261 results on '"atopic march"'
Search Results
2. Fecal zonulin as a prognostic marker of atopic march in children with food allergy
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N. G. Prikhodchenko, T. A. Shumatova, and D. V. Kovalenko
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fecal zonulin level ,atopic march ,food allergy ,children ,intestinal barrier permeability ,Pediatrics ,RJ1-570 - Abstract
Introduction. The onset of allergic diseases most often occurs in early childhood with the onset of food allergies, which can subsequently lead to the implementation of the atopic march. Increased intestinal permeability with high production of zonulin, the main moderator of intestinal tight junctions, can be an important link in the development of comorbid allergic diseases.Material and methods. In order to study the significance of fecal zonulin as a marker for predicting the atopic march in children with food allergy, a cross-sectional retrospective study was conducted on 73 children aged 5 years who were diagnosed with food allergy (FA) to cow’s milk proteins in the first year of life. In all children, when the diagnosis was made in the first year of life, the content of zonulin in feces was determined using the ELISA method.Results. As a result of dynamic observation, all children with food allergy were divided into 2 groups: the first group consisted of children with food allergy who developed allergic rhinitis and/or bronchial asthma within 5 years (group I, n = 39), group 2 consisted of 34 children with food allergy who did not implement the atopic march within 5 years of observation (group II, n = 34). Our study showed statistically significant differences in the fecal zonulin level in the first year of life: group I Me = 2.39 ng/ml (Q1-Q3: 1.78–2.65 ng/ml), group II Me = 1.85 ng/ml (Q1-Q3: 0.49–0.91 ng/ml), p = 0.034. Strong direct correlations were found (Spearman correlation coefficient S = 0.681 (p < 0.05)) between the zonulin level in feces at the onset of the disease and the development of allergic rhinitis and/or bronchial asthma up to 5 years of age, the data were confirmed by comparing the areas under the curves during ROC analysis, AUC in the study of fecal zonulin as a prognostic marker of the risk of atopic march in children is 0.887, the optimal threshold (cutoff point) is 1.94 ng/ml.Conclusions. Fecal zonulin level in children with food allergy can be an effective prognostic marker of atopic march development, its values in feces above 1.94 ng/ml allow us to predict with a high degree of probability the risk of atopic march development in children with food allergy to cow’s milk proteins within 5 years
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- 2024
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3. A Cross-Sectional Study for the Assessment of Fractional Exhaled Nitric Oxide in Children with Atopic Dermatitis and Reactive Airway Disease in Comparison to Healthy Controls
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Mimi Ganguly, Aniruddha Ghosh, Sandipan Dhar, Indrani Roy, and Ritabrata Kundu
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asthma ,atopic dermatitis ,atopic march ,fractional exhaled nitric oxide ,nitric oxide ,Dermatology ,RL1-803 ,Pediatrics ,RJ1-570 - Abstract
Introduction: Nitric oxide (NO) is an important biological mediator of inflammation which is exhaled after being produced in the lungs. Fractional exhaled NO (FENO) is a new tool which measures the amount of NO exhaled. Aims and Objective: The objective of our study was to find the correlation between the FENO levels between atopic dermatitis and asthma patients in comparison to healthy controls and hence identify steroid responsiveness. Methodology: Our study was a cross-sectional observational study performed in a tertiary care hospital involving 150 children (>5–
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- 2024
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4. New Opportunities of Dupilumab in Achieving Disease Control in Preschool Age Patients with Atopic Dermatitis: Clinical Case
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Julia G. Levina, Polina A. Pyzhyanova, Vera G. Kalugina, Kamilla E. Efendieva, Elena A. Vishneva, Anna A. Alekseeva, and Leyla S. Namazova-Baranova
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children ,atopic dermatitis ,atopic march ,management ,dupilumab ,clinical case ,Pediatrics ,RJ1-570 ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Background. Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases in children. It manifests during the first year of life in majority of cases. Early AD manifestation is a risk factor for the development of other atopic spectrum diseases in the future. Nowadays, the ability of the dupilumab, as a genetically engineered biologic drug (GEBD), to modify the disease course, to reduce the frequency of AD persistence and the possibility of multimorbid atopic phenotype development is widely discussed. Thus, dupilumab management in young children with early onset and severe course arouses specific interest. Clinical case description. This article demonstrates the experience of effective administration of GEBD dupilumab in 4-year old patient with severe AD and comorbid food allergies. Continuous therapy for 12 weeks allowed to recover disease’s skin manifestations. No adverse events were reported. Conclusion. Long-term continuous dupilumab administration in children aged from 6 months to 5 years has proven its efficacy and acceptable safety profile. The potential disease-modifying effect of dupilumab is especially significant for young and preschool children due to the high risk atopic multimorbidity developing during this period.
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- 2024
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5. From Pathogenesis to Treatment: Targeting Type-2 Inflammation in Eosinophilic Esophagitis.
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Barchi, Alberto, Mandarino, Francesco Vito, Yacoub, Mona-Rita, Albarello, Luca, Massimino, Luca, Savarino, Edoardo Vincenzo, Ungaro, Federica, Passaretti, Sandro, Masclee, Gwen M. C., Danese, Silvio, Bredenoord, Albert J., and Vespa, Edoardo
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EOSINOPHILIC esophagitis , *IMMUNOMODULATORS , *ALLERGIC rhinitis , *NASAL polyps , *DRUG target - Abstract
Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder of the esophagus. EoE shares a common pathogenetic mechanism with other chronic disorders pertaining to the type 2 inflammatory spectrum, such as atopic dermatitis (AD), allergic rhinitis (AR), asthma, and chronic rhinosinusitis with nasal polyps (CRSwNP). The recent advancements in EoE pathogenesis understanding have unveiled new molecular targets implied within the "atopic march" picture as well as specific to EoE. These discoveries have led to the clinical evaluation of several novel drugs (monoclonal antibodies and immune modulators), specifically aimed at the modulation of Th2 inflammation. In this comprehensive review, we have focused on the subtle mechanisms of type 2 inflammatory disorders, highlighting the similarities and differences with EoE, taking a deeper look into the evolving field of biologic therapies, already approved or under current investigation. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Eosinophilic esophagitis in the 'atopic march': dupilumab as an 'umbrella' strategy for multiple coexisting atopic diseases
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Nicola Lutzu, Agnese Favale, Mauro Demurtas, Stefano Del Giacco, Sara Onali, and Massimo Claudio Fantini
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esophagitis ,atopic march ,anti-IL4 ,anti-IL13 ,eosinophils ,dupilumab ,Medicine (General) ,R5-920 - Abstract
Dupilumab is a monoclonal antibody targeting interleukin-4 and interleukin-13, approved for the treatment of multiple T2 diseases and more recently for Eosinophilic Esophagitis (EoE). EoE is a chronic T2 inflammatory disease, believed to be a member of the “atopic march”, due to multiple similarities with other atopic diseases, ranging from epidemiology to genetics and pathophysiology. Although often co-existing in the same patient, these diseases are still treated as separated entities by different specialists, resulting in polypharmacy and chronic use of steroids. Thus, a shared-decision approach by a multidisciplinary team composed of different specialists might improve clinical management and outcomes. Yet, prospective data on the effectiveness of dupilumab as a single agent for multiple T2 inflammatory diseases are lacking, since only few case reports and small studies have been published so far reporting outcomes in patients affected by multiple T2 diseases. The purpose of this review is to illustrate the rationale and clinical evidence supporting the possibility of using dupilumab as a single therapeutic agent in those patients affected by multiple T2 diseases in addition to EoE.
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- 2025
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7. Dupilumab and atopic march; Reduction of incident allergic events or Clinical control?
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Jorge Sánchez, Leidy Alvarez, and Susana Diez
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Monoclonal antibody ,Atopic March ,Dupilumab ,Atopic dermatitis ,Immunologic diseases. Allergy ,RC581-607 - Abstract
To the editor: The article by Geba et al., entitled “Attenuating the atopic march: Meta-analysis of the dupilumab atopic dermatitis database for incident allergic events”,1,2 published in JACI 2023 Mar; 151 (3): 756-766, offers insights into the potential of dupilumab in modulating the atopic march. The author’s comment: “…Dupilumab reduced the risk of new/worsening allergies by 34% (IRR 0.66; 95% confidence interval [CI], 0.52-0.84) and new allergies by 37% (IRR: 0.63; 95%CI: 0.48-0.83) versus placebo”, and “…These treatment benefits did not reverse on treatment discontinuation in off-treatment follow-up”. Although the results are interesting, the study presents some methodological and conceptual aspects that call to be cautious with interpreting the results. • The study's primary objective was "…to determine the rate of acquisition of new or worsened allergic events for dupilumab versus placebo in patients with AD". However, the use of dupilumab may mask symptoms of different allergic conditions, and these may only become evident after therapy discontinuation.3 Despite the authors' claim that “These treatment benefits did not reverse on treatment discontinuation in off-treatment follow-up,” when reviewing information about “off-treatment period” in Figure E3 we observe that the confidence interval of all studies crosses 1 and, additionally, the incidence rate ratio (IRR) was 0.99 (CI 95% 0.62-1.59.) Therefore, these results do not support the previous affirmation. • Table E1 reveals a follow-up time of 16 to 52 weeks in the studies. Within this short period and considering predominantly adult patients, the observed variation in allergic events between dupilumab and control groups appears more attributable to disease control than a genuine reduction in incidence. • The main result of the study present in Figure 3 “Dupilumab reduced the risk of new/worsening allergies by 34% (IRR 0.66; 95% confidence interval [CI], 0.52-0.84) and new allergies by 37% (IRR 0.63; 95% CI, 0.48-0.83) versus placebo.” Of the 12 studies included in the Forest plot A and B, 11 crosses 1. Additionally, a single study (R668-AD-1224) does not cross 1 and contributes with 47.6% of the weight, dragging down the observed significance. This may be due to the ecological fallacy, where aggregate analyses are interpreted but not the interindividual variability of patients.4 Also, lack of bias assessment and publication verification reduces the reliability of the study's findings. • It is not clear how the authors defined some terms used in the article as “allergic conditions”, “chemical allergy”, “metal allergy”, “contact dermatitis”, “asthma”, and “wheezing”. The lack of clarity in the definitions generates a risk of ambiguity fallacy.5 • It´s controversial that all conditions included in the study are really part of the atopic march. For example, authors included “pruritus” or “urticaria.” • How was pet’s allergy defined? While biologics may suppress specific IgE responses, their influence on clinical outcomes is not adequately addressed. In summary, we thank Geba et al. for raising an interesting question about the impact of dupilumab on the atopic march. The question remains largely unanswered, underscoring the importance of future studies for a comprehensive understanding of biologics' effects on the atopic march.
