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早年的特应性皮炎与10岁时的疼痛:一项探索性研究。

Atopic dermatitis in early life and pain at 10 years of age: An exploratory study.

作者信息

Gorito Vanessa, Brandão Maria, Azevedo Inês, Moreira André, Lucas Raquel

机构信息

EPIUnit - Instituto de Saúde Pública e Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas 135, 050-600, Porto, Portugal.

Serviço de Pediatria e Neonatologia, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal.

出版信息

Eur J Pediatr. 2024 May;183(5):2239-2249. doi: 10.1007/s00431-024-05439-0. Epub 2024 Feb 24.

Abstract

Pain is a distinctive burden in atopic dermatitis and recognized as an important and highly prevalent symptom. It is unknown if the presence of atopic disease may sensitize children to adverse pain profiles in the long term. We aimed to assess the impact of early-life atopic dermatitis-like symptoms on pain at 10 years of age. We used data from 1302 and 874 participants of the Generation XXI birth cohort evaluated at 6 and 15 months, respectively, and 10 years. Atopy-like symptoms since birth, including atopic dermatitis, were collected at ages 6 and 15 months by interviewing parents. Pain history in the last 3 months at age 10 was collected from parents and children using structured questionnaires. We computed relative risks (RR) and respective 95% confidence intervals of pain features at age 10 according to each atopic-like symptom at 6 and 15 months. Children whose parents reported atopic dermatitis-like symptoms at 6 months and at 15 months had higher risk of reporting any pain (RR 1.75 [1.15-2.66]) and multisite pain, respectively (RR 1.67 [1.18-2.37]) at 10 years of age.  Conclusion: Atopic dermatitis symptoms in early life were associated with a higher risk of pain at age 10, suggesting that potential for sensitization during the first decade of life and highlighting the importance of improving the health care of children with atopic dermatitis is worth investigating. What is Known: • Atopic disorders have been associated with many non-atopic comorbidities, including chronic pain. • Pain and atopic dermatitis share common inflammatory pathways. Inflammation, injury to the skin from scratching, fissures, and intolerance to irritants related to atopic dermatitis can cause pain. What is New: • Atopic dermatitis in early life is linked to an increased likelihood of experiencing pain at the age of 10, which suggests that exploring the potential for sensitization is a worthwhile area of investigation. • Our proof-of-concept study highlights the potential benefit of studying management targets and improving itching and relieving skin pain as quickly as possible, avoiding potential long-term consequences of the sensitization process.

摘要

疼痛是特应性皮炎中一个突出的负担,并且被认为是一种重要且极为常见的症状。尚不清楚特应性疾病的存在是否会使儿童在长期内对不良疼痛状况敏感。我们旨在评估早期类似特应性皮炎的症状对10岁时疼痛的影响。我们使用了来自二十一世纪出生队列的1302名和874名参与者的数据,分别在6个月、15个月以及10岁时进行评估。通过询问父母,在6个月和15个月时收集自出生以来的类似特应性症状,包括特应性皮炎。使用结构化问卷从父母和孩子那里收集10岁时过去3个月的疼痛史。我们根据6个月和15个月时的每种类似特应性症状计算了10岁时疼痛特征的相对风险(RR)及相应的95%置信区间。父母报告在6个月和15个月时有类似特应性皮炎症状的儿童,在10岁时报告任何疼痛(RR 1.75 [1.15 - 2.66])和多部位疼痛(RR 1.67 [1.18 - 2.37])的风险更高。结论:早期生活中的特应性皮炎症状与10岁时更高的疼痛风险相关,这表明在生命的第一个十年中存在致敏的可能性,并突出了改善特应性皮炎患儿医疗保健的重要性,值得进行研究。已知信息:• 特应性疾病与许多非特应性合并症有关,包括慢性疼痛。• 疼痛和特应性皮炎有共同的炎症途径。炎症、搔抓引起的皮肤损伤、裂缝以及与特应性皮炎相关的对刺激物的不耐受都可导致疼痛。新发现:• 早期生活中的特应性皮炎与10岁时经历疼痛的可能性增加有关,这表明探索致敏的可能性是一个值得研究的领域。• 我们的概念验证研究强调了研究管理目标以及尽快改善瘙痒和缓解皮肤疼痛的潜在益处,避免致敏过程可能产生的长期后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e90/11035428/c018535346f0/431_2024_5439_Fig1_HTML.jpg

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