Prenatal PM exposure combined with skin barrier dysfunction is associated with AD and its persistence in early life: COCOA study

Exposure to particulate matter (PM) during critical periodS affects development of allergic diseases. Skin barrier dysfunction is the key pathophysiologies of AD. We identified the effect of exposure to PM during prenatal period on AD in combined with trans-epidermal water loss (TEWL). This study enrolled 468 infants from the Cohort for Childhood Origin of Asthma and allergic diseases (COCOA). Levels of outdoor PM2.5 and PM10 were estimated by land-use regression models. Levels of indoor PM2.5 and PM10 were measured using a particle discriminator. Levels of TEWL were measured at age 1. AD was diagnosed on the basis of parents-reported physician diagnosis. Exposure to higher levels of indoor PM2.5 at 36 weeks of gestation and outdoor PM2.5 at the first trimester was increased the risk of AD at age 1 in infants with high levels of TEWL (aOR 3.23, 95% CI, 1.18-8.82; aOR 3.03, 95% CI, 1.25-7.32 respectively). Exposure to higher levels of outdoor PM10 at the first and third trimester was increased the risk of AD at age 1 in infants with high levels of TEWL(aOR 2.75, 95% CI, 1.07-7.03; aOR 3.51, 95% CI, 1.03-9.46). SCORAD at age 1 was increased in infants with high TEWL combined with exposure to higher levels of outdoor PM2.5 and PM10 during prenatal periods. Prenatal PM exposure is associated with AD in early life, when combined with skin barrier dysfunction. Avoidance of PM exposure during prenatal period and enhancement of skin barrier function might be helpful to prevent the development of AD.