title: Epicutaneous aeroallergen sensitization in atopic dermatitis infants - determining the role of epidermal barrier impairment.
abstract: BACKGROUND
  Sensitization to atopens is an early phenomenon that overlaps with the onset of atopic dermatitis (AD) in infancy. Early epidermal barrier impairment may facilitate the epicutaneous penetration of atopens.
  
  
  OBJECTIVE
  To correlate transepidermal water loss (TEWL) and aeroallergen sensitization in infants with AD.
  
  
  METHODS
  In this cross-sectional study we enrolled 59 AD children and 30 controls aged 3-12 months. Transepidermal water loss in uninvolved skin, specific immunoglobulin E, atopy patch test (APT) and skin prick tests were performed with respect to seven aeroallergens, i.e., Dermatophagoides pteronyssinus, D. farinae, cat, dog, birch pollen, ambrosia, and cockroach. Environmental conditions were assessed by a questionnaire, and the house dust mite (HDM) concentration was determined in dust samples.
  
  
  RESULTS
  Eighty-nine percent of AD infants had a positive APT vs one out of eleven controls. AD infants had a significantly higher mean TEWL than controls (27.4 vs 11.1 g/m(2)/h, P < 0001). Children with two or more positive APT had higher TEWL than the others (31.1 vs 19.0 g/m(2)/h, P < 0.025). No correlation was found between indoor APT results and exposure to HDM, cats, and dogs at home.
  
  
  CONCLUSIONS
  This study confirms the high prevalence of delayed sensitization to indoor and outdoor aeroallergens in AD infants, and shows that the higher the TEWL, the higher the prevalence of sensitization to aeroallergens. These data are in favor of a major role of a constitutive epidermal barrier impairment in determining early atopen sensitization in infants with AD.
authors.affiliation: Pediatric Dermatology Unit, Bordeaux Children's Hospital, CHU de Bordeaux, France.
authors.forename: F
authors.initials: F
authors.lastname: Boralevi
authors.forename: T
authors.initials: T
authors.lastname: Hubiche
authors.forename: C
authors.initials: C
authors.lastname: Léauté-Labrèze
authors.forename: E
authors.initials: E
authors.lastname: Saubusse
authors.forename: M
authors.initials: M
authors.lastname: Fayon
authors.forename: S
authors.initials: S
authors.lastname: Roul
authors.forename: S
authors.initials: S
authors.lastname: Maurice-Tison
authors.forename: A
authors.initials: A
authors.lastname: Taïeb
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects / Q000032:analysis / Q000276:immunology*; D000485:Allergens / Q000009:adverse effects / Q000032:analysis / Q000276:immunology*; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000032:analysis / Q000276:immunology; D002415:Cats; D003058:Cockroaches / Q000276:immunology; D003876:Dermatitis, Atopic / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000276:immunology; D004285:Dogs; D004391:Dust / Q000032:analysis / Q000276:immunology; D004817:Epidermis / Q000276:immunology / Q000503:physiopathology*; D005260:Female; D006798:Housing; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000276:immunology; D007223:Infant; D008297:Male; D010328:Patch Tests; D011058:Pollen / Q000276:immunology; D012882:Skin Tests; D014870:Water Loss, Insensible
chemical_list: D000393:Air Pollutants; D000485:Allergens; D039741:Antigens, Dermatophagoides; D004391:Dust