Frontiers in Pediatrics (Mar 2022)
Associations Between Eczema and Attention Deficit Hyperactivity Disorder Symptoms in Children
- Evelyn Xiu Ling Loo,
- Evelyn Xiu Ling Loo,
- Evelyn Xiu Ling Loo,
- Delicia Shu Qin Ooi,
- Minyee Ong,
- Le Duc Huy Ta,
- Hui Xing Lau,
- Michelle Jia Yu Tay,
- Qai Ven Yap,
- Yiong Huak Chan,
- Elizabeth Huiwen Tham,
- Elizabeth Huiwen Tham,
- Elizabeth Huiwen Tham,
- Elizabeth Huiwen Tham,
- Anne Eng Neo Goh,
- Hugo Van Bever,
- Hugo Van Bever,
- Oon Hoe Teoh,
- Johan Gunnar Eriksson,
- Johan Gunnar Eriksson,
- Johan Gunnar Eriksson,
- Johan Gunnar Eriksson,
- Yap Seng Chong,
- Yap Seng Chong,
- Peter Gluckman,
- Peter Gluckman,
- Fabian Kok Peng Yap,
- Fabian Kok Peng Yap,
- Fabian Kok Peng Yap,
- Neerja Karnani,
- Neerja Karnani,
- Neerja Karnani,
- Jia Xu,
- Karen Mei Ling Tan,
- Kok Hian Tan,
- Bee Wah Lee,
- Michael Kramer,
- Michael Kramer,
- Lynette Pei-chi Shek,
- Lynette Pei-chi Shek,
- Michael J. Meaney,
- Michael J. Meaney,
- Michael J. Meaney,
- Michael J. Meaney,
- Birit F. P. Broekman,
- Birit F. P. Broekman
Affiliations
- Evelyn Xiu Ling Loo
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Evelyn Xiu Ling Loo
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Evelyn Xiu Ling Loo
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Delicia Shu Qin Ooi
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Minyee Ong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Le Duc Huy Ta
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Hui Xing Lau
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Michelle Jia Yu Tay
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Qai Ven Yap
- Department of Biostatistics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Yiong Huak Chan
- Department of Biostatistics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Elizabeth Huiwen Tham
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Elizabeth Huiwen Tham
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Elizabeth Huiwen Tham
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Elizabeth Huiwen Tham
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
- Anne Eng Neo Goh
- Allergy Service, Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
- Hugo Van Bever
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Hugo Van Bever
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
- Oon Hoe Teoh
- Respiratory Service, Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
- Johan Gunnar Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Johan Gunnar Eriksson
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Johan Gunnar Eriksson
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Johan Gunnar Eriksson
- Folkhälsan Research Center, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Yap Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Peter Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Peter Gluckman
- 1Liggins Institute, University of Auckland, Auckland, New Zealand
- Fabian Kok Peng Yap
- 2Duke-NUS Medical School, Singapore, Singapore
- Fabian Kok Peng Yap
- 3Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Fabian Kok Peng Yap
- 4Endocrinology Service, Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
- Neerja Karnani
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Neerja Karnani
- 5Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Neerja Karnani
- 6Bioinformatics Institute, Agency for Science, Technology and Research, Singapore, Singapore
- Jia Xu
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Karen Mei Ling Tan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Kok Hian Tan
- 7Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
- Bee Wah Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Michael Kramer
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Michael Kramer
- 8Department of Pediatrics and of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, QC, Canada
- Lynette Pei-chi Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Lynette Pei-chi Shek
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
- Michael J. Meaney
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Michael J. Meaney
- 9Sackler Program for Epigenetics & Psychobiology at McGill University, Montreal, QC, Canada
- Michael J. Meaney
- 0Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, QC, Canada
- Michael J. Meaney
- 1Department of Psychiatry, McGill University, Montreal, QC, Canada
- Birit F. P. Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Birit F. P. Broekman
- 2Department of Psychiatry, OLVG and Amsterdam UMC, VU University, Amsterdam, Netherlands
- DOI
- https://doi.org/10.3389/fped.2022.837741
- Journal volume & issue
-
Vol. 10
Abstract
BackgroundEpidemiological studies suggest a link between eczema and attention deficit hyperactivity disorder (ADHD), but underlying mechanisms have not been examined.ObjectiveWe aim to investigate the association between eczema and subsequent ADHD symptoms in the Growing Up in Singapore Towards healthy Outcomes cohort and explore the role of pro-inflammatory cytokines and gut microbiome.MethodsThe modified International Study of Asthma and Allergies in Childhood questionnaire and Computerized Diagnostic Interview Schedule for Children Version IV were administered to assess reported eczema within the first 18 months and presence of ADHD symptoms at 54 months, respectively. Skin prick testing at 18 months, cytokines in maternal blood during pregnancy and cord blood and the mediating role of the gut microbiome at 24 months were assessed.ResultsAfter adjusting for confounders, eczema with or without a positive skin prick test was associated with doubling the risk of ADHD symptoms. No differences in maternal and cord blood cytokines were observed in children with and without eczema, or children with and without ADHD. Gut microbiome dysbiosis was observed in children with eczema and children with ADHD. Children with eczema also had lower gut bacterial Shannon diversity. However, the relationship between eczema and ADHD was not mediated by gut microbiome.ConclusionEarly life eczema diagnosis is associated with a higher risk of subsequent ADHD symptoms in children. We found no evidence for underlying inflammatory mechanism or mediation by gut microbiome dysbiosis. Further research should evaluate other mechanisms underlying the link between eczema and ADHD.Clinical Trial Registration[https://clinicaltrials.gov/ct2/show/NCT01174875], identifier [NCT01174875].
Keywords