Factors Influencing Atopic Dermatitis Incidence in Offspring
Abstract
Atopic dermatitis (AD) is a chronic, recurrent skin condition resulting from both genetic and environmental factors. In recent decades, the prevalence of AD has increased considerably in some countries. However, given that the role of genetics is unlikely to have changed over this short period, the increased prevalence is more likely to be explained by changes in environmental and maternal factors. The aim of this review is to comprehensively summarize the various factors impacting AD incidence in offspring and provide guidance for primary prevention. Recent research has demonstrated that environmental and climate factors, maternal history of allergies, gestational diabetes, and stress play essential roles in increasing the risk of AD in infants. Some factors have protective effects against the incidence of AD, including probiotic supplementation, fish intake, and moisturizers. This review also considers fundamental research into AD prevalence and factors that in the past were mistakenly thought to affect that prevalence, such as caesarean section and antigen avoidance. The potential influence of these factors on infant AD incidence remains inconclusive and needs further study. Furthermore, infants with a family history of atopic disease may benefit from early weaning or reduced breastfeeding duration.
1. Grammatikos AP. The genetic and environmental basis of atopic diseases. Ann med 2008;40(7):482-495.
2. Guttman-Yassky E, Nograles KE and Krueger JG. Contrasting pathogenesis of atopic dermatitis and psoriasis--part I: clinical and pathologic concepts. J Allergy Clin Immunol 2011;127(5):1110-1118.
3. Nowicki R, Trzeciak M, Wilkowska A, Sokolowska-Wojdyl M, Lugowska-Ume H, Baranska-Rybak W, et al. Atopic dermatitis: current treatment guidelines. Statement of the experts of the Dermatological Section, Polish Society of Allergology, and the Allergology Section, Polish Society of Dermatology. Postepy Dermatol Alergol 2015;32(4):239-249.
4. Garg N, Silverberg JI. Epidemiology of childhood atopic dermatitis. Clin Dermatol 2015;33(3):281-288.
5. Penard-Morand C, Raherison C, Charpin D, Kopferschmitt C, Lavaud F, Caillaud D, et al. Long-term exposure to close-proximity air pollution and asthma and allergies in urban children. Eur Respir J 2010;36(1):33-40.
6. Jedrychowski W, Perera F, Maugeri U, Mrozek-Budzyn D, Miller RL, Flak E, et al. Effects of prenatal and perinatal exposure to fine air pollutants and maternal fish consumption on the occurrence of infantile eczema. Int Arch Allergy Immunol 2011; 155(3):275-281.
7. Herbarth O, Fritz GJ, Rehwagen M, Richter M, Roder S, Schlink U. Association between indoor renovation activities and eczema in early childhood. Int J Hyg Environ Health 2006;209(3):241-277.
8. Okada Y, Kumagai H, Morikawa Yand Akasawa A. Epidemiology of pediatric allergic diseases in the Ogasawara Islands. Allergol Int 2016;65(1):37-43.
9. Silverberg JI, Hanifin J, Simpson EL. Climatic factors are associated with childhood eczema prevalence in the United States. J Invest Dermatol 2013;133(7):1752-1759.
10. Hanski I, von Hertzen L, Fyhrquist N, Koskinen K, Torppa K, Laatikainen T,
, et al. Environmental biodiversity, human microbiota, and allergy are interrelated. Proc Natl Acad Sci USA 2012;109(21):8334-8339.
11. Silverberg JI, Simpson EL, Durkin HG, Joks R. Prevalence of allergic disease in foreign-born American children. JAMA Pediatr 2013;167(6):554-560.
12. Marcon A, Cazzoletti L, Rava M, Gisondi P, Pironi V, Ricci P, et al. Incidence of respiratory and allergic symptoms in Italian and immigrant children. Respir Med 2011;105(2):204-210.
