SEAL (Stopping Atopic dermatitis and ALlergy) Study: Prevent allergy by enhancing the skin barrier

SEAL（停止过敏和过敏）研究的项目摘要和摘要 食物过敏（FA）是美国儿童中的一种流行病，英国，等国人们日益 有证据表明，通过功能障碍的皮肤屏障的表皮过敏原致敏导致过敏性 而早期食用食物过敏原诱导口服耐受性，如双重免疫反应所述。 过敏原暴露假说在学习早期关于花生LEAP和询问宽容（EAT） 研究，皮肤干燥和湿疹或特应性皮炎（AD）的严重程度和持续时间在生命的第一年 是花生过敏（PA）和致敏的预测因子。在海豹突击队的研究中，我们的目标是在 高危婴儿组，一旦他们在出生后的前10周内最早出现皮肤干燥或湿疹， 但在他们过敏之前通过减少湿疹的持续时间和严重程度， 湿疹恶化，我们的目标是防止表皮过敏原致敏，并显着减少 FA的发生率。我们的主要目的是测试在生命早期使用三脂皮肤润肤剂与 与对照组相比，主动外用类固醇降低了FA的患病率。 我们提出了一个随机（1：1），对照试验设计的婴儿皮肤干燥或湿疹（n = 750）， 比较主动治疗与反应性治疗组预防FA的效果，通过 减少皮肤干燥，以及婴儿早期湿疹的严重程度和持续时间。我们将测试我们的假设与 遵循特定的目标，使用世界一流的临床研究单位，以出色的招募和保留 患者队列、机械测试和最新技术研究。具体目标1：确定是否主动 在一项前瞻性、随机化和对照研究中， 婴儿湿疹干预试验具体目标2：测试儿童皮肤是否在积极主动 治疗将显示上皮屏障标志物的改善，同时肠道细菌定殖增加。 具体目标3：确定主动治疗是否与保护性免疫相关 应答如果目标得以实现，我们的提案将通过提供一种新的临床 预防出现最早皮肤干燥体征的婴儿发生FA的策略， 湿疹

Project Summary and Abstract for the SEAL (Stopping Eczema and ALlergy) Study Food allergy (FA) is an epidemic among children in the U.S., U.K., and other countries. There is increasing evidence that epicutaneous allergen sensitization through a dysfunctional skin barrier results in allergic responses whereas early consumption of food allergens induces oral tolerance, as described by the dual allergen exposure hypothesis. In the Learning Early About Peanut LEAP and Enquiring About Tolerance (EAT) studies, dry skin and the severity and the duration of eczema or atopic dermatitis (AD) in the 1st year of life were predictors of peanut allergy (PA) and sensitization. In the SEAL study, we aim to intervene very early in a high-risk infant group, as soon they have the earliest onset of dry skin or eczema in the 1st 10 weeks of life, but before they have developed allergies. By reducing the duration and severity of eczema and preventing eczema exacerbations, we aim to prevent epicutaneous allergen sensitization and significantly reduce the incidence of FA. Our primary objective is to test if the combination of trilipid skin emollient use early in life with proactive topical steroids decreases the prevalence of FA compared to controls. We propose a randomized (1:1), controlled trial design for infants with dry skin or eczema (n=750 total) to compare the effect of proactive treatment against a reactive treatment group for the prevention of FA, by reducing dry skin, and the severity and duration of eczema in early infancy. We will test our hypothesis with the following specific aims using world-class clinical research units known for excellent recruitment and retention of patient cohorts, mechanistic testing, and state of the art research. Specific Aim 1: To determine if proactive versus reactive treatment will reduce the occurrence of FA in a prospective, randomized, and controlled intervention trial of infants with eczema. Specific Aim 2: To test whether the skin of children in the proactive treatment will show improved epithelial barrier markers with increased commensal bacteria colonization. Specific Aim 3: To determine whether proactive treatment will be associated with protective immune responses. If the aims are achieved, our proposal will make a clinical impact by providing a new, clinical strategy to prevent the occurrence of FA in young infants that present with the earliest signs of dry skin or eczema.