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Atopic dermatitis in early life: evidence for at least three phenotypes? Results from the GUSTO Study

Atopic dermatitis in early life: evidence for at least three phenotypes? Results from the GUSTO Study
Atopic dermatitis in early life: evidence for at least three phenotypes? Results from the GUSTO Study
Background: atopic dermatitis (AD) has been highlighted as a likely first step in the ‘atopic march', emphasizing the need to define predisposing factors.

Methods: we evaluated AD risk factors and phenotypes in an Asian mother-offspring cohort. We defined three phenotypes of doctor-diagnosed AD based on the time of onset of the disease: early AD occurring within the first 6 months of life, AD occurring between 6 and 12 months and late-onset AD starting after the age of 12 months.

Results: maternal allergic history was associated with an increased risk of developing early-onset AD (adjusted odds ratio (aOR) 20.46, 95% confidence interval (CI) 2.73-153.15, p < 0.01). Maternal allergic history and attendance at a daycare centre increased the odds of the development of AD between 6 and 12 months (aOR 4.19, 95% CI 1.01-17.45, p = 0.049 and aOR 11.42, 95% CI 1.49-87.50, p = 0.02, respectively). Risk factors associated with increased odds of late-onset AD from 12 months were the consumption of probiotics between the age of 9 and 12 months and antibiotic treatment in the first 6 months of life (aOR 4.32, 95% CI 1.07-17.45, p = 0.04 and aOR 3.11, 95% CI 1.10-8.76, p = 0.03, respectively). Early-onset AD was associated with an increased risk of developing allergic sensitization (aOR 46.51, 95% CI 3.44-628.81, p < 0.01).

Conclusion: we found that early-onset AD was mainly associated with familial factors, while late-onset AD was associated with the consumption of antibiotics or probiotics. The findings support the concept that different phenotypes of AD exist in young children
1018-2438
273-279
Loo, E.X.
256b504f-2273-4e9e-a3da-82667f09a547
Shek, L.P.
eb7d2e42-ed76-42a5-8649-06657984882b
Goh, A.
4111f2f7-4940-40c5-aa90-3e2a97f3dca1
Teoh, O.H.
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Chan, Y.H.
e0bbae11-84f4-42b4-81be-bdd85f50cb3b
Soh, S.E.
00a5ad13-4c5b-4fad-aaa9-d080d9aa63e8
Saw, S.M.
0684517e-f27e-49f0-98c3-7630e8fd1bbd
Kwek, K.
1a9b6c6e-a5e9-40a2-9bfe-44c2cea62a98
Gluckman, P.D.
492295c0-ef71-4871-ad5a-771c98e1059a
Godfrey, K.M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Chong, Y.S.
b50c99c9-4d83-46c5-a1c7-23f9a553ab8a
Lee, B.W.
643a0988-a441-4752-a190-e1e392c98738
Van Bever, H.P.
811c130d-8a9a-440c-bc97-64d7a8a314f6
Loo, E.X.
256b504f-2273-4e9e-a3da-82667f09a547
Shek, L.P.
eb7d2e42-ed76-42a5-8649-06657984882b
Goh, A.
4111f2f7-4940-40c5-aa90-3e2a97f3dca1
Teoh, O.H.
17cb4904-9194-4aea-a5e5-44b99f4b9c84
Chan, Y.H.
e0bbae11-84f4-42b4-81be-bdd85f50cb3b
Soh, S.E.
00a5ad13-4c5b-4fad-aaa9-d080d9aa63e8
Saw, S.M.
0684517e-f27e-49f0-98c3-7630e8fd1bbd
Kwek, K.
1a9b6c6e-a5e9-40a2-9bfe-44c2cea62a98
Gluckman, P.D.
492295c0-ef71-4871-ad5a-771c98e1059a
Godfrey, K.M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Chong, Y.S.
b50c99c9-4d83-46c5-a1c7-23f9a553ab8a
Lee, B.W.
643a0988-a441-4752-a190-e1e392c98738
Van Bever, H.P.
811c130d-8a9a-440c-bc97-64d7a8a314f6

Loo, E.X., Shek, L.P., Goh, A., Teoh, O.H., Chan, Y.H., Soh, S.E., Saw, S.M., Kwek, K., Gluckman, P.D., Godfrey, K.M., Chong, Y.S., Lee, B.W. and Van Bever, H.P. (2015) Atopic dermatitis in early life: evidence for at least three phenotypes? Results from the GUSTO Study. International Archives of Allergy and Immunology, 166 (4), 273-279. (doi:10.1159/000381342). (PMID:25925088)

Record type: Article

Abstract

Background: atopic dermatitis (AD) has been highlighted as a likely first step in the ‘atopic march', emphasizing the need to define predisposing factors.

Methods: we evaluated AD risk factors and phenotypes in an Asian mother-offspring cohort. We defined three phenotypes of doctor-diagnosed AD based on the time of onset of the disease: early AD occurring within the first 6 months of life, AD occurring between 6 and 12 months and late-onset AD starting after the age of 12 months.

Results: maternal allergic history was associated with an increased risk of developing early-onset AD (adjusted odds ratio (aOR) 20.46, 95% confidence interval (CI) 2.73-153.15, p < 0.01). Maternal allergic history and attendance at a daycare centre increased the odds of the development of AD between 6 and 12 months (aOR 4.19, 95% CI 1.01-17.45, p = 0.049 and aOR 11.42, 95% CI 1.49-87.50, p = 0.02, respectively). Risk factors associated with increased odds of late-onset AD from 12 months were the consumption of probiotics between the age of 9 and 12 months and antibiotic treatment in the first 6 months of life (aOR 4.32, 95% CI 1.07-17.45, p = 0.04 and aOR 3.11, 95% CI 1.10-8.76, p = 0.03, respectively). Early-onset AD was associated with an increased risk of developing allergic sensitization (aOR 46.51, 95% CI 3.44-628.81, p < 0.01).

Conclusion: we found that early-onset AD was mainly associated with familial factors, while late-onset AD was associated with the consumption of antibiotics or probiotics. The findings support the concept that different phenotypes of AD exist in young children

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More information

Accepted/In Press date: 27 February 2015
Published date: 30 April 2015
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 381499
URI: http://eprints.soton.ac.uk/id/eprint/381499
ISSN: 1018-2438
PURE UUID: 584aa533-6d82-4462-ad56-f446d3c39157
ORCID for K.M. Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 08 Oct 2015 08:41
Last modified: 07 Oct 2020 01:35

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Contributors

Author: E.X. Loo
Author: L.P. Shek
Author: A. Goh
Author: O.H. Teoh
Author: Y.H. Chan
Author: S.E. Soh
Author: S.M. Saw
Author: K. Kwek
Author: P.D. Gluckman
Author: K.M. Godfrey ORCID iD
Author: Y.S. Chong
Author: B.W. Lee
Author: H.P. Van Bever

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