Prenatal Fish Oil Supplementation, Maternal COX1 Genotype, and Childhood Atopic Dermatitis: A Secondary Analysis of a Randomized Clinical Trial.

IF 11.5 1区 医学 Q1 DERMATOLOGY JAMA dermatology Pub Date : 2024-10-01 DOI:10.1001/jamadermatol.2024.2849
Liang Chen, Nicklas Brustad, Yang Luo, Tingting Wang, Mina Ali, Parvaneh Ebrahimi, Ann-Marie M Schoos, Nilo Vahman, Mario Lovric, Morten A Rasmussen, Johan Kolmert, Craig E Wheelock, Jessica A Lasky-Su, Jakob Stokholm, Klaus Bønnelykke, Bo Chawes
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引用次数: 0

Abstract

Importance: Eicosanoids have a pathophysiological role in atopic dermatitis (AD), but it is unknown whether this is affected by prenatal ω-3 long-chain polyunsaturated fatty acid (n-3 LCPUFA; ie, fish oil) supplementation and genetic variations in the cyclooxygenase-1 (COX1) pathway.

Objective: To explore the association of n-3 LCPUFA supplementation during pregnancy with risk of childhood AD overall and by maternal COX1 genotype.

Design, setting, and participants: This prespecified secondary analysis of a randomized clinical trial included mother-child pairs from the Danish Copenhagen Prospective Studies on Asthma in Childhood 2010 birth cohort, with prospective follow-up until children were aged 10 years. In the trial, maternal and child COX1 genotypes were determined, and urinary eicosanoids were quantified when the child was 1 year of age. The present study was conducted from January 2019 to December 2021, and data were analyzed from January to September 2023.

Intervention: A total of 736 pregnant women at 24 weeks' gestation were randomized 1:1 to 2.4 g of n-3 LCPUFA (fish oil) or placebo (olive oil) per day until 1 week post partum.

Main outcomes and measures: Risk of childhood AD until age 10 years overall and by maternal COX1 genotype.

Results: At age 10 years, 635 children (91%; 363 [57%] female) completed the clinical follow-up, and these mother-child pairs were included in this study; 321 (51%) were in the intervention group and 314 (49%) in the control group. Pregnancy n-3 LCPUFA supplementation was associated with lower urinary thromboxane A2 metabolites at age 1 year (β, -0.46; 95% CI, -0.80 to -0.13; P = .006), which was also associated with COX1 rs1330344 genotype (β per C allele, 0.47; 95% CI, 0.20-0.73; P = .001). Although neither n-3 LCPUFA supplementation (hazard ratio [HR], 1.00; 95% CI, 0.76-1.33; P = .97) nor maternal COX1 genotype (HR, 0.94; 95% CI, 0.74-1.19; P = .60) was associated with risk of childhood AD until age 10 years, there was evidence of an interaction between these variables (P < .001 for interaction). Among mothers with the TT genotype, risk of AD was reduced in the n-3 LCPUFA group compared with the placebo group (390 mother-child pairs [61%]; HR, 0.70; 95% CI, 0.50-0.98; P = .04); there was no association for mothers with the CT genotype (209 [33%]; HR, 1.29; 95% CI, 0.79-2.10; P = .31), and risk was increased among offspring of mothers with the CC genotype (37 [6%]; HR, 5.77; 95% CI, 1.63-20.47; P = .007). There was a significant interaction between n-3 LCPUFA supplementation and child COX1 genotype and development of AD (P = .002 for interaction).

Conclusions and relevance: In this secondary analysis of a randomized clinical trial, the association of prenatal n-3 LCPUFA supplementation with risk of childhood AD varied by maternal COX1 genotype. The findings could be used to inform a personalized prevention strategy of providing supplementation only to pregnant individuals with the TT genotype.

Trial registration: ClinicalTrials.gov: NCT00798226.

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产前补充鱼油、母体 COX1 基因型与儿童特应性皮炎:一项随机临床试验的二次分析。
重要性:二十烷酸在特应性皮炎(AD)中起着病理生理作用,但产前补充ω-3长链多不饱和脂肪酸(n-3 LCPUFA;即鱼油)和环氧化酶-1(COX1)通路的基因变异是否会对其产生影响尚不清楚:探讨孕期补充 n-3 LCPUFA 与儿童注意力缺失症总体风险及母体 COX1 基因型的关系:这项随机临床试验的预设二次分析纳入了丹麦哥本哈根儿童哮喘前瞻性研究 2010 年出生队列中的母婴对,并进行了前瞻性随访,直至儿童 10 岁。在试验中,测定了母婴的 COX1 基因型,并在儿童 1 岁时对尿液中的二十烷酸进行了量化。本研究于2019年1月至2021年12月进行,数据分析于2023年1月至9月进行:共有736名妊娠24周的孕妇按1:1随机分配到每天2.4克n-3 LCPUFA(鱼油)或安慰剂(橄榄油),直至产后1周:主要结果和测量指标:10岁前儿童患AD的总体风险和母体COX1基因型风险:结果:10 岁时,635 名儿童(91%;363 [57%]为女性)完成了临床随访,本研究纳入了这些母子对;干预组中有 321 名儿童(51%),对照组中有 314 名儿童(49%)。孕期补充 n-3 LCPUFA 与 1 岁时尿液中血栓素 A2 代谢物的降低有关(β,-0.46;95% CI,-0.80 至 -0.13;P = .006),这也与 COX1 rs1330344 基因型有关(每个 C 等位基因的 β,0.47;95% CI,0.20 至 0.73;P = .001)。虽然 n-3 LCPUFA 补充剂(危险比 [HR],1.00;95% CI,0.76-1.33;P = .97)和母体 COX1 基因型(HR,0.94;95% CI,0.74-1.19;P = .60)均与 10 岁前儿童注意力缺失症的风险无关,但有证据表明这些变量之间存在相互作用(P 结论和相关性):在这项随机临床试验的二次分析中,产前补充 n-3 LCPUFA 与儿童注意力缺失症风险的关系因母体 COX1 基因型而异。研究结果可用于制定个性化预防策略,即只为TT基因型的孕妇提供补充剂:试验注册:ClinicalTrials.gov:NCT00798226。
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来源期刊
JAMA dermatology
JAMA dermatology DERMATOLOGY-
CiteScore
14.10
自引率
5.50%
发文量
300
期刊介绍: JAMA Dermatology is an international peer-reviewed journal that has been in continuous publication since 1882. It began publication by the American Medical Association in 1920 as Archives of Dermatology and Syphilology. The journal publishes material that helps in the development and testing of the effectiveness of diagnosis and treatment in medical and surgical dermatology, pediatric and geriatric dermatology, and oncologic and aesthetic dermatologic surgery. JAMA Dermatology is a member of the JAMA Network, a consortium of peer-reviewed, general medical and specialty publications. It is published online weekly, every Wednesday, and in 12 print/online issues a year. The mission of the journal is to elevate the art and science of health and diseases of skin, hair, nails, and mucous membranes, and their treatment, with the aim of enabling dermatologists to deliver evidence-based, high-value medical and surgical dermatologic care. The journal publishes a broad range of innovative studies and trials that shift research and clinical practice paradigms, expand the understanding of the burden of dermatologic diseases and key outcomes, improve the practice of dermatology, and ensure equitable care to all patients. It also features research and opinion examining ethical, moral, socioeconomic, educational, and political issues relevant to dermatologists, aiming to enable ongoing improvement to the workforce, scope of practice, and the training of future dermatologists. JAMA Dermatology aims to be a leader in developing initiatives to improve diversity, equity, and inclusion within the specialty and within dermatology medical publishing.
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