Kowalik Aleksandra, Wêglarczyk Kazimierz, Klimek Małgorzata, Goliñska Zofia, Malinowska Barbara, Siedlar Maciej, Kwinta Przemko
Department of Paediatrics, Institute of Paediatrics, Jagiellonian University Medical College, Krakow, Poland.
Department of Clinical Immunology, Institute of Paediatrics, Jagiellonian University Medical College, Krakow, Poland.
Postepy Dermatol Alergol. 2025 Aug 18;42(4):414-422. doi: 10.5114/ada.2025.153589. eCollection 2025 Aug.
Preterm children suffer from atopic dermatitis (AD) less frequently than term children do. The reason for this phenomenon has not yet been identified. Hypotheses include changes in the T-helper 1 (Th1)/T-helper 2 (Th2) balance or altered development of the thymus.
This study was designed to compare the Th1/Th2 cytokine balance and thymus size in preterm and term children and investigate the associations between these results and a possible diagnosis of AD in the second year of life.
The population comprised 28 preterm and 19 term children. During the first week of life, Th1/Th2/Th17 cytokine levels in the blood were assessed, and the thymus was measured via ultrasound. In the second year of life, 30 children were examined to determine whether AD was present, and the abovementioned procedures were repeated.
AD was diagnosed in 3 out of 18 (16.7%) preterm children and 1 out of 12 (8.3%) term children (OR = 2.2; 95% CI: 0.201-24.086). For all patients, the thymus/weight index was lower, and there was a significant decrease in the level of IL-2 and increases in the levels of IL-4 and IL-17 in the second year of life compared with those after birth. There were no differences in cytokine levels or thymus size in the second year of life between the preterm/term and AD/non-AD subgroups.
The observed associations may indicate that the immunological status of preterm children in the second year of life may not vastly differ from that of term children.
早产儿患特应性皮炎（AD）的频率低于足月儿。这一现象的原因尚未明确。假说是辅助性T细胞1（Th1）/辅助性T细胞2（Th2）平衡的改变或胸腺发育异常。
本研究旨在比较早产儿和足月儿的Th1/Th2细胞因子平衡及胸腺大小，并研究这些结果与出生后第二年AD可能诊断之间的关联。
研究对象包括28名早产儿和19名足月儿。在出生后第一周，评估血液中Th1/Th2/Th17细胞因子水平，并通过超声测量胸腺大小。在出生后第二年，对30名儿童进行检查以确定是否患有AD，并重复上述操作。
18名（16.7%）早产儿中有3名被诊断为AD，12名（8.3%）足月儿中有1名被诊断为AD（比值比=2.2；95%可信区间：0.201 - 24.086）。对于所有患者，与出生后相比，出生后第二年胸腺/体重指数较低，白细胞介素-2（IL-2）水平显著降低，IL-4和IL-17水平升高。早产儿/足月儿和AD/非AD亚组在出生后第二年的细胞因子水平或胸腺大小无差异。
观察到的关联可能表明，早产儿在出生后第二年的免疫状态可能与足月儿没有很大差异。
