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Total IgE at 6 months predicts remittance or persistence of atopic dermatitis at 14 months
Norio Kawamoto1, Toshiyuki Fukao, Hideo Kaneko
1Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.
Insights
Total IgE at 6 months is a key predictor for persistent infantile atopic dermatitis (AD). Higher levels indicate a higher likelihood of AD continuing past 14 months of age.
Area of Science:
- Immunology
- Pediatrics
- Dermatology
Background:
- Infantile atopic dermatitis (AD) outcomes vary, with some infants achieving remission while others experience persistent disease.
- Predictive markers for infantile AD prognosis remain unclear, necessitating further research.
Purpose of the Study:
- To identify predictive markers for the outcome of infantile atopic dermatitis (AD).
- To differentiate between transient and persistent AD in infants using laboratory data.
Main Methods:
- A birth cohort study followed 314 infants from birth to 14 months.
- Cord blood was collected, and physical examinations and blood tests were performed at 6 and 14 months for a subset of participants (n=144).
- Laboratory data, including lymphocyte percentages and IgE levels, were compared between infants with transient AD (n=16) and persistent AD (n=18) at 6 months.
Main Results:
- Infants with persistent AD showed significantly higher percentages of CD8+ T cells in cord blood and higher total IgE levels at 6 months compared to the transient group.
- Receiver operating characteristic (ROC) analysis indicated predictive value for these markers (AUCs 0.792 and 0.722).
- Persistent AD was associated with elevated total IgE, T-helper (Th) 2 cell percentages, and IL-4 production at 14 months, confirming Th2 polarization.
Conclusions:
- Total IgE levels at 6 months of age are a valuable and practical predictive marker for the long-term outcome of infantile atopic dermatitis.
- Th2 immune response polarization is evident in infants with persistent AD.
- Early identification of infants at risk for persistent AD can potentially guide timely interventions.
Abstract:
Some patients with infantile atopic dermatitis (AD) achieve remission around 1 year old, but in others it persists. The difference between them is unclear. We performed a birth cohort study to find the markers predicting the outcome of infantile AD. We followed up a cohort (n = 314) from birth to 14 months of age, and cord blood was taken from the participants. Some of them (n = 144) had a physical examination and a blood test at 6 and 14 months of age. The subjects who had AD at 6 months (n = 34) were divided into two groups, named the transient group (those who had no AD at 14 months of age; n = 16) and the persistent group (those who still had AD at 14 months of age; n = 18). Then, laboratory data were compared between these two groups. Percentage of CD8 in cord blood lymphocytes and total IgE at 6 months of age in the persistent group was significantly higher than those of the transient group. The area under the curves of a receiver operating characteristic analysis were 0.792 (p = 0.007) and 0.722 (p = 0.027). In the persistent group, total IgE, percentages of T-helper (Th) 2 and phytohemagglutinin-induced IL-4 production from peripheral blood mononuclear cells at 14 months of age were also significantly higher than those of the transient group. Thus Th2 polarization in the persistent group was confirmed. In clinical use, total IgE at 6 months of age is the most useful predictive marker to know the outcome of infantile AD. The clinical trial registration ID is UMIN000002926.
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