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Open Access 21.05.2024 | Originalien

Impaired skin barrier and allergic sensitization in 16-year-old adolescents

verfasst von: PD Dr. Sonali Pechlivanis, PhD, Elisabeth Schmausser-Hechfellner, BSc, Bianca Schaub, MD, Chrysanthi Skevaki, MD, Cindy Barnig, MD, Caroline Roduit, MD, Amandine Divaret-Chauveau, MD, Anne M. Karvonen, PhD, Josef Riedler, MD PhD, Sabina Illi, PhD, Erika von Mutius, MD MSc, PASTURE Study Group

Erschienen in: Monatsschrift Kinderheilkunde

Abstract

Background

Transepidermal water loss (TEWL) has been used to measure skin barrier function and has been associated with atopic dermatitis and allergic diseases in infancy. However, few studies have assessed the association between TEWL and allergic diseases in adolescents.

Objective

To investigate the association between TEWL and allergic sensitizations in 16-year-old adolescents.

Materials and methods

The study was conducted in 78 adolescents of the PASTURE study. Different types of sensitization (seasonal, perennial, inhalant, food and any) were defined using serum specific immunoglobulin E (IgE) and skin prick test. TEWL was measured on the crook of either right or the left arm using a TEWAMETER® TM 300 (Courage + Khazaka electronic, Cologne, Germany) at mean temperature and humidity of 24.1 °C and 36.1%, respectively. The mean TEWL and interquartile range (IQR) were 11.9 ± 4.4 and 4.8 g/m2/h respectively.

Results

In our study, TEWL was positively associated with any sensitization (adjusted odds ratio [OR] per-IQR of the probability of increased TEWL [95% confidence interval]: OR 2.64; [1.12–6.19]; p = 0.03) and allergic rhinoconjunctivitis (ARC; OR 1.92; [1.04–3.54]; p = 0.04), but not with asthma or atopic dermatitis. When separating any sensitization into perennial and seasonal, only perennial sensitization (OR 3.30; [1.42–7.43]; p = 0.005) was associated with TEWL.

Conclusion

In the present study, we show the association of defective skin barrier function measured as TEWL with perennial sensitization and ARC suggesting its possible role in the pathogenesis of ARC through sensitization.
Hinweise

Redaktion

Berthold Koletzko, München
Thomas Lücke, Bochum
Ertan Mayatepek, Düsseldorf
Ute Spiekerkötter, Freiburg
Norbert Wagner, Aachen
Stefan Wirth, Wuppertal
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Background

The key function of the skin is to provide a barrier between external environmental factors and the internal body environment. Transepidermal water loss (TEWL) has been successfully used to measure skin barrier function. High TEWL is associated with skin dysfunction, whereas low TEWL is related to healthy skin [1]. High TEWL has been associated to atopic dermatitis (AD) and allergic sensitization in infancy [25]. During puberty, however, individuals undergo profound physiological changes, which affect both skin function [6] and sex-specific risk of atopy [7]. We therefore hypothesized that the association of TEWL and atopic sensitization to allergens may change with these profound alterations in adolescence. Using the data of the PASTURE study, we aimed to investigate the association between TEWL and allergic sensitizations at 16 years of age using a cross-sectional study design.

Study design

PASTURE is a longitudinal birth cohort conducted in children from rural areas of five European countries (Austria, Finland, France, Germany, and Switzerland) [8]. The study was designed to evaluate risk and preventive factors for atopic diseases and was approved by the local research ethics committees in each country [9, 10]. Written informed consent was obtained from the children’s parents and adolescents at age 16 years. Pregnant women were invited to participate during their third trimester of pregnancy and were then classified into farm and non-farm groups. The children from the participating women were recruited at birth. Information was obtained through questionnaires in interviews or self-administered questionnaires from mothers. Current study population is a subsample of the German arm at age 16 years.

