New insights into the allergic march

Shaker, Marcus

doi:10.1097/mop.0000000000000120

Cited by 74 publications

(58 citation statements)

References 28 publications

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“…Japanese adult patients with AD reported a higher prevalence of arthritis, as well as the atopic comorbidities asthma and nasal allergies/hay fever relative to matched non‐AD controls. The association between AD and other atopic conditions has been recognized in previous studies,6, 28, 29 and is consistent with the concept of the “atopic march”, which postulates that AD predicts the development of other common allergic conditions 30…”

Section: Discussionsupporting

confidence: 87%

Burden of atopic dermatitis in Japanese adults: Analysis of data from the 2013 National Health and Wellness Survey

Arima

Gupta

Gadkari

et al. 2018

The Journal of Dermatology

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Atopic dermatitis is a chronic inflammatory skin disease. The objective of this study was to characterize the burden of atopic dermatitis in Japanese adult patients relative to the general population. Japanese adults (≥18 years) with a self‐reported diagnosis of atopic dermatitis and adult controls without atopic dermatitis/eczema/dermatitis were identified from the 2013 Japan National Health and Wellness Survey. Atopic dermatitis patients were propensity‐score matched with non‐atopic dermatitis controls (1:2 ratio) on demographic variables. Patient‐reported outcome data on comorbidities, mood and sleep disorders, health‐related quality of life, work productivity and activity impairment, and health‐care resource utilization were analyzed in atopic dermatitis patients and matched controls. A total of 638 Japanese adult patients with atopic dermatitis were identified, of whom 290 (45.5%) rated their disease as “moderate/severe” and 348 (54.5%) as “mild”. The analysis cohort comprised 634 atopic dermatitis patients and 1268 matched controls. Atopic dermatitis patients reported a significantly higher prevalence of arthritis, asthma, nasal allergies/hay fever, anxiety, depression and sleep disorders compared with controls (all P < 0.001). Atopic dermatitis patients also reported a significantly poorer health‐related quality of life, higher overall work and activity impairment, and higher health‐care resource utilization (all P < 0.001). Self‐rated disease severity was not associated with disease burden, except for a significantly higher overall work and activity impairment. In conclusion, Japanese adult patients with atopic dermatitis reported a substantial disease burden relative to adults without atopic dermatitis, suggesting an unmet need for effective strategies targeting disease management.

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Section: Discussionsupporting

confidence: 87%

Burden of atopic dermatitis in Japanese adults: Analysis of data from the 2013 National Health and Wellness Survey

Arima

Gupta

Gadkari

et al. 2018

The Journal of Dermatology

View full text Add to dashboard Cite

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“…1 ) which represents the natural history of atopic manifestations, characterized by a typical sequence of atopic diseases in childhood preceding the development of other allergic disorders later in life [2][3][4] . Fifty percent of all those with AD develop other allergic symptoms within their first year of life and probably as many as 85% of the patients experience an onset below 5 years of age.…”

Section: Introductionmentioning

confidence: 99%

Atopic Dermatitis: Global Epidemiology and Risk Factors

2015

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Fifty percent of all those with atopic dermatitis develop other allergic symptoms within their first year of life and probably as many as 85% of patients experience an onset below 5 years of age Key insights Atopic dermatitis often begins in early childhood and is the first Key WordsAtopic dermatitis · Atopic march · Skin barrier defect · Immune dysregulation · Genetics · Environment Abstract Atopic dermatitis (AD) is a chronic inflammatory skin disease posing a significant burden on health-care resources and patients' quality of life. It is a complex disease with a wide spectrum of clinical presentations and combinations of symptoms. AD affects up to 20% of children and up to 3% of adults; recent data show that its prevalence is still increasing, especially in low-income countries. First manifestations of AD usually appear early in life and often precede other allergic diseases such as asthma or allergic rhinitis. Individuals affected by AD usually have genetically determined risk factors affecting the skin barrier function or the immune system. However, genetic mutations alone might not be enough to cause clinical manifestations of AD, and it is merely the interaction of a dysfunctional epidermal barrier in genetically predisposed individuals with harmful effects of environmental agents which leads to the development of the disease. AD has been described as an allergic skin disease, but today, the contribution of allergic reactions to the initiation of AD is challenged, and it is proposed that allergy is rather a consequence of AD in subjects with a concomitant underlying atopic constitution. Treatment at best achieves symptom control rather than cure; there is thus a strong need to identify alternatives for disease prevention. • AD usually starts in early childhood and can be the initial step of the so-called 'atopic march'.• The prevalence of AD is as high as 20% in children in some countries and continues to increase, affecting now not only developed countries but also lowincome countries.• AD is a complex disease, and the relationship between allergy and AD (allergy being a cause and/or an exacerbating factor of AD) is still debated.• Genetics has recently been shown to be an important risk factor for AD, and the strongest association so far with the gene encoding filaggrin has raised the recent interest in the role of skin barrier impairment in the development of AD.• Environmental factors and specifically exposure to microbes are also recognized to play a role in the development of the disease.• AD is a multifactorial disease presenting with different endophenotypes.• The prevention of AD should start as soon as possible (possibly even in utero), targeting both skin barrier, immune/allergy and environmental aspects.

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“…Interestingly, in people, AD is typically the first step in a progression of events called "atopic march" which starts in the skin and progresses in many, but not all cases, into respiratory signs (rhinitis and later on asthma) [37]. As mentioned above, it is important to point out that although this progression is noted in individual patients, debate exists on the evidence of this phenomenon.…”

Section: Atopic Dermatitis: Comparative Observationsmentioning

confidence: 97%

Animal Models of Allergic Diseases

Santoro

Marsella

2014

Veterinary Sciences

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Allergic diseases have great impact on the quality of life of both people and domestic animals. They are increasing in prevalence in both animals and humans, possibly due to the changed lifestyle conditions and the decreased exposure to beneficial microorganisms. Dogs, in particular, suffer from environmental skin allergies and develop a clinical presentation which is very similar to the one of children with eczema. Thus, dogs are a very useful species to improve our understanding on the mechanisms involved in people's allergies and a natural model to study eczema. Animal models are frequently used to elucidate mechanisms of disease and to control for confounding factors which are present in studies with patients with spontaneously occurring disease and to test new therapies that can be beneficial in both species. It has been found that drugs useful in one species can also have benefits in other species highlighting the importance of a comprehensive understanding of diseases across species and the value of comparative studies. The purpose of the current article is to review allergic diseases across species and to focus on how these diseases compare to the counterpart in people.

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New insights into the allergic march

Abstract: Understanding of the interrelationships of atopic diseases allows earlier diagnosis of allergic conditions in at-risk patient populations and may lead to novel approaches to health promotion and disease prevention.

Cited by 74 publications

References 28 publications

Burden of atopic dermatitis in Japanese adults: Analysis of data from the 2013 National Health and Wellness Survey

Burden of atopic dermatitis in Japanese adults: Analysis of data from the 2013 National Health and Wellness Survey

Atopic Dermatitis: Global Epidemiology and Risk Factors

Animal Models of Allergic Diseases

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