Atopic dermatitis phenotype with early onset and high serum IL-13 is linked to the new development of bronchial hyperresponsiveness in school children

作者：Lee E; Lee S H; Kwon J W; Kim Y H; Cho H J; Yang S I; Jung Y H; Kim H Y; Seo J H; Kim B J; Kim H B; Lee S Y; Kwon H J; Hong S J^*

来源：Allergy, 2016, 71(5): 692-700.

DOI：10.1111/all.12844

• allergic march
• atopic dermatitis
• bronchial
• hyperresponsiveness
• IL-13
• phenotype

Background: Atopic dermatitis (AD) is characterized by a heterogeneous clinical spectrum, and some forms of AD are associated with the initial steps of allergic march. The aims of this study were to determine AD phenotypes in school-age children and investigate their associations with the allergic march in each cluster.
Methods: We included 242 children (6-8 years) with current AD from the Children's HEalth and Environmental Research study, a 4-year prospective follow-up study with 2-year survey intervals. Latent class analysis was used. Serum IL-13 and thymic stromal lymphopoietin (TSLP) levels at the time of enrollment were measured using ELISA.
Results: We identified four current AD phenotypes in children, characterized as early onset with low atopy' (26.4% of the sample; group 1), early onset with high atopy and high eosinophil percentages' (48.3%; group 2), late onset with low atopy' (9.9%; group 3), and late onset with high atopy and normal eosinophils' (15.3%; group 4). Although groups 2 and 4 demonstrated high atopic burden, children in group 2 showed the persistence of AD and eosinophilia associated with a high prevalence of new cases of bronchial hyper-responsiveness and asthma symptoms during follow-up. The serum IL-13 level was significantly increased in the early-onset AD groups, but there was no significant difference in the serum TSLP levels across all four groups.
Conclusion: An allergic march-associated AD phenotype exists that is characterized by early onset of AD with its persistence, increased serum IL-13 levels, high atopy, and a persistently increased blood eosinophil percentage.

• 出版日期2016-5