Outcome

Serum specific immunoglobulin E (IgE) and skin prick test (SPT) was assessed at age 16 years. Serum specific IgE was assessed using the semiquantitative Allergy Screen test panel for atopy (Mediwiss Analytic, Moers, Germany). SPTs were performed on the anterior part of the forearm using a Stallerpoint® (Stallergenes, Antony, France). Different types of sensitization were defined as having at least one IgE specific ≥ 0.7 IUml−1 or SPT as a wheal diameter ≥ 3 mm as follows: i) seasonal: alder, birch, hazel, grass, rye grass, mugwort, plantain, or alternaria; ii) perennial: cat, dog, horse, Dermatophagoides (D.Pteronyssinus, or D. farinae; iii) inhalant: seasonal or perennial; iv) food: hen’s egg, cow’s milk, peanut, hazelnut, carrot, wheat flour, or soy; and v) any: seasonal, perennial or food. Asthma at 16 years was defined as a physician’s diagnosis of asthma or recurrent obstructive bronchitis ever until the age of 16 years. Children were labeled as having atopic dermatitis ever when the parents and/or adolescents reported in the questionnaires that the child had atopic dermatitis diagnosed by a doctor until 16 years of age. Allergic rhinoconjunctivitis (ARC) ever at 16 years was defined as parental and/or adolescent reported symptoms (itchy, runny, or blocked nose without a cold accompanied by red itchy eyes) and/or physician’s diagnosis ever of allergic rhinitis until the age 16 years.

Transepidermal water loss measurement

TEWL measurements were performed only in the German arm at the 16-year visit. TEWL was measured on the crook of either right or the left arm using a TEWAMETER® TM 300 (Courage + Khazaka electronic, Cologne, Germany). Additionally, it was taken care that no signs of atopic dermatitis were found at the skin area where TEWL measurement was carried out.
The subjects were instructed neither to wash this area on the day of the study visit nor to use cream or lotion. Three measurements were carried out for 30 s each. For each measurement, the mean value over these 30 s was calculated. The final TEWL value was calculated as the mean of the mean values of all three measurements. The mean TEWL, temperature and humidity were 11.9 ± 4.4 g/m2/h, 24.1 °C and 36.1%, respectively. TEWL was further transformed by dividing the original variable by the interquartile range (IQR 4.8) and the new continuous variable was included in the regression models. For the present study, we included 78 adolescents with data on TEWL and/or IgE/SPT.

Statistical analyses

The associations between TEWL and the different types of sensitization as well as the outcomes (asthma, AD, and ARC) were assessed by logistic regression adjusting for most relevant exposure (growing up on a farm). The results are presented as odds ratios (OR) per-interquartile-range of the probability of increased TEWL along with the 95% confidence interval [95%CI]. The test for differences between the groups was carried out by χ2/Fischer exact test for categorical variables and Mann–Whitney U test for continuous variables. A P-value of 0.05 was considered significant. All the analyses were performed in SAS (v9.4 software; SAS Institute, Cary, NC).

Results

Characteristics of the study population

Any sensitization at the age of 16 years was reported in 67.1% of the adolescents. Subjects with any sensitization had higher TEWL values and had more often ARC than subjects without any sensitization (Table 1). Perennial sensitization was reported in 39.7% of the adolescents. Subjects with perennial sensitization were more often seen in non-farmers, had higher TEWL values and had more often ARC (Table 1). In our study we did not find association between TEWL and farming status (farm vs non-farm: 11.9 ± 3.5 vs 11.8 ± 5.1; P-value = 0.33) or with other sensitization types (seasonal vs no seasonal: 11.9 ± 4.0 vs 11.7 ± 4.6; P-value = 0.75, inhalants vs no inhalants: 12.7 ± 4.9 vs 10.7 ± 3.5; P-value = 0.11, and food vs no food: 11.8 ± 3.5 vs 11.7 ± 4.6; P-value = 0.49).
Table 1
Basic characteristic
Characteristic
All
(N = 78)
Any sensitization (N = 47 [67.1%])
No sensitization (N = 23 [32.9%])
P value
Perennial sensitization (N = 27 [39.7%])
No perennial sensitization (N = 41 [60.3%])
P value
N (%)
N (%)
N (%)
 
N (%)
N (%)
 
