic eczema at each survey wave.Results: The annual period prevalence of atopic eczema ranged from 5% to 15% in 2 cohorts of more than 17,000 participants each followed from birth through middle age. There was no clear trend in prevalence by age, and among adults reporting active atopic eczema during a given year, only 38% had symptom onset reported in childhood. When compared with subjects whose eczema started in childhood, those with adult onset disease were more likely to be women, from Scotland or Northern England, of lower childhood socioeconomic group, smokers in adulthood, and less likely to have a history of asthma. In a subanalysis using data from the 1958 cohort only, genetic mutations previously associated with atopic eczema, including filaggrin-null mutations, and allergen-specific IgE were more common among those with childhood-onset disease.Conclusion: Rates of self-reported atopic eczema remain high after childhood, and adult-onset atopic eczema has different risk factor associations than childhood-onset eczema.