Epicutaneous sensitization to food allergens in atopic dermatitis: What do we know?

Atopic dermatitis (AD) is a chronic inflammatory skin disease mainly affecting children, which has no definitive curative therapy apart from natural outgrowing. AD is persistent in 30%‐40% of children. Epithelial barrier dysfunction in AD is a significant risk factor for the development of epicutane...

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Bibliographic Details
Published in:Pediatric allergy and immunology 2020-01, Vol.31 (1), p.7-18
Main Authors: Tham, Elizabeth Huiwen, Rajakulendran, Mohana, Lee, Bee Wah, Van Bever, Hugo P. S., Sampson, Hugh
Format: Article
Language:English
Subjects:
Allergens
Allergic rhinitis
allergy prevention
anaphylaxis
Asthma
Atopic dermatitis
atopic march
Children
Dermatitis
Dermatitis, Atopic - immunology
Disease Progression
Eczema
epicutaneous sensitization
Female
food allergens
Food allergies
food allergy
food hypersensitivity
Food Hypersensitivity - immunology
Histamine
Humans
Male
nutrition
oral tolerance
Rhinitis
Risk factors
Skin diseases
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Summary:Atopic dermatitis (AD) is a chronic inflammatory skin disease mainly affecting children, which has no definitive curative therapy apart from natural outgrowing. AD is persistent in 30%‐40% of children. Epithelial barrier dysfunction in AD is a significant risk factor for the development of epicutaneous food sensitization, food allergy, and other allergic disorders. There is evidence that prophylactic emollient applications from birth may be useful for primary prevention of AD, but biomarkers are needed to guide cost‐effective targeted therapy for high‐risk individuals. In established early‐onset AD, secondary preventive strategies are needed to attenuate progression to other allergic disorders such as food allergy, asthma, and allergic rhinitis (the atopic march). This review aims to describe the mechanisms underpinning the development of epicutaneous sensitization to food allergens and progression to clinical food allergy; summarize current evidence for interventions to halt the progression from AD to food sensitization and clinical food allergy; and highlight unmet needs and directions for future research.
ISSN:0905-6157
1399-3038
DOI:10.1111/pai.13127