AT 2015 AAAAI ANNUAL MEETING
HOUSTON (FRONTLINE MEDICAL NEWS) – New-onset eczema during pregnancy is a common phenomenon with several newly identified risk factors.
This disease entity deserves a proper name: gestational eczema, Dr. Wilfried J.J. Karmaus asserted at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.
In contrast, the likelihood of new-onset asthma arising during pregnancy isn’t significantly more common than in an affected woman’s male partner during the same time frame.
“There was no large difference in wheezing between the women and men. Therefore, we cannot propose the term ‘gestational asthma,’” said Dr. Karmaus, professor of epidemiology at the University of Memphis. “Investigations into how to prevent eczema and asthma in pregnancy are really important, because eczema and asthma in pregnancy can increase the risk of these diseases in the offspring. This is a totally undeveloped field.”
He presented new findings from the Isle of Wight study, a prospective study in which a cohort of women has been followed from birth through pregnancy across three generations.
Eczema and asthma are common atopic diseases, and they are particularly common during pregnancy. Indeed, eczema is the most common skin disease seen in pregnancy, accounting for 35%-50% of all dermatoses in previous studies by other investigators. In those studies, only 20%-40% of women with eczema during pregnancy had a prepregnancy history of the disease.
In the Isle of Wight cohort, women were evaluated for asthma and eczema symptoms at ages 1, 2, 4, 10, and 18 years and again during pregnancy at gestational weeks 20 and 28. A total of 26 of 116 women developed eczema during pregnancy, with eight of them (31%) experiencing the skin disease for the first time in their lives. In contrast, only six of their male partners had eczema during the pregnancy time frame, and just one of them had new-onset eczema.
A history of maternal eczema in the preceding generation was associated with a 52% increased relative risk of having eczema by age 18 and a 3.1-fold increased likelihood of eczema during pregnancy. Also, methylation of the filaggrin gene at the cytosine-phosphate-guanine site cg13447818 when assessed at age 18 was associated with a significantly increased likelihood of eczema in a subject’s mother as well as increased risk of gestational eczema 1-7 years later, Dr. Karmaus continued.
Eighteen percent of women in the Isle of Wight cohort had asthma during pregnancy, as did a similar proportion of their male partners. Twenty-seven percent of women with asthma during pregnancy had no previous history of the respiratory disease, a rate which was again comparable in their male partners with asthma.
DNA methylation of the IL1RL1 gene at cg17738684 was significantly associated with asthma heritability across three generations in the Isle of Wight study. The IL1RL1 gene at cg17738684 is a candidate gene for asthma that encodes for interleukin-33. This finding raises the possibility that addressing this DNA methylation could prove fruitful as a transgenerational asthma prevention strategy.
The Isle of Wight birth cohort study is funded by the National Institutes of Health, Asthma UK, and the Isle of Wight Trust. Dr. Karmaus reported having no financial conflicts of interest.