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. 2022 May;77(5):1464-1476.
doi: 10.1111/all.15170. Epub 2021 Nov 12.

Impaired skin barrier and allergic sensitization in early infancy

Sabina Wärnberg Gerdin  1   2 , Anine Lie  3   4 , Anna Asarnoj  1   2 , Magnus P Borres  5 , Karin C Lødrup Carlsen  3   4 , Martin Färdig  1   2 , Jon R Konradsen  1   2 , Christine Monceyron Jonassen  6   7 , Caroline-Aleksi Olsson Mägi  1   2 , Eva Maria Rehbinder  4   8 , Knut Rudi  7 , Håvard Ove Skjerven  3   4 , Anne Cathrine Staff  4   9 , Cilla Söderhäll  1   2 , Sandra G Tedner  1   2 , Marianne van Hage  10 , Riyas Vettukattil  3   4 , Björn Nordlund  1   2
Affiliations

Impaired skin barrier and allergic sensitization in early infancy

Sabina Wärnberg Gerdin et al. Allergy. 2022 May.

Abstract

Background: Factors predicting allergic sensitization in the first 6 months of life are poorly understood. We aimed to determine whether eczema, dry skin, and high transepidermal water loss (TEWL) at 3 months were associated with allergic sensitization at 6 months of age and, secondarily, to establish whether these characteristics predicted sensitization from 3 to 6 months of age.

Methods: At 3 months of age, 1,994 infants from the population-based PreventADALL birth cohort in Norway and Sweden were assessed for eczema and dry skin on the cheeks and/or extensors; impaired skin barrier function, defined as TEWL in the upper quartile (>9.4 g/m2 /h), and allergen-specific IgE levels <0.1 kUA /L, available in 830. At 6 months, we assessed allergic sensitization to any food (egg, cow's milk, peanut, wheat, soy) or inhalant (birch, timothy grass, dog, and cat) allergen by a skin prick test wheal diameter ≥2 mm larger than negative control.

Results: Any sensitization was found in 198 of the 1,994 infants (9.9%), the majority to food allergens (n = 177, 8.9%). Eczema, dry skin, and high TEWL at 3 months increased the risk of sensitization at 6 months; adjusted odds ratios 4.20 (95% CI 2.93-6.04), 2.09 (95% CI 1.51-2.90) and 3.67 (95% CI 2.58-5.22), respectively. Eczema predicted sensitization with 55.6% sensitivity and 68.1% specificity; dry skin with 65.3% sensitivity and 57.3% specificity; and high TEWL with 61.7% sensitivity and 78.1% specificity.

Conclusion: Eczema, dry skin, and high TEWL at 3 months predicted allergic sensitization at 6 months of age.

Keywords: PreventADALL; allergic sensitization; infancy; skin barrier.

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References

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