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- 2024
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8. A Cross-Sectional Study for the Assessment of Fractional Exhaled Nitric Oxide in Children with Atopic Dermatitis and Reactive Airway Disease in Comparison to Healthy Controls.
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Ganguly, Mimi, Ghosh, Aniruddha, Dhar, Sandipan, Roy, Indrani, and Kundu, Ritabrata
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ASTHMATICS ,ATOPIC dermatitis ,PATIENT compliance ,INFLAMMATORY mediators ,ASTHMA - Abstract
Introduction: Nitric oxide (NO) is an important biological mediator of inflammation which is exhaled after being produced in the lungs. Fractional exhaled NO (FENO) is a new tool which measures the amount of NO exhaled. Aims and Objective: The objective of our study was to find the correlation between the FENO levels between atopic dermatitis and asthma patients in comparison to healthy controls and hence identify steroid responsiveness. Methodology: Our study was a cross-sectional observational study performed in a tertiary care hospital involving 150 children (>5–<18 years) who were either attending the outpatient departments or were admitted as inpatients. Relevant history and physical findings were noted and severity scorings were done in the preformed pro forma. Their FENO levels were then recorded and compared. Results: The level of FENO was higher in both bronchial asthma and atopic dermatitis patients as compared to controls. The level of FENO was higher in treatment-naïve patients as compared to treated cases. There was also a strong positive correlation between the levels of FENO and disease severity in both the groups. Conclusion: FENO is a relatively new tool and as such still requires standardization and acceptance in the medical field. It can be a very useful tool in not only identifying these atopic diseases, but it can also act as a prognostic marker as well as a marker for patient compliance. There being a gap in literature related to FENO, hopefully our study will provide some insight to its usefulness. [ABSTRACT FROM AUTHOR]
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- 2024
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9. Recent prevalence of allergic rhinitis caused by house dust mites among the pediatric population in Fukui, Japan
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Yoshimasa Imoto, MD, PhD, Masafumi Sakashita, MD, PhD, Takahiro Tokunaga, MD, PhD, Masafumi Kanno, MD, PhD, Kyoko Saito, MD, Anna Shimizu, MD, Ayako Maegawa, MD, and Shigeharu Fujieda, MD, PhD
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Allergic rhinitis ,House dust mites ,Elementary school children ,Onset of allergic rhinitis ,Atopic march ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Background: Allergic rhinitis (AR) is an IgE-mediated type I allergic chronic nasal disease common among all age groups, including the pediatric population. House dust mites (HDMs) are globally ubiquitous and the most important indoor aeroallergen. However, the recent prevalence of HDM-caused AR (AR-HDM) in Japan remains unknown, especially after the COVID-19 pandemic. Objective: The objective of this study was to investigate the current prevalence of AR-HDM, its clinical features, and the current status of medical examinations in elementary school students. Methods: A survey of 41,000 elementary school students was conducted during July 2021 in Fukui Prefecture, Japan. Parents were asked to complete a questionnaire that examined allergic disease history and clinical background. Results: A total of 17,974 subjects were analyzed in the study. The results showed that the current prevalence of AR-HDM in elementary school children is 18.8%. We found that AR-HDM had already developed before entrance into elementary school in 68.3% of affected subjects. Among these subjects, 82.3% had received some form of treatment, such as prescription medications, whereas 4.2% were treated by allergen immunotherapy. Multiple logistic regression analysis of the onset of AR-HDM revealed that male sex, being the first-born child, comorbidity of bronchial asthma, atopic dermatitis, food allergy, and allergic conjunctivitis are associated with development of AR-HDM. Conclusions: The present study revealed the prevalence of AR-HDM in elementary school children. The results emphasize the importance of appropriate diagnosis and treatment from infancy through early childhood.
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- 2024
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10. Polygenic prediction of atopic dermatitis improves with atopic training and filaggrin factors
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Arehart, Christopher H, Daya, Michelle, Campbell, Monica, Boorgula, Meher Preethi, Rafaels, Nicholas, Chavan, Sameer, David, Gloria, Hanifin, Jon, Slifka, Mark K, Gallo, Richard L, Hata, Tissa, Schneider, Lynda C, Paller, Amy S, Ong, Peck Y, Spergel, Jonathan M, Guttman-Yassky, Emma, Leung, Donald YM, Beck, Lisa A, Gignoux, Christopher R, Mathias, Rasika A, and Barnes, Kathleen C
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Biomedical and Clinical Sciences ,Immunology ,Genetics ,Prevention ,Clinical Research ,Human Genome ,Aetiology ,2.1 Biological and endogenous factors ,Dermatitis ,Atopic ,Female ,Filaggrin Proteins ,Genetic Predisposition to Disease ,Genome-Wide Association Study ,Humans ,Infant ,Linkage Disequilibrium ,Loss of Function Mutation ,Male ,Phenotype ,Atopic dermatitis ,polygenic risk score ,atopic march ,allergic disease ,genetic architecture ,filaggrin ,disease prediction ,genetic predisposition ,Allergy - Abstract
BackgroundWhile numerous genetic loci associated with atopic dermatitis (AD) have been discovered, to date, work leveraging the combined burden of AD risk variants across the genome to predict disease risk has been limited.ObjectivesThis study aims to determine whether polygenic risk scores (PRSs) relying on genetic determinants for AD provide useful predictions for disease occurrence and severity. It also explicitly tests the value of including genome-wide association studies of related allergic phenotypes and known FLG loss-of-function (LOF) variants.MethodsAD PRSs were constructed for 1619 European American individuals from the Atopic Dermatitis Research Network using an AD training dataset and an atopic training dataset including AD, childhood onset asthma, and general allergy. Additionally, whole genome sequencing data were used to explore genetic scoring specific to FLG LOF mutations.ResultsGenetic scores derived from the AD-only genome-wide association studies were predictive of AD cases (PRSAD: odds ratio [OR], 1.70; 95% CI, 1.49-1.93). Accuracy was first improved when PRSs were built off the larger atopy genome-wide association studies (PRSAD+: OR, 2.16; 95% CI, 1.89-2.47) and further improved when including FLG LOF mutations (PRSAD++: OR, 3.23; 95% CI, 2.57-4.07). Importantly, while all 3 PRSs correlated with AD severity, the best prediction was from PRSAD++, which distinguished individuals with severe AD from control subjects with OR of 3.86 (95% CI, 2.77-5.36).ConclusionsThis study demonstrates how PRSs for AD that include genetic determinants across atopic phenotypes and FLG LOF variants may be a promising tool for identifying individuals at high risk for developing disease and specifically severe disease.
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- 2022
11. Personalized genotype-associated diagnosis of the progression of atopic march in children
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V.O. Dytiatkovskyi
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atopic march ,children ,phenotypes ,single nucleotide variants ,thymic stromal lymphopoietin ,orosomucoid-like-1 protein 3 ,Pediatrics ,RJ1-570 - Abstract
Background. Atopic march (AM) is the progression of atopic lesions (AL) from monoorganic phenotypes (MOPh), usually atopic dermatitis (AD), to a combination with allergic rhinitis/rhinoconjunctivitis (AR/ARC) and bronchial asthma (BA) in the full-scope polyorganic phenotype (POPh) AD + AR/ARC + BA. At the same time, AD is the initial and basic AM MOPh. The basis of AL and AM is the human genotype, in particular, single nucleotide variants (SNV) of genes that predispose to the development of AL phenotypes. Namely, these are SNV of thymic stromal lymphopoietin (TSLP) and orоsomucoid-1-like protein 3 (ORMDL3): SNV rs_11466749 TSLP and rs_7216389 ORMDL3. The purpose of this study was to detect the associations and risks of developing AM POPh AD + AR/ARC and AD + AR/ARC + BA related to baseline MOPh AD and to each other in children with different SNV rs_11466749 TSLP and rs_7216389 ORMDL3 genotypes. Materials and methods. Two hundred and thirty-two children aged 3 to 18 years took part in the study. The main group consisted of 127 patients with 3 studied AM phenotypes: one MOPh AD (n = 58) and two POPh: AD + AR/ARC (n = 43) and AD + AR/ARC + BA (n = 26). The control group included 105 children without AL, suffering from gastrointestinal diseases. All children in the study groups underwent a buccal swab of the DNA material, which then was studied using the real-time polymerase chain reaction with restriction fragment length polymorphism to determine the genotypes of SNV candidates: A/A, A/G, G/G rs_11466749 TSLP and C/C, C/T, T/T rs_7216389 ORMDL3. Pearson’s χ2 criterion and Fisher’s exact test, Bravais-Pearson contingency coefficient (r), logistic regression analysis with determination of odds ratio (OR) with 95% confidence interval (95% CI), receiver operating characteristic (ROC) analysis with calculation of the area under the ROC curve with a 95% CI and operating characteristics — sensitivity and specificity were used for statistical processing. The critical level of statistical significance of the results during testing of all hypotheses was p < 0.05, the tendency to probability was determined at p = 0.05–0.1. Results. The following statistically significant differences were detected in the occurrence of genotypes related to the control group: for POPh AD + AR/ARC: SNV rs_7216389 ORMDL3: C/C — 14.0 %, T/T — 39.5 to 27.6 and 15.2 %, respectively (p = 0.08 and p < 0.05); for POPh AD + AR/ARC + BA: SNV rs_11466749 TSLP: A/A — 77.0 %, A/G — 11.5 to 50.5 and 45.7 %, respectively (p < 0.05 and p < 0.01). Among the phenotypes of the main group, the following statistically significant differences in the genotypes incidence had been detected: AD + AR/ARC related to AD: G/G rs_11466749 TSLP — 9.3 to 1.7 % (p = 0.08), T/T rs_7216389 ORMDL3 — 39.5 to 19.0 % (p
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- 2023
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12. Atopic March or Atopic Multimorbidity—Overview of Current Research.
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Mrkić Kobal, Iva, Plavec, Davor, Vlašić Lončarić, Željka, Jerković, Ivana, and Turkalj, Mirjana
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ALLERGIC rhinitis ,ALLERGIES ,ATOPIC dermatitis ,FOOD allergy ,JUVENILE diseases ,ATOPY - Abstract
The atopic march encompasses a sequence of allergic conditions, including atopic dermatitis, food allergy, allergic rhinitis, and asthma, that frequently develop in a sequential pattern within the same individual. It was introduced as a conceptual framework aimed at elucidating the developmental trajectory of allergic conditions during childhood. Following the introduction of this concept, it was initially believed that the atopic march represented the sole and definitive trajectory of the development of allergic diseases. However, this perspective evolved with the emergence of new longitudinal studies, which revealed that the evolution of allergic diseases is far more intricate. It involves numerous immunological pathological mechanisms and may not align entirely with the traditional concept of the atopic march. The objective of our review is to portray the atopic march alongside other patterns in the development of childhood allergic diseases, with a specific emphasis on the potential for a personalized approach to the prevention, diagnosis, and treatment of atopic conditions. [ABSTRACT FROM AUTHOR]
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- 2024
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13. Nurturing Infants to Prevent Atopic Dermatitis and Food Allergies: A Longitudinal Study.
