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Increasing Severity of Early-Onset Atopic Dermatitis, But Not Late-Onset, Associates with Development of Aeroallergen Sensitization and Allergic Rhinitis in Childhood
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  • Ann-Marie Malby Schoos,
  • Bo Chawes,
  • Klaus Bønnelykke,
  • Jakob Stokholm,
  • Morten Rasmussen,
  • Hans Bisgaard
Ann-Marie Malby Schoos
Copenhagen Prospective Studies on Asthma in Childhood
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Bo Chawes
Copenhagen Prospective Studies on Asthma in Childhood
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Klaus Bønnelykke
Copenhagen Prospective Studies on Asthma in Childhood
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Jakob Stokholm
Copenhagen Prospective Studies on Asthma in Childhood
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Morten Rasmussen
Copenhagen Prospective Studies on Asthma in Childhood
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Hans Bisgaard
Copenhagen Prospective Studies on Asthma in Childhood
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Abstract

Background: Early exposure to allergens through a defect skin barrier has been proposed as a mechanism for inducing sensitization and development of allergic diseases. We hypothesized that early-onset, severe atopic dermatitis (AD) is associated with development of aeroallergen sensitization and allergic rhinitis. Methods: We included 368 children from the Copenhagen Prospective Studies on Asthma in Childhood 2000 (COPSAC 2000) at-risk mother-child cohort. AD was diagnosed prospectively based on Hanifin&Rajka’s criteria and severity assessed using the Scoring Atopic Dermatitis (SCORAD) index. Early-onset AD was defined as debut ≤1 year, late-onset as debut from 1-6 years. Aeroallergen sensitization and allergic rhinitis were diagnosed at ages 6-7 and 12 years. Associations between early-onset and late-onset AD and allergy endpoints were calculated using general estimating equations (GEE) models to compute the overall odds ratios (OR) for both time points. Results: Early-onset AD (yes/no) and severity (SCORAD) were associated with development of aeroallergen sensitization during childhood; GEE OR=1.68 [1.08; 2.62], p=0.02 and 1.08 [1.03; 1.12], p<0.001, whereas late-onset was not; GEE OR=1.65 [0.92; 2.94], p=0.08 and 1.01 [0.97; 1.06], p=0.55. The same trend was seen for allergic rhinitis with significant association between early-onset AD and allergic rhinitis; GEE OR=1.56 [1.01; 2.41], p=0.04 and severity; GEE OR=1.09 [1.05; 1.13], p<0.001, whereas late-onset AD showed no association. The effects on sensitization and rhinitis of early-onset vs. late-onset AD severity were significantly different: p-interaction sensitization=0.03 and p-interaction rhinitis<0.01. Conclusion: Increasing severity of early-onset AD, but not late-onset AD, associates with aeroallergen sensitization and allergic rhinitis later in childhood.

Peer review status:ACCEPTED

08 Jul 2021Submitted to Allergy
08 Jul 2021Submission Checks Completed
08 Jul 2021Assigned to Editor
08 Jul 2021Reviewer(s) Assigned
20 Jul 2021Review(s) Completed, Editorial Evaluation Pending
21 Jul 2021Editorial Decision: Revise Minor
12 Aug 20211st Revision Received
13 Aug 2021Submission Checks Completed
13 Aug 2021Assigned to Editor
14 Aug 2021Reviewer(s) Assigned
16 Aug 2021Review(s) Completed, Editorial Evaluation Pending
19 Aug 2021Editorial Decision: Accept