Atopic March: Collegium Internationale Allergologicum Update 2020

Area of Science:

• Allergy and immunology
• Epidemiology of allergic diseases

Background:

• Global prevalence of allergic diseases has significantly increased.
• The atopic march model proposes a sequential progression: atopic dermatitis (AD) to allergic asthma (AA) then allergic rhinitis (AR).
• Existing epidemiological and longitudinal studies support aspects of this progression, noting inverse relationships between disease prevalences.

Purpose of the Study:

• To critically evaluate the current atopic march model.
• To discuss the debate surrounding its legitimacy and proposed mechanisms.
• To explore alternative models and identify key risk factors for allergic disease progression.

Main Methods:

• Review of epidemiological evidence and criticism of longitudinal studies.
• Analysis of factors influencing allergic disease development and progression.
• Emphasis on the need for long-term longitudinal studies from infancy to adulthood.

Main Results:

• The atopic march model's prevalence and mechanisms are increasingly questioned.
• Evidence suggests potential overstatement of the model's predictive accuracy.
• Risk factors such as age, severity, family history, phenotype, and genetics are crucial for understanding disease progression.

Conclusions:

• The atopic march model requires re-evaluation due to conflicting evidence.
• Alternative models are needed to accurately explain allergic disease progression.
• Further comprehensive longitudinal research is essential to elucidate the complex pathways of allergic diseases.