Format

Send to

Choose Destination
See comment in PubMed Commons below
Allergy. 2014 Jan;69(1):17-27. doi: 10.1111/all.12268. Epub 2013 Oct 14.

Atopic dermatitis and the atopic march revisited.

Author information

1
Centre for Molecular, Environmental, Genetic & Analytic (MEGA) Epidemiology, School of Population and Global Health, The University of Melbourne, Carlton, Vic., Australia; Murdoch Childrens Research Institute & Royal Children's Hospital, Parkville, Vic., Australia.

Abstract

Atopic dermatitis (AD) has become a significant public health problem because of increasing prevalence, together with increasing evidence that it may progress to other allergic phenotypes. While it is now acknowledged that AD commonly precedes other allergic diseases, a link termed 'the atopic march', debate continues as to whether this represents a causal relationship. An alternative hypothesis is that this association may be related to confounding by familial factors or phenotypes that comanifest, such as early-life wheeze and sensitization. However, there is increasing evidence from longitudinal studies suggesting that the association between AD and other allergies is independent of confounding by comanifest allergic phenotypes. The hypotheses on plausible biological mechanisms for the atopic march focus on defective skin barrier function and overexpression of inflammatory mediators released by the skin affected by AD (including thymic stromal lymphopoietin). Both human and animal studies have provided evidence supporting these potential biological mechanisms. Evidence from prevention trials is now critical to establishing a causal nature of the atopic march. An emerging area of research is investigation into environmental modifiers of the atopic march. Such information will assist in identifying secondary prevention strategies to arrest the atopic march. Despite much research into the aetiology of allergies, little progress has been made in identifying effective strategies to reduce the burden of allergic conditions. In this context, the atopic march remains a promising area of investigation.

KEYWORDS:

allergic rhinitis; asthma; atopic dermatitis; atopic march; eczema

PMID:
24117677
DOI:
10.1111/all.12268
[Indexed for MEDLINE]
Free full text
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley
    Loading ...
    Support Center