13. Farfel A, Green MS, Shochat T, Noyman I, Levy Y, Afek A. Trends in specific morbidity prevalence in male adolescents in Israel over a 50 year period and the impact of recent immigration. Isr Med Assoc J 2007;9(3):149-152.
14. Vatanen T, Kostic AD, d'Hennezel E, Siljander H, Franzosa EA, Yassour M,
, et al. Variation in Microbiome LPS Immunogenicity Contributes to Autoimmunity in Humans. Cell 2016;165(4):842-853.
15. Roduit C, Wohlgensinger J, Frei R, Bitter S, Bieli C, Loeliger S, et al. Prenatal animal contact and gene expression of innate immunity receptors at birth are associated with atopic dermatitis. J Allergy Clin Immunol 2011;127(1):179-185.
16. Illi S, Depner M, Genuneit J, Horak E, Loss G, Strunz-Lehner C, et al. Protection from childhood asthma and allergy in Alpine farm environments-the GABRIEL Advanced Studies. J Allergy Clin Immunol 2012;129(6):1470-1477.
17. Pelucchi C, Galeone C, Bach JF, La Vecchia C, Chatenoud L. Pet exposure and risk of atopic dermatitis at the pediatric age: a meta-analysis of birth cohort studies. J Allergy Clin Immunol 2013;132(3):616-622.
18. Netting MJ, Middleton PF, Makrides M. Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches. Nutrition 2013; 3(S3):1-2.
19. Miyake Y, Okubo H, Sasaki S, Tanaka K, Hirota Y. Maternal dietary patterns during pregnancy and risk of wheeze and eczema in Japanese infants aged 16-24 months: the Osaka Maternal and Child Health Study. Pediatr Allergy Immunol
2011;22(7):734-741.
20. Kramer MS , Kakuma. Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Cochrane Database Syst Rev 2003;9 (4) :CD000133-CD000133.
21. Simpson MR, Dotterud CK, Storro O, Johnsen R, Oien T. Perinatal probiotic supplementation in the prevention of allergy related disease: 6 year follow up of a randomised controlled trial. BMC dermatology 2015;15(1):1-8.
22. Wickens K, Stanley T, Mitchell E, Barthow C, Fitzharris P, Purdie G, et al. O09-Early supplementation with Lactobacillus rhamnosus HN001 reduces eczema prevalence to 6 years: does it also reduce atopic sensitisation? Clin Exp Allergy 2014; 4 (S1);1-1.
23. Wickens K, Black P, Stanley TV, Mitchell E, Barthow C, Fitzharris P, et al. A protective effect of Lactobacillus rhamnosus HN001 against eczema in the first 2 years of life persists to age 4 years. Clin Exp Allergy 2012;42(7):1071-1079.
24. West CE, Hammarstrom ML, Hernell O. Probiotics in primary prevention of allergic disease--follow-up at 8-9 years of age. Allergy 2013;68(8):1015-1020.
25. Montes LR, Chisaguano AM, Castellote AI, Morales E, Sunyer J, pez-Sabater ML. Fatty-acid composition of maternal and umbilical cord plasma and early childhood atopic eczema in a Spanish cohort. Eur J Clin Nutr 2013;67(8):658-663.
26. Romieu I, Torrentw M, Garcia-Esteban R, Ferrer C, Ribas-Fito N, Anto JM , et al. Maternal fish intake during pregnancy and atopy and asthma in infancy. Clin Exp Allergy 2007;37(4):518-525.
27. Gunaratne AW, Makrides M, Collins CT. Maternal prenatal and/or postnatal n-3 long chain polyunsaturated fatty acids (LC-PUFA) supplementation for preventing allergies in early childhood. Cochrane Database Syst Rev 2015;7(7):678–687.
28. Bremmer SF, Simpson EL. Dust mite avoidance for the primary prevention of atopic dermatitis: A systematic review and meta-analysis. Pediatr Allergy Immunol 2015;26(7):646-654.
