Longitudinal Atopic Dermatitis Endotypes: An Atopic March Paradigm That Includes Black Children

Atopic dermatitis and the atopic march: Considering racial and ethnic diversity in atopic disease progression

“…TRAP was previously associated with asthma in children living in the Cincinnati area. 7 Biagini et al 6 appropriately conclude that in their study cohort, Black and White children with AD have different atopic marches. 6 As most prior studies on the atopic march have included primarily White individuals or those of European descent, this study adds important and much-needed racial diversity to the existing literature.…”

“…The PARS is calculated on the basis of history of parental asthma, eczema, wheezing when healthy, early wheezing, allergies, and race. 6 Between the first and second visits, the rates of development of FA and AR were about 3 times higher among White children than among Black children, and the risk of asthma was almost 2.5-fold higher among Black children than among White children. 6 Specifically, the mean PARS (see Fig 2 in Biagini et al 6 ) among Black children was about 7.5 whereas that among White children was 4.5, but notably, the PARS includes 2 points for Black/African American race and zero points for White race.…”

“…6 Between the first and second visits, the rates of development of FA and AR were about 3 times higher among White children than among Black children, and the risk of asthma was almost 2.5-fold higher among Black children than among White children. 6 Specifically, the mean PARS (see Fig 2 in Biagini et al 6 ) among Black children was about 7.5 whereas that among White children was 4.5, but notably, the PARS includes 2 points for Black/African American race and zero points for White race. 6 Importantly, in Biagini et al, 6 environmental exposures such as traffic-related air pollution (TRAP) were also higher among Black children.…”

“…6 Specifically, the mean PARS (see Fig 2 in Biagini et al 6 ) among Black children was about 7.5 whereas that among White children was 4.5, but notably, the PARS includes 2 points for Black/African American race and zero points for White race. 6 Importantly, in Biagini et al, 6 environmental exposures such as traffic-related air pollution (TRAP) were also higher among Black children. TRAP was previously associated with asthma in children living in the Cincinnati area.…”

“…4 In this issue of the Journal of Allergy and Clinical Immunology, Biagini et al report on a well-designed longitudinal inception cohort of children with AD from the United States (in Cincinnati, Ohio), in which they observed different sequences for risk of asthma and rates of onset for FA and AR in Black children versus in White children. 6 Most of the children were enrolled by the age of 2 years, with outcomes determined at enrollment and approximately 2 years later. Allergic outcomes included sensitization (by skin prick testing), FA (by parental report of a physician diagnosis), AR (by parental report of symptoms), and asthma risk rather than by diagnosis based on the Pediatric Asthma Risk Score (PARS).…”