Dataset Information

Longitudinal atopic dermatitis endotypes: An atopic march paradigm that includes Black children.

ABSTRACT:

Background

The atopic march has been studied mostly in White populations, biasing our current paradigms.

Objective

We sought to define the atopic march in Black and White children and explore mechanisms for racial differences.

Methods

Utilizing the Mechanisms of Progression of Atopic Dermatitis to Asthma in Children (MPAACH) cohort (n = 601), we assessed longitudinal sensitization, food allergy (FA), allergic rhinitis, risk of asthma development (through the Pediatric Asthma Risk Score), Scoring for Atopic Dermatitis (SCORAD), transepidermal water loss, skin filaggrin (FLG) expression, exposures, and genetic heritability to define AD progression endotypes in Black and White children.

Results

White MPAACH children were more likely to be sensitized to aero and food allergens (P = .0001) and over 3 times more likely to develop FA and/or allergic rhinitis (AR) without asthma risk (P < .0001). In contrast, Black children were over 6 times more likely to proceed to high asthma risk without FA, sensitization, or AR (P < .0001). White children had higher lesional and nonlesional transepidermal water loss (both P < .001) as well as decreased nonlesional keratinocyte FLG expression (P = .02). Black children had increased genetic heritability for asthma risk and higher rates of exposures to secondhand smoke and traffic-related air pollution.

Conclusions

Black and White children with AD have distinct allergic trajectories defined by different longitudinal endotypes. Black children exhibit higher asthma risk despite a more intact skin barrier and less sensitization, FA, and AR. White children have less asthma risk, despite a more dysfunctional skin barrier, and more FA, AR, and sensitization. The observed racial differences are likely due in part to increased genetic heritability for asthma risk and harmful environmental exposures in Black children. Collectively, our findings provide a new paradigm for an atopic march that is inclusive of Black children.

SUBMITTER: Biagini JM

PROVIDER: S-EPMC9275099 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Longitudinal atopic dermatitis endotypes: An atopic march paradigm that includes Black children.

Biagini Jocelyn M JM Kroner John W JW Baatyrbek Kyzy Asel A Gonzales Alexandra A He Hua H Stevens Mariana M Grashel Brittany B Spagna Daniel D Paul Samuel S Patel Rahul R Bucci Angelo A Sherenian Michael G MG Murrison Liza Bronner LB Martin Lisa J LJ Khurana Hershey Gurjit K GK

The Journal of allergy and clinical immunology 20211018 5

<h4>Background</h4>The atopic march has been studied mostly in White populations, biasing our current paradigms.<h4>Objective</h4>We sought to define the atopic march in Black and White children and explore mechanisms for racial differences.<h4>Methods</h4>Utilizing the Mechanisms of Progression of Atopic Dermatitis to Asthma in Children (MPAACH) cohort (n = 601), we assessed longitudinal sensitization, food allergy (FA), allergic rhinitis, risk of asthma development (through the Pediatric Asthm ...[more]

PMID: 34673050

Similar Datasets

Project description:PurposeEvidence supporting a link between indoor formaldehyde exposure and atopic dermatitis (AD) in humans is limited. The purpose of this longitudinal study was to investigate whether AD symptoms in children could be affected by indoor formaldehyde levels in ordinary households.MethodsFifty-five children with moderate-to-severe AD aged under 18 years were enrolled as a panel. They were followed up from February 2019 through February 2020. Indoor formaldehyde levels of patients' houses and their AD symptoms were repeatedly measured on a daily basis. The generalized linear mixed model was utilized for statistical analysis. Subdivision analysis was performed by stratifying patients by sex, body mass index, presence of parental allergy, and indoor environments including mold/dampness, temperature, and relative humidity (RH).ResultsA total of 4,789 person-days of AD symptom data were collected. The average concentration of formaldehyde was 13.6 ± 16.4 ppb, with the highest value found in spring (18.1 ± 20.6 ppb). Higher levels of formaldehyde were observed when there was parental smoking, increased indoor temperature over 25.5°C, or RH over 60% (P < 0.0001). When the effect size was compared between each season after controlling for ambient particulate matter, temperature, and RH, an increase in 10 ppb of formaldehyde increased AD symptoms by 79.2% (95% confidence interval [CI], 19.6-168.4) in spring and by 39.9% (95% CI, 14.3-71.2) in summer. AD symptoms in children aged 6-18 years appeared to increase significantly, whereas there was no significant increase in children under 6 years. When indoor temperature was over 25.5°C, an increase in formaldehyde by 10 ppb increased AD symptoms by 17.8% (95% CI, 3.9-33.6).ConclusionsIndoor formaldehyde can exacerbate AD symptom in children with moderate-to-severe AD, particularly in spring and summer, even at allowable levels. Thus, minimizing exposure to indoor formaldehyde may be needed for the proper management of AD in children.

Dataset Information

Longitudinal atopic dermatitis endotypes: An atopic march paradigm that includes Black children.

Background

Objective

Methods

Results

Conclusions

Publications

Longitudinal atopic dermatitis endotypes: An atopic march paradigm that includes Black children.

Similar Datasets

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