Farm child (yes)
34 (43.6)
18 (38.3)
11 (47.8)
0.45
7 (25.9)
22 (53.7)
0.02
TEWLa
11.8 ± 4.4
12.7 ± 4.9
10.1 ± 2.5
0.05
13.8 ± 5.3
10.6 ± 3.0
0.01
Humiditya
36.2 ± 9.7
37.3 ± 9.5
34.4 ± 10.0
0.26
34.3 ± 9.1
37.6 ± 10.1
0.20
Temperaturea
24.1 ± 1.5
24.2 ± 1.6
24.1 ± 1.4
0.98
23.9 ± 1.2
24.3 ± 1.6
0.61
Exposure to cats at age of 2 months (yes)
26 (33.3)
14 (29.8)
10 (43.5)
0.26
6 (22.2)
17 (41.5)
0.10
Exposure to dogs at age of 2 months (yes)
10 (12.8)
5 (10.6)
4 (17.4)
0.46
5 (18.5)
4 (9.8)
0.47
Parental atopy (yes)
45 (58.4) (57.7)
27 (58.7)
15 (65.2)
0.60
16 (61.5)
24 (58.4)
0.81
Missing
1 (1.3)
1
1
Breast feeding at age of 2 months (yes)
72 (92.3)
42 (89.4)
22 (95.7)
0.66
26 (96.3)
36 (87.8)
0.39
Gender (female)
35 (44.9)
20 (42.6)
9 (39.1)
0.78
13 (48.2)
15 (39.0)
0.46
Having more than 2 siblings (yes)
19 (24.4)
10 (21.3)
7 (30.4)
0.40
5 (18.5)
12 (29.3)
0.32
Any sensitization
47 (67.1)
NA
NA
NA
27 (100.0)
18 (43.9)
<0.0001
 
8
Perennial sensitization
27 (39.7)
27 (60.0)
0 (0)
<0.0001
NA
NA
NA
Missing
10
2
Inhalants sensitization
39 (55.7)
39 (83.0)
0 (0.0)
<0.0001
26 (96.3)
11 (26.8)
<0.0001
 
8
Seasonal sensitization
28 (40.6)
28 (60.9)
0 (0.0)
<0.0001
15 (57.7)
11 (26.8)
0.01
 
9
1
1
Food sensitization
17 (25.8)
17 (39.5)
0 (0.0)
0.0005
9 (36.0)
8 (19.5)
0.14
 
12
4
2
Asthma
10 (12.8)
7 (14.9)
3 (13.0)
0.99
7 (25.9)
3 (7.3)
0.08
Atopic dermatitis
8 (10.3)
6 (12.8)
2 (8.7)
0.99
5 (18.5)
3 (7.5)
0.25
Allergic rhinoconjunctivitis
22 (28.6)
20 (43.2)
2 (8.7)
0.005
14 (51.9)
7 (17.1)
0.002
 
1
1
The categorical variables are presented as frequency (percentage) and the continuous variables as amean ± standard deviation. The test for differences between the groups are χ2/Fischer exact test for categorical variables and Mann–Whitney U test for continuous variables. Farm child was defined as “Children of mothers living on family-run livestock farms were assigned to the farm group. The nonfarm group included children of mothers from the same rural areas but not living on a farm”. Exposure to cats/dogs at the age of 2 months was defined by asking “if you have cats?”/“if you have dogs?” and “if they stay indoors in the house?” Parental atopy was defined as doctor’s diagnosis of hay fever, atopic dermatitis, or asthma ever in mother or father. Breastfeeding at 2 months of age (yes or no) was defined by “if you have ever breastfed?” Patterns of sensitization are defined as having at least one IgE specific ≥ 0.7 IUml-1 or SPT as a wheal diameter ≥ 3 mm as follows i) seasonal: alder, birch, hazel, grass, rye grass, mugwort, plantain, alternaria; ii) perennial: cat, dog, horse, D. Pteronyssinus, D. farinae; iii) inhalant: seasonal or perennial; iv) food: hen’s egg, cow’s milk, peanut, hazelnut, carrot, wheat flour, soy; and v) any: seasonal, perennial or food. Asthma was defined as a physician’s diagnosis of asthma or recurrent obstructive bronchitis ever until 16 years. Children were labeled as having atopic dermatitis ever when the parents and/or adolescents reported in the questionnaires that the child had atopic dermatitis diagnosed by a doctor until 16 years of age. Allergic rhinoconjunctivitis ever is defined as parental and/or adolescent reported symptoms (itchy, runny, or blocked nose without a cold accompanied by red itchy eyes) and/or physician’s diagnosis of allergic rhinitis until age 16 years. P value in italics are significant.
NA not applicable

