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Clinical onset of atopic eczema: Results from two nationally representative British birth cohorts followed through mid-life

Abuabara, K; Ye, M; McCulloch, CE; Sullivan, A; Margolis, DJ; Strachan, DP; Paternoster, L; Yew, YW; Williams, HC; Langan, SM (2019) Clinical onset of atopic eczema: Results from two nationally representative British birth cohorts followed through mid-life. Journal of Allergy and Clinical Immunology, 144 (3). pp. 710-719. ISSN 0091-6749 https://doi.org/10.1016/j.jaci.2019.05.040
SGUL Authors: Strachan, David Peter

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Abstract

Background Atopic eczema onset is described primarily in early childhood; the frequency and characteristics of adult-onset disease remain controversial. Objective To determine the proportion of individuals who report atopic eczema symptoms between birth and mid adulthood, and to examine demographic, immunologic, and genetic factors associated with period of symptom onset. Methods We conducted a longitudinal study using data from two nationally representative community-based birth cohorts from the United Kingdom: the British Cohort Studies 1958 and 1970. Individuals were followed from birth through age 42-50. The primary outcome was the age period of self-reported atopic eczema symptom onset based on repeated measures of self-reported atopic eczema at each survey wave. Results The annual period prevalence of atopic eczema ranged from 5-15% in two cohorts of over 17,000 participants each followed from birth through mid-age. There was no clear trend in prevalence by age, and among adults reporting active atopic eczema during a given year, only 38% had symptom onset reported in childhood. When compared with individuals whose eczema started in childhood, those with adult-onset disease were more likely to be women, from Scotland or Northern England, of lower childhood socio-economic group, smokers in adulthood, and less likely to have a history of asthma. In a sub-analysis using data from the 1958 cohort only, genetic mutations previously associated with atopic eczema, including filaggrin null mutations, and allergen-specific IgE were more common among those with childhood-onset disease. Conclusion Rates of self-reported atopic eczema remain high after childhood, and adult-onset atopic eczema has different risk factor associations than childhood-onset eczema.

Item Type: Article
Additional Information: © 2019 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. Under a Creative Commons license (https://creativecommons.org/licenses/by/4.0/)
Keywords: 1107 Immunology, Allergy
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Journal of Allergy and Clinical Immunology
ISSN: 0091-6749
Dates:
DateEvent
September 2019Published
28 June 2019Published Online
31 May 2019Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
UNSPECIFIEDRobert Wood Johnson FoundationUNSPECIFIED
K23AR073915National Institutes of Healthhttp://dx.doi.org/10.13039/100000002
205039/Z/16/ZWellcome Trusthttp://dx.doi.org/10.13039/100004440
G0000934Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
068545/Z/02Wellcome Trusthttp://dx.doi.org/10.13039/100004440
076113/B/04/ZWellcome Trusthttp://dx.doi.org/10.13039/100004440
U01 DK062418National Institutes of Healthhttp://dx.doi.org/10.13039/100000002
079895Wellcome Trusthttp://dx.doi.org/10.13039/100004440
018996European Commissionhttp://dx.doi.org/10.13039/501100000780
URI: https://openaccess.sgul.ac.uk/id/eprint/111009
Publisher's version: https://doi.org/10.1016/j.jaci.2019.05.040

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