Impaired skin barrier and allergic sensitization in early infancy
Sabina Wärnberg Gerdin, Anine Lie, Anna Asarnoj, Magnus P. Borres, Karin C. Lødrup Carlsen, Martin Färdig, Jon R. Konradsen, Christine Monceyron Jonassen, Caroline‐Aleksi Olsson Mägi, Eva Maria Rehbinder, Knut Rudi, Håvard Ove Skjerven, Anne Cathrine Staff, Cilla Söderhäll, Sandra G. Tedner, Marianne van Hage, Riyas Vettukattil, Björn Nordlund
Abstract
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/m 2 /h), and allergen‐specific IgE levels <0.1 kU A /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.