Effect of TEWL on allergic sensitization

In adjusted logistic regression TEWL was positively associated with any sensitization (adjusted odds ratio [OR] per IQR of the probability of increased TEWL [95% confidence interval], P‑value: 2.64 [1.12–6.19], 0.03; Fig. 1a). TEWL was furthermore significantly associated with ARC (1.92 [1.04; 3.54], 0.04), but not with asthma or atopic dermatitis (Fig. 1b). The low number of included subjects with asthma (N = 10), ARC (N = 22), and AD (N = 8) and TEWL measurements did not allow to assess with any certainty whether the association between TEWL and any sensitization was stronger in those with asthma, ARC or AD.
When dissecting any sensitization into perennial and seasonal, only perennial sensitization (3.30 [1.42; 7.43], 0.005; Fig. 1a) was positively associated with TEWL. This may contradict the strong association with ARC, which is often also termed hay fever. Moreover, 66.7% of the adolescents in this analysis with ARC were sensitized to at least one perennial allergen.

Conclusion for the practitioner

The findings of the present study add to our understanding of the association between TEWL and allergic sensitization (any and perennial sensitization) in adolescence. Interesting was the finding of the perennial sensitization where 66.7% of the adolescence with ARC were sensitized to at least one perennial allergen. Even though the profound physiological changes occurring during adolescence did not change the association between TEWL and ARC in our study. These results are similar to the studies conducted in infants showing TEWL to predict allergic sensitization [25]. In our study, we could not find any association between TEWL and AD which could be due to the lower number of adolescents with AD (N = 8) in the present study. Additionally, 75% of the children with AD reported to have itchy rash with scratching and rubbing of the skin during last 12 months. Our results point to a possible role of epidermal barrier impairment in the sensitization to perennial allergens in ARC. Because of low numbers of included subjects, we could not investigate the role of filaggrin mutations in this population.
The strength of our study is the inclusion of adolescents recruited from the general population in Bavaria, Germany. However, the present study has several limitations. One of the limitations is the small study sample in the current analyses. Due to the low numbers, we were not able to associate TEWL measured at age 16 years with the age of onset of diseases and transient symptoms. Moreover, TEWL may be different for distinct age groups, which could have led to false positive or false negative results when associating TEWL to “ever doctor’s diagnosed disease”. Another weakness is the cross-sectional design of the current analyses, which makes is difficult to determine whether the exposure or the outcome occurred first. Hence, we could only speculate on causality in our study. However, by excluding the adolescents with any or perennial sensitization at 10.5 years (using the data from the examination at 10.5 years) did not alter the results. Nevertheless, it will be interesting to investigate the association between skin barrier dysfunction and incident clinical manifestation such as ARC in adolescence.
In the present study, we show the association of defective skin barrier function measured as TEWL with perennial sensitization and ARC. These results potentially indicate an important role of measuring TEWL in adolescents in clinical practice. Further larger longitudinal studies are necessary to prove if a causal relationship between high TEWL and ARC exists which will ensure the importance of TEWL measurement as a screening tool for allergy diseases as prevention strategies.

Members of PASTURE Study Group

The members of the PASTURE study group are (in alphabetical order by study center) as follows: Claudia Beerweiler; Andreas Böck; Harald Renz; Francesco Foppiano; Jon Genuneit; Johanna Theodorou; Martin Depner; Markus J Ege; Giulia Pagani; Michael Kabesch; Petra I. Pfefferle (Germany); Juha Pekkanen; Marjut Roponen; Martin Täubel; Pirkka V. Kirjavainen (Finland); Remo Frei; Roger Lauener (Switzerland); Lucie Laurent; Marie-Laure Dalphin (France).

Funding

The PASTURE study was supported by the European Commission (research grants QLK4-CT-2001-00250, FOOD-CT-2006-31708 and KBBE-2007-2-2-06). CS is supported by the Universities Giessen and Marburg Lung Center (UGMLC), the German Center for Lung Research (DZL), University Hospital Giessen and Marburg (UKGM) research funding according to article 2, section 3 cooperation agreement, and Forschungsgemeinschaft (DFG, German Research Foundation)-SFB 1021 (Project Number 197785619), KFO 309 (Project Number 284237345), and SK 317/1‑1 (Project Number 428518790) as well as by the Foundation for Pathobiochemistry and Molecular Diagnostics. BS is supported by the Deutsche Forschungsgemeinschaft (DFG; SCHA 997/9‑1, SCHA 997/10‑1, and SCHA 997/11-1).