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Vassilopoulou, Emilia, Rallis, Dimitrios, Milani, Gregorio Paolo, Agostoni, Carlo, Feketea, Gavriela, Lithoxopoulou, Maria, Stefanaki, Evangelia, Ladomenou, Fani, Douladiris, Nikolaos, Cronin, Caoimhe, Popescu, Codruta Alina, Pop, Raluca Maria, Bocsan, Ioana Corina, and Tsabouri, Sophia
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Background: Atopic dermatitis (AD) at a young age often precedes the development of food allergies. Although AD affects millions of infants worldwide, prenatal and postnatal risk factors, and their association with the development of food allergies later on, are not fully elucidated. This study seeks to investigate AD epidemiology in infancy and its risk factors, examining early-life factors (both prenatal and postnatal) that could contribute to the later development of food allergies. Methods: Between January 2019 and December 2019, 501 infants were included in this prospective cohort study. Longitudinal data collection was performed through maternal interviews, the first one conducted within three days after the delivery and the second within 24 to 36 months after the delivery, encompassing variables such as demographics, family history of atopy, maternal smoking, antibiotic use during pregnancy, the mode of delivery, breastfeeding history, food practices, and greenness exposure within 3 days from delivery, while they were still in the hospital. Results: Maternal smoking during pregnancy (p = 0.001) and an older sibling atopy history (p = 0.03) was significantly linked to AD incidence. Cesarean section delivery (p = 0.04) was associated with a higher risk of food allergies in infants with AD. Having a garden at home correlated with a higher likelihood of AD (p = 0.01), and food elimination without medical guidance (p = 0.02) due to AD correlated with an elevated risk of food allergies. Conclusions: Encouraging timely allergenic food introduction while promoting dietary diversity, rich in plant-based foods, maternal smoking cessation, and professional dietary guidance may help minimize AD and food allergy risk. Future studies should address the role of greenness in the development of AD and food allergies. [ABSTRACT FROM AUTHOR]
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- 2024
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14. Antigen Protease Activity on Intact or Tape-Stripped Skin Induces Acute Itch and T Helper Sensitization Leading to Airway Eosinophilia in Mice
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Toru Kimitsu, Seiji Kamijo, Tomoko Yoshimura, Yurie Masutani, Saya Shimizu, Keiko Takada, Punyada Suchiva, Hideoki Ogawa, Ko Okumura, Shigaku Ikeda, and Toshiro Takai
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Murine model ,Protease antigen ,Acute itch ,Th sensitization ,Atopic march ,Dermatology ,RL1-803 - Abstract
Respiratory allergen sources such as house dust mites frequently contain proteases. In this study, we demonstrated that the epicutaneous application of a model protease antigen, papain, onto intact or tape-stripped ear skin of mice induced acute scratching behaviors and T helper (Th)2, Th9, Th17/Th22, and/or Th1 sensitization in a protease activity–dependent manner. The protease activity of papain applied onto the skin was also essential for subsequent airway eosinophilia induced by an intranasal challenge with low-dose papain. With tape stripping, papain-treated mice showed barrier dysfunction, the accelerated onset of acute scratching behaviors, and attenuated Th17/Th22 sensitization. In contrast, the protease activity of inhaled papain partially or critically contributed to airway atopic march responses in mice sensitized through intact or tape-stripped skin, respectively. These results indicated that papain protease activity on epicutaneous application through intact skin or skin with mechanical barrier damage is critical to the sensitization phase responses, including acute itch and Th sensitization and progression to the airway atopic march, whereas dependency on the protease activity of inhaled papain in the atopic march differs by the condition of the sensitized skin area. This study suggests that exogenous protease-dependent epicutaneous mechanisms are a target for controlling allergic sensitization and progression to the atopic march.
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- 2024
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15. Association of single-nucleotide variants of the orsomucoid-1-like protein 3 gene with phenotypes of atopic march in children
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V.O. Dytiatkovskyi
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atopic march ,children0 ,snv rs7216389 ormd l3 ,monoorganic phenotypes ,polyorganic phenotypes ,Pediatrics ,RJ1-570 - Abstract
Background. The problem of atopic march (AM), namely its progression from monoorganic phenotypes of atopic dermatitis (AD), allergic rhinitis/rhinoconjunctivitis (AR/ARC), bronchial asthma (BA) to their multiorgan combinations, is one of the biggest in the modern pediatrics. One of the most important causes for the development of these pathologies are single nucleotide variants (SNV) of the causative genes, orsomucoid-1-like protein 3 (ORMDL3), in particular rs_7216389 ORMDL3. The roles of T- and C-alleles in relation to monoorganic and polyorganic AM phenotypes have not been sufficiently studied. The objective was to study associations of the SNVs rs_7216389 ORMDL3 in the development of different AM phenotypes in children. Materials and methods. There were 293 children recruited into the main group and 105 controls aged 3 to 18 years. Children of the main group had monoorganic and polyorganic phenotypes of AM: AD, AR/ARC, BA, AD+AR/ARC, BA+AR/ARC, AD+AR/ARC+BA. Children of the control group suffered from organic and functional digestive pathology without clinical or paraclinical signs of AM. All children were genotyped for C/C, T/T, C/T variants of SNV rs_7216389 ORMDL3 by allelic discrimination method based on real time polymerase chain reaction with restriction fragment length polymorphism of the buccal swab obtained from each patient. Spearman’s correlation coefficient (rs) was used to determine associations; risks and protective effects were determined using logistic regression analysis by calculating odds ratios (OR) and 95% confidence intervals (CI). The results obtained were significant at p < 0.05 according to the Student’s test. Results. Risks and associations for the monoorganic AR/ARC phenotype: C/C SNV rs_7216389 ORMDL3: rs = 0.197, OR = 0.33 (95% CI 0.14–0.78, p < 0.05); T/T SNV rs_7216389 ORMDL3: rs = 0.246, OR = 3.21 (95% CI 1.57–6.59, p < 0.05). For the monoorganic BA phenotype: T/T SNV rs_7216389 ORMDL3: rs = 0.192, CI = 2.97 (95% CI 1.08–8.14, p < 0.05). For the polyorganic AD+AR/ARC phenotype: C/C SNV rs_7216389 ORMDL3: rs = 0.146, OR = 0.42 (95% CI 0.16–1.11, p = 0.05–0.1); T/T SNV rs_7216389 ORMDL3: rs = 0.265, OR = 3.64 (95% CI 1.62–8.18, p < 0.05). For the polyorganic BA+AR/ARC phenotype: C/C SNV rs_7216389 ORMDL3: rs = 0.163, OR = 0.42 (95% CI 0.19–0.93, p < 0.05); T/T SNV rs_7216389 ORMDL3: rs = 0.255, OR = 3.34 (95% CI 1.63–6.82, p < 0.01). The C/T SNV rs7216389 ORMDL3 genotype did not reveal significant associations or impact on the development of any AM phenotypes in children. Conclusions. The T-allele SNV rs7216389 ORMDL3 has an inductive impact on the development of AM in children — the homozygous T/T genotype of SNV rs7216389 ORMDL3 is significantly associated with and increases the risk of developing the monoorganic AR/ARC and BA phenotypes, as well as polyorganic AD+AR/ARC and BA+AR/ARC phenotypes. The C-allele SNV rs7216389 ORMDL3 has a protective impact on the development of AM in children — the homozygous genotype C/C of SNV rs7216389 ORMDL3 is significantly associated with and reduces the risk of developing the monoorganic AR/AR phenotype, as well as polyorganic AD+AR/AR and BA+AR/ARC phenotypes.
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- 2023
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16. The hen and the egg question in atopic dermatitis: allergy or eczema comes first
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Anastasiia Allenova and Razvigor Darlenski
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Eczema ,Atopy ,Asthma ,Atopic march ,Treatment ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Atopic dermatitis (AD) as a chronic inflammatory systemic condition is far more than skin deep. Co-morbidities such as asthma and allergic rhinitis as well as the psychological impact influence seriously the quality of life of the patients. Recent studies have shown that only 10% of atopic patients undergo full manifestation of the atopic march, while 40% demonstrate concomitant food allergy. Exposure to food allergens in the environment causes sensitization and food allergy through the disruption of the skin barrier, as in AD. Food allergy and AD are closely related. While not all AD patients have a food allergy, 20–40% of children with moderate to severe AD will have an IgE-mediated food allergy. It is known that they may coexist but it is unclear if food allergy worsens the course of AD. Experimental, clinical, and epidemiological studies have provided evidence of the primary role of an epidermal barrier defect in the development of sensitization to environmental allergens and that this process occurs in the damaged skin barrier rather than the gastrointestinal or respiratory tract. There is strong evidence for a connection between early AD onset and the development of other allergic diseases later in life.
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- 2023
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17. Eczema phenotypes and IgE component sensitization in adolescents: A population-based birth cohort
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Tomoyuki Kiguchi, Kiwako Yamamoto-Hanada, Mayako Saito-Abe, Tatsuki Fukuie, and Yukihiro Ohya
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Adolescents ,Atopic march ,Eczema ,IgE component ,Phenotype ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Background: Eczema patients are commonly immunoglobulin (Ig)E polysensitized. Although atopic dermatitis (AD) phenotypes have been recognized, IgE sensitization patterns based on AD phenotypes have not been well illustrated. We aimed to investigate how eczema phenotypes impact IgE component sensitization patterns. Methods: This birth cohort study investigated a general population in the Tokyo Children's Health, Illness, and Development Study (T-Child Study) until children reached the age of 13 years. Eczema was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Allergen component specific IgE antibody titers were measured using a multiplex array ImmunoCAP ISAC. Results: Persistent eczema phenotype until adolescence was strongly associated with allergic march symptoms, such as wheezing and hay fever, and oral allergy symptoms, and IgE component sensitizations of airborne (Japanese cedar, house dust mite, Timothy, cat, and dog) and cross-reactive allergens (Bet v 1 family) compared to early-remission and late-onset eczema. On the other hand, late-onset eczema did not show any strong associations with allergic symptoms and IgE sensitization. Adolescents with persistent eczema have high comorbidity of symptoms of pollen-food allergy syndrome. Conclusions: Early-onset eczema is deeply connected with the later allergic march, and late-onset eczema differs from the phenotype of allergic march. Early-onset eczema characterizing IgE sensitization was likely to be an extrinsic type, and late-onset eczema, which was not related to IgE sensitization, was likely an intrinsic type. Pollen-Food Allergy Syndrome is one of the allergic features in allergic march.
