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Atopic dermatitis and prematurity - a prospective study with analysis of the cytokine profile and thymus growth: a
Aleksandra Kowalik1, Kazimierz Wêglarczyk2, Małgorzata Klimek1
1Department of Paediatrics, Institute of Paediatrics, Jagiellonian University Medical College, Krakow, Poland.
Insights
Preterm and term children show similar immune profiles and thymus sizes by age two. This suggests that early life differences in immune development may not significantly impact atopic dermatitis risk later on.
Area of Science:
- Immunology
- Pediatrics
- Dermatology
Background:
- Preterm infants exhibit lower rates of atopic dermatitis (AD) compared to full-term infants, a phenomenon not yet fully understood.
- Hypotheses suggest altered T-helper 1 (Th1)/T-helper 2 (Th2) immune balance or thymus development in preterm infants may play a role.
Purpose of the Study:
- To compare thymus size and Th1/Th2 cytokine balance between preterm and term children.
- To investigate the association between these immunological markers and the incidence of AD in the second year of life.
Main Methods:
- Blood cytokine levels (Th1/Th2/Th17) and thymus size via ultrasound were measured in 28 preterm and 19 term infants within the first week of life.
- These assessments were repeated in the second year of life for 30 children, alongside AD diagnosis.
Main Results:
- AD was diagnosed in 16.7% of preterm and 8.3% of term children.
- A decrease in IL-2 and increases in IL-4 and IL-17 were observed in all children by the second year compared to birth.
- No significant differences in cytokine levels or thymus size were found between preterm/term or AD/non-AD groups in the second year.
Conclusions:
- The immunological status of preterm children in their second year of life appears comparable to that of term children.
- Findings suggest that early immunological differences may not be the primary driver for the observed lower incidence of atopic dermatitis in preterm infants.
Introduction:
Preterm children suffer from atopic dermatitis (AD) less frequently than term children do. The reason for this phenomenon has not yet been identified. Hypotheses include changes in the T-helper 1 (Th1)/T-helper 2 (Th2) balance or altered development of the thymus.
Aim:
This study was designed to compare the Th1/Th2 cytokine balance and thymus size in preterm and term children and investigate the associations between these results and a possible diagnosis of AD in the second year of life.
Material And Methods:
The population comprised 28 preterm and 19 term children. During the first week of life, Th1/Th2/Th17 cytokine levels in the blood were assessed, and the thymus was measured via ultrasound. In the second year of life, 30 children were examined to determine whether AD was present, and the abovementioned procedures were repeated.
Results:
AD was diagnosed in 3 out of 18 (16.7%) preterm children and 1 out of 12 (8.3%) term children (OR = 2.2; 95% CI: 0.201-24.086). For all patients, the thymus/weight index was lower, and there was a significant decrease in the level of IL-2 and increases in the levels of IL-4 and IL-17 in the second year of life compared with those after birth. There were no differences in cytokine levels or thymus size in the second year of life between the preterm/term and AD/non-AD subgroups.
Conclusions:
The observed associations may indicate that the immunological status of preterm children in the second year of life may not vastly differ from that of term children.
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