29. Miyake Y, Tanaka K, Okubo H, Sasaki S, Arakawa M. Maternal consumption of dairy products, calcium, and vitamin D during pregnancy and infantile allergic disorders. Ann Allergy Asthma Immunol 2014;113(1):82-87.
30. Back O, Blomquist HK, Hernell O, Stenberg B. Does vitamin D intake during infancy promote the development of atopic allergy? Acta Derm Venereol 2009;89(1):28-32.
31. Chiu CY, Huang SY, Peng YC, Tsai MH, Hua MC, Yao TC, et al. Maternal vitamin D levels are inversely related to allergic sensitization and atopic diseases in early childhood. Pediatr Allergy Immunol 2015;26(4):337-343.
32. Gazibara T, Elbert NJ, den Dekker HT, de Jongste JC, Reiss I, McGrath JJ, et al: Associations of maternal and fetal 25-hydroxyvitamin D levels with childhood eczema: The Generation R Study. Pediatr Allergy Immunol 2015;27(3):283-289.
33. Benson AA, Toh JA, Vernon N, Jariwala SP. The role of vitamin D in the immunopathogenesis of allergic skin diseases. Allergy 2012;67(3):296-301.
34. Magdelijns FJ, Mommers M, Penders J, Smits L, Thijs C. Folic acid use in pregnancy and the development of atopy, asthma, and lung function in childhood. Pediatrics 2011;128(1):e135-44.
35. Kim JH, Jeong KS, Ha EH, Park H, Ha M, Hong YC, et al. Relationship between prenatal and postnatal exposures to folate and risks of allergic and respiratory diseases in early childhood. Pediatr Pulmonol 2014;50(2):155-163.
36. Kiefte-de Jong JC, Timmermans S, Jaddoe VW, Hofman A, Tiemeier H,
Steegers EA, et al. High circulating folate and vitamin B-12 concentrations in women during pregnancy are associated with increased prevalence of atopic dermatitis in their offspring. J Nutr 2012;142(2):731-738.
37. Miyake Y, Sasaki S, Tanaka K, Hirota Y. Maternal B vitamin intake during pregnancy and wheeze and eczema in Japanese infants aged 16-24 months: the Osaka Maternal and Child Health Study. Pediatr Allergy Immunol 2011;22 (1-Part-I):69-74.
38. Loo EX, Shek LP, Goh A, Teoh OH, Chan YH, Soh SE, et al. Atopic Dermatitis in Early Life: Evidence for at Least Three Phenotypes? Results from the GUSTO Study. Int Arch Allergy Immunol 2015;166(4):273-279.
39. Wickens K, Ingham T, Epton M, Pattemore P, Town I, Fishwick D, et al. The association of early life exposure to antibiotics and the development of asthma, eczema and atopy in a birth cohort: confounding or causality? Clin Exp Allergy 2008; 38(8):1318-1324.
40. Kummeling I, Stelma FF, Dagnelie PC, Snijders BE, Penders J, Huber M, et al. Early life exposure to antibiotics and the subsequent development of eczema, wheeze, and allergic sensitization in the first 2 years of life: the KOALA Birth Cohort Study. Pediatrics 2007;119(1):e225-231.
41. Garcia-Marcos L, Gonza´ lez-Dı´ az C, Garvajal-Uruen ˜ a I, Pac-Sa MR,
Busquets-Monge RM, Sua´ rez-Varela MM, et al. Early exposure to paracetamol or to antibiotics and eczema at school age: modification by asthma and rhinoconjunctivitis. Pediatr Allergy Immunol 2010;21(7):1036-1042.
42. Van Boeckel TP, Gandra S, Ashok A, Caudron Q, Grenfell BT, Levin SA , et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis 2014;14(8):742-750.
43. O'Donovan SM, J OBH, Murray DM, Kenny LC, Khashan AS, Chaoimh CN,
, et al. Neonatal adiposity increases the risk of atopic dermatitis during the first year of life. J Allergy Clin Immunol 2016;137(1):108-117.
