Preventing the onset of atopic dermatitis

Abstract

　Loss-of-function mutations in filaggrin are known to be major predisposing factors for atopic dermatitis (AD) . Experiments using filaggrin-null mice demonstrated that complete filaggrin deficiency led to altered barrier integrity and enhanced sensitization. Protecting the skin barrier with a moisturizer during the neonatal period was hypothesized to prevent the development of AD and allergic sensitization. Randomized controlled trials to investigate this hypothesis were performed at the same time by two groups, in Japan and abroad, USA and UK. Both groups concluded that daily application of moisturizer during the first weeks of life reduces the risk of AD/eczema in infants. By post-hoc analysis, the Japanese group found a significant difference in the cumulative AD incidence between the high and low transepidermal water loss (TEWL) groups of the forehead. The probability without AD was lower in the high TEWL group than in the low TEWL group. The high TEWL group also exhibited a higher rate of sensitization to ovomucoid.