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Beyond the Skin: Reduced Lung Function Associated With Atopic Dermatitis in Infants
Zeynep Gulec Koksal1, Pinar Uysal1
1Department of Pediatric Allergy and Immunology, Aydin Adnan Menderes University Faculty of Medicine, Aydin, Turkey.
Insights
Tidal breath analysis (TBA) reveals reduced lung function in infants with atopic dermatitis (AD), indicating early airway obstruction. This method shows promise for objective clinical assessment in children with AD.
Area of Science:
- Pediatric Pulmonology
- Dermatology
- Allergy Immunology
Background:
- Atopic dermatitis (AD) is linked to a higher risk of developing asthma.
- Lung function assessment in infants with AD is underexplored.
- Tidal breath analysis (TBA) offers a potential method for evaluating lung function in this population.
Purpose of the Study:
- To measure lung function using TBA in infants with AD and healthy controls (HCs).
- To investigate the impact of AD severity, food sensitivity, and recurrent wheezing on TBA parameters.
- To assess TBA's utility in detecting airway obstruction in infants with AD.
Main Methods:
- A prospective cross-sectional study involving 230 infants (150 with AD, 80 HCs).
- Lung function assessed via TBA.
- Disease severity evaluated using SCORing Atopic Dermatitis; food sensitivity determined by IgE or skin prick tests.
Main Results:
- Infants with AD exhibited significantly lower TBA parameters compared to HCs (P < .05).
- Key parameters like expiratory flow and respiratory rate were reduced in the AD group.
- The ratio of time to peak expiratory flow to expiratory time effectively differentiated AD with high sensitivity and specificity (AUC=0.826).
Conclusions:
- TBA is a valuable tool for identifying expiratory airway obstruction in infants with AD.
- Objective lung function data can be obtained using TBA for clinical use.
- Bronchial obstruction in infants with AD is present regardless of disease severity or associated factors.
Background:
Very few studies have examined lung function parameters using tidal breath analysis (TBA) in atopic dermatitis (AD) with its high potential for progression to asthma.
Objective:
To measure lung functions using TBA in infants with AD and in healthy controls (HCs), and to investigate the effects of disease severity, food sensitivity, and history of recurrent wheezing on TBA parameters in infants with AD.
Methods:
Two hundred thirty infants were included in this prospective cross-sectional study, including an AD group (n = 150) and an HC group (n = 80). Food sensitivity was assessed by means of food-specific IgE or the skin prick test. The severity of the disease was evaluated using the SCORing Atopic Dermatitis. Lung function was assessed using TBA.
Results:
The following TBA parameters were significantly lower in the AD group than in the HC group (P < .05): time to peak tidal expiratory flow, exhaled volume to peak tidal expiratory flow, ratio of time to peak tidal expiratory flow to expiratory time, ratio of exhaled volume to peak tidal expiratory flow to total expiratory volume, expiratory flow when 25% of tidal volume remains in the lungs, respiratory rate, and minute ventilation. No difference was observed in the AD group when TBA parameters were compared according to disease severity, food sensitivity, and history of recurrent wheezing (P > .05). The receiver-operating characteristic curve demonstrated by the ratio of time to peak tidal expiratory flow to expiratory time yielded an area under the curve of 0.826 (CI, 0.772-0.879), with a cutoff value of 31.65 or higher in differentiating AD, with a sensitivity of 78.7% and a specificity of 77.5%.
Conclusions:
TBA curves can be a useful tool for demonstrating expiratory airway obstruction in AD and for providing objective information for the clinician. Bronchial obstruction was detected in young children with AD irrespective of the severity of the disease, food sensitivity, and history of recurrent wheezing.
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