It is currently unknown whether alterations in the skin microbiome exist before development of atopic dermatitis (AD). In this prospective Danish birth cohort of 300 children, we examined whether skin microbiome alterations during the first 2 months of life were associated with an increased risk of AD in the first 2 years and its severity after adjustment for environmental factors and selected skin chemokine and natural moisturizing factor levels. We found no overall association between the skin microbiome at birth and age 2 months and AD during the first 2 years of life. However, when restricting the analysis to children with at least one parent with atopy, a lower alpha diversity at age 2 months was associated with an increased risk of AD (adjusted hazard ratio = 1.7, 95% confidence interval = 1.1–2.6). We observed a stronger association in children where both parents had atopy (adjusted hazard ratio = 4.4, 95% confidence interval = 1.1–18.2). The putative pathogenic role of changes in the skin microbiome on AD risk remains uncertain but may play a role in those with an atopic predisposition.

目前尚不清楚在特应性皮炎 (AD) 发生之前是否存在皮肤微生物组的改变。在这个由 300 名儿童组成的前瞻性丹麦出生队列中，我们检查了生命前 2 个月内皮肤微生物组的变化是否与前 2 年内 AD 风险增加及其严重程度相关，并调整了环境因素和选定的皮肤趋化因子和自然因子。保湿因子水平。我们发现出生时和 2 个月大时的皮肤微生物组与生命最初 2 年内的 AD 之间没有总体关联。然而，当将分析限制于至少一位父母患有特应性的儿童时，2 个月大时较低的 α 多样性与 AD 风险增加相关（调整后的风险比 = 1.7，95% 置信区间 = 1.1-2.6）。我们观察到，在父母双方都有特应性的儿童中，这种关联性更强（调整后的风险比 = 4.4，95% 置信区间 = 1.1–18.2）。皮肤微生物组变化对 AD 风险的假定致病作用仍不确定，但可能对有特应性倾向的人起作用。