Application of moisturizer to neonates prevents development of atopic dermatitis

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:134

Article

Horimukai, Kenta¹  Morita, Kumiko¹  Narita, Masami¹  Kondo, Mai¹  Kitazawa, Hiroshi¹  Nozaki, Makoto²  Shigematsu, Yukiko²  Yoshida, Kazue²  Niizeki, Hironori²  Motomura, Ken-ichiro³  Sago, Haruhiko³  Takimoto, Tetsuya⁴  Inoue, Eisuke⁴  Kamemura, Norio⁵  Kido, Hiroshi⁵  Hisatsune, Junzo⁶  Sugai, Motoyuki⁶  Murota, Hiroyuki⁷  Katayama, Ichiro⁷  Sasaki, Takashi⁸  Amagai, Masayuki⁸  Morita, Hideaki⁹  Matsuda, Akio⁹  Matsumoto, Kenji⁹  Saito, Hirohisa⁹  Ohya, Yukihiro¹ 

[1] Natl Ctr Child Hlth & Dev, Dept Med Subspecialties, Div Allergy, Tokyo, Japan

[2] Natl Ctr Child Hlth & Dev, Dept Surg Subspecialties, Div Dermatol, Tokyo, Japan

[3] Natl Ctr Child Hlth & Dev, Ctr Maternal Fetal Neonatal & Reprod Med, Tokyo, Japan

[4] Natl Ctr Child Hlth & Dev, Clin Res Ctr, Tokyo, Japan

[5] Univ Tokushima, Inst Enzyme Res, Div Enzyme Chem, Tokushima, Japan

[6] Hiroshima Univ, Grad Sch Biomed & Hlth Sci, Dept Bacteriol, Hiroshima 730, Japan

[7] Osaka Univ, Grad Sch Med, Course Integrated Med, Dept Dermatol, Suita, Osaka 565, Japan

[8] Keio Univ, Sch Med, Dept Dermatol, Tokyo, Japan

[9] Natl Res Inst Child Hlth & Dev, Dept Allergy & Immunol, Tokyo, Japan

关键词: Atopic dermatitis;    atopy;    allergic sensitization;    food allergy;    IgE;    randomized controlled trial;   

DOI  :  10.1016/j.jaci.2014.07.060

来源: Elsevier

【 摘 要 】

Background: Recent studies have suggested that epidermal barrier dysfunction contributes to the development of atopic dermatitis (AD) and other allergic diseases. Objective: We performed a prospective, randomized controlled trial to investigate whether protecting the skin barrier with a moisturizer during the neonatal period prevents development of AD and allergic sensitization. Methods: An emulsion-type moisturizer was applied daily during the first 32 weeks of life to 59 of 118 neonates at high risk for AD (based on having a parent or sibling with AD) who were enrolled in this study. The onset of AD(eczematous symptoms lasting >4 weeks) and eczema (lasting >2 weeks) was assessed by a dermatology specialist on the basis of the modified Hanifin and Rajka criteria. The primary outcome was the cumulative incidence of AD plus eczema (AD/eczema) at week 32 of life. A secondary outcome, allergic sensitization, was evaluated based on serum levels of allergen-specific IgE determined by using a high-sensitivity allergen microarray of diamond-like carbon-coated chips. Results: Approximately 32% fewer neonates who received the moisturizer had AD/eczema by week 32 than control subjects (P = .012, log-rank test). We did not show a statistically significant effect of emollient on allergic sensitization based on the level of IgE antibody against egg white at 0.34 kU(A)/L CAP-FEIA equivalents. However, the sensitization rate was significantly higher in infants who had AD/eczema than in those who did not (odds ratio, 2.86; 95% CI, 1.22-6.73). Conclusion: Daily application of moisturizer during the first 32 weeks of life reduces the risk of AD/eczema in infants. Allergic sensitization during this time period is associated with the presence of eczematous skin but not with moisturizer use.

【 授权许可】

Free