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Published on: August 7, 2017
Skin Barrier Function and Infant Tidal Flow-Volume Loops-A Population-Based Observational Study
Martin Färdig1,2, Hrefna Katrín Gudmundsdóttir3,4, Angela Hoyer1
1Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden.
Insights
Reduced skin barrier function, indicated by high transepidermal water loss (TEWL), eczema, or Filaggrin (FLG) mutations, was not linked to lower infant lung function. However, high TEWL showed an inverse association with peak expiratory flow.
Area of Science:
- Neonatal Health
- Dermatology
- Pulmonology
Background:
- The connection between infant skin barrier integrity and lung function is not well understood.
- Early life skin conditions like eczema and genetic factors like Filaggrin (FLG) mutations may influence respiratory health.
- Investigating these links can inform early interventions for respiratory and skin conditions.
Purpose of the Study:
- To determine if reduced skin barrier function (high transepidermal water loss [TEWL], eczema, FLG mutations) is associated with diminished lung function in 3-month-old infants.
- To explore potential early indicators of respiratory health in relation to skin barrier status.
- To add to the understanding of inter-organ development and health in infancy.
Main Methods:
- Utilized data from the population-based PreventADALL cohort, including 899 infants with lung function measurements.
- Assessed skin barrier function via transepidermal water loss (TEWL) and presence of eczema at three months.
- Genotyped participants for common Filaggrin (FLG) mutations (R501X, 2282del4, R2447X) and analyzed tidal flow-volume loops for lung function parameters (tPTEF/tE, tPTEF).
Main Results:
- Neither high TEWL, eczema, nor FLG mutations were significantly associated with a lower ratio of time to peak tidal expiratory flow to expiratory time (tPTEF/tE).
- A high TEWL was inversely associated with a lower time to peak tidal expiratory flow (tPTEF) (adjusted OR [95% CI] 1.61 [1.08, 2.42]).
- Eczema and FLG mutations did not show a significant association with reduced lung function parameters.
Conclusions:
- In healthy 3-month-old infants, high TEWL, eczema, and FLG mutations are generally not associated with lower lung function.
- An observed inverse association between high TEWL and tPTEF suggests a potential link between skin barrier health and lung function in early infancy.
- Further research is warranted to elucidate the mechanisms underlying the skin-lung axis in neonates.
Abstract:
Background: The relationship between the skin barrier- and lung function in infancy is largely unexplored. We aimed to explore if reduced skin barrier function by high transepidermal water loss (TEWL), or manifestations of eczema or Filaggrin (FLG) mutations, were associated with lower lung function in three-month-old infants. Methods: From the population-based PreventADALL cohort, 899 infants with lung function measurements and information on either TEWL, eczema at three months of age and/or FLG mutations were included. Lower lung function by tidal flow-volume loops was defined as a ratio of time to peak tidal expiratory flow to expiratory time (tPTEF/tE) <0.25 and a tPTEF <0.17 s (<25th percentile). A high TEWL >8.83 g/m2/h (>75th percentile) denoted reduced skin barrier function, and DNA was genotyped for FLG mutations (R501X, 2282del4 and R2447X). Results: Neither a high TEWL, nor eczema or FLG mutations, were associated with a lower tPTEF/tE. While a high TEWL was associated with a lower tPTEF; adjusted OR (95% CI) 1.61 (1.08, 2.42), the presence of eczema or FLG mutations were not. Conclusions: Overall, a high TEWL, eczema or FLG mutations were not associated with lower lung function in healthy three-month-old infants. However, an inverse association between high TEWL and tPTEF was observed, indicating a possible link between the skin barrier- and lung function in early infancy.
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