Increasing Severity of Early-Onset Atopic Dermatitis, But Not Late-Onset, Associates with Development of Aeroallergen Sensitization and Allergic Rhinitis in Childhood

Ann-Marie Malby Schoos, Bo Lund Chawes, Klaus Bønnelykke, Jakob Stokholm, Morten Arendt Rasmussen, Hans Bisgaard*

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstract

BACKGROUND: Early exposure to allergens through a defect skin barrier has been proposed as a mechanism for inducing sensitization and development of allergic diseases. We hypothesized that early-onset, severe atopic dermatitis (AD) is associated with development of aeroallergen sensitization and allergic rhinitis.

METHODS: We included 368 children from the Copenhagen Prospective Studies on Asthma in Childhood 2000 (COPSAC 2000 ) at-risk mother-child cohort. AD was diagnosed prospectively based on Hanifin&Rajka's criteria and severity assessed using the Scoring Atopic Dermatitis (SCORAD) index. Early-onset AD was defined as debut ≤1 year, late-onset as debut from 1-6 years. Aeroallergen sensitization and allergic rhinitis were diagnosed at ages 6-7 and 12 years. Associations between early-onset and late-onset AD and allergy endpoints were calculated using general estimating equations (GEE) models to compute the overall odds ratios (OR) for both time points.

RESULTS: Early-onset AD (yes/no) and severity (SCORAD) were associated with development of aeroallergen sensitization during childhood; GEE OR = 1.68 [1.08; 2.62], p = .02 and 1.08 [1.03; 1.12], p < .001, whereas late-onset AD showed a borderline significant association and late-onset severity showed no association; GEE OR = 1.65 [0.92; 2.94], p = .08 and 1.01 [0.97; 1.06], p = .55. The same trend was seen for allergic rhinitis with significant association between early-onset AD and allergic rhinitis; GEE OR = 1.56 [1.01; 2.41], p = .04 and severity; GEE OR = 1.09 [1.05; 1.13], p < .001, whereas late-onset AD showed no association. The effects on sensitization and rhinitis of early-onset versus late-onset AD severity were significantly different: p-interaction sensitization = .03 and p-interaction rhinitis < .01.

CONCLUSION: Increasing severity of early-onset AD, but not late-onset AD, associates with aeroallergen sensitization and allergic rhinitis later in childhood.

OriginalsprogEngelsk
Sider (fra-til)1254-1262
Antal sider9
TidsskriftAllergy
Vol/bind77
Udgave nummer4
Tidlig onlinedato24 sep. 2021
DOI
StatusUdgivet - apr. 2022

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©2021 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

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