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- 2023
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18. The Role of a Novel Generation of Emollients, ‘Emollients Plus’, in Atopic Dermatitis
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Araviiskaia E, Pincelli C, Sparavigna A, and Luger T
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atopic dermatitis ,atopic march ,emollient ,emollient plus ,maintenance therapy ,skin barrier ,Dermatology ,RL1-803 - Abstract
Elena Araviiskaia,1 Carlo Pincelli,2 Adele Sparavigna,3 Thomas Luger4 1Department of Dermatology and Venereal Diseases, First Pavlov State Medical University of St Petersburg, St Petersburg, Russia; 2DermoLab, Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy; 3Derming Clinical Research and Bioengineering Institute, Milan, Italy; 4Department of Dermatology, University of Munster, Munster, GermanyCorrespondence: Thomas Luger, Dermatology Clinic, University of Münster, Von-Esmarch-Straẞe 58, Münster, 48149, Germany, Email luger@uni-muenster.deAbstract: Emollients are the mainstay maintenance treatment for atopic dermatitis (AD). A novel generation of emollients, ‘emollients plus’, containing active, non-medicated substances, has softened the distinction between emollients and topical drugs. A literature search for selected key words was performed using PubMed. Additional papers were identified based on author expertise. Whilst the inclusion of five components of an ideal emollient has been proposed, no such consensus exists for emollients plus and they can vary markedly in their composition and modes of action for AD treatment. This could have a profound effect on their clinical efficacy. The efficacy of emollients plus in restoring and maintaining skin barrier function has been demonstrated on multiple levels, with evidence reported for their effects on the physical and biochemical, microbial, immunological, and neurosensory barriers. When selecting an appropriate AD treatment approach, the safety profiles of the available topical therapies must be carefully considered. There are several proposed treatment approaches for AD, including preventive, proactive, intermittent, and synergistic approaches. Emollients plus may be effective not only as maintenance therapy for AD, but also when used synergistically with anti-inflammatory pharmacological therapies.Keywords: atopic dermatitis, atopic march, emollient, emollient plus, maintenance therapy, skin barrier
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- 2022
19. Sex, Age, and Regional Disparities in the Burden of Asthma in Mexico from 1990 to 2019: A Secondary Analysis of the Global Burden of Disease Study 2019.
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Lopez-Bago, Ana, Lascurain, Ricardo, Hernandez-Carreño, Pavel E., Gallardo-Vera, Francisco, Argueta-Donohue, Jesus, Jimenez-Trejo, Francisco, Fuentes-Zavaleta, David A., Beltran-Ontiveros, Saul A., Becerril-Camacho, Delia M., Contreras-Rodriguez, Victor A., and Diaz, Daniel
- Abstract
Asthma is the most prevalent cause of chronic respiratory diseases. Herein, we evaluate the asthma burden in Mexico based on results from the Global Burden of Disease (GBD 2019) study 2019. Using data from the GBD 2019, we estimated asthma prevalence, incidence, mortality, and disability-adjusted lived years (DALYs) counts and crude and age-standardized rates per 100,000 people with a 95% uncertainty interval (UI) by sex and age at the national and subnational levels in Mexico from 1990 to 2019. At the national level, asthma affected 3.35 million (95% UI, 2.59–4.37) people, with 606.0 thousand (433.0–811.1) new incident cases and 1655 (3–1931) deaths during 2019. Asthma caused a slightly higher burden in females and affected mainly age groups between 1 and 14 years of age. The burden of asthma gradually decreased from 1990 to 2010. However, during the last decade (2010–2019), prevalence increased by 8.2%, as did incidence, by 11.3%, whereas mortality and DALYs decreased by 23.3 and 1.6%, respectively. Finally, the burden of asthma displayed a heterogeneous pattern of disease at the subnational level. In conclusion, asthma causes a significant health loss in Mexico that differentially affects the population distributed among the states of the country, thus causing health disparities that should be addressed to provide sustainable asthma diagnosis and control to reduce its burden, especially in the early stages of life. [ABSTRACT FROM AUTHOR]
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- 2023
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20. Scientific and Practical Innovations in Restoring Skin Barrier Properties in Children with Atopic Dermatitis
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Nikolay N. Murashkin, Roza Y. Nezhvedilova, Dmitri V. Fedorov, Roman V. Epishev, Roman A. Ivanov, Alexander I. Materikin, Leonid A. Opryatin, Alena A. Savelova, and Lyudmila L. Rusakova
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children ,atopic dermatitis ,atopic march ,epidermal barrier ,staphylococcus aureus ,corneal layer ,transcutaneous sensibilization ,Pediatrics ,RJ1-570 - Abstract
Atopic dermatitis (AD) is a multifactorial inflammatory skin disease. Its pathogenetic basis is epidermal barrier dysfunction, immune system dysregulation, as well as skin microbiome diversity decrease that occurs due to genetic predisposition. Considering these factors, the skin of patients with AD requires constant care and use of medications with active regenerative properties. The inclusion of anti-inflammatory components in the composition of modern emollients (zinc sulfate and sucralfate) is crucial for restoring the microbiome and immune mechanisms controlling the skin. This article presents data on pathogenetic applicability and clinical efficacy of emollients with anti-inflammatory compounds in patients with AD.
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- 2022
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21. The Precision Allergy Molecular Diagnosis (PAMD@) in Monitoring the Atopic March in a Child with a Primary Food Allergy: Case Report
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Knyziak-Mędrzycka I, Szychta M, Majsiak E, Fal AM, Doniec Z, and Cukrowska B
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atopic march ,allergy ,anaphylaxis ,sige ,pamd ,multiplex molecular tests ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Izabela Knyziak-Mędrzycka,1,2 Monika Szychta,3 Emilia Majsiak,4 Andrzej M Fal,2,5,6 Zbigniew Doniec,7 Bożena Cukrowska8 1Allergy Clinic, Children’s Memorial Health Institute, Warsaw, Poland; 2The Department of Allergy, Pulmonary Diseases and Internal Medicine, Central Clinical Hospital of the Ministry of Interior and Administration in Warsaw, Warsaw, Poland; 3Department of Gastroenterology, Hepatology, Nutritional Disturbances and Pediatrics, Children’s Memorial Health Institute, Warsaw, Poland; 4Department of Health Promotion, Chair of Nursing Development, Faculty Health of Sciences, Medical University of Lublin, Lublin, Poland; 5Collegium Medicum, Faculty of Medicine, Cardinal Stefan Wyszyński University, Warsaw, Poland; 6Department of Public Health, Wroclaw Medical University, Wrocław, Poland; 7The Institute of Tuberculosis and Lung Diseases, Regional Branch in Rabka-Zdrój, Rabka-Zdrój, Poland; 8Department of Pathomorphology, Children’s Memorial Health Institute, Warsaw, PolandCorrespondence: Emilia Majsiak, Department of Health Promotion, Chair of Nursing Development, Faculty Health of Sciences, Medical University of Lublin, Staszica 4 m.6 (Collegium Maximum), Lublin, 20-081, Poland, Tel +48 81 448 6700, Fax +48 48 814 4867, Email emiliamajsiak@umlub.pl; wnoz@umlub.plAbstract: The case of a 9-month-old boy with an initial diagnosis of atopic dermatitis and confirmed allergy to hen’s egg, cow’s milk allergens with episodes of anaphylaxis who developed birch allergy whilst under observation with asthma symptoms was presented. The precision allergy molecular diagnosis (PAMD @) allowed for individualisation of dietary recommendations and observing the early progression of food sensitisation to the main birch molecule. The presented identification of major allergic molecules with PAMD@ in the preclinical phase of asthma contributes to the discussion related to early specific immunotherapy to suppress molecular spread and allergic march. However, more research is needed to verify this hypothesis.Graphical Abstract: Keywords: atopic march, allergy, anaphylaxis, sIgE, PAMD@, multiplex molecular tests
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- 2022
22. Systematic exploration of eczema‐associated paediatric diseases in a Chinese population of millions: A retrospective observation study.
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Zheng, Huiwen, Yang, Jian, Feng, Yuqing, Duan, Huilong, Du, Lizhong, Shu, Qiang, and Li, Haomin
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CHINESE people , *IMMUNOLOGIC diseases , *FISHER exact test , *CHILD patients , *JUVENILE diseases , *BONFERRONI correction , *CHILDREN'S hospitals - Abstract
Background: Eczema is the most common form of dermatitis and also the starting point of atopic march. Although many eczema‐associated allergic and immunologic disorders have been studied, there remains a gap in the systematic quantitative knowledge regarding the relationships between all childhood disorders and eczema. This study aimed to systematically explore eczema‐associated childhood diseases using a real‐world, long‐term clinical dataset generated from millions of children in China. Methods: Data were collected at 8,907,735 outpatient healthcare visits from 2,592,147 children between January 1, 2013, and August 15, 2019, at the largest comprehensive pediatric medical center in Zhejiang Province of China. The period prevalence differences in various pediatric diseases between children with and without eczema were used to test the independence of various pediatric disorders and eczema using Fisher's exact test. Bonferroni correction was used to adjust the p value in multiple testing. Odds ratio >2 with 95% confidence interval not including 1 and adjusted p < 0.05 was used to identify eczema‐associated diseases. Results: Overall, 234 pediatric disorders were identified from more than 6000 different pediatric disorders. An interactive eczema‐associated disease map that has related quantitative epidemiological features called ADmap was published at http://pedmap.nbscn.org/admap. Thirty‐six of these disease associations have not been reported in previous studies. Conclusion: This systematic exploratory study confirmed the associations of many well‐known diseases with eczema in Chinese children and also identified some novel and interesting associations. These results are valuable for the development of a comprehensive approach to the management of eczema in childhood. [ABSTRACT FROM AUTHOR]
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- 2023
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23. Early symptoms of atopy — as a factor in the implementation of the atopic march on the example of a clinical case
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N. A. Ilenkova, L. V. Stepanova, and D. F. Sergienko
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atopy ,allergic diseases ,atopic march ,atopic dermatitis ,atopic bronchial asthma ,allergic rhinitis ,children ,Medicine (General) ,R5-920 - Abstract
Understanding the atopic march hypothesis is important for the clinical manifestation of allergic diseases, since it determines the prognosis of whether people with early symptoms of atopy will follow the traditional atopic march. Currently, there is substantial evidence of the presence of the atopic march, but its prevalence may be exaggerated. The legitimacy of the atopic march as a model for the formation of atopic diseases is currently being discussed. Atopic dermatitis reaches its peak in early childhood, opening the door for the subsequent development of the atopic march. It is practically significant to establish risk factors that determine the start of the atopic march: early onset of atopic dermatitis, severity, persistence of the disease, presence of FLG mutation, polysensitization, atopy on the part of parents. The analysis of prospective studies of patients with atopic march from infancy to adulthood is valuable, which will allow us to develop specific programs for the timely prevention of the implementation of severe allergic diseases. The article presents a case from pediatric practice with early symptoms of atopy and the implementation of the atopic march in a 15-year-old patient. The clinical case demonstrates early symptoms and consistent development of atopic diseases: food allergy, atopic dermatitis, bronchial asthma, allergic rhinitis with the addition of allergic conjunctivitis, progressive severity of diseases, against the background of polyvalent sensitization and hereditary burden of allergic diseases. Thus, the clinical example of a 15-year-old patient demonstrates that the atopic march is a reality. On the example of a clinical case, several important factors were identified that increase the risk of developing other allergic diseases: earlier, the onset of symptoms of atopy – food allergy, then the consistent development of diseases of atopic dermatitis, bronchial asthma, allergic rhinitis, against the background of emerging polyvalent sensitization to allergens and hereditary burden of allergic diseases. This example showed that the atopic march can be realized due to sensitization through an early broken barrier of atopic dermatitis, due to common possibly genetic and environmental factors.
