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dc.contributor.authorIRVINE, ALANen
dc.date.accessioned2015-11-05T15:26:24Z
dc.date.available2015-11-05T15:26:24Z
dc.date.issued2015en
dc.date.submitted2015en
dc.identifier.citationKelleher M, Dunn-Galvin A, Hourihane JO, Murray D, Campbell LE, McLean WH, Irvine AD, Skin barrier dysfunction measured by transepidermal water loss at 2 days and 2 months predates and predicts atopic dermatitis at 1 year., The Journal of allergy and clinical immunology, 135, 4, 2015, 930-5.e1en
dc.identifier.issn0091-6749en
dc.identifier.otherYen
dc.identifier.urihttp://hdl.handle.net/2262/74851
dc.descriptionPUBLISHEDen
dc.description.abstractLoss-of-function mutations in the skin barrier protein filaggrin (FLG) are a major risk for atopic dermatitis (AD). The pathogenic sequence of disturbances in skin barrier function before or during the early development of AD is not fully understood. A more detailed understanding of these events is needed to develop a clearer picture of disease pathogenesis. A robust, noninvasive test to identify babies at high risk of AD would be important in planning early intervention and/or prevention studies. OBJECTIVES: To ascertain whether a noninvasive measurement of skin barrier function at day 2 after birth and at 2 months predicts the development of AD at 1 year. Furthermore, to determine whether increases in transepidermal water loss (TEWL) predate the development of clinical AD. METHODS: A total of 1903 infants were enrolled in the Cork Babies After Scope: Evaluating the Longitudinal Impact Using Neurological and Nutritional Endpoints Birth Cohort study from July 2009 to October 2011. Measurements of TEWL were made at birth (day 2) and at 2 and 6 months. The presence of AD was ascertained at 6 and 12 months, and disease severity was assessed by using the SCORing Atopic Dermatitis clinical tool at 6 months and by using both the SCORing Atopic Dermatitis clinical tool and Nottingham Severity Score at 12 months. A total of 1300 infants were genotyped for FLG mutations. RESULTS: At 6 months, 18.7% of the children had AD, and at 12 months, 15.53%. In a logistic regression model, day 2 upper quartile TEWL measurement was significantly predictive of AD at 12 months (area under the receiver operating characteristic curve, 0.81; P < .05). Lowest quartile day 2 TEWL was protective against AD at 12 months. An upper quartile 2 month TEWL was also strongly predictive of AD at 12 months (area under the receiver operating characteristic curve, 0.84; P < .05). At both ages, this effect was independent of parental atopy, FLG status, or report of an itchy flexural rash at 2 months. Associations were increased when parental atopy status or child FLG mutation status was added into the linear regression model. CONCLUSIONS: Impairment of skin barrier function at birth and at 2 months precedes clinical AD. In addition to providing important mechanistic insights into disease pathogenesis, these findings have implications for the optimal timing of interventions for the prevention of ADen
dc.format.extent930-5.e1en
dc.relation.ispartofseriesThe Journal of allergy and clinical immunologyen
dc.relation.ispartofseries135en
dc.relation.ispartofseries4en
dc.rightsYen
dc.subjectInfanten
dc.subjectskin barrieren
dc.subjectTEWLen
dc.subjectatopic dermatitisen
dc.subjectfilaggrinen
dc.subjectpredictoren
dc.subjectbiomarkeren
dc.titleSkin barrier dysfunction measured by transepidermal water loss at 2 days and 2 months predates and predicts atopic dermatitis at 1 year.en
dc.typeJournal Articleen
dc.type.supercollectionscholarly_publicationsen
dc.type.supercollectionrefereed_publicationsen
dc.identifier.peoplefinderurlhttp://people.tcd.ie/irvineaen
dc.identifier.rssinternalid107262en
dc.identifier.doihttp://dx.doi.org/10.1016/j.jaci.2014.12.013en
dc.rights.ecaccessrightsopenAccess
dc.identifier.orcid_id0000-0002-9048-2044en


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