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Br J Dermatol. 2019 May 3. doi: 10.1111/bjd.18087. [Epub ahead of print]

Direct infant UV light exposure is associated with eczema and immune development: A Critical Appraisal.

Author information

1
UK Dermatology Clinical Trials Network, University of Nottingham, Kings Meadow Campus, Lenton Lane, Nottingham, NG7 2NR.

Abstract

AIM:

Reuter et al. aimed to "determine the effects of early postnatal vitamin D supplementation on infant eczema and immune development".

SETTING AND DESIGN:

A double-blind randomised placebo-controlled trial with an additional non-randomised exploratory analysis on the effects of ultraviolet (UV) exposure led from a hospital setting.

STUDY EXPOSURE:

Vitamin D (400 iU/d) drops or placebo drops (coconut and palm kernel oil) allocated randomly to 195 infants born to families with a first-degree relative with atopic disease. 86 of these infants were allocated personal UV dosimeters in a non-randomised fashion to measure UV light (290-380 nm) exposure until 3 months of age.

OUTCOMES:

Eczema and wheeze were assessed at 3 and 6 months and 25 immune function markers were assessed at 6 months of age.

REGISTERED PRIMARY OUTCOMES:

Infant vitamin D levels and immune functions measured at 6 months of age.

RESULTS:

Although vitamin D levels were significantly greater for the intervention group than the placebo group at 3 and 6 months of age, there was no difference in eczema between groups at either time point (10.0% vs. 6.7% at 3 months and 21.8 vs. 19.3% at 6 months for the Vitamin D and placebo groups respectively). In the subset of infants given a dosimeter, those with eczema had less UV light exposure (median, 555 J/m2) compared with infants who did not develop eczema (median, 998 J/m2). Across the 25 immune functions, UV light exposure was inversely correlated with IL-2, GM-CSF, and eotaxin production to Toll-like receptor ligands.

CONCLUSIONS:

Vitamin D supplementation in high-risk infants increased Vitamin D levels but did not reduce eczema. Exploratory post-hoc analyses in a non-randomised subset showed an association between greater direct UV light exposure and reduction of eczema. The authors claim that "our findings indicate that UV light exposure appears more beneficial than vitamin D supplementation as an allergy prevention strategy in early life". This article is protected by copyright. All rights reserved.

PMID:
31054159
DOI:
10.1111/bjd.18087

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