Declarations

Conflict of interest

S. Pechlivanis has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. E. Schmausser-Hechfellner has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. B. Schaub has received the following support for this manuscript: DFG. In the past 36 months: Grants or contracts: DFG, BMBF, EU; Consulting fees: Sanofi; Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: GlaxoSmithKline, Novartis, Sanofi; Participation on a Data Safety Monitoring Board or Advisory Board: Sanofi. C. Skevaki has not received any support for this manuscript. In the past 36 months: Grants or contracts: Universities Giessen and Marburg Lung Center (UGLMC) – Payment to institution, German Center for Lung Research (DZL) – Payment to Institution, University Hospital Giessen and Marburg (UKGM) research funding – According to article 2, section 3 cooperation agreement, Payment to Institution, Deutsche Forschungsgemeinschaft (DFG) - SFB1021 (C04)- Project-ID 197785619, KFO 309 (P10), SK 317/1-1 (Project Nr. 428518790), Payment to Institution, TransMIT - Payment to me and Institution, Mead Johnson Nutrition (MJN) – Payment to Institution; Consulting fees: Bencard Allergie – Payment to me, Thermo Fisher Scientific – Payment to me; Support for attending meetings and/or travel: Bencard Allergy – Payment to me, regarding AD. Board meetings; Participation on a Data Safety Monitoring Board or Advisory Board: Bencard Allergy – Payment to me, regarding AD. Board meetings; Leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid: ESGREV Board Member – unpaid, DZL ALLIANCE ExCom Member – unpaid; Receipt of equipment, materials, drugs, medical writing, gifts or other services: Bencard Allergie – MCT adjuvant for animal experiments. C. Barnig has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. C. Roduit has not received any support for this manuscript. In the past 36 months: Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: ALK, University Bern; Support for attending meetings and/or travel: ALK. A. Divaret-Chauveau has received the following support for this manuscript: Grant from Don du Souffle for the PASTURE 16-yr – University Hospital of Besançon, Grant from Fondation du Souffle for the PASTURE 16-yr visit – University Hospital of Besançon, Grant from ARAIRLOR (Association Régionale d’Aide aux Insuffisants Respiratoires de Lorraine) for the PASTURE 16-yr visit – University Hospital of Besançon; In the past 36 months: Grants or contracts: Contract with the French public agency ANSES as an expert in allergy and paediatric for the Human Nutrition Committee – From 2018 to 2021, Grant from Novartis for a study on the protective role of farm environment on asthma and cough – University Hospital of Besançon, Grant from ARAIRLOR (Association Régionale d’Aide aux Insuffisants Respiratoires de Lorraine) for a study on the protective role of farm environment on asthma and cough – EA3450 DevAH, University of Lorraine; Consulting fees: Expert in pediatric allergy for Sanofi, Expert in food allergy for Stallergens, Expert in pediatric allergy for ALK, Expert in food allergy for Aimmune Therapeutics (all direct payment); Payment or honoraria: Novartis (speaker at symposium at the Pulmonology and Allergy Paediatric congress in France in 2020) – Direct payment, ALK speaker at symposium at a Paediatric congress in France in 2023) – Direct payment; Support for attending meetings and/or travel: Novartis for the French congress of Allergy 2022, ALK for the Pediatric congress 2023, Novartis for the French congress of Allergy 2023, ALK for the EAACI congress 2023 (all: Support for attending meeting and travel); Stock or stock options: Essilor Luxottica. A.M. Karvonen has not received any support for this manuscript. In the past 36 months: Grants or contracts: Päivikki and Sakari Sohlberg Foundation, Academy of Finland, Juho Vainio Foundation, Yrjö Jahnsson Foundation, Kuopio Area Respiratory Foundation, The Finnish Cultural Foundation (all: Payments were made to our institution). J. Riedler has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. S. Illi has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. E. von Mutius has received the following support for this manuscript: PASTURE. In the past 36 months: Grants or contracts: German Federal Ministry of Education and Research (BMBF) German Center for Lung Research, Bavarian State Ministry of Health and Care for “URS Study”, 