Chiu Chih-Yung, Yang Chia-Hsuan, Su Kuan-Wen, Tsai Ming-Han, Hua Man-Chin, Liao Sui-Ling, Lai Shen-Hao, Chen Li-Chen, Yeh Kuo-Wei, Huang Jing-Long
Department of Pediatrics, Chang Gung Memorial Hospital at Keelung and Chang Gung University College of Medicine, Taoyuan, Taiwan; Community Medicine Research Centre, Chang Gung Memorial Hospital, Keelung, Taiwan; Division of Pediatric Pulmonology, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Department of Pediatrics, Chang Gung Memorial Hospital at Keelung and Chang Gung University College of Medicine, Taoyuan, Taiwan; Community Medicine Research Centre, Chang Gung Memorial Hospital, Keelung, Taiwan.
J Microbiol Immunol Infect. 2020 Dec;53(6):1008-1013. doi: 10.1016/j.jmii.2019.04.007. Epub 2019 May 8.
Atopic eczema and food allergy most commonly occur in the early childhood. However, the relationships between eczema onset and their relevance to the occurrence of atopic diseases relating to allergen sensitization remain unclear.
We investigated 186 children who were followed up regularly at the clinic for 4 years in a birth cohort study. The children were classified into three groups: early-onset eczema (<2 years old, n = 55), late-onset eczema (≥2 years old, n = 40), and never eczema groups (n = 91). The associations between the different onsets of eczema and total immunoglobulin E levels, absolute eosinophil count, sensitization to food and inhalant allergens, and allergic outcomes were assessed.
A significantly higher prevalence of sensitization to food, especially milk was observed in children with early-onset eczema compared with those without eczema at age 1, 1.5, 2, 3, and 4 years. Furthermore, a significantly higher number of eosinophils was detected in children with early or late-onset eczema at the age of 1.5 years. Both the early- and late-onset eczema were significantly associated with a higher prevalence of allergic rhinitis at age 2, 3, and 4 years, and asthma at age 2. Moreover, the early-onset eczema group showed a significantly increased risk of allergic rhinitis (P = 0.010) and asthma (P = 0.032) at age 4.
The children with early-onset eczema (<2 years old) appear to be associated with an increased prevalence of milk sensitization and risk of rhinitis and asthma in early childhood.
特应性湿疹和食物过敏最常见于幼儿期。然而，湿疹发病与其与变应原致敏相关的特应性疾病发生之间的关系仍不清楚。
在一项出生队列研究中，我们对186名在诊所定期随访4年的儿童进行了调查。这些儿童被分为三组：早发型湿疹（<2岁，n = 55）、晚发型湿疹（≥2岁，n = 40）和无湿疹组（n = 91）。评估了不同发病时间的湿疹与总免疫球蛋白E水平、绝对嗜酸性粒细胞计数、对食物和吸入性变应原的致敏情况以及过敏结局之间的关联。
与1岁、1.5岁、2岁、3岁和4岁时无湿疹的儿童相比，早发型湿疹儿童对食物尤其是牛奶的致敏率显著更高。此外，在1.5岁时，早发型或晚发型湿疹儿童中检测到的嗜酸性粒细胞数量显著更多。早发型和晚发型湿疹在2岁、3岁和4岁时均与过敏性鼻炎的较高患病率显著相关，在2岁时与哮喘显著相关。此外，早发型湿疹组在4岁时患过敏性鼻炎（P = 0.010）和哮喘（P = 0.032）的风险显著增加。
早发型湿疹（<2岁）儿童似乎与幼儿期牛奶致敏率增加以及鼻炎和哮喘风险增加有关。
