Natural history of sensitizations in atopic dermatitis. A 3-year follow-up in 250 children: food allergy and high risk of respiratory symptoms

Guillet, G.

doi:10.1001/archderm.128.2.187

Cited by 85 publications

(52 citation statements)

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“…Clinically, this was seen in a group of young children (under 2 years old) with mild AE) who were sensitive to food allergens, but not to aeroallergens. Within 3 years, these children (27/29 cases) developed more severe AD with sensitivity to aeroallergens; in addition, 23 of these children developed respiratory symptoms (28). Therefore, control of IgE production is not only important for symptom treatment in allergy, but may also prevent deterioration of allergy through the mechanism of CD23/lgE-mediated allergen presentation by B cells.…”

Section: Resultsmentioning

confidence: 99%

IgE‐mediated antigen presentation

Mudde¹,

Bheekha²,

Bruijnzeel-Koomen³

1995

Allergy

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Mudde GC, Bheekha R, Bruijnzeel-Koomen CAFM. IgE-mediated antigen presentation. Allergy 1995: 50: 193-199 Atopic allergy afflicts at least 20% of the population in developed countries. It comprises a wide range of IgE-mediated disorders, such as hay fever, asthma, atopic dermatitis (AD), and food allergies. Higher serum IgE concentrations correlate with hyperreactive diseases in which larger parts of skin, mucosa, or both are involved ( Fig. 1) (66). Clearly, there is a direct connection between IgE titers and the distribution of effector cells which bear high-affinity receptors for IgE (Ec,-RI), such as mast cells and basophils. However, the view that these cells are unique in expressing Fc^Rl cannot be sustained since the recent discovery of FCfRI on normal Langerhans' cells (6, 65), on monocytes from atopic patients (36), and on eosinophils in parasitic infections (54). The finding of Fc,-RI in human skin (44) and blood, on cells different from effector cells such as mast cells and basophils, suggests an additional role for IgE in immune responses (38). Moreover, not only can FCjRI be found on antigen-presenting cells (APCs), but also the low-affinity receptor for IgE (Fc^RII or CD23) can be found and induced on many different cell types including APCs (60). Therefore, the data pointing to a role of IgE in antigen focusing are accumulating. In addition, we propose that IgE has a role in allergy expansion by generating allergies to new allergens.

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Section: Resultsmentioning

confidence: 99%

IgE‐mediated antigen presentation

Mudde¹,

Bheekha²,

Bruijnzeel-Koomen³

1995

Allergy

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“…It is now stated that AD patients have an increased risk of developing ARD [13, 14, 15, 29, 30, 31, 32]. The ARD can arise when AD has disappeared or in active AD, i.e.…”

Section: Discussionmentioning

confidence: 99%

Adult-Onset Atopic Dermatitis in a Patch Test Population

Ingordo¹,

D’Andria²,

D’Andria³

2003

Dermatology

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Background: Epidemiological studies about atopic dermatitis (AD) almost exclusively relate to childhood disease with little mention of adult-onset disease. In clinical practice, however, patients who have AD and in whom the onset of disease occurs in adult life are sometimes seen. Objective: Because the subjects with a chronic and recalcitrant eczema are frequently patch tested, the aim of this study was to evaluate the prevalence of adult-onset AD in a patch test population and the differences existing between the early- and adult-onset subsets. Methods: This retrospective analysis was performed on 502 adults (458 males, 44 females) affected by eczematous dermatitis, consecutively examined in the Department of Dermatology of the Italian Navy Hospital in Taranto. In this department, all the eczematous subjects are routinely submitted to the following tests: standard series (GIRDCA or SIDAPA with integrative haptens), prick test with environmental aeroallergens and common food allergens and dosage of total serum IgE. If it is required, additional series of patch tests are also applied. Many patients are also submitted to the atopy patch test (APT) with whole bodies of house dust mites at a concentration of 20%. In the AD patients, diagnosed according to the criteria of Hanifin and Rajka, the ages of onset were subdivided into the following categories: infancy (0–3 years); childhood (4–11 years); adolescence (≧12 years). We arbitrarily also used the age of 18 years as the cut-off mark to allocate the patients to the adult-onset group (AOG) and defined as early-onset group (EOG) the cases encompassed in the aforesaid categories (i.e. onset ≤17 years). Results: 8.8% of all eczemas were adult-onset ADs. 28 (5.6% of all eczemas) adult-onset ADs were ‘sole’ ADs, while 22 cases (3.2% of all eczemas) were adult-onset ADs in which a contact sensitization was detected. The mean SCORAD indexes, according to the age-of-onset groups, decreased when the age of onset increased. No statistical difference was detected between the EOG and AOG with regard to true contact sensitization, clinically relevant or non-relevant contact sensitization, prevalence of ‘pure’ AD and ‘mixed’ AD, and outcome of the APT. The hands were the most frequently affected site in the AOG. Conclusion: A small but significant number of patch-test-negative eczematous cases could be adult-onset ADs and, in this instance, the other two allergological tests (i.e. prick tests and dosage of total serum IgE) and an accurate evaluation according to stated clinical criteria should be performed. However, other studies on large series of patients are required to confirm our observation.

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“…colic, diarrhea and vomiting) and may aggravate the dermatitis [2]. Above all, it is an early pathogenic event during the childhood of atopic patients and is a prognostic factor for the subsequent development of severe AD [5]. Although the exact incidence of food intolerance among atopics is still uncertain, the proportion of our screened AD population found to have abnormal intestinal permeability to lactulose (17%) is in conformity with published reports, indicating a 10–20% incidence in AD subjects over 10 years of age [2, 6].…”

Section: Discussionmentioning

confidence: 99%

Low-Salt Water Reduces Intestinal Permeability in Atopic Patients

Dupuy

Cassé

André³

et al. 1999

Dermatology

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Background: Clinical remission of atopic dermatitis (AD) after intake of a low-salt water has recently been reported. Methods: We here investigated the effects of a low-salt water in AD patients with increased intestinal permeability to lactulose. From an initial group of 75 atopic patients, who undertook a treatment in a medical spa center, 12 were included because of abnormal urinary excretion of lactulose (>0.6%), which is absorbed in the enterocytic interspaces, at baseline. The excretion of mannitol with an extraenterocytic absorption was also studied as control. During 18 days, the patients followed a medical spa treatment course, including topical application and oral ingestion of a low-mineral water. Patients were asked not to modify their usual food regimen during the cure. At the end of treatment (day 18), the determination of the excretion of both sugars in urine was repeated. Results: At baseline, the mean urine excretion of lactulose in the study population was 1.21 ± 0.08 SEM. At the end of treatment (day 18), the lactulose concentration in urine diminished dramatically by 55% (mean 0.55 ± 0.09 SEM, p = 0.0005). Urine mannitol was also found to be reduced over the cure period, although to a lesser extent (30%, p = 0.04). Conclusion: This study indicates that low-mineral water normalizes the intestinal permeability of patients with AD.

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Natural history of sensitizations in atopic dermatitis. A 3-year follow-up in 250 children: food allergy and high risk of respiratory symptoms

Cited by 85 publications

References 0 publications

IgE‐mediated antigen presentation

IgE‐mediated antigen presentation

Adult-Onset Atopic Dermatitis in a Patch Test Population

Low-Salt Water Reduces Intestinal Permeability in Atopic Patients

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