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- 2022
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24. Atopic March or Atopic Multimorbidity—Overview of Current Research
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Iva Mrkić Kobal, Davor Plavec, Željka Vlašić Lončarić, Ivana Jerković, and Mirjana Turkalj
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atopic march ,atopic dermatitis ,allergic rhinitis ,allergic asthma ,pathological mechanism ,risk factors ,Medicine (General) ,R5-920 - Abstract
The atopic march encompasses a sequence of allergic conditions, including atopic dermatitis, food allergy, allergic rhinitis, and asthma, that frequently develop in a sequential pattern within the same individual. It was introduced as a conceptual framework aimed at elucidating the developmental trajectory of allergic conditions during childhood. Following the introduction of this concept, it was initially believed that the atopic march represented the sole and definitive trajectory of the development of allergic diseases. However, this perspective evolved with the emergence of new longitudinal studies, which revealed that the evolution of allergic diseases is far more intricate. It involves numerous immunological pathological mechanisms and may not align entirely with the traditional concept of the atopic march. The objective of our review is to portray the atopic march alongside other patterns in the development of childhood allergic diseases, with a specific emphasis on the potential for a personalized approach to the prevention, diagnosis, and treatment of atopic conditions.
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- 2023
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25. New Insight into Drugs to Alleviate Atopic March via Network Pharmacology-Based Analysis
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Ki-Kwang Oh, Md. Adnan, and Dong-Ha Cho
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atopic dermatitis ,allergic rhinitis ,allergic asthma ,atopic march ,protein–protein interaction ,molecular docking test ,Biology (General) ,QH301-705.5 - Abstract
In the present study, a subject of atopic dermatitis (AD) is exposed progressively to allergic rhinitis (AR) and asthma (AS), which is defined as atopic march (AM). However, both the targets and compounds against AM are still largely unknown. Hence, we investigated the overlapping targets related directly to the occurrence and development of AD, AR, and AS through public databases (DisGeNET, and OMIM). The final overlapping targets were considered as key targets of AM, which were visualized by a Venn diagram. The protein–protein interaction (PPI) network was constructed using R package software. We retrieved the association between targets and ligands via scientific journals, and the ligands were filtered by physicochemical properties. Lastly, we performed a molecular docking test (MDT) to identify the significant ligand on each target. A total of 229 overlapping targets were considered as AM causal elements, and 210 out of them were interconnected with each other. We adopted 65 targets representing the top 30% highest in degree centrality among 210 targets. Then, we obtained 20 targets representing the top 30% greatest in betweenness centrality among 65 targets. The network analysis unveiled key targets against AM, and the MDT confirmed the affinity between significant compounds and targets. In this study, we described the significance of the eight uppermost targets (CCL2, CTLA4, CXCL8, ICAM1, IL10, IL17A, IL1B, and IL2) and eight ligands (Bindarit, CTLA-4 inhibitor, Danirixin, A-205804, AX-24 HCl, Y-320, T-5224, and Apilimod) against AM, providing a scientific basis for further experiments.
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- 2022
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26. Food Sensitization Impact on Asthma Attacks in Children According to Age Group
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Snezhina Lazova, Diana Hristova, Stamatios Priftis, and Tsvetelina Velikova
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asthma ,food sensitization ,asthma attacks ,atopic march ,age-dependent sensitization ,Medicine - Abstract
Introduction: The progression of allergy disorders is termed “atopic march.” Having one allergic disorder increases the likelihood of acquiring others. Asthma and food allergies often coexist. There are no thresholds for specific IgE (sIgE) associated with the presence of clinical symptoms. Each allergen shows a particular trend with age. Objective: Our study and analysis aim to identify food sensitization in children with asthma and evaluate its impact on asthma attacks and clinical control. Material and methods: As a part of a bigger study, 56 children (mean age 11.07 years (5.3–17.5), 38 boys, and 18 girls) with bronchial asthma were tested for total IgE and sIgE against food and inhalator allergens. All children performed baseline and post-BD spirometry and were assessed for asthma control. Results: In the studied population of children, sIgE against several food allergens was positive in the same patient. A significant correlation was found between the positive sIgE for milk and soy (p < 0.0001), for milk and egg yolk (p = 0.01), compared to milk and peanuts (p = 0.004), compared to egg yolk and fish (p < 0.0001), compared to egg yolk and casein (p < 0.001), and soy (p < 0.0001). The children who are positive for sIgE antibodies in cats, dogs, Cladosporium, Aspergillus, wormwood from aeroallergens and soy from food allergens have a higher risk of hospitalization for exacerbation of bronchial asthma. (p < 0.05). In the studied population, sensitization to food allergens among asthmatics does not contribute to the number of asthma attacks. Conclusions: Food sensitivity is associated with eczema, while mite sensitization is strongly associated with rhinitis and asthma. Food sensitization is not a risk factor for asthma exacerbation in children older than five years old.
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- 2022
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27. How an Immune-Factor-Based Formulation of Micro-Immunotherapy Could Interfere with the Physiological Processes Involved in the Atopic March.
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Jacques, Camille and Floris, Ilaria
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ALLERGIC rhinitis , *ALLERGIES , *FOOD allergy , *ATOPIC dermatitis , *MAST cells , *IMMUNOGLOBULIN E - Abstract
Allergic diseases consist of improper inflammatory reactions to antigens and are currently an important healthcare concern, especially considering their increasing worldwide development in recent decades. The "atopic march" defines the paradigm of allergic diseases occurring in chronological order and displaying specific spatial manifestations, as they usually start as atopic dermatitis (AD) and food allergies during infancy and progressively evolve into allergic asthma (AA) and allergic rhinitis (AR) or rhino-conjunctivitis in childhood. Many immune cell subtypes and inflammatory factors are involved in these hypersensitivity reactions. In particular, the T helpers 2 (Th2) subset, through its cytokine signatures made of interleukins (ILs), such as IL-4, IL-5, IL-10, and IL-13, as well as mast cells and their related histamine pathways, contribute greatly to the perpetuation and evolution of the atopic march. By providing low doses (LD) and ultra-low doses (ULD) of ILs and immune factors to the body, micro-immunotherapy (MI) constitutes an interesting therapeutic strategy for the management of the atopic march and its symptoms. One of the aims of this review is to shed light on the current concept of the atopic march and the underlying immune reactions occurring during the IgE-mediated responses. Moreover, the different classes of traditional and innovative treatments employed in allergic diseases will also be discussed, with a special emphasis on the potential benefits of the MI medicine 2LALERG® formulation in this context. [ABSTRACT FROM AUTHOR]
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- 2023
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28. The link between atopic dermatitis and asthma- immunological imbalance and beyond
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Martina Yaneva and Razvigor Darlenski
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Atopy ,Atopic march ,Comorbidities ,Asthma ,Endotypes ,Phenotypes ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Atopic diseases are multifactorial chronic disturbances which may evolve one into another and have overlapping pathogenetic mechanisms. Atopic dermatitis is in most cases the first step towards the development of the atopic march and represents a major socio-economic burden in the industrialized countries. The treatment of atopic diseases is often long-lasting and in some cases with lower effectiveness than expected. In order to prevent the development of the atopic march, the links between the atopic diseases have to be understood. The aim of this review is to present some major points outlining the link between atopic dermatitis and asthma, through a research in the medical literature from recent years. Stratifying patient populations according to the clinical phenotype of their disease and according to specific measurable values (biomarkers) can help to establish the main etiopathogenetic mechanisms of the disease in these populations. This will add predictive value for the evolution of the disease, and will allow the use and research of more targeted therapy in order to stop this evolution and comorbidities.
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- 2021
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29. Association between exposure to greenness and atopic march in children and adults—A systematic review and meta-analysis
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Xue Wang, Nan Zhou, and Yuxiang Zhi
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allergic disease ,atopic march ,greenness exposure ,NDVI ,asthma ,Public aspects of medicine ,RA1-1270 - Abstract
IntroductionAllergic diseases are a global public health problem. Food allergy, atopic dermatitis (AD), allergic rhinoconjunctivitis, allergic rhinitis (AR) and asthma represent the natural course of allergic diseases, also known as the “atopic march”. In recent years, a large number of studies have been published on the association between greenness exposure and allergic diseases. However, systematic reviews on the association between greenness exposure and multiple allergic diseases or atopic march are lacking.MethodsIn this study, PubMed, EMBASE, ISI Web of Science, and Scopus were systematically searched. Meta-analyses were performed if at least three studies reported risk estimates for the same outcome and exposure measures.ResultsOf 2355 records, 48 studies were included for qualitative review. Five birth cohort studies, five cross-sectional studies, and one case-control study were included for asthma meta-analysis, respectively. Four birth cohort studies were included for AR meta-analysis. Our results support that exposure to a greener environment at birth reduces the risk of asthma and AR in childhood. In addition, higher greenness exposure was associated with decreased odds of current asthma in children.DiscussionThere was a large heterogeneity among the included studies and most of them did not specify the vegetation type and causative allergens. Therefore the study results need to be further validated. In addition, a small number of studies evaluated the association between greenness and food allergy, AD and allergic rhinoconjunctivitis. More research is needed to strengthen our understanding of the association between greenness and allergic diseases.
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- 2023
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30. (R)Evolution in Allergic Rhinitis Add-On Therapy: From Probiotics to Postbiotics and Parabiotics.