44. Harpsoe MC, Basit S, Bager P, Wohlfahrt J, Benn CS, Nøhr EA, et al. Maternal obesity, gestational weight gain, and risk of asthma and atopic disease in offspring: a study within the Danish National Birth Cohort. J Allergy Clin Immunol 2013;131(4):1033-1040.
45. Kumar R, Ouyang F, Story RE, Wohlfahrt J, Benn CS, Nohr EA, et al. Gestational diabetes, atopic dermatitis, and allergen sensitization in early childhood. J Allergy Clin Immunol 2009;124(5):1031-1038.
46. Wang IJ, Wen HJ, Chiang TL, Lin SJ, Chen PC, YL G. Does pregnancy complications increase the risk of atopic disorders in children? Allergy 2013;68:64.
47. Williams HC, Grindlay DJ. What's new in atopic eczema? An analysis of systematic reviews published in 2007 and 2008. Part 2. Disease prevention and treatment. Clin Exp Dermatol 2010;35(3):223-227.
48. Madhok V, Futamura M, Thomas KS, Barbarot S. What's new in atopic eczema? An analysis of systematic reviews published in 2012 and 2013. Part 1. Epidemiology, mechanisms of disease and methodological issues. Clin Exp Dermatol 2015;40(4):238-242.
49. Kahr N, Naeser V, Stensballe LG, Kyvik KO, Skytthe A, Backer V, et al. Gene-environment interaction in atopic diseases: a population-based twin study of early-life exposures. Clin Respir J 2015;9(1):79-86.
50. Martel MJ, Beauchesne MF, Malo JL, Rey E, Perreault S, Forget A , et al. Maternal asthma, its control and severity in pregnancy, and the incidence of atopic dermatitis and allergic rhinitis in the offspring. J Pediatr 2009;155(5):707-713.
51. Ito J, Fujiwara T. Breastfeeding and risk of atopic dermatitis up to the age 42 months: a birth cohort study in Japan. Ann Epidemiol 2014;24(4):267-272.
52. Turati F, Bertuccio P, Galeone C, Pelucchi C, Naldi L, Bach JF, et al. Early weaning is beneficial to prevent atopic dermatitis occurrence in young children. Allergy 2016;71(6):878-888.
53. Backhed F, Roswall J, Peng Y, Feng Q, Jia H, Kovatcheva-Datchary P, et al. Dynamics and Stabilization of the Human Gut Microbiome during the First Year of Life. Cell Host Microbe 2015;17(5):690-703.
54. Hartwig IRV, Sly PD, Schmidt LA, van Lieshout RJ, Bienenstock J, Holt PG , et al. Maternal prenatal life events increase risk for atopic disorders in children. Brain Behav Immun 2013;29(29):S15.
55. Wang IJ, Wen HJ, Chiang TL, Lin SJ, Chen PC, Guo YL. Maternal employment and atopic dermatitis in children: a prospective cohort study. Br J Dermatol 2013; 168(4):794-801.
56. Wang IJ, Wen HJ, Chiang TL, Lin SJ, Guo YL. Maternal psychologic problems increased the risk of childhood atopic dermatitis. Pediatr Allergy Immunol 2016;27(2):169-176.
57. Horimukai K, Morita K, Narita M, Kondo M, Kitazawa H, Nozaki M, et al. Application of moisturizer to neonates prevents development of atopic dermatitis. J Allergy Clin Immunol 2014;134(4):824-830.
58. Simpson EL, Chalmers JR, Hanifin JM, Thomas KS, Cork MJ, McLean WH , et al. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol 2014;134(4):818-823.
Files | ||
Issue | Vol 18, No 4 (2019) | |
Section | Review Article(s) | |
DOI | https://doi.org/10.18502/ijaai.v18i4.1413 | |
PMID | 31522443 | |
Keywords | ||
Atopic dermatitis Factors Offspring Prevalence Primary prevention |
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