Prevention of Transcutaneous Sensitization to Cow Milk Proteins in Infants with Atopic Dermatitis: Cohort Study

Background. Malformations in epidermal barrier in children with atopic dermatitis (AD) can cause transcutaneous sensitization with further development of allergic diseases that can worsen the AD course and significantly reduces patients’ quality of life.Objective. The aim of the study was to determi...

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Main Authors: Nikolay N. Murashkin, Svetlana G. Makarova, Stepan G. Grigorev, Dmitri V. Fedorov, Roman A. Ivanov, Eduard T. Ambarchian, Roman V. Epishev, Alexander I. Materikin, Leonid A. Opryatin, Alena A. Savelova
Format: Article
Language:English
Published: "Paediatrician" Publishers LLC 2020-12-01
Series:Вопросы современной педиатрии
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Online Access:https://vsp.spr-journal.ru/jour/article/view/2519
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author Nikolay N. Murashkin
Svetlana G. Makarova
Stepan G. Grigorev
Dmitri V. Fedorov
Roman A. Ivanov
Eduard T. Ambarchian
Roman V. Epishev
Alexander I. Materikin
Leonid A. Opryatin
Alena A. Savelova
author_facet Nikolay N. Murashkin
Svetlana G. Makarova
Stepan G. Grigorev
Dmitri V. Fedorov
Roman A. Ivanov
Eduard T. Ambarchian
Roman V. Epishev
Alexander I. Materikin
Leonid A. Opryatin
Alena A. Savelova
author_sort Nikolay N. Murashkin
collection DOAJ
description Background. Malformations in epidermal barrier in children with atopic dermatitis (AD) can cause transcutaneous sensitization with further development of allergic diseases that can worsen the AD course and significantly reduces patients’ quality of life.Objective. The aim of the study was to determine the effect of topical treatment and maintenance therapy with pimecrolimus 1% cream (PIM) and topical glucocorticosteroids (tGCS) in infants with AD on reducing the risk of developing transcutaneous sensitization (due to the levels of specific IgE to the cow milk protein over time) and on reducing the disease severity (by the EASI scale).Methods. The study included children aged from 1 to 4 months with early manifestations of moderate and severe AD. The severity of AD was estimated via the EASI scale at start of observation, then at 6, 9 and 12 months of life. The class and level of specific IgE to cow milk proteins (CMP) were determined by the ImmunoCAP method at the point of enrolment and at the ages of 6 and 12 months. Statistical analysis of studied indicators dynamics and their comparison in research groups was carried out using multifactorial dispersion analysis.Results. The study included 36 patients. All patients have received standard tGCS therapy in combination with emollients (wet wrap) for 10 days. The maintenance therapy was prescribed in postacute period. It included topical calcineurin inhibitor PIM 2 times/day for 3 months, then double application (morning/evening) 3 times/week up to the age of 1 year old (group 1). Other group had maintenance therapy — tGCS2 times/week for 3 months, and then at AD aggravation (group 2). Group 1 has shown lower level of sensitization to CMP at the age of 6 and 12 months and more significant decrease in AD severity according to EASI scale compared to group 2.Conclusion. The treatment with PIM is effective in therapy of AD and prevention of transcutaneous sensitization in infants.
