Early infection linked to the development of atopic dermatitis in infants and children

The incidence of infectious diseases, skin infections, and systemic exposure to antibiotics were all associated with the development of atopic dermatitis in infants and young children.

According to the results of a study recently published in Journal of the European Academy of Dermatology and Venereology.

In patients with AD, the skin barrier and immune deficiencies are known to increase the risk of infection. With infections also exacerbating the severity outcomes of Alzheimer’s disease, the researchers note that accumulating evidence shows that microorganisms may also underlie the development of the skin condition.

“Microbial colonization early in life can shape host immune development, leading to long-lasting consequences: immune tolerance to environmental exposures or susceptibility to allergic disease later in life,” they explained.

Seeking to further investigate the risk of developing Alzheimer’s disease as a result of early infections, the authors conducted a population-based nested case-control study using patient data from the research database. on Taiwan’s National Health Insurance for people born between 1997 and 2013.

In the study, 5,454 patients with AD were matched 1:3 with 16,362 control subjects without AD on age, sex, index date, and maternal age at delivery; demographic characteristics, comorbidities and maternal factors were also compared. Conditional stepwise logistic regression analysis assessed the risk between early infections and subsequent AD.

Among the two groups, the mean (SD) age was 2.6 (2.9) years, with overall infections before AD diagnosis more common in AD patients than in control subjects (41.8 % versus 28.9%; P

  • Infectious diseases (OR adjusted [aOR], 1.40; 95% CI, 1.29-1.51)
  • Skin infections (aOR, 1.55; 95% CI, 1.40-1.71)
  • Systemic exposure to antibiotics (aOR, 1.67; 95% CI, 1.55-1.79)

“These results were consistent across observation periods (0-1, 1-2, and >2 years after birth) and sensitivity analyzes after redefining the index date as 3 or 6 months before the date of diagnosis of the MA,” the study authors noted.

Notably, each additional year of age was associated with a lower risk of AD (aOR, 0.90; 95% CI, 0.89-0.92). Other independent risk factors associated with the development of AD included asthma (aOR, 1.47; 95% CI, 1.29-1.68), allergic rhinitis (aOR, 1.44; 95%, 1.29-1.68), intussusception (aOR, 1.49; 95% CI, 1.10-2.02) and neonatal hyperbilirubinemia (aOR, 1.23; 95% CI, 1. 05-1.45).

No association with later AD was found for maternal age at delivery, cesarean delivery, or prenatal antibiotic exposure.

“Our results suggest that infectious diseases in early life, including gross infections and skin infections, are associated with later AD,” the researchers concluded. “Interactions between infections, microbiota dysbiosis and immune development deserve further investigation.”

Reference

Lin TL, Fan YH, Chang YL, Ho HJ, Wu CY, Chen YJ. Early infections in association with the development of atopic dermatitis in infancy and early childhood: a nationwide nested case-control study. J Eur Acad Dermatol Venereol. Published online January 9, 2022. doi:10.1111/jdv.17908

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