Atopic dermatitis in a high-risk cohort: natural history, associated allergic outcomes, and risk factors
Atopic dermatitis in a high-risk cohort: natural history, associated allergic outcomes, and risk factors
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DOI：
10.1016/j.anai.2012.10.005
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发表时间：
2013-01-01
影响因子：
5.9
通讯作者：
Chan-Yeung, Moira
中科院分区：
文献类型：
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作者：
Carlsten, Chris;Dimich-Ward, Helen;Chan-Yeung, Moira
背景：特应性皮炎 (AD) 通常与儿童时期的哮喘和其他特应性疾病相关。目的：评估 7 岁以下高危人群中 AD 的自然病程及其与其他过敏结局的关系。方法：共有 373 名高危婴儿接受了随机对照试验，在出生后第一年应用哮喘一级预防干预措施，并在出生后 1、2 和 1 岁评估哮喘、AD 和过敏性过敏情况。 7年。结果：尽管显着降低了哮喘患病率，但多方面的干预计划并未减少AD。 62 名儿童 (16.6%) 在头 2 年内患有 AD（早发性 AD）；其中，26 人在 7 岁时继续患有 AD（持续性），而 36 人在 7 岁时不再患有该疾病（非持续性）。 23 名儿童 (6.2%) 仅在 2 岁后才患上 AD（晚发性 AD）。早发性 AD，无论是持续性还是非持续性，都与出生后 2 年内对食物过敏原过敏的风险增加以及第 7 年诊断出哮喘的风险增加相关。然而，只有持续性 AD 与第 7 年其他特应性疾病以及对食物和空气过敏原过敏的风险增加相关。晚发性 AD 与第 7 年的特应性疾病或过敏性过敏无关，但链格孢除外。结论：在这组哮喘高危婴儿中，早发型持续性 AD 与特应性致敏高度相关，增加了儿童后期患特应性疾病的风险，因此似乎是特应性病征程的一部分。 (C) 2013 年美国过敏、哮喘和免疫学学院。由爱思唯尔公司出版。保留所有权利。
Background: Atopic dermatitis (AD) is commonly associated with asthma and other atopic disorders in childhood.Objective: To evaluate the natural history of AD and its association with other allergic outcomes in a high-risk cohort through the age of 7 years.Methods: A total of 373 high-risk infants, who had undergone a randomized controlled trial with intervention measures for primary prevention of asthma applied during the first year of life, were assessed for asthma, AD, and allergic sensitization at 1, 2, and 7 years.Results: The multifaceted intervention program did not reduce AD despite reducing the prevalence of asthma significantly. Sixty-two children (16.6%) had AD during the first 2 years (early-onset AD); of these, 26 continue to have AD at the age of 7 years (persistent), whereas 36 no longer had the disease (nonpersistent) at the age of 7 years. Twenty-three children (6.2%) developed AD only after the age of 2 years (late-onset AD). Early-onset AD, persistent or nonpersistent, was associated with increased risk of allergic sensitization to food allergens within the first 2 years of life and asthma diagnosis at year 7. However, only persistent AD was associated with an increased risk of other atopic diseases and allergic sensitization to food and aeroallergens at year 7. Late-onset AD was not associated with atopic diseases or allergic sensitization at year 7 with the exception of Alternaria alternans.Conclusion: In this cohort of infants at high risk of asthma, early-onset persistent AD, which was highly associated with atopic sensitization, increased the risk of atopic diseases in later childhood and thus appears to be part of the atopic march. (C) 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.