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Eczema in early childhood increases the risk of allergic multimorbidity
L A Miltner1, J M Vonk2,3, J L van der Velde3,4
1Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Insights
Early-onset persistent eczema significantly increases the risk of developing food allergy, asthma, and hay fever in children. Identifying infants at risk is crucial for preventing allergic multimorbidity.
Area of Science:
- Pediatric Allergy and Immunology
- Dermatology
- Epidemiology
Background:
- Early childhood eczema is linked to later allergic diseases like food allergy (FA), asthma, and hay fever.
- Eczema presentation varies, influencing allergic outcomes.
- Eczema sub-phenotypes may predict allergic multimorbidity.
Purpose of the Study:
- To associate eczema phenotypes with FA, asthma, and hay fever in children/adolescents.
- To describe disease trajectories stratified by FA presence.
Main Methods:
- Utilized the TRACKER cohort study (n=6852).
- Investigated seven eczema phenotypes based on onset and persistence.
- Employed logistic regression and calculated disease prevalence at different ages.
Main Results:
- Persistent eczema throughout childhood elevated risks for FA, hay fever, and asthma.
- "Very early onset-persistent" eczema showed the strongest associations.
- FA presence correlated with significantly higher prevalence of eczema, asthma, and hay fever across all ages.
Conclusions:
- This large cohort study confirms that early-onset, persistent eczema heightens the risk of allergic multimorbidity.
- Early identification of infants susceptible to very early-onset eczema is vital for prevention strategies.
Background:
Eczema in early childhood is associated with the development of subsequent allergic diseases, including food allergy (FA), asthma and hay fever. However, eczema has a heterogenous presentation regarding onset age and persistence, which may lead to different allergic outcomes during childhood/adolescence. Recently, sub-phenotypes of eczema have been suggested as predictors of allergic multimorbidity. Thus, we aimed to identify associations of eczema phenotypes with FA, asthma and hay fever during childhood/adolescence. Additionally, we described the trajectories of eczema, asthma and hay fever stratified by FA presence.
Methods:
TRACKER (Trajectories of Allergy in Children in Real Life Databases) is a population-based cohort study of 6852 children/adolescents from the Lifelines cohort. We investigated the associations of seven eczema phenotypes, based on onset age and persistence, with FA, asthma and hay fever using logistic regression, adjusted for appropriate covariates. Disease trajectories were determined by calculating prevalence at different ages.
Results:
Participants who suffered from eczema throughout childhood showed higher risks of developing FA, hay fever and asthma. "Very early onset-persistent" eczema showed the strongest associations with FA, asthma and hay fever. The prevalence of eczema, asthma and hay fever at all ages was significantly higher in participants with FA, compared to those without.
Conclusion:
One of the largest cohort studies on this topic to date shows that (very) early onset and persistent eczema increases the risk of allergic multimorbidity. Identification of infants at risk for developing (very) early onset eczema is of utmost importance to prevent allergic multimorbidity.
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