The allergic march: can we prevent allergies and asthma?

Area of Science:

• Immunology
• Allergology
• Pediatrics

Background:

• The allergic march describes the typical progression of atopic diseases, starting with eczema, then developing into asthma, and finally allergic rhinoconjunctivitis.
• This progression is linked to a localized allergic response that compromises the epithelial barrier, triggering systemic allergic inflammation.
• Genetic and environmental factors play a significant role in an individual's susceptibility to the allergic march.

Purpose of the Study:

• To explore potential interventions for preventing the progression of the allergic march from eczema to asthma.
• To review current data supporting preventative strategies against the development of asthma in the context of the allergic march.

Main Methods:

• Review of existing data on interventions aimed at preventing asthma in infants and children.
• Analysis of studies investigating the efficacy of probiotics, breastfeeding, hydrolyzed formulas, and allergen immunotherapy.

Main Results:

• Dietary probiotic supplements show promise in preventing asthma development.
• Exclusive breastfeeding in early infancy is associated with reduced asthma risk.
• Use of extensively hydrolyzed infant formulas offers an alternative preventative measure.
• Inhalant allergen immunotherapy (subcutaneous or sublingual) is also supported by data as a preventative treatment.

Conclusions:

• Multiple interventions, including dietary adjustments and immunotherapies, can potentially halt the allergic march before asthma onset.
• Early-life interventions targeting the epithelial barrier and immune response may be key to preventing allergic disease progression.
• Further research is warranted to optimize these interventions for widespread clinical application.