Dual Factors May Be Necessary for Development of Atopic March in Early Infancy

Abstract

The incidence of atopic diseases, including atopic dermatitis (AD), food allergies, allergic rhinitis, and asthma, has increased in recent decades, and currently affects approximately 20% of the population. Atopic march is the development of AD in infancy and subsequent food allergies, allergic rhinitis, and asthma in later childhood. Patients with infantile eczema may develop typical symptoms of AD, allergic rhinitis, and asthma at certain ages. Some patients' symptoms persist for several years, whereas others may have resolution with aging. Development of these diseases is strongly influenced by the following two factors: skin dysfunction caused by filaggrin mutations and development of colonization of microflora in early infancy. Filaggrin mutations predisposing to asthma, allergic rhinitis, and allergic sensitization, only in the presence of AD, strongly support the role of filaggrin in the pathogenesis of AD and in subsequent progression of the atopic march. Several studies have shown that development of colonization of microflora in early infancy might affect development of allergic disease or food desensitization. Therefore, massive allergen exposure to genetic skin dysfunction in early infancy and an imbalance of microflora might be necessary for development of atopic march.

Comorbidities and Environmental Factors Associated with Atopic Dermatitis in Children and Adults in Dermatology-Venereology in Cotonou, Benin

“…[12,13,[16][17][18]. According to some authors, the risk of developing allergic rhinitis and asthma in the presence of AD is more or less important [1,2,16,19]. Considered as the key initiating event of atopic march, the alteration of the skin barrier accounts for the link between atopic dermatitis and subsequent atopic diseases [14,[19][20][21][22].…”

“…According to the authors of the hygiene theory, the presence of helminthiasis induces the secretion of anti-inflammatory cytokines and/or an increased response of suppressor T lymphocytes. e reduction of infectious diseases through vaccination and deworming leads to a reorientation of the immune system towards the 2 mechanism and so an increased sensitization to allergens [15,19,[25][26][27][28][29]. e hygiene theory also supports the fact that the lack of stimulation of the body by microbes is a risk factor for the onset of atopic diseases.…”

“…[ 12 , 13 , 16 – 18 ]. According to some authors, the risk of developing allergic rhinitis and asthma in the presence of AD is more or less important [ 1 , 2 , 16 , 19 ].…”

“…Considered as the key initiating event of atopic march, the alteration of the skin barrier accounts for the link between atopic dermatitis and subsequent atopic diseases [ 14 , 19 – 22 ]. In our study, asthma, which is significantly more frequent in adolescents, and the multiplicity of allergic diseases, associated with the onset of AD, confirm this hypothesis.…”