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J Pediatr (Rio J). 2018 Sep 20. pii: S0021-7557(18)30373-5. doi: 10.1016/j.jped.2018.07.012. [Epub ahead of print]

Prenatal mold exposure is associated with development of atopic dermatitis in infants through allergic inflammation.

Author information

1
Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea.
2
Department of Environmental Engineering, Pusan National University, Busan, Republic of Korea.
3
University of Ulsan College of Medicine, Asan Institute for Life Sciences, Seoul, Republic of Korea.
4
Department of Pediatrics, Childhood Asthma and Atopy Center, University of Ulsan College of Medicine, Asan Medical Center, Environmental Health Center, Seoul, Republic of Korea.
5
Department of Pediatrics, Mediplex Sejong Hospital, Incheon, Republic of Korea.
6
Department of Pediatrics, Catholic Kwandong University, International St. Mary's Hospital, Incheon, Republic of Korea.
7
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.
8
Department of Pediatrics, CHA University School of Medicine, CHA Medical Center, Seoul, Republic of Korea.
9
Department of Pediatrics, Yonsei University, College of Medicine, Severance Children's Hospital, Seoul, Republic of Korea.
10
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
11
Department of Pediatrics, Childhood Asthma and Atopy Center, University of Ulsan College of Medicine, Asan Medical Center, Environmental Health Center, Seoul, Republic of Korea. Electronic address: sjhong@amc.seoul.kr.

Abstract

OBJECTIVE:

Mold exposure in early life may be associated with development of atopic dermatitis; however, studies of this link are inconclusive and evidence for the underlying mechanism(s) is lacking. This study identified the association between the time of mold exposure and development of atopic dermatitis and investigated the underlying mechanisms.

METHOD:

The association between atopic dermatitis and mold exposure was examined in the Cohort for Childhood Origin of Asthma and Allergic Diseases birth cohort study (n=1446). Atopic dermatitis was diagnosed at 1 year of age by pediatric allergists. Exposure to mold was assessed by questionnaire. The Illumina MiSeq platform was used to examine the environmental mycobiome in 20 randomly selected healthy infants and 20 infants with atopic dermatitis at 36 weeks of gestation.

RESULTS:

Prenatal, but not postnatal, mold exposure was significantly associated with atopic dermatitis (adjusted odds ratio, 1.36; 95% confidence interval, 1.01-1.83). Levels of total serum IgE at 1 year of age were higher in infants with atopic dermatitis exposed to mold during pregnancy than in healthy infants not exposed to mold during pregnancy (p=0.021). The relative abundance of uncultured Ascomycota was higher in infants with atopic dermatitis than in healthy infants. The relative abundance of uncultured Ascomycota correlated with total serum IgE levels at 1 year of age (r=0.613, p<0.001).

CONCLUSION:

Indoor mold exposure during the fetal period is associated with development of atopic dermatitis via IgE-mediated allergic inflammation. Avoidance of mold exposure during this critical period might prevent the development of atopic dermatitis.

KEYWORDS:

Allergic inflammation; Ambiente; Atopic dermatitis; Dermatite atópica; Environment; Microbioma; Mofo; Mold; Mycobiome; Prenatal; Pré-natal; Reação alérgica

PMID:
30243937
DOI:
10.1016/j.jped.2018.07.012
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