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J Allergy Clin Immunol. 2019 Mar;143(3):894-913. doi: 10.1016/j.jaci.2019.01.003. Epub 2019 Jan 9.

Report from the National Institute of Allergy and Infectious Diseases workshop on "Atopic dermatitis and the atopic march: Mechanisms and interventions".

Author information

1
National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Md.
2
Department of Pediatrics, National Jewish Health, Denver, and the Department of Pediatrics, University of Colorado at Denver Health Sciences Center, Aurora, Colo. Electronic address: LeungD@njhealth.org.
3
University of Rochester Medical Center, Rochester, NY.
4
Department of Pediatrics, Mindich Child Health and Development Institute, Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
5
Department of Pediatrics, National Jewish Health, Denver, and the University of Colorado School of Medicine, Aurora, Colo.
6
University of Wisconsin School of Medicine and Public Health, Madison, Wis.
7
Division of Immunology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
8
Division of Immunology, Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, Mass.
9
Department of Dermatology and the Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, and the Laboratory for Investigative Dermatology, Rockefeller University, New York, NY.
10
Paediatric Dermatology, Our Lady's Children's Hospital, Crumlin, National Children's Research Centre and Trinity College, Dublin, Ireland.
11
Center for the Study of Itch, the Division of Dermatology, Department of Medicine, the Department of Anesthesiology, and the Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Mo.
12
Dermatology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Md.
13
Paediatric Allergy, Department of Women and Children's Health, Peter Gorer Department of Immunobiology, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.
14
Sean N. Parker Center for Allergy and Asthma Research at Stanford University, and the Department of Medicine Department of Pediatrics, Stanford University, Stanford, Calif.
15
Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom.
16
Department of Dermatology, Oregon Health & Science University, Portland, Ore.
17
Department of Pediatrics, Division of Allergy and Immunology, The Children's Hospital of Philadelphia, Philadelphia, and the Institute for Immunology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa.
18
Department of Pediatric Pneumology and Immunology, Charité, Berlin, Germany.
19
Johns Hopkins University School of Medicine, Baltimore, Md.
20
Department of Medicine, University of Virginia School of Medicine, Charlottesville, Va.
21
Immunology Program, Benaroya Research Institute, Seattle, Wash.

Abstract

Atopic dermatitis (AD) affects up to 20% of children worldwide and is an increasing public health problem, particularly in developed countries. Although AD in infants and young children can resolve, there is a well-recognized increased risk of sequential progression from AD to other atopic diseases, including food allergy (FA), allergic rhinitis, allergic asthma, and allergic rhinoconjunctivitis, a process referred to as the atopic march. The mechanisms underlying the development of AD and subsequent progression to other atopic comorbidities, particularly FA, are incompletely understood and the subject of intense investigation. Other major research objectives are the development of effective strategies to prevent AD and FA, as well as therapeutic interventions to inhibit the atopic march. In 2017, the Division of Allergy, Immunology, and Transplantation of the National Institute of Allergy and Infectious Diseases sponsored a workshop to discuss current understanding and important advances in these research areas and to identify gaps in knowledge and future research directions. International and national experts in the field were joined by representatives from several National Institutes of Health institutes. Summaries of workshop presentations, key conclusions, and recommendations are presented herein.

KEYWORDS:

Atopic march; asthma; atopic dermatitis; biomarkers; food allergy; interventions; skin barrier; skin microbiome

PMID:
30639346
DOI:
10.1016/j.jaci.2019.01.003

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