Mechanisms by Which Atopic Dermatitis Predisposes to Food Allergy and the Atopic March

Overview

Journal Allergy Asthma Immunol Res

Date 2018 Nov 28

PMID 30479073

Citations 35

Authors

Elizabeth Huiwen Tham

Donald Ym Leung

Affiliations

Soon will be listed here.

Abstract

The Atopic march denotes the progression from atopic dermatitis (AD) to the development of other allergic disorders such as immunoglobulin (Ig) E-mediated food allergy, allergic rhinitis and asthma in later childhood. There is increasing evidence from prospective birth cohort studies that early-onset AD is a risk factor for other allergic diseases or is found in strong association with them. Animal studies now provide mechanistic insights into the pathways that may be responsible for triggering the progression from the skin barrier dysfunction seen in AD to epicutaneous sensitization, food allergy and allergic airway disorders. Recent large randomized controlled trials have demonstrated the efficacy of early interventions targeted at AD and food allergy prevention. These show great promise for research into future strategies aimed at prevention of the atopic march.

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References

Spergel J, Mizoguchi E, Brewer J, Martin T, Bhan A, Geha R . Epicutaneous sensitization with protein antigen induces localized allergic dermatitis and hyperresponsiveness to methacholine after single exposure to aerosolized antigen in mice. J Clin Invest. 1998; 101(8):1614-22. PMC: 508742. DOI: 10.1172/JCI1647. View

Akei H, Brandt E, Mishra A, Strait R, Finkelman F, Warrier M . Epicutaneous aeroallergen exposure induces systemic TH2 immunity that predisposes to allergic nasal responses. J Allergy Clin Immunol. 2006; 118(1):62-9. DOI: 10.1016/j.jaci.2006.04.046. View

Marenholz I, Esparza-Gordillo J, Ruschendorf F, Bauerfeind A, Strachan D, Spycher B . Meta-analysis identifies seven susceptibility loci involved in the atopic march. Nat Commun. 2015; 6:8804. PMC: 4667629. DOI: 10.1038/ncomms9804. View

Barker J, Palmer C, Zhao Y, Liao H, Hull P, Lee S . Null mutations in the filaggrin gene (FLG) determine major susceptibility to early-onset atopic dermatitis that persists into adulthood. J Invest Dermatol. 2006; 127(3):564-7. DOI: 10.1038/sj.jid.5700587. View

Noti M, Kim B, Siracusa M, Rak G, Kubo M, Moghaddam A . Exposure to food allergens through inflamed skin promotes intestinal food allergy through the thymic stromal lymphopoietin-basophil axis. J Allergy Clin Immunol. 2014; 133(5):1390-9, 1399.e1-6. PMC: 4007098. DOI: 10.1016/j.jaci.2014.01.021. View

Hussain M, Borcard L, Walsh K, Pena Rodriguez M, Mueller C, Kim B . Basophil-derived IL-4 promotes epicutaneous antigen sensitization concomitant with the development of food allergy. J Allergy Clin Immunol. 2017; 141(1):223-234.e5. DOI: 10.1016/j.jaci.2017.02.035. View

Hirota T, Nakayama T, Sato S, Yanagida N, Matsui T, Sugiura S . Association study of childhood food allergy with genome-wide association studies-discovered loci of atopic dermatitis and eosinophilic esophagitis. J Allergy Clin Immunol. 2017; 140(6):1713-1716. DOI: 10.1016/j.jaci.2017.05.034. View

Fallon P, Sasaki T, Sandilands A, Campbell L, Saunders S, Mangan N . A homozygous frameshift mutation in the mouse Flg gene facilitates enhanced percutaneous allergen priming. Nat Genet. 2009; 41(5):602-8. PMC: 2872154. DOI: 10.1038/ng.358. View

Han H, Xu W, Headley M, Jessup H, Lee K, Omori M . Thymic stromal lymphopoietin (TSLP)-mediated dermal inflammation aggravates experimental asthma. Mucosal Immunol. 2012; 5(3):342-51. PMC: 3328620. DOI: 10.1038/mi.2012.14. View

10.

Lowe A, Angelica B, Su J, Lodge C, Hill D, Erbas B . Age at onset and persistence of eczema are related to subsequent risk of asthma and hay fever from birth to 18 years of age. Pediatr Allergy Immunol. 2017; 28(4):384-390. DOI: 10.1111/pai.12714. View

11.

Martinez F, Wright A, Taussig L, Holberg C, Halonen M, Morgan W . Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med. 1995; 332(3):133-8. DOI: 10.1056/NEJM199501193320301. View

12.

Bartnikas L, Gurish M, Burton O, Leisten S, Janssen E, Oettgen H . Epicutaneous sensitization results in IgE-dependent intestinal mast cell expansion and food-induced anaphylaxis. J Allergy Clin Immunol. 2013; 131(2):451-60.e1-6. PMC: 3587010. DOI: 10.1016/j.jaci.2012.11.032. View

13.

Alduraywish S, Standl M, Lodge C, Abramson M, Allen K, Erbas B . Is there a march from early food sensitization to later childhood allergic airway disease? Results from two prospective birth cohort studies. Pediatr Allergy Immunol. 2016; 28(1):30-37. DOI: 10.1111/pai.12651. View

14.

Kim B, Leung D . Significance of Skin Barrier Dysfunction in Atopic Dermatitis. Allergy Asthma Immunol Res. 2018; 10(3):207-215. PMC: 5911439. DOI: 10.4168/aair.2018.10.3.207. View

15.

Kelleher M, Dunn-Galvin A, Gray C, Murray D, Kiely M, Kenny L . Skin barrier impairment at birth predicts food allergy at 2 years of age. J Allergy Clin Immunol. 2016; 137(4):1111-1116.e8. DOI: 10.1016/j.jaci.2015.12.1312. View

16.

Boussault P, Leaute-Labreze C, Saubusse E, Maurice-Tison S, Perromat M, Roul S . Oat sensitization in children with atopic dermatitis: prevalence, risks and associated factors. Allergy. 2007; 62(11):1251-6. DOI: 10.1111/j.1398-9995.2007.01527.x. View

17.

Kelleher M, Dunn-Galvin A, OB Hourihane J, Murray D, Campbell L, McLean W . Skin barrier dysfunction measured by transepidermal water loss at 2 days and 2 months predates and predicts atopic dermatitis at 1 year. J Allergy Clin Immunol. 2015; 135(4):930-935.e1. PMC: 4382348. DOI: 10.1016/j.jaci.2014.12.013. View

18.

Simpson E, Chalmers J, Hanifin J, Thomas K, Cork M, McLean W . Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol. 2014; 134(4):818-23. PMC: 4180007. DOI: 10.1016/j.jaci.2014.08.005. View

19.

Cianferoni A, Spergel J . The importance of TSLP in allergic disease and its role as a potential therapeutic target. Expert Rev Clin Immunol. 2014; 10(11):1463-74. PMC: 4332833. DOI: 10.1586/1744666X.2014.967684. View

20.

Stremnitzer C, Manzano-Szalai K, Starkl P, Willensdorfer A, Schrom S, Singer J . Epicutaneously applied Der p 2 induces a strong TH 2-biased antibody response in C57BL/6 mice, independent of functional TLR4. Allergy. 2014; 69(6):741-51. PMC: 4023119. DOI: 10.1111/all.12399. View