Eczema in early childhood is strongly associated with the development of asthma and rhinitis in a prospective cohort
Tóm tắt
This study aimed to estimate the association between eczema in early childhood and the onset of asthma and rhinitis later in life in children. A total of 3,124 children aged 1–2 years were included in the Dampness in Building and Health (DBH) study in the year 2000, and followed up 5 years later by a parental questionnaire based on an International Study of Asthma and Allergies in Childhood protocol. The association between eczema in early childhood and the incidence of asthma and rhinitis later in life was estimated by univariable and multivariable logistic regression modelling. The prevalence of eczema in children aged 1–2 years was 17.6% at baseline. Children with eczema had a 3-fold increased odds of developing asthma (adjusted odds ratio [aOR], 3.07; 95% confidence interval (CI) 1.79–5.27), and a nearly 3-fold increased odds of developing rhinitis (aOR, 2.63; 1.85–3.73) at follow-up compared with children without eczema, adjusted for age, sex, parental allergic disease, parental smoking, length of breastfeeding, site of living, polyvinylchloride flooring material, and concomitant allergic disease. When eczema was divided into subgroups, moderate to severe eczema (aOR, 3.56; 1.62–7.83 and aOR, 3.87; 2.37–6.33, respectively), early onset of eczema (aOR, 3.44; 1.94–6.09 and aOR, 4.05; 2.82–5.81; respectively), and persistence of eczema (aOR, 5.16; 2.62–10.18 and aOR, 4.00; 2.53–6.22, respectively) further increased the odds of developing asthma and rhinitis. Further independent risk factors increasing the odds of developing asthma were a parental history of allergic disease (aOR, 1.83; 1.29–2.60) and a period of breast feeding shorter than 6 months (aOR, 1.57; 1.03–2.39). The incidence of rhinitis was increased for parental history of allergic disease (aOR, 2.00; 1.59–2.51) and polyvinylchloride flooring (aOR, 1.60; 1.02–2.51). Eczema in infancy is associated with development of asthma and rhinitis during the following 5-year period, and eczema is one of the strongest risk factors. Early identification is valuable for prediction of the atopic march.
Tài liệu tham khảo
Williams H, Stewart A, von Mutius E, Cookson W, Anderson HR: Is eczema really on the increase worldwide? J Allergy Clin Immunol 2008, 121: 947–954. 10.1016/j.jaci.2007.11.004
Lewis-Jones S: Quality of life and childhood atopic dermatitis: the misery of living with childhood eczema. Int J Clin Pract 2006, 60: 984–992. 10.1111/j.1742-1241.2006.01047.x
Carroll CL, Balkrishnan R, Feldman SR, Fleischer AB Jr, Manuel JC: The burden of atopic dermatitis: impact on the patient, family, and society. Pediatr Dermatol 2005, 22: 192–199. 10.1111/j.1525-1470.2005.22303.x
Spergel JM, Paller AS: Atopic dermatitis and the atopic march. J Allergy Clin Immunol 2003, 112: S118-S127. 10.1016/j.jaci.2003.09.033
Beasley R, Keil U, von Mutius E, et al.: Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet 1998, 351: 1225–1232. 10.1016/S0140-6736(97)07302-9
Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ, the Group Health Medical Associates: Asthma and wheezing in the first six years of life. N Engl J Med 1995, 332: 133–138. 10.1056/NEJM199501193320301
Illi S, von Mutius E, Lau S, Nickel R, Gruber C, Niggemann B, et al.: The natural course of atopic dermatitis from birth to age 7 years and the association with asthma. J Allergy Clin Immunol 2004, 113: 925–931. 10.1016/j.jaci.2004.01.778
Klinnert MD, Nelson HS, Price MR, Adinoff AD, Leung DY, Mrazek DA: Onset and persistence of childhood asthma: predictors from infancy. Pediatrics 2001, 108: E69. 10.1542/peds.108.4.e69
Arshad SH, Kurukulaaratchy RJ, Fenn M, Matthews S: Early life risk factors for current wheeze, asthma, and bronchial hyperresponsiveness at 10 years of age. Chest 2005, 127: 502–508. 10.1378/chest.127.2.502
Burgess JA, Dharmage SC, Byrnes GB, Matheson MC, Gurrin LC, Wharton CL, Johns DP, Abramson MJ, Hopper JL, Walters EH: Childhood eczema and asthma incidence and persistence: a cohort study from childhood to middle age. J Allergy Clin Immunol 2008, 122: 280–285. 10.1016/j.jaci.2008.05.018
Martin PE, Matheson MC, Gurrin L, Burgess JA, Osborne N, Lowe AJ, Morrison S, Meszaros D, Giles GG, Abramson MJ, et al.: Childhood eczema and rhinitis predict atopic but not nonatopic adult asthma: a prospective cohort study over 4 decades. J Allergy Clin Immunol 2011, 127: 1473–1479. e1471 10.1016/j.jaci.2011.02.041
Ricci G, Patrizi A, Baldi E, Menna G, Tabanelli M, Masi M: Long-term follow-up of atopic dermatitis: retrospective analysis of related risk factors and association with concomitant allergic diseases. J Am Acad Dermatol 2006, 55: 765–771. 10.1016/j.jaad.2006.04.064
Gustafsson D, Sjoberg O, Foucard T: Development of allergies and asthma in infants and young children with atopic dermatitis–a prospective follow-up to 7 years of age. Allergy 2000, 55: 240–245. 10.1034/j.1398-9995.2000.00391.x
Queille-Roussel C, Raynaud F, Saurat JH: A prospective computerized study of 500 cases of atopic dermatitis in childhood. I. Initial analysis of 250 parameters. Acta Derm Venereol Suppl (Stockh) 1985, 114: 87–92.
