Atopic Dermatitis Associated With Reduced Lung Function in Infants

A recent study examined the intricacies of lung function in infants affected by atopic dermatitis (AD), shedding light on AD’s potential progression to asthma.

In this prospective cross-sectional study, 230 infants were enrolled, bifurcated into 2 groups: 150 with AD and 80 constituting a cohort of healthy controls (HCs). Notably, the study delved into the realm of food sensitivity, evaluated via food specific IgE or the skin prick test, and the severity of AD, assessed utilizing the SCORing Atopic Dermatitis tool. However, the research's distinctive facet was the implementation of tidal breath analysis (TBA) as a tool to gauge lung function.

Several TBA parameters, including time to peak tidal expiratory flow, exhaled volume to peak tidal expiratory flow, and respiratory rate, displayed marked disparities between the AD group and the HC group, exhibiting a significance level of P < .05 and establishing a clear and intriguing correlation between AD and infant lung function.

Moreover, the study revealed that bronchial obstruction, a pertinent marker of potential future respiratory issues, was discernible in young children with AD. This outcome held true, irrespective of disease severity, the presence of food sensitivity, or a history of recurrent wheezing. These findings postulate a compelling argument in favor of early monitoring and intervention to address lung-related complications in infants diagnosed with AD, potentially mitigating the likelihood of progression to asthma in later stages of life.

A standout discovery was the potential diagnostic value of the ratio of time to peak tidal expiratory flow to total expiratory time. This parameter demonstrated an impressive diagnostic capacity, boasting an area under the curve of 0.826. This statistic underscores its viability as a diagnostic tool, being characterized by a sensitivity of 78.7% and a specificity of 77.5%.

“TBA curves can be a useful tool for demonstrating expiratory airway obstruction in AD and for providing objective information for the clinician,” concluded the study authors. “Bronchial obstruction was detected in young children with AD irrespective of the severity of the disease, food sensitivity, and history of recurrent wheezing.”

Reference
Gulec Koksal Z, Uysal P. Beyond the skin: reduced lung function associated with atopic dermatitis in infants. J Allergy Clin Immunol Pract. 2023;11(9):2839-2847. doi:10.1016/j.jaip.2023.06.055