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Capponi, Martina, Gori, Alessandra, De Castro, Giovanna, Ciprandi, Giorgio, Anania, Caterina, Brindisi, Giulia, Tosca, Mariangela, Cinicola, Bianca Laura, Salvatori, Alessandra, Loffredo, Lorenzo, Spalice, Alberto, and Zicari, Anna Maria
- Subjects
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ALLERGIC rhinitis , *PROBIOTICS , *ALLERGIES , *COLONIZATION (Ecology) , *DRUG target , *ATOPY - Abstract
Starting from the "Hygiene Hypothesis" to the "Microflora hypothesis" we provided an overview of the symbiotic and dynamic equilibrium between microbiota and the immune system, focusing on the role of dysbiosis in atopic march, particularly on allergic rhinitis. The advent of deep sequencing technologies and metabolomics allowed us to better characterize the microbiota diversity between individuals and body sites. Each body site, with its own specific environmental niches, shapes the microbiota conditioning colonization and its metabolic functionalities. The analysis of the metabolic pathways provides a mechanistic explanation of the remote mode of communication with systems, organs, and microflora of other body sites, including the ecosystem of the upper respiratory tract. This axis may have a role in the development of respiratory allergic disease. Notably, the microbiota is significant in the development and maintenance of barrier function; influences hematopoiesis and innate immunity; and shows its critical roles in Th1, Th2, and Treg production, which are necessary to maintain immunological balance and promote tolerance, taking part in every single step of the inflammatory cascade. These are microbial biotherapy foundations, starting from probiotics up to postbiotics and parabiotics, in a still-ongoing process. When considering the various determinants that can shape microbiota, there are several factors to consider: genetic factors, environment, mode of delivery, exposure to antibiotics, and other allergy-unrelated diseases. These factors hinder the engraftment of probiotic strains but may be upgradable with postbiotic and parabiotic administration directly on molecular targets. Supplementation with postbiotics and parabiotics could represent a very exciting perspective of treatment, bypassing probiotic limitations. At present, this avenue remains theoretical and to be explored, but it will certainly be a fascinating path to follow. [ABSTRACT FROM AUTHOR]
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- 2022
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31. Visualizing the knowledge domains and research trends of childhood asthma: A scientometric analysis with CiteSpace
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Jinghua Wu, Yi Yu, Xinmeng Yao, Qinzhun Zhang, Qin Zhou, Weihong Tang, Xianglong Huang, and Chengyin Ye
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childhood asthma ,citespace ,bibliometrics analysis ,scientometric analysis ,atopic march ,asthma management ,Pediatrics ,RJ1-570 - Abstract
BackgroundAsthma is one of the most common chronic diseases in children globally. In recent decades, advances have been made in understanding the mechanism, diagnosis, treatment and management for childhood asthma, but few studies have explored its knowledge structure and future interests comprehensively.ObjectiveThis scientometric study aims to understand the research status and emerging trends of childhood asthma.MethodsCiteSpace (version 5.8.R3) was used to demonstrate national and institutional collaborations in childhood asthma, analyze research subjects and journal distribution, review research keywords and their clusters, as well as detect research bursts.ResultsA total of 14,340 publications related to childhood asthma were extracted from Web of Science (core database) during January 2011 to December 2021. The results showed that academic activities of childhood asthma had increased steadily in the last decade. Most of the research was conducted by developed countries while China, as a developing country, was also actively engaged in this field. In addition to subjects of allergy and immunology, both public health aspects and ecological environmental impacts on the disease were emphasized recently in this research field. Keywords clustering analysis indicated that research on asthma management and atopy was constantly updated and became the two major research focuses recently, as a significant shift in research hotspots from etiology and diagnosis to atopic march and asthma management was identified. Subgroup analysis for childhood asthma management and atopy suggested that caregiver- or physician-based education and interventions were emerging directions for asthma management, and that asthma should be carefully studied in the context of atopy, together with other allergic diseases.ConclusionsThis study presented a comprehensive and systematic overview of the research status of childhood asthma, provided clues to future research directions, and highlighted two significant research trends of asthma management and atopy in this field.
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- 2022
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32. The role of filaggrin mutations leading to a decrease in the amount of protein in the development of atopic dermatitis and bronchial asthma in children
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S. I. Makarova, D. V. Mitrofanov, E. G. Komova, I. V. Kaloshkin, A. B. Shintyapina, L. F. Kaznacheeva, V. V. Zelenskaya, Е. G. Kondyurina, О. A. Batychko, and V. A. Vavilin
- Subjects
filaggrin gene ,point mutations ,bronchial asthma ,atopic dermatitis ,atopic march ,Medicine - Abstract
Atopic diseases remain one of the most common childhood diseases. At the beginning of life, atopic dermatitis (AD) occurs, and only then bronchial asthma (BA). This staged development of sensitization and transformation of clinical manifestations is called the atopic march. Are the genetic factors of predisposition to AD the same for BA? There is still no definite answer to this question. Mutations in the filaggrin gene (FLG) are known to impair skin barrier function. Filaggrin is expressed not only in the skin, but also in the respiratory organs of the nasal mucosa, lungs, and bronchi. Filaggrin defects lead not only to disruption of the skin barrier, but also to an increase in the Th2 response and increased production of IgE, typical of bronchial asthma. Therefore, mutations in the FLG gene can be a risk factor for the development of not only AD, but also BA.The aim of this study was to compare the values of the association of mutations in the FLG gene with AD and BA in the Russian sample.Material and methods. Case-control study design. We used 265 blood samples from children. 4 mutations in the filaggrin gene were identified by real-time PCR. The association of mutations with disease was assessed by odds ratio.Results. We showed a strongly pronounced association of the deletion of 4 nucleotides (2282del4) with AD, but not with BA, although for patients with atopic BA the indicator of the association of this mutation with the disease was higher than for the group with symptoms of bronchial asthma identified by the ISAAC questionnaire. These results lead to the conclusion that the role of the filaggrin gene for BA is much less significant than for AD.
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- 2021
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33. Genetic Variants in Epidermal Differentiation Complex Genes as Predictive Biomarkers for Atopic Eczema, Allergic Sensitization, and Eczema-Associated Asthma in a 6-Year Follow-Up Case–Control Study in Children.
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Dębińska, Anna, Danielewicz, Hanna, and Sozańska, Barbara
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ATOPIC dermatitis , *GENETIC variation , *FILAGGRIN , *ECZEMA , *ATOPY , *ALLERGIES , *BIOMARKERS , *CASE-control method - Abstract
Atopic eczema is the most common chronic inflammatory skin disease of early childhood and is often the first manifestation of atopic march. Therefore, one challenge is to identify the risk factors associated with atopic eczema that may also be predictors of atopic disease progression. The aim of this study was to investigate the association of SNPs in hornerin (HRNR) and filaggrin-2 (FLG2) genes with childhood atopic eczema, as well as other atopic phenotypes. Genotyping for HRNR and FLG2 was performed in 188 children younger than 2 years of age, previously screened for the FLG null mutations, and followed at yearly intervals until the age of 6. We demonstrated that risk variants of HRNR rs877776[C] and FLG2 rs12568784[T] were associated with atopic eczema, allergic sensitization, and susceptibility to the complex phenotype—asthma plus eczema. These effects seem to be supplementary to the well-known associations for FLG mutations and may be modulated by gene–gene interactions. Additionally, in children with eczema, these genetic variants may also be considered, along with FLG mutations, as predictive biomarkers for eczema-associated asthma. In conclusion, our results indicate that genetic variants in the epidermal differentiation complex gene could contribute to the pathogenesis of atopic eczema and progression to subsequent allergic disease. [ABSTRACT FROM AUTHOR]
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- 2022
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34. Claudin-1 Mediated Tight Junction Dysfunction as a Contributor to Atopic March.
- Author
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Xia, Yuhan, Cao, Han, Zheng, Jie, and Chen, Lihong
- Subjects
TIGHT junctions ,CLAUDINS ,FOOD allergy ,ATOPIC dermatitis ,ALLERGIES ,ATOPY - Abstract
Atopic march refers to the phenomenon wherein the occurrence of asthma and food allergy tends to increase after atopic dermatitis. The mechanism underlying the progression of allergic inflammation from the skin to gastrointestinal (GI) tract and airways has still remained elusive. Impaired skin barrier was proposed as a risk factor for allergic sensitization. Claudin-1 protein forms tight junctions and is highly expressed in the epithelium of the skin, airways, and GI tract, thus, the downregulation of claudin-1 expression level caused by CLDN-1 gene polymorphism can mediate common dysregulation of epithelial barrier function in these organs, potentially leading to allergic sensitization at various sites. Importantly, in patients with atopic dermatitis, asthma, and food allergy, claudin-1 expression level was significantly downregulated in the skin, bronchial and intestinal epithelium, respectively. Knockdown of claudin-1 expression level in mouse models of atopic dermatitis and allergic asthma exacerbated allergic inflammation, proving that downregulation of claudin-1 expression level contributes to the pathogenesis of allergic diseases. Therefore, we hypothesized that the tight junction dysfunction mediated by downregulation of claudin-1 expression level contributes to atopic march. Further validation with clinical data from patients with atopic march or mouse models of atopic march is needed. If this hypothesis can be fully confirmed, impaired claudin-1 expression level may be a risk factor and likely a diagnostic marker for atopic march. Claudin-1 may serve as a valuable target to slowdown or block the progression of atopic march. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
35. From Skin Barrier Dysfunction to Systemic Impact of Atopic Dermatitis: Implications for a Precision Approach in Dermocosmetics and Medicine.