01/21, “Impact Chip Study“, OM Pharma S.A., Go Bio Initial Grant, BMBF (Federal Ministry of Education and Research), European Research Council award, “BEAR Study”, O.M. Pharma S.A.; Royalties or licenses: Elsevier GmbH, Georg Thieme Verlag, Springer-Verlag GmbH, Elsevier Ltd., Springer Nature Group; Consulting fees: Chinese University of Hongkong, European Commission, HiPP GmbH & Co KG, AstraZeneca, Imperial College London, OM Pharma, ALK-Abello Arzneimittel GmbH; Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: Massachusetts Medical Society, Springer-Verlag GmbH, Elsevier Ltd., Böhringer Ingelheim International GmbH, European Respiratory Society (ERS), Universiteit Utrecht, Faculteit Diergeneeskunde, Universität Salzburg, Springer Medizin Verlag GmbH, Japanese Society of Pediatric Allergy and Clinical Immunology (JSPACI), Klinikum Rechts der Isar, University of Colorado, Paul-Martini-Stiftung, Astra Zeneca, Imperial College London, Children’s Hospital Research Institute of Manitoba, Kompetenzzentrum für Ernährung (Kern), OM Pharma S.A., Swedish Pediatric Society for Allergy and Lung Medicine, Chinese College of Allergy and Asthma (CCAA), ALK-Abello Arzneimittel GmbH, Abbott Laboratories, Deutscher Apotheker Verlag GmbH & Co. KG, Japanese Society of Allergology, British Society for Asthma and Clinical Immunology, American Academy of Allergy, Asthma & Immunology, OM Pharma S.A.; Support for attending meetings and/or travel: Verein zur Förderung der Pneumologie am Krankenhaus Großhansdorf e.V., Pneumologie Developpement, Mondial Congress & Events GmbH & Co. KG, American Academy of Allergy, Asthma & Immunology, Imperial College London, Margaux Orange, Volkswagen Stiftung, Böhringer Ingelheim International GmbH, European Respiratory Society (ERS), Universiteit Utrecht, Faculteit Diergeneeskunde, Österreichische Gesellschaft f. Allergologie u. Immunologie, Massachusetts Medical Society, OM Pharma S. A., Hanson Wade Ltd., iKOMM GmbH, DSI Dansk Borneastma Center, American Thoracic Society, HiPP GmbH & Co KG, Universiteit Utrecht, Faculteit Bètawetenschappen, ALK-Abello Arzneimittel GmbH, Deutsches Zentrum für Lungenforschung (DZL), Fabio Luigi Massimo Ricciardolo/Contatto S.r.l., Fraunhofer ITEM Hannover, MCCA Institut für Immunologie Uni Wien, Swiss Institute of Allergy and Asthma Research (SIAF) Davos (Associated Institute of the University of Zurich), MHH (Medizinische Hochschule Hannover, European Respiratory Socierty, Natasha Allergy Research Foundation, Deutsche Forschungsgemeinschaft, Gordon Research Conferences, Socieded Chilena de Enfermedades Respiratorias, Arla, Universität Leiden, American Academy of Allergy, Asthma & Clinical Immunology, Deutsche Forschungsgemeinschaft (DFG), ERS, Deutsches Zentrum für Lungenforschung; Patents planned, issued or pending: EvM has patent No. PCT/EP2019/085016 (Barn dust extract for the prevention and treatment of diseases) pending (Barn dust extract for the prevention and treatment of diseases) pending, royalties paid to ProtectImmun for patent EP2361632 (Specific environmental bacteria for the protection from and/or the treatment of allergic, chronic inflammatory and/or autoimmune disorders, granted on 19 March 2014), and patents EP1411977 (Composition containing bacterial antigens used for the prophylaxis and the treatment of allergic diseases, granted on 18 April 2007), EP1637147 (Stable dust extract for allergy protection, granted on 10 December 2008), and EP 1964570 (Pharmaceutical compound to protect against allergies and inflammatory diseases, granted on 21 November 2012) licensed to ProtectImmun. Patent EP21189353.2. 2021. von Mutius E, Rankl B, Bracher F, Müller C, Walker A, Hauck SM, Merl-Pham J, inventors; PROTEINS IDENTIFIED FROM BARN DUST EXTRACT FOR THE PREVENTION AND TREATMENT OF DISEASES. Patent CT/US2021/016918. 2021. Martinez FD, Vercelli D, Snyder SA, von Mutius E, Pivniouk V, Marques dos Santos M, inventors; THERAPEUTIC FRACTIONS AND PROTEINS FROM ASTHMA-PROTECTIVE FARM DUST. Patent EP21189353.2. 2021. von Mutius E, Rankl B, Bracher F, Müller C, Walker A, Hauck SM, Merl-Pham J, Adler H, Yildirim A.