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Title: Associations between eczema and attention deficit hyperactivity disorder symptoms in children
Authors: Loo, Evelyn Xiu Ling
Ooi, Delicia Shu Qin
Ong, Minyee
Ta, Le Duc Huy
Lau, Hui Xing
Tay, Michelle Jia Yu
Yap, Qai Ven
Chan, Yiong Huak
Tham, Elizabeth Huiwen
Goh, Anne Eng Neo
Van Bever, Hugo
Teoh, Oon Hoe
Eriksson, Johan Gunnar
Chong, Yap Seng
Gluckman, Peter
Yap, Fabian Kok Peng
Karnani, Neerja
Xu, Jia
Tan, Karen Mei Ling
Tan, Kok Hian
Lee, Bee Wah
Kramer, Michael
Shek, Lynette Pei-Chi
Meaney, Michael J.
Broekman, Birit F. P.
Keywords: Science::Medicine
Issue Date: 2022
Source: Loo, E. X. L., Ooi, D. S. Q., Ong, M., Ta, L. D. H., Lau, H. X., Tay, M. J. Y., Yap, Q. V., Chan, Y. H., Tham, E. H., Goh, A. E. N., Van Bever, H., Teoh, O. H., Eriksson, J. G., Chong, Y. S., Gluckman, P., Yap, F. K. P., Karnani, N., Xu, J., Tan, K. M. L., ...Broekman, B. F. P. (2022). Associations between eczema and attention deficit hyperactivity disorder symptoms in children. Frontiers in Pediatrics, 10, 837741-.
Project: NMRC/TCR/004-NUS/2008 
NMRC/TCR/012- NUHS/2014 
Journal: Frontiers in Pediatrics 
Abstract: Background: Epidemiological studies suggest a link between eczema and attention deficit hyperactivity disorder (ADHD), but underlying mechanisms have not been examined. Objective: We 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. Methods: The 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. Results: After 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. Conclusion: Early 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: [], identifier [NCT01174875].
ISSN: 2296-2360
DOI: 10.3389/fped.2022.837741
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Organisations: Duke-NUS Medical School
KK Women’s and Children’s Hospital
Rights: © 2022 Loo, Ooi, Ong, Ta, Lau, Tay, Yap, Chan, Tham, Goh, Van Bever, Teoh, Eriksson, Chong, Gluckman, Yap, Karnani, Xu, Tan, Tan, Lee, Kramer, Shek, Meaney and Broekman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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