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spelling doaj-art-338b358bf0e647caacaf2e4da4d18e992025-08-20T03:59:53Zeng"Paediatrician" Publishers LLCВопросы современной педиатрии1682-55271682-55352020-12-0119653854410.15690/vsp.v19i6.21521927Prevention of Transcutaneous Sensitization to Cow Milk Proteins in Infants with Atopic Dermatitis: Cohort StudyNikolay N. Murashkin0Svetlana G. Makarova1Stepan G. Grigorev2Dmitri V. Fedorov3Roman A. Ivanov4Eduard T. Ambarchian5Roman V. Epishev6Alexander I. Materikin7Leonid A. Opryatin8Alena A. Savelova9National Medical Research Center of Children’s Health; Sechenov First Moscow State Medical University (Sechenov University); Central State Medical Academy of Department of Presidential Affairs; Research Institute of Pediatrics and Children’s Health in “Central Clinical Hospital of the Russian Academy of Sciences”National Medical Research Center of Children’s Health; Research Institute of Pediatrics and Children’s Health in “Central Clinical Hospital of the Russian Academy of Sciences”Military Medical Academy n.a. S.M. Kirov; Pediatric Research and Clinical Center for Infectious Diseases under the Federal Medical Biological AgencyNational Medical Research Center of Children’s HealthNational Medical Research Center of Children’s HealthNational Medical Research Center of Children’s Health; Sechenov First Moscow State Medical University (Sechenov University); Research Institute of Pediatrics and Children’s Health in “Central Clinical Hospital of the Russian Academy of Sciences”National Medical Research Center of Children’s HealthNational Medical Research Center of Children’s HealthNational Medical Research Center of Children’s HealthCentral State Medical Academy of Department of Presidential AffairsBackground. Malformations in epidermal barrier in children with atopic dermatitis (AD) can cause transcutaneous sensitization with further development of allergic diseases that can worsen the AD course and significantly reduces patients’ quality of life.Objective. The aim of the study was to determine the effect of topical treatment and maintenance therapy with pimecrolimus 1% cream (PIM) and topical glucocorticosteroids (tGCS) in infants with AD on reducing the risk of developing transcutaneous sensitization (due to the levels of specific IgE to the cow milk protein over time) and on reducing the disease severity (by the EASI scale).Methods. The study included children aged from 1 to 4 months with early manifestations of moderate and severe AD. The severity of AD was estimated via the EASI scale at start of observation, then at 6, 9 and 12 months of life. The class and level of specific IgE to cow milk proteins (CMP) were determined by the ImmunoCAP method at the point of enrolment and at the ages of 6 and 12 months. Statistical analysis of studied indicators dynamics and their comparison in research groups was carried out using multifactorial dispersion analysis.Results. The study included 36 patients. All patients have received standard tGCS therapy in combination with emollients (wet wrap) for 10 days. The maintenance therapy was prescribed in postacute period. It included topical calcineurin inhibitor PIM 2 times/day for 3 months, then double application (morning/evening) 3 times/week up to the age of 1 year old (group 1). Other group had maintenance therapy — tGCS2 times/week for 3 months, and then at AD aggravation (group 2). Group 1 has shown lower level of sensitization to CMP at the age of 6 and 12 months and more significant decrease in AD severity according to EASI scale compared to group 2.Conclusion. The treatment with PIM is effective in therapy of AD and prevention of transcutaneous sensitization in infants.https://vsp.spr-journal.ru/jour/article/view/2519atopic dermatitisatopic marchchildrensensibilizationcow milk proteinsigeimmunocappimecrolimus
spellingShingle Nikolay N. Murashkin
Svetlana G. Makarova
Stepan G. Grigorev
Dmitri V. Fedorov
Roman A. Ivanov
Eduard T. Ambarchian
Roman V. Epishev
Alexander I. Materikin
Leonid A. Opryatin
Alena A. Savelova
Prevention of Transcutaneous Sensitization to Cow Milk Proteins in Infants with Atopic Dermatitis: Cohort Study
Вопросы современной педиатрии
atopic dermatitis
atopic march
children
sensibilization
cow milk proteins
ige
immunocap
pimecrolimus
title Prevention of Transcutaneous Sensitization to Cow Milk Proteins in Infants with Atopic Dermatitis: Cohort Study
title_full Prevention of Transcutaneous Sensitization to Cow Milk Proteins in Infants with Atopic Dermatitis: Cohort Study
title_fullStr Prevention of Transcutaneous Sensitization to Cow Milk Proteins in Infants with Atopic Dermatitis: Cohort Study
title_full_unstemmed Prevention of Transcutaneous Sensitization to Cow Milk Proteins in Infants with Atopic Dermatitis: Cohort Study
title_short Prevention of Transcutaneous Sensitization to Cow Milk Proteins in Infants with Atopic Dermatitis: Cohort Study
title_sort prevention of transcutaneous sensitization to cow milk proteins in infants with atopic dermatitis cohort study
topic atopic dermatitis
atopic march
children
sensibilization
cow milk proteins
ige
immunocap
pimecrolimus
url https://vsp.spr-journal.ru/jour/article/view/2519
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