Does atopic dermatitis cause food allergy? A systematic review

Area of Science:

• Immunology
• Dermatology
• Allergy

Background:

• The relationship between atopic dermatitis (AD) and food allergy (FA) is complex and requires further understanding for effective prevention and treatment strategies.
• A potential causal link between AD and FA has been proposed, highlighting the need for comprehensive research.

Purpose of the Study:

• To systematically review the association between AD and FA.
• To investigate the impact of FA on AD severity, chronicity, and age of onset.
• To determine the temporal relationship between the development of AD and FA.

Main Methods:

• A systematic literature search was conducted using Medline and Embase databases.
• Studies published from inception up to November 2014 were included if they investigated both AD and FA.
• Data from 66 identified studies, including population-based studies and cohorts with established AD or FA, were analyzed.

Main Results:

• Population-based studies revealed a significantly higher likelihood of food sensitization in infants with AD compared to healthy controls.
• Prevalence of food sensitization reached up to 66% in patients with AD, with challenge-proven FA up to 81% in some cohorts.
• FA was associated with more severe and persistent AD phenotypes, and AD often preceded the onset of FA.

Conclusions:

• A robust, dose-dependent association exists between AD, food sensitization, and FA.
• Severe and chronic AD are particularly linked to FA, supporting a potential causal pathway.
• Evidence suggests AD may precede FA development, reinforcing the hypothesis of a causal relationship.