Atopic Dermatitis With Coexisting Food Allergy in Early Life Is Associated With Childhood Asthma

Area of Science:

• Pediatric Allergy and Immunology
• Dermatology
• Respiratory Medicine

Background:

• Atopic dermatitis (AD) and food allergy (FA) are linked to respiratory conditions, forming the 'atopic march.'
• The precise mechanisms and disease trajectories, especially concerning coexisting AD and FA, remain incompletely understood.
• Understanding early-life disease phenotypes is crucial for predicting later respiratory comorbidities.

Purpose of the Study:

• To investigate if specific phenotypes of AD with coexisting FA in early childhood influence the development of asthma or allergic rhinitis (AR) in school-aged children.
• To analyze the impact of AD onset and persistence, alongside FA history, on the prevalence of respiratory comorbidities.

Main Methods:

• A cohort of 1,579 children from the Panel Study on Korean Children (PSKC) was followed.
• Participants with AD were categorized based on age of onset, persistence, and history of FA.
• The presence of asthma and AR was compared across different AD phenotypes.

Main Results:

• Early-onset persistent AD, irrespective of FA, was linked to asthma and AR at ages 6-8.
• Children with AD and FA exhibited a significantly higher risk of wheezing at age 8 compared to those with AD alone (aOR=8.09).
• Early-onset persistent AD with FA demonstrated a distinct disease course with increased prevalence of wheezing and AR from ages 5-8.

Conclusions:

• Early-life AD, particularly when coexisting with FA, strongly predicts asthma and AR in school children.
• The combination of early-onset persistent AD and FA has an additive effect on asthma risk.
• Phenotypic classification of early AD, considering FA, is vital for predicting and preventing childhood asthma and AR.