Study finds higher risk of IBD in adults and children with atopic dermatitis.
Study finds higher risk of IBD in adults and children with atopic dermatitis.
How Atopic Dermatitis Increases the Risk of Inflammatory Bowel Disease
Experts note that atopic dermatitis can occur in children as well as adults. vladans/Getty Images
Atopic dermatitis, a chronic skin condition characterized by dryness, itching, and rash, affects around 223 million people worldwide, with approximately 43 million children between the ages of 1 and 4 being affected. This condition, commonly known as eczema, is associated with inflammation and has been linked to several other health issues such as heart diseases, asthma, chronic kidney disease, and autoimmune diseases like rheumatoid arthritis, celiac disease, Crohn’s disease, and ulcerative colitis. Now, researchers from the University of Pennsylvania have shed light on how atopic dermatitis increases the risk of inflammatory bowel disease (IBD).
IBD is an umbrella term for two conditions: ulcerative colitis and Crohn’s disease. Both are characterized by chronic inflammation of the digestive tract, which is caused by an autoimmune response where the body’s immune system mistakenly attacks healthy tissues in the digestive tract. Crohn’s disease can affect any part of the digestive system, while ulcerative colitis mainly affects the large intestine. However, sometimes it is difficult to distinguish between the two, and the diagnosis is referred to as indeterminate colitis. The exact cause of IBD is not known, but factors such as age, ethnicity, genetics, and environmental factors play a role.
The link between atopic dermatitis and IBD has been a topic of interest for researchers, as another skin condition called psoriasis has long been associated with IBD, suggesting shared genetic factors. A study in Korea published in 2020 found that people with any atopic disease, including atopic dermatitis, had an increased risk of developing IBD, with the risk increasing with the number of atopic diseases present. However, a study in 2021 reported that atopic dermatitis was not independently associated with IBD development, while a study in 2022 found a causal link between atopic dermatitis and IBD, but not the reverse.
In the recent study conducted by the University of Pennsylvania, researchers analyzed data from over 409,000 children and 625,000 adults with atopic dermatitis, comparing them to control groups of more than 1.8 million children and almost 2.7 million adults without the disease. The analysis revealed a statistically significant increased risk of new-onset IBD among both children (44%) and adults (34%) with atopic dermatitis. Furthermore, the risk of IBD increased with the severity of atopic dermatitis.
- Study finds childhood trauma affects adult sex life in women.
- Expert Offers Tips for Affordable Healthy Eating
- Handling Toxic Parents
Dr. Joel Gelfand, a professor at the University of Pennsylvania and senior author of the study, highlighted the surprising finding that the association between atopic dermatitis and IBD was stronger for Crohn’s disease in children, despite both atopic dermatitis and ulcerative colitis being considered Th2 diseases. Th2 diseases are characterized by barrier dysfunction, microbiome alterations, and chronic inflammation. Gelfand emphasized the importance of epidemiological studies in understanding the distribution and determinants of health in humans, as biologically derived hypotheses can sometimes be reversed when studied in patients.
The study’s findings hold significance in better understanding the health trajectories of people with atopic dermatitis. Treatments for atopic dermatitis have improved dramatically, but it is important to determine if these treatments reduce or increase the risk of other immune-mediated diseases over time. For example, certain biologic treatments for atopic dermatitis may effectively manage symptoms but potentially induce other immune problems, such as psoriasis and inflammatory arthritis, in a subset of patients. Therefore, studying long-term health outcomes and exploring the impact of novel treatments on overall health is crucial.
Dr. Rudolph Bedford, a gastroenterologist at Providence Saint John’s Health Center in California, commented on the study, stating that he was not surprised by the link between atopic dermatitis and IBD. He explained that patients with inflammatory bowel disease often present with various skin manifestations, suggesting a shared genetic predisposition. Immune cell activation, environmental factors, and gut microbiota are believed to play a role in both atopic dermatitis and IBD. Dermatologists’ awareness of this link could lead to earlier identification of patients at risk of developing inflammatory bowel disease, particularly those with severe atopic dermatitis.
In conclusion, the research conducted by the University of Pennsylvania highlights the increased risk of inflammatory bowel disease in both children and adults with atopic dermatitis. The severity of atopic dermatitis further amplifies the association, with Crohn’s disease showing a stronger correlation in children. These findings contribute to our understanding of the long-term health implications of atopic dermatitis and emphasize the need for further exploration and investigation of potential treatments to minimize the risk of other immune-mediated diseases for individuals with this skin condition.
