Allergy Asthma Immunol Res.  2019 Jan;11(1):4-15. 10.4168/aair.2019.11.1.4.

Mechanisms by Which Atopic Dermatitis Predisposes to Food Allergy and the Atopic March

• Tham EH
• Leung DY

• KMID: 2426781
• DOI: http://doi.org/10.4168/aair.2019.11.1.4

Abstract

The Atopic march denotes the progression from atopic dermatitis (AD) to the development of other allergic disorders such as immunoglobulin (Ig) E-mediated food allergy, allergic rhinitis and asthma in later childhood. There is increasing evidence from prospective birth cohort studies that early-onset AD is a risk factor for other allergic diseases or is found in strong association with them. Animal studies now provide mechanistic insights into the pathways that may be responsible for triggering the progression from the skin barrier dysfunction seen in AD to epicutaneous sensitization, food allergy and allergic airway disorders. Recent large randomized controlled trials have demonstrated the efficacy of early interventions targeted at AD and food allergy prevention. These show great promise for research into future strategies aimed at prevention of the atopic march.

Keyword

Atopic march; atopic dermatitis; allergic rhinitis, asthma, food allergy

MeSH Terms

Animals
Asthma
Cohort Studies
Dermatitis, Atopic*
Early Intervention (Education)
Food Hypersensitivity*
Immunoglobulins
Parturition
Prospective Studies
Rhinitis, Allergic
Risk Factors
Skin
Immunoglobulins

Figure

• 

  Fig. 1 The atopic march. The figure shows the age at diagnosis of each allergic disease. Reproduced with permission from Ann Allergy Asthma Immunol 2018;120:131-7.4

• 

  Fig. 2 Emollient therapy for AD prevention. Early skin barrier protection with prophylactic emollient therapy might prevent AD development. Original source: J Allergy Clin Immunol 2014;134:818-23, an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/).59 AD, atopic dermatitis; FLG, filaggrin; TSLP, thymic stromal lymphopoietin.

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