Sex-specific developmental trajectories of eczema from infancy to age 26 years: A birth cohort study
Sex-specific developmental trajectories of eczema from infancy to age 26 years: A birth cohort study
Background: Eczema is a common inflammatory skin disease with varying developmental trajectories/patterns that are influenced by different risk factors. The aim of this study was to investigate eczema development from infancy to early adulthood by identifying distinct developmental trajectories that describe disease patterns over time and evaluate the role of prenatal and early-life risk factors. Methods: The Isle of Wight Birth Cohort (n = 1456) was prospectively assessed at birth, 1, 2, 4, 10, 18 and 26 years. In all assessments, eczema was defined as chronic or chronically relapsing itchy dermatitis lasting >6 weeks with characteristic morphology and distribution in the past 12 months. Developmental trajectories of eczema between 1 or 2 and 26 years were identified separately for males and females by applying semiparametric mixture models. Associations were assessed by applying a modified Poisson regression to estimate adjusted risk ratios (aRR) and 95% confidence intervals (CI). Results: In both males and females, the following eczema developmental trajectories were identified: unaffected/transient (males: 77.7% vs. females: 73.0%), mid-onset late-resolving (males: 7.8% vs. females: 4.4%), late-onset (males: 5.2% vs. females: 9.5%) and early-onset persistent (males: 9.3% vs. females: 5.4%). In females, an additional trajectory was identified as follows: early-onset early-resolving (7.7%). Among males, filaggrin gene (FLG) variants (aRR = 2.45, 95% CI: 1.34–4.46) and paternal eczema (2.66, 1.39–5.08) were associated with the early-onset persistent trajectory. Among females, maternal eczema (2.84, 1.42–5.70) and high birthweight (2.25, 1.08–4.69) were associated with the early-onset persistent trajectory. Conclusions: Four and five trajectories represented eczema development among males and females, respectively, with different predisposing risk factors. Our results indicate that males and females may experience a different course of eczema.
atopic dermatitis, basic mechanisms, dermatology, epidemiology, natural history, trajectories
416 - 425
Ziyab, Ali H.
12905e44-3fd1-47c2-98e5-35320e89815b
Mukherjee, Nandini
f64f02d6-2fd0-40db-88ee-5f85b59b8e0b
Zhang, Hongmei
9f774048-54d6-4321-a252-3887b2c76db0
Arshad, Syed Hasan
917e246d-2e60-472f-8d30-94b01ef28958
Karmaus, Wilfried
fff03ed3-75af-4ebc-a410-aca9f91f0683
12 December 2021
Ziyab, Ali H.
12905e44-3fd1-47c2-98e5-35320e89815b
Mukherjee, Nandini
f64f02d6-2fd0-40db-88ee-5f85b59b8e0b
Zhang, Hongmei
9f774048-54d6-4321-a252-3887b2c76db0
Arshad, Syed Hasan
917e246d-2e60-472f-8d30-94b01ef28958
Karmaus, Wilfried
fff03ed3-75af-4ebc-a410-aca9f91f0683
Ziyab, Ali H., Mukherjee, Nandini, Zhang, Hongmei, Arshad, Syed Hasan and Karmaus, Wilfried
(2021)
Sex-specific developmental trajectories of eczema from infancy to age 26 years: A birth cohort study.
Clinical and Experimental Allergy, 52 (3), .
(doi:10.1111/cea.14068).
Abstract
Background: Eczema is a common inflammatory skin disease with varying developmental trajectories/patterns that are influenced by different risk factors. The aim of this study was to investigate eczema development from infancy to early adulthood by identifying distinct developmental trajectories that describe disease patterns over time and evaluate the role of prenatal and early-life risk factors. Methods: The Isle of Wight Birth Cohort (n = 1456) was prospectively assessed at birth, 1, 2, 4, 10, 18 and 26 years. In all assessments, eczema was defined as chronic or chronically relapsing itchy dermatitis lasting >6 weeks with characteristic morphology and distribution in the past 12 months. Developmental trajectories of eczema between 1 or 2 and 26 years were identified separately for males and females by applying semiparametric mixture models. Associations were assessed by applying a modified Poisson regression to estimate adjusted risk ratios (aRR) and 95% confidence intervals (CI). Results: In both males and females, the following eczema developmental trajectories were identified: unaffected/transient (males: 77.7% vs. females: 73.0%), mid-onset late-resolving (males: 7.8% vs. females: 4.4%), late-onset (males: 5.2% vs. females: 9.5%) and early-onset persistent (males: 9.3% vs. females: 5.4%). In females, an additional trajectory was identified as follows: early-onset early-resolving (7.7%). Among males, filaggrin gene (FLG) variants (aRR = 2.45, 95% CI: 1.34–4.46) and paternal eczema (2.66, 1.39–5.08) were associated with the early-onset persistent trajectory. Among females, maternal eczema (2.84, 1.42–5.70) and high birthweight (2.25, 1.08–4.69) were associated with the early-onset persistent trajectory. Conclusions: Four and five trajectories represented eczema development among males and females, respectively, with different predisposing risk factors. Our results indicate that males and females may experience a different course of eczema.
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Eczema_Natural_Course_11_8_2021 CEA Revised Clean
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More information
Accepted/In Press date: 29 November 2021
e-pub ahead of print date: 1 December 2021
Published date: 12 December 2021
Additional Information:
Funding Information:
We would like to acknowledge the help of all the staff at The David Hide Asthma and Allergy Research Centre in undertaking all assessments of 1989 Isle of Wight birth cohort study. We are specifically grateful to the research team including Mr Stephen Potter, Mrs Susan Grevatt, Mrs Gill Glasby, Miss Kaisha Bennett, Mrs Debbie Fraser, Mrs Nicky Tongue and Mrs. Sharon Matthews. Our sincere thanks to the participants and their families who helped us with this project over the last three decades. The Isle of Wight Birth Cohort assessments have been supported by the National Institutes of Health USA (grant no. R01 HL082925, R01 AI121226, R01 HL132321), Asthma UK (grant no. 364) and the David Hide Asthma and Allergy Research Trust. The funding bodies had no role in study design, data collection, analysis and interpretation of data and decision to publish or preparation of the manuscript.
Publisher Copyright:
© 2021 John Wiley & Sons Ltd
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
Keywords:
atopic dermatitis, basic mechanisms, dermatology, epidemiology, natural history, trajectories
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Local EPrints ID: 454858
URI: http://eprints.soton.ac.uk/id/eprint/454858
ISSN: 0954-7894
PURE UUID: 00eca89d-2ba5-4986-814e-d4e433b7c4de
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Date deposited: 28 Feb 2022 17:31
Last modified: 18 Mar 2024 05:28
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Contributors
Author:
Ali H. Ziyab
Author:
Nandini Mukherjee
Author:
Hongmei Zhang
Author:
Wilfried Karmaus
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