Sixty percent of children with AD are seen to clear of the disease by 10 years of age. It happens due to age specific changes in immunity and skin barrier function. What is/ are the immunological change/changes that favor the clearance of the disease?
Dear Harasit Kumar Paul,
I think etiology could be really complicated and multifactorial. But some researchers show some fact which can be helpful for understanding this problem.
I found such papers related to the problem:
Article Allergic disease in 8-year old children is preceded by delay...
Article Higher B-cell activating factor levels at birth are positive...
Article Atopic Dermatitis in Children
Excellent compilation of knowledge related to maturation of immune system and factors which from my point of view could be critical for lower AD morbidity after 10-12 years gives Georgountzou and Papadopoulos:
" TLR1 and 3 expression was significantly higher in infants (aged 3–10 months) and children (5–12 years) than in adults (18–31 years) and an opposite trend was observed for TLR6 expression "
" levels of stool calprotectin (...) finally stabilize to adult levels after the fourth year of life "
" Pott et al. reported age-related differences in TLR3 expression of the intestinal epithelium, with a significant upregulation noted in children of 5 years and older, correlating with the enhanced resistance to rotavirus infection "
" chemotaxis was significantly defective (...) at 2–5 years (131), or still decreased in teenagers under 16 years when compared to adults "
" Neonates also have relatively high eosinophil counts, but a decline is observed with age "
" pDC-to-mDC ratio stabilized to the usual adult level 1:2 around the 10th year of age "
"RSV-induced IFN-α production in PBMCs from human neonates and young children aged 12–59 months was found significantly lower than in adult"
" TLR4 induced p19 subunit of IL-23 gradually increased, to reach adult levels between 4 and 13 years "
" during childhood years, IL-10 production is stabilized or increased to reach adult levels "
from: https://www.frontiersin.org/articles/10.3389/fimmu.2017.00957/full
Concluding that many factors including microbiome, related to immune system maturity between 5-12 years child is changing and could be a factors related to lower AD morbidity.
Best regards,
Tomasz
Dear Tomasz Grabowski, thanks for your quick and informative response. It will be of great help for the reader including myself. Best regards, Harasit Kumar Paul.
A complex issue.
To our understanding there are at least 3 phenotypes of Atopic Demratitis.
One of them, the most common one, is called atopic eczema of infancy, typically disappears at the age of 3-4 years
The other one may persist until adulthood.
The problem is, that we are not able to distinguish them in a smoal kid.
Best,
Wojciech
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