- Author
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Maintz, Laura, Bieber, Thomas, Simpson, Helen D., and Demessant-Flavigny, Anne-Laure
- Subjects
- *
ATOPIC dermatitis , *SKIN inflammation , *ALLERGIC rhinitis , *FOOD allergy , *INDIVIDUALIZED medicine - Abstract
Atopic dermatitis (AD) affects up to 20% of children and is considered the starting point of the atopic march with the development of food allergy, asthma, and allergic rhinitis. The heterogeneous phenotype reflects distinct and/or overlapping pathogenetic mechanisms with varying degrees of epidermal barrier disruption, activation of different T cell subsets and dysbiosis of the skin microbiome. Here, we review current evidence suggesting a systemic impact of the cutaneous inflammation in AD together with a higher risk of asthma and other comorbidities, especially in severe and persistent AD. Thus, early therapy of AD to restore the impaired skin barrier, modified microbiome, and target type 2 inflammation, depending on the (endo)phenotype, in a tailored approach is crucial. We discuss what we can learn from the comorbidities and the implications for preventive and therapeutic interventions from precision dermocosmetics to precision medicine. The stratification of AD patients into biomarker-based endotypes for a precision medicine approach offers opportunities for better long-term control of AD with the potential to reduce the systemic impact of a chronic skin inflammation and even prevent or modify the course, not only of AD, but possibly also the comorbidities, depending on the patient's age and disease stage. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
36. Strategies for Selecting Therapeutic Tactics for Reducing Transcutaneous Sensibilisation Risk in Infants with Atopic Dermatitis: Cohort Retrospective Prospective Study
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Dmitri V. Fedorov, Nikolay N. Murashkin, Svetlana G. Makarova, and Roman A. Ivanov
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atopic dermatitis ,atopic march ,transcutaneous sensibilisation ,sige ,immunocap ,pimecrolimus ,topical gluco corticosteroids ,children ,Pediatrics ,RJ1-570 ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Background. One of the key aspects in the development of atopic dermatitis (AtD) is epidermal barrier dysfunction leading to the penetration of pathogens and allergens through the skin with further body sensibilisation to them. Such pathological interaction can later on lead to the development of various allergic diseases in the child which not only worsen the course of atopic dermatitis itself, but also significantly reduce the quality of life of these patients. Objective. Aim of the study is to estimate the efficacy of therapeutic approaches for treatment of atopic dermatitis in reducing the transcutaneous sensibilisation risk in infants. Methods. The study included children aged 1 to 4 months with established AtD from moderate to severe forms. The severity of AtD was estimated via the EASI index. The level of specific IgE (sIgE) to food and domestic allergens was measured by the ImmunoCAP method using special reagents’ sets. The sensibilisation class was established depending on the sIgE index. Statistical analysis of the studied indexes shift and their comparison between the study groups was performed via multivariate analysis of variance (ANOVA). Results. The study included 81 patients. All patients were divided into two groups after basic AtD therapy with topical glucocorticosteroids (tGCS). Patients from study group № 1 received maintenance therapy with topical calcineurin inhibitor (TCI) (pimecrolimus 1%; PIM) for a long time, while patients from group № 2 continued to apply tGCS as proactive therapy. We have revealed that the level of sensibilisation to chicken protein and to the mixture of domestic allergens “domestic dust” was lower to the 12th month of life in group № 1 compared to group № 2 as a result of the data analysis. Children in group № 1 had faster and more significant decrease in the severity of AtD in comparison to group № 2 according to EASI index. Conclusion. Maintenance therapy including PIM is more efficient in reducing AtD severity and in prevention of transcutaneous sensibilisation in infants.
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- 2021
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37. Claudin-1 Mediated Tight Junction Dysfunction as a Contributor to Atopic March
- Author
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Yuhan Xia, Han Cao, Jie Zheng, and Lihong Chen
- Subjects
atopic march ,claudin-1 ,epithelial barrier ,asthma ,food allergy ,atopic dermatitis ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Atopic march refers to the phenomenon wherein the occurrence of asthma and food allergy tends to increase after atopic dermatitis. The mechanism underlying the progression of allergic inflammation from the skin to gastrointestinal (GI) tract and airways has still remained elusive. Impaired skin barrier was proposed as a risk factor for allergic sensitization. Claudin-1 protein forms tight junctions and is highly expressed in the epithelium of the skin, airways, and GI tract, thus, the downregulation of claudin-1 expression level caused by CLDN-1 gene polymorphism can mediate common dysregulation of epithelial barrier function in these organs, potentially leading to allergic sensitization at various sites. Importantly, in patients with atopic dermatitis, asthma, and food allergy, claudin-1 expression level was significantly downregulated in the skin, bronchial and intestinal epithelium, respectively. Knockdown of claudin-1 expression level in mouse models of atopic dermatitis and allergic asthma exacerbated allergic inflammation, proving that downregulation of claudin-1 expression level contributes to the pathogenesis of allergic diseases. Therefore, we hypothesized that the tight junction dysfunction mediated by downregulation of claudin-1 expression level contributes to atopic march. Further validation with clinical data from patients with atopic march or mouse models of atopic march is needed. If this hypothesis can be fully confirmed, impaired claudin-1 expression level may be a risk factor and likely a diagnostic marker for atopic march. Claudin-1 may serve as a valuable target to slowdown or block the progression of atopic march.
- Published
- 2022
- Full Text
- View/download PDF
38. Atopic March: Dermatologic perspectives.
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Dhar, Sandipan and Jagadeesan, Soumya
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- *
ASTHMA risk factors , *DERMATOLOGISTS , *DISEASE progression , *SKIN , *RHINITIS , *CONTINUING education units , *ATOPIC dermatitis , *ALLERGIES , *MEDICAL practice , *MEDICAL research , *FOOD allergy , *DISEASE risk factors - Abstract
The progression of allergic diseases with the development of atopic dermatitis and food allergy in infancy and subsequent asthma and allergic rhinitis in the later childhood is known as 'atopic march'. There have been many arguments in favour of and against this concept. This article reviews the latest epidemiology, immunological mechanisms and translational implications in clinical practice and research, which is relevant to the dermatologists. The role of skin as a site of initiation and the potential for interventions on skin that may prevent subsequent allergic diseases is also highlighted. [ABSTRACT FROM AUTHOR]
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- 2022
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39. Association of heat shock protein 8 with atopic march in a murine experimental model.
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Kyu-Tae Jeong, Ji-Hye Do, Sung-Hee Lee, Jeom-Kyu Lee, and Woo-Sung Chang
- Subjects
GEL electrophoresis ,HEAT shock proteins ,DERMATOPHAGOIDES pteronyssinus ,YOUNG adults ,ATOPIC dermatitis ,ALLERGIC rhinitis - Abstract
Background: Atopic march (AM), a unique characteristic of allergic diseases, refers to the sequential progression of atopic dermatitis (AD) in infants to allergic asthma and allergic rhinitis in children and young adults, respectively. Although there are several studies on AM, the establishment of an AM murine model to expand our understanding of the underlying mechanism and to identify the potential biomarkers is yet to be achieved. In this study, an improved murine model was established by applying a method to minimize skin irritation in inducing AD, and it was used to perform integrated analyses to discover candidate biomarkers. Methods: To induce atopic dermatitis, 2,4-dinitrochlorobenzene (DNCB) was applied to the ear skin once a week, and this was continued for 5 weeks. From the second application of DNCB, Dermatophagoides pteronyssinus (Dp) extract was applied topically 2 days after each DNCB application; this was continued for 4 weeks. Dp sensitization and intranasal challenges were then performed for 4 weeks to develop conditions mimicking AM. Results: Exacerbated airway inflammation and allergic responses observed in the AM-induced group suggested successful AM development in our model. Two-dimensional gel electrophoresis (2-DE) and mass spectrometry analysis identified 753 candidate proteins from 124 2-DE spots differentially expressed among the experimental groups. Functional analyses, such as Gene Ontology (GO) annotation and protein-protein interaction (PPI) analysis were conducted to investigate the relationship among the candidate proteins. Seventy-two GO terms were significant between the two groups; heat shock protein 8 (Hspa8) was found to be included in six of the top 10 GO terms. Hspa8 scored high on the PPI parameters as well. Conclusion: We established an improved murine model for AM and proposed Hspa8 as a candidate biomarker for AM. [ABSTRACT FROM AUTHOR]
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- 2022
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40. New Directions in Understanding Atopic March Starting from Atopic Dermatitis.
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Maiello, Nunzia, Comberiati, Pasquale, Giannetti, Arianna, Ricci, Giampaolo, Carello, Rossella, and Galli, Elena
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EOSINOPHILIC esophagitis ,ASTHMA ,ALLERGIC rhinitis ,RISK assessment ,ATOPIC dermatitis ,SEASONAL variations of diseases ,FOOD allergy ,DISEASE risk factors ,DISEASE complications - Abstract
Recent evidence showed that the postulated linear progression of the atopic march, from atopic dermatitis to food and respiratory allergies, does not capture the heterogeneity of allergic phenotypes, which are influenced by complex interactions between environmental, genetic, and psychosocial factors. Indeed, multiple atopic trajectories are possible in addition to the classic atopic march. Nevertheless, atopic dermatitis is often the first manifestation of an atopic march. Improved understanding of atopic dermatitis pathogenesis is warranted as this could represent a turning point in the prevention of atopic march. In this review, we outline the recent findings on the pathogenetic mechanisms leading to atopic dermatitis that could be targeted by intervention strategies for the prevention of atopic march. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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41. Early-onset-early-resolving atopic dermatitis does not increase the risk of development of allergic diseases at 3 Years old
- Author
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Li-Chieh Wang and Bor-Luen Chiang
- Subjects
Atopic dermatitis ,Atopic march ,Parental atopy history ,Medicine (General) ,R5-920 - Abstract
Background: Epidemiological findings showed the increased risk of allergic rhinitis (AR) and asthma in the children with preceding atopic dermatitis (AD). In this study, we aimed to observe the development of allergic diseases in infantile AD patients. Methods: We followed up the prospective observational cohort enrolling two-to four-month-old exclusively breastfed infants. The presence of physician-diagnosed asthma, AR and AD at age 3 was recorded with the laboratory tests for atopic sensitization. Results: Fifty infantile AD patients and 48 healthy controls were enrolled. The sex, age and parental atopy history were not significantly different between the two groups. At age 3, 21 (42%) patients had persistent AD in the infantile AD group while only 2 (4.2%) patients had newly diagnosed AD in the control group (p
- Published
- 2020
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42. Prevention of Transcutaneous Sensitization to Cow Milk Proteins in Infants with Atopic Dermatitis: Cohort Study
- Author
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Nikolay N. Murashkin, Svetlana G. Makarova, Stepan G. Grigorev, Dmitri V. Fedorov, Roman A. Ivanov, Eduard T. Ambarchian, Roman V. Epishev, Alexander I. Materikin, Leonid A. Opryatin, and Alena A. Savelova
- Subjects
atopic dermatitis ,atopic march ,children ,sensibilization ,cow milk proteins ,ige ,immunocap ,pimecrolimus ,Pediatrics ,RJ1-570 - Abstract
Background. Malformations in epidermal barrier in children with atopic dermatitis (AD) can cause transcutaneous sensitization with further development of allergic diseases that can worsen the AD course and significantly reduces patients’ quality of life.Objective. The aim of the study was to determine the effect of topical treatment and maintenance therapy with pimecrolimus 1% cream (PIM) and topical glucocorticosteroids (tGCS) in infants with AD on reducing the risk of developing transcutaneous sensitization (due to the levels of specific IgE to the cow milk protein over time) and on reducing the disease severity (by the EASI scale).Methods. The study included children aged from 1 to 4 months with early manifestations of moderate and severe AD. The severity of AD was estimated via the EASI scale at start of observation, then at 6, 9 and 12 months of life. The class and level of specific IgE to cow milk proteins (CMP) were determined by the ImmunoCAP method at the point of enrolment and at the ages of 6 and 12 months. Statistical analysis of studied indicators dynamics and their comparison in research groups was carried out using multifactorial dispersion analysis.Results. The study included 36 patients. All patients have received standard tGCS therapy in combination with emollients (wet wrap) for 10 days. The maintenance therapy was prescribed in postacute period. It included topical calcineurin inhibitor PIM 2 times/day for 3 months, then double application (morning/evening) 3 times/week up to the age of 1 year old (group 1). Other group had maintenance therapy — tGCS2 times/week for 3 months, and then at AD aggravation (group 2). Group 1 has shown lower level of sensitization to CMP at the age of 6 and 12 months and more significant decrease in AD severity according to EASI scale compared to group 2.Conclusion. The treatment with PIM is effective in therapy of AD and prevention of transcutaneous sensitization in infants.