Ö., Sattler M, Santos Dias Mourao A, Borggräfe J, O’Connor P.D., Plettenburg O, inventors; PROTEINS IDENTIFIED FROM BARN DUST EXTRACT FOR THE PREVENTION AND TREATMENT OF DISEASES.; Participation on a Data Safety Monitoring Board or Advisory Board: Member of the EXPANSE (funded by European Commission) Scientific Advisory Board, Member of the BEAMS External Scientific Advisory Board (ESAB), Member of the Editorial Board of “The Journal of Allergy and Clinical Immunology: In Practice”, Member of the Scientific Advisory Board of the Children’s Respiratory and Environmental Workgroup (CREW), Member of the International Scientific & Societal Advisory Board (ISSAB) of Utrecht Life Sciences (ULS), University of Utrecht, Member of External Review Panel of the Faculty of Veterinary Science, University of Utrecht, Member of the Selection Committee for the Gottfried Wilhelm Leibniz Programme (DFG), Member of the International Advisory Board of Asthma UK Centre for Applied Research (AUKCAR), Member of the International Advisory Board of “The Lancet Respiratory Medicine”, Member of the Scientific Advisory Board of the CHILD (Canadian Healthy Infant Longitudinal Development) study, McMaster University, Hamilton, Canada, Asthma UK Centre for Applied Research, Pediatric Scientific Advisory Board Iceland, Abbott Allergy Risk Reduction Advisory Board. PASTURE Study Group: C. Beerweiler has not received any support for this manuscript. In the past 36 months: Grants or contracts: Friedrich-Baur-Foundation Grant 2023; Support for attending meetings and/or travel: EAACI 2023 Travel Grant. A. Böck has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. H. Renz has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. F. Foppiano has not received any support for this manuscript. In the past 36 months: Support for attending meetings and/or travel: EAACI 2023 Travel Grant. J. Genuneit has not received any support for this manuscript. In the past 36 months: Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: yearly honoraria for work as Associate Editor for the journal Pediatric Allergy and Immunology. J. Theodorou has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. M. Depner has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. M.J. Ege has not received any support for this manuscript. In the past 36 months: Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: EAACI; Payment for expert testimony: EU, SNSF; Support for attending meetings and/or travel: ERS; Patents planned, issued or pending: EP000002361632B1, EP000001964570B1. G. Pagani has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. M. Kabesch has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. P.I. Pfefferle (Germany) has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. J. Pekkanen has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. M. Roponen has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. M. Täubel has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. P.V. Kirjavainen (Finland) has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. R. Frei has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. R. Lauener (Switzerland) has received the following support for this manuscript: Kühne Foundation / CK-CARE – Research Grant to institution, EU – Research Grant. In the past 36 months: Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: AstraZeneca, Pfizer, ALK, Vifor, Milupa, Sanofi – Payment: None related to the content of this manuscript. L. Laurent has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript. M.-L. Dalphin (France) has not received any support for this manuscript. There are no relationships, activities or interests related to the content of the manuscript.
All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the local research ethics committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the local research ethics committee, and written informed consent were obtained from children’s parents and the adolescence.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.

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Metadaten
Titel
Impaired skin barrier and allergic sensitization in 16-year-old adolescents
verfasst von
PD Dr. Sonali Pechlivanis, PhD
Elisabeth Schmausser-Hechfellner, BSc
Bianca Schaub, MD
Chrysanthi Skevaki, MD
Cindy Barnig, MD
Caroline Roduit, MD
Amandine Divaret-Chauveau, MD
Anne M. Karvonen, PhD
Josef Riedler, MD PhD
Sabina Illi, PhD
Erika von Mutius, MD MSc
PASTURE Study Group
Publikationsdatum
21.05.2024
Verlag
Springer Medizin
Erschienen in
Monatsschrift Kinderheilkunde
Print ISSN: 0026-9298
Elektronische ISSN: 1433-0474
DOI
https://doi.org/10.1007/s00112-024-01978-w

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