Larsson M, Hagerhed-Engman L, Sigsgaard T, Janson S, Sundell J, Bornehag CG: Incidence rates of asthma, rhinitis and eczema symptoms and influential factors in young children in Sweden. Acta Paediatr 2008, 97: 1210–1215. 10.1111/j.1651-2227.2008.00910.x
Bornehag CG, Sundell J, Sigsgaard T: Dampness in buildings and health (DBH): Report from an ongoing epidemiological investigation on the association between indoor environmental factors and health effects among children in Sweden. Indoor Air 2004,14(Suppl 7):59–66.
Asher MI, Keil U, Anderson HR, Beasley R, Crane J, Martinez F, et al.: International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur RespirJ. 1995, 8: 483–491. 10.1183/09031936.95.08030483
Williams H, Robertson C, Stewart A, Aït-Khaled N, Anabwani G, Anderson R, et al.: Worldwide variations in the prevalence of symptoms of atopic eczema in the International Study of Asthma and Allergies in Childhood. J Allergy Clin Immunol 1999, 103: 125–138. 10.1016/S0091-6749(99)70536-1
Lemeshow S, Hosmer DW Jr: A review of goodness of fit statistics for use in the development of logistic regression models. Am J Epidemiol 1982, 115: 92–106.
Lowe AJ, Carlin JB, Bennett CM, Hosking CS, Abramson MJ, Hill DJ, et al.: Do boys do the atopic march while girls dawdle? J Allergy Clin Immunol 2008, 121: 1190–1195. 10.1016/j.jaci.2008.01.034
Kolarik B, Naydenov K, Larsson M, Bornehag CG, Sundell J: The association between phthalates in dust and allergic diseases among Bulgarian children. Environ Health Perspect 2008, 116: 98–103.
Cookson W: The immunogenetics of asthma and eczema: a new focus on the epithelium. Nat Rev Immunol 2004, 4: 978–988. 10.1038/nri1500
Weidinger S, Illig T, Baurecht H: Loss-of-function variations within the filaggrin gene predispose for atopic dermatitis with allergic sensitizations. J Allergy Clin Immunol 2006, 118: 214–219. 10.1016/j.jaci.2006.05.004
Weidinger S, O'Sullivan M, Illig T: Filaggrin mutations, atopic eczema, hay fever, and asthma in children. J Allergy Clin Immunol 2008, 121: 1203–1209. 10.1016/j.jaci.2008.02.014
Lack G, Fox D, Northstone K, Golding J: Factors associated with the development of peanut allergy in childhood. N Engl J Med 2003, 348: 977–985. 10.1056/NEJMoa013536
Peroni DG, Piacentini GL, Alfonsi L, Zerman L, Di Blasi P, Visona G, et al.: Rhinitis in pre-school children: prevalence, association with allergic diseases and risk factors. Clin Exp Allergy 2003, 33: 1349–1354. 10.1046/j.1365-2222.2003.01766.x
Hederos C-A, Hasselgren M, Hedlin G, Bornehag C-G: Comparison of clinically diagnosed asthma with parental assessment of children's asthma in a questionnaire. Pediatr Allergy Immunol 2007, 18: 135–141. 10.1111/j.1399-3038.2006.00474.x
Williams HC: Atopic dermatitis: the epidemiology, causes and prevention of atopic eczema. Cambridge: Cambridge University Press; 2000.
Mohrenschlager M, Schafer T, Huss-Marp J, Eberlein-Konig B, Weidinger S, Ring J, et al.: The course of eczema in children aged 5–7 years and its relation to atopy: differences between boys and girls. Br J Dermatol 2006, 154: 505–513. 10.1111/j.1365-2133.2005.07042.x
Brown SJ, Asai Y, Cordell HJ, Campbell LE, Zhao Y, Liao H, et al.: Loss-of-function variants in the filaggrin gene are a significant risk factor for peanut allergy. J Allergy Clin Immunol 2011, 127: 661–667. 10.1016/j.jaci.2011.01.031
Simpson EL, Berry TM, Brown PA, Hanifin JM: A pilot study of emollient therapy for the primary prevention of atopic dermatitis. J Am Acad Dermatol 2010, 63: 587–593. 10.1016/j.jaad.2009.11.011
The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-5945/12/11/prepub