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- 2020
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43. Modern Outlooks on «Atopic March» Secondary Prevention Capabilities in Children with Atopic Dermatitis
- Author
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Nikolay N. Murashkin, Leyla S. Namazova-Baranova, Roman A. Ivanov, Dmitri V. Fedorov, Eduard T. Ambarchian, Alena A. Savelova, Roman V. Epishev, Alexander I. Materikin, and Leonid A. Opryatin
- Subjects
dermatitis ,atopic march ,sensibilization ,children ,proactive therapy ,methylprednisolone aceponate ,Pediatrics ,RJ1-570 - Abstract
Atopic dermatitis (AD) is one of the most common inflammatory diseases of childhood, and it is the first one in gradual development of allergic diseases, also known as «atopic march». Sensitization establishment during the AD uncontrolled course is associated with the high risk of developing of serious allergic pathologies, increase in the severity of the disease course, and patients’ quality of life reduction. Thereby, it is crucial to achieve quick jugulation of the inflammatory process in case of severe AD with early onset of disease. This article shows modern therapeutic approaches to disease control in children.
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- 2020
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44. Role of Emollients in Prevention of the Comorbid Allergic Diseases Development in Children with Atopic Dermatitis
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Nikolay N. Murashkin, Roman A. Ivanov, Dmitri V. Fedorov, Eduard T. Ambarchyan, Roman V. Epishev, Alexander I. Materikin, Leonid A. Opryatin, and Alena A. Savelova
- Subjects
atopic dermatitis ,epidermal barrier ,atopic march ,emollients ,Pediatrics ,RJ1-570 ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Atopic dermatitis (AD) is one of the common multifactorial inflammatory diseases manifesting predominantly in childhood. There is significant number of cases of self-regression of the disease with aging. On the other hand, there is also another scenario ending with AD persistent course and/or development of comorbid allergic pathologies that can significantly worsen patient’s quality of life and finally lead to social maladjustment. The pathogenesis of such way includes epidermal barrier disturbance, transcutaneous sensibilisation and aberrant allergic (Th2) immune systemic response development. Main role in preventing of this pathological pathway is lying on the new class of moisturizers containing active components "emollients plus". They are considered as foundation for the therapy and prevention of the development of AD and other allergic diseases. This literature review provides relevant data on AD pathogenesis and development of comorbid allergic pathologies. This paper also covers data on the effect of emollients in restoration of the epidermal barrier and their use as preventive measures.
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- 2020
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45. Editorial: Dietary Interventions and Nutritional Factors in the Prevention of Allergic Diseases in Infants
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Enza D'Auria, Roberto Berni Canani, and Gian Vincenzo Zuccotti
- Subjects
allergic diseases ,diet ,atopic march ,hydrolyzed formulas ,preterm newborns ,gut microbiota ,Pediatrics ,RJ1-570 - Published
- 2022
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46. Oral Administration of Lactococcus lactis Expressing Mite and Cockroach Major Allergens Alleviates Progression of Atopic March in a Mouse Model.
- Author
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Lee MF, Chen YH, Chiang CH, Wu CS, Li MH, and Wang NM
- Abstract
Purpose: Atopic march is defined as the development of atopic dermatitis in early childhood. We recently developed an atopic march mouse model through skin sensitization with aeroallergens from house dust mites and cockroaches. Using this model, this study aimed to evaluate the oral immunotherapy efficacy of Lactococcus lactis harboring specific antigens on the progression of atopic march., Methods: Dust mite major allergen Der p 2 and cockroach Per a 2-372 were expressed in L. lactis as a fusion recombinant clone (D2P2). L. lactis -D2P2 was administered intragastrically to Aeroallergen patch-sensitized mice once a day for a total of 35 times. The immunological variables in sera, scratching behavior, airway hyperresponsiveness (AHR), and pathology of lungs and skin were evaluated., Results: Our data showed that L. lacti s-D2P2 significantly lowered total immunoglobulin E levels, decreased scratch bouts, and relieved AHR compared with the control mice. Histological analysis of the skin and lung tissue demonstrated the therapeutic effects of L. lactis -D2P2 to modulate immune responses via decreased eosinophil infiltration and reduced expression of key cytokines, interleukin (IL)-31 and IL-13, respectively., Conclusions: The results imply that mucosal allergen-specific immunotherapy of L. lactis -D2P2 is a more cost-effective alternative to conventional subcutaneous allergen-specific immunotherapy. This study provides a promising platform for the development of novel oral protein-based vaccines in the early prevention of allergies., Competing Interests: There are no financial or other issues that might lead to conflict of interest., (Copyright © 2024 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease.)
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- 2024
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47. Current Insights into Atopic March.
- Author
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Mitsuru Tsuge, Masanori Ikeda, Naomi Matsumoto, Takashi Yorifuji, and Hirokazu Tsukahara
- Subjects
DISEASE incidence ,ATOPIC dermatitis ,PEDIATRIC epidemiology ,OXIDATIVE stress ,ALLERGIC rhinitis ,DISEASE progression - Abstract
The incidence of allergic diseases is increasing, and research on their epidemiology, pathophysiology, and the prevention of onset is urgently needed. The onset of allergic disease begins in infancy with atopic dermatitis and food allergy and develops into allergic asthma and allergic rhinitis in childhood; the process is defined as “atopic march”. Atopic march is caused by multiple immunological pathways, including allergen exposure, environmental pollutants, skin barrier dysfunction, type 2 inflammation, and oxidative stress, which promote the progression of atopic march. Using recent evidence, herein, we explain the involvement of allergic inflammatory conditions and oxidative stress in the process of atopic march, its epidemiology, and methods for prevention of onset. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
48. Sensitization to Molecular Components in 104 Atopic Dermatitis Patients in Relation to Subgroups of Patients Suffering from Bronchial Asthma and Allergic Rhinitis
- Author
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Radka Vaňková, Jarmila Čelakovská, Josef Bukač, Irena Krčmová, Jan Krejsek, and Ctirad Andrýs
- Subjects
molecular components ,multiplex ISAC testing ,severity of atopic dermatitis ,bronchial asthma ,allergic rhinitis ,atopic march ,Medicine - Abstract
Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease. The progression from AD to bronchial asthma (AB) and allergic rhinitis (AR) is called atopic march. The aim of this study was to evaluate the difference in the sensitization to molecular components in patients suffering from AD in relation to subgroups of patients with AR and AB. Material and Methods: The complete dermatological and allergological examinations were performed. Specific IgE antibodies against 112 molecular components were measured with the multiplex ImmnoCAP ISAC test. Results: Altogether 104 atopic dermatitis patients (50 men, 54 women) at the average age 40.1 years were examined. The sensitization to molecular components was confirmed in 93.3% of patients. The sensitization to components of mites, grasses, trees, animals, moulds, and shrimps was significantly more frequent in patients with severe form of AD and the sensitization to components of grasses, trees, and moulds was significantly higher in subgroup of patients with AB. In subgroup of patients suffering from AR the higher occurrence of pollen-derived and pollen-food derived PR-10 proteins, grasses, mites, and animals was observed also. Conclusions: We have confirmed the significant differences in the sensitization to molecular components in patients suffering from severe form of AD, and in subgroups of patients suffering from AB and AR. These molecular components may play the important role in the consecutive development of different allergy pathologies called atopic march.
- Published
- 2020
- Full Text
- View/download PDF
49. Achieving Precision Medicine in Allergic Disease: Progress and Challenges
- Author
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Steven P. Proper, Nurit P. Azouz, and Tesfaye B. Mersha
- Subjects
precision medicine ,allergic disease ,atopic march ,omics ,endotypes ,exposome ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Allergic diseases (atopic dermatitis, food allergy, eosinophilic esophagitis, asthma and allergic rhinitis), perhaps more than many other traditionally grouped disorders, share several overlapping inflammatory pathways and risk factors, though we are still beginning to understand how the relevant patient and environmental factors uniquely shape each disease. Precision medicine is the concept of applying multiple levels of patient-specific data to tailor diagnoses and available treatments to the individual; ideally, a patient receives the right intervention at the right time, in order to maximize effectiveness but minimize morbidity, mortality and cost. While precision medicine in allergy is in its infancy, the recent success of biologics, development of tools focused on large data set integration and improved sampling methods are encouraging and demonstrates the utility of refining our understanding of allergic endotypes to improve therapies. Some of the biggest challenges to achieving precision medicine in allergy are characterizing allergic endotypes, understanding allergic multimorbidity relationships, contextualizing the impact of environmental exposures (the “exposome”) and ancestry/genetic risks, achieving actionable multi-omics integration, and using this information to develop adequately powered patient cohorts and refined clinical trials. In this paper, we highlight several recently developed tools and methods showing promise to realize the aspirational potential of precision medicine in allergic disease. We also outline current challenges, including exposome sampling and building the “knowledge network” with multi-omics integration.
- Published
- 2021
- Full Text
- View/download PDF
50. Immunonutrition for Pediatric Patients With Cow's Milk Allergy: How Early Interventions Could Impact Long-Term Outcomes
- Author
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Laura Carucci, Serena Coppola, Anna Luzzetti, Luana Voto, Veronica Giglio, Lorella Paparo, Rita Nocerino, and Roberto Berni Canani
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food allergy ,gut microbiome ,dietary peptides ,immune tolerance ,atopic march ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Cow's milk allergy (CMA) is one of the most common food allergies and one of the main causes of food-induced anaphylaxis in the pediatric age. Moreover, up to 45% of CMA children develop other atopic manifestations later in life, a phenomenon commonly named atopic march. Thus, CMA imposes a significant cost to health care systems as well as to families, and has emerged as one of the most expensive allergic diseases. The immunonutrition strategy builds its foundation on the ability of selected dietary factors to modulate immune system development and function. Recent studies highlighted the potential of immunonutrition in the management of CMA. This review is focused on the mechanisms and long-term clinical outcomes of the immunonutrition approach in children with CMA.
- Published
- 2021
- Full Text
- View/download PDF
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