Urine phthalate levels were associated with skin barrier dysfunction and atopic sensitization in children

Abstract

OBJECTIVE: Phthalates can cause immunological disorders and aggravate allergic diseases. Thus, we investigated the re-lationship between urinary phthalate, skin barri-er function, and atopic sensitization in children.PATIENTS AND METHODS: In total, 448 school children [334 with severe allergic dis-ease; and 123 with severe atopic dermatitis (AD)] aged 10-12 years were enrolled in this study be-tween June and July 2017. Four high -molecu-lar-weight phthalates (HMWP) [sigma 4HMWP] and three low-molecular-weight phthalates (LMWP) [sigma 3LMWP] metabolites in urine samples, specif-ic immunoglobulin E (IgE), and total eosinophil count were measured. Four-part trans epidermal water loss (TEWL) (cheek, leg, and upper/low-er arm; sigma 4TEWL) was measured to evaluate the skin barrier function. RESULTS: After adjusting for confounding variables, sigma 4TEWL was significantly associat-ed with the quartiles of urinary sigma 4HMWP [ad-justed beta =7.897, 95% confidence interval (CI): 0.636-15.158, p=0.033] and sigma 3LMWP (adjusted beta =9.670, 95% CI: 2.422-16.919, p=0.009). The ad-justed analyses revealed that the quartiles of urinary sigma 4HMWP and sigma 3LMWP were not signifi-cantly associated with total eosinophil count, atopic sensitization, and severe AD (p>0.05). Ac-cording to the quartiles of urinary sigma 4HMWP and sigma 3LMWP, there were significant differences in the TEWL of the lower arm and leg (p<0.05) but not in cheek and upper arm.CONCLUSIONS: Exposure to HMWPs and LMWPs was significantly associated with skin barrier dysfunction but not with atopic sensiti-zation. These results suggest that children ex-posed to phthalates may be more susceptible to fragile skin barrier function.