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Do boys do the atopic march while girls dawdle?
Adrian J Lowe1, John B Carlin, Catherine M Bennett
1Center for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Melbourne, Australia. lowe.adrian@gmail.com
The Journal of Allergy and Clinical Immunology
|March 4, 2008
Summary
Infantile eczema increases asthma risk in boys but not girls, independent of early wheezing or sensitization. Preventing childhood eczema in boys could significantly reduce asthma incidence.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology of Allergic Diseases
- Atopic March Research
Background:
- The atopic march hypothesis posits a link between infant eczema and childhood asthma.
- Alternative views suggest sensitization or early wheezing are necessary for this association.
Purpose of the Study:
- To investigate infantile eczema as a predictor of childhood asthma.
- To analyze the independent and modifying effects of early wheeze, sensitization, and sex on this relationship.
Main Methods:
- Prospective cohort study of 620 infants with a family history of allergy.
- Eczema and wheeze documented to age 2; sensitization assessed via skin prick tests.
- Asthma ascertained through interviews at ages 6 and 7.
Main Results:
- Eczema in the first 2 years was linked to higher childhood asthma risk in boys (aOR 2.45).
- No significant association was found in girls (OR 0.88), with a significant sex interaction (P=.031).
- These findings held after adjusting for early sensitization and wheeze.
Conclusions:
- Infantile eczema is a significant risk factor for childhood asthma specifically in boys.
- No association between infantile eczema and childhood asthma was observed in girls.
- Potential for eczema prevention in boys to reduce childhood asthma rates was suggested.
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