ATOPIC dermatitis (AD), a chronic inflammatory skin condition, affects millions globally and is linked to systemic immune dysregulation. Similarly, inflammatory bowel disease (IBD), encompassing Crohn’s disease (CD), or ulcerative colitis (UC), is a major gastrointestinal disorder marked by chronic inflammation. Shared genetic, environmental, and microbial factors suggest a potential relationship between these diseases. This systematic review aimed to clarify whether AD elevates the risk of IBD by focusing on high-quality longitudinal data.
A total of eight retrospective cohort studies, involving 61,190,816 participants, were included. Data were sourced from PubMed, CENTRAL, Embase, Scopus, and Web of Science databases up to April 2024. The meta-analysis revealed that AD was associated with a significantly increased risk of IBD (odds ratio [OR]: 1.37, 95% confidence interval [CI]: 1.31–1.43) with no statistical heterogeneity. Subgroup analyses further showed that AD elevated the risk of CD (OR: 1.51, 95% CI: 1.31–1.76) and UC (OR: 1.33, 95% CI: 1.13–1.56), although with high inter-study heterogeneity (I² = 83% and 89%, respectively). Sensitivity analyses supported the robustness of these findings.
The findings indicate that AD is not only a skin disorder but also a systemic condition with significant implications for gastrointestinal health. For clinical practice, this association underscores the need for heightened awareness among healthcare providers regarding the potential development of IBD in patients with AD. Early identification and monitoring of gastrointestinal symptoms in this population could enable timely intervention and improve outcomes.
Future research should aim to unravel the biological mechanisms underlying this relationship and address the high heterogeneity observed in subgroup analyses. Prospective cohort studies and investigations into the impact of targeted AD treatments on IBD risk are also recommended to refine management strategies and enhance patient care.
Abigail Craig, EMJ
Reference
Yu P et al. The Association Between Atopic Dermatitis and Inflammatory Bowel Disease Risk: A Meta-Analysis of Longitudinal Studies. JGH Open. 2024;8(12):e70077.
