Atopic dermatitis and prematurity - a prospective study with analysis of the cytokine profile and thymus growth: a preliminary report.

Abstract

Introduction: Preterm children suffer from atopic dermatitis (AD) less frequently than term children do. The reason for this phenomenon has not yet been identified. Hypotheses include changes in the T-helper 1 (Th1)/T-helper 2 (Th2) balance or altered development of the thymus.

Aim: This study was designed to compare the Th1/Th2 cytokine balance and thymus size in preterm and term children and investigate the associations between these results and a possible diagnosis of AD in the second year of life.

Material and methods: The population comprised 28 preterm and 19 term children. During the first week of life, Th1/Th2/Th17 cytokine levels in the blood were assessed, and the thymus was measured via ultrasound. In the second year of life, 30 children were examined to determine whether AD was present, and the abovementioned procedures were repeated.

Results: AD was diagnosed in 3 out of 18 (16.7%) preterm children and 1 out of 12 (8.3%) term children (OR = 2.2; 95% CI: 0.201-24.086). For all patients, the thymus/weight index was lower, and there was a significant decrease in the level of IL-2 and increases in the levels of IL-4 and IL-17 in the second year of life compared with those after birth. There were no differences in cytokine levels or thymus size in the second year of life between the preterm/term and AD/non-AD subgroups.

Conclusions: The observed associations may indicate that the immunological status of preterm children in the second year of life may not vastly differ from that of term children.