Direct infant UV light exposure is associated with eczema and immune development

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:143

Article

Rueter, Kristina^1,2,3  Jones, Anderson P.⁴  Siafarikas, Aris^1,2,4  Lim, Ee-Mun^5,6  Bear, Natasha⁷  Noakes, Paul S.^1,4  Prescott, Susan L.^1,2,3,4  Palmer, Debra J.^1,4 

[1] Univ Western Australia, Sch Med, Crawley, Australia

[2] Princess Margaret Hosp, Subiaco, WA, Australia

[3] WUN, InVIVO Planetary Hlth Grp, West New York, NJ USA

[4] Univ Western Australia, Telethon Kids Inst, Subiaco, WA, Australia

[5] Sir Charles Gairdner Hosp, Dept Endocrinol & Diabet, Nedlands, WA, Australia

[6] Queen Elizabeth II Med Ctr, Dept Clin Biochem, PathWest Lab Med, Nedlands, WA, Australia

[7] Child Adolescent Hlth Serv, Dept Clin Res & Educ, Perth, WA, Australia

关键词: Allergy prevention;    eczema;    hereditary risk;    infant;    immune function;    randomized controlled trial;    UV light;    vitamin D supplementation;    wheeze;   

DOI  :  10.1016/j.jaci.2018.08.037

来源: Elsevier

【 摘 要 】

Background: Suboptimal vitamin D levels during critical periods of immune development have emerged as an explanation for higher rates of allergic diseases associated with industrialization and residing at higher latitudes. Objective: We sought to determine the effects of early postnatal vitamin D supplementation on infant eczema and immune development. Methods: By using a double- blind randomized controlled trial, newborn infants were randomized to receive vitamin D supplementation (400 IU/d) or a placebo until 6 months of age. Some infants also wore personal UV dosimeters to measure direct UV light (290-380 nm) exposure. Infant vitamin D levels were measured at 3 and 6 months of age. Eczema, wheeze, and immune function outcomes were assessed at 6 months of age. Results: At 3 (P<.01) and 6 (P = .02) months of age, vitamin D levels were greater for the vitamin D-supplemented group than the placebo group, but there was no difference in eczema incidence between groups. Infants with eczema were found to have had less UV light exposure (median, 555 Joules per square meter [J/m(2); interquartile range, 322-1210 J/m(2)]) compared with those without eczema (median, 998 J/m(2) [interquartile range, 676-1577 J/m(2)]; P = .02). UV light exposure was also inversely correlated with IL-2, GM-CSF, and eotaxin production to Toll-like receptor ligands. Conclusion: This study is the first to demonstrate an association between greater direct UV light exposures in early infancy with lower incidence of eczema and proinflammatory immune markers by 6 months of age. Our findings indicate that UV light exposure appears more beneficial than vitamin D supplementation as an allergy prevention strategy in early life.

【 授权许可】

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