The allergy march: from food to pollen

Area of Science:

• Allergy and Immunology
• Epidemiology
• Pediatrics

Background:

• Epidemiological evidence suggests a sequential development of atopic diseases.
• The 'atopic march' describes the progression from early-onset food allergies and atopic dermatitis to later respiratory allergies like asthma.

Purpose of the Study:

• To elucidate the systematic sequence of clinical manifestations and IgE antibody development in atopy.
• To identify early risk markers and predictors for atopic disorders.

Main Methods:

• Analysis of longitudinal epidemiological data.
• Observation of IgE antibody development against food and aeroallergens.
• Correlation of early clinical signs with later allergic outcomes.

Main Results:

• Food allergy-associated gastrointestinal disorders and atopic dermatitis often precede respiratory allergies.
• Detectable food-specific IgE antibodies (e.g., against egg, milk) typically appear before or with early clinical symptoms.
• Sensitization to indoor aeroallergens precedes sensitization to outdoor aeroallergens, preceding respiratory allergy.
• Early atopic dermatitis, elevated food-specific IgE in the first two years, and family history predict aeroallergen sensitization.

Conclusions:

• The atopic march follows a predictable sequence of allergic manifestations and sensitization.
• Early atopic events serve as crucial risk markers and predictors for implementing timely preventive strategies.
• Identifying high-risk infants through early clinical signs and serological markers can guide interventions for atopic diseases.