Food sensitization in early AD linked to later allergic respiratory diseases

Pediatric patients with early atopic dermatitis (AD) who reported an incidence of food sensitization were associated with later allergic respiratory disease, in which persistence of AD was linked to multiple food allergies.

According to the results of a study published today in French Journal of Allergology.

Characterized by the progression of atopic disorders, the widely held concept called atopic march explains the pattern in which AD developed in children is later followed by food allergies, allergic rhinitis and allergic asthma.

Several prospective birth cohorts have shown an association between the early onset of AD and the development of allergic rhinitis and asthma at school age, in which sensitization to immunoglobulin E (IgE ) may increase the risk of developing these conditions.

“Atopy is defined as a personal and/or familial propensity to produce IgE antibodies and sensitization in response to exposures to allergens. The main food allergens in pediatric patients with AD include egg whites, cow’s milk, soy, wheat and peanuts,” explained the study author.

Seeking to further study the course of allergic diseases in pediatric patients with early Alzheimer’s disease, a retrospective single-center cohort study of data from Diyarbakır Children’s Hospital in Turkey was performed. Patients aged 3-7 years with AD in the first 2 years of life and their control counterparts (N=211) were screened for the diagnosis of wheeze, AD, and allergic rhinitis from baseline. hospital data and the government’s e-health service.

The study cohort included 119 children diagnosed with AD aged 0-2 years in 2013 (mean [SD] age, 12.1 [7.3] month; 60.5% men; mean [SD] serum total IgE, 157.9 [232.5] kU/L) and 92 children from the control group aged 0 to 3 months who underwent a screening hearing test in the same year.

Between the 2 groups, the average number of blood eosinophils was found to be significantly higher in the AD group compared to the control group (738/mm3 against 364/mm3; P P = 0.002), while the frequency of at least one wheezing attack (28.6% versus 29.3%), at least 3 wheezing attacks (15.1% versus 9.8%) and allergic rhinitis (22.7% versus 22.8%) were not significantly different between the AD and control groups in children 3 to 7 years old.

However, the results further showed that in the AD group, the frequency of at least 1 attack of wheezing (42.6% vs. 19.4%; P = 0.006), at least 3 attacks of wheezing (25.6% versus 8.3%; P = 0.011) and allergic rhinitis (38.3% versus 12.5%; P = 0.001) were significantly higher in children with food sensitization than in individuals without food sensitization.

Although the frequency of persistent AD was not significantly different between those with and without food sensitization (19.1% versus 23.6%; P = 0.367), the frequency of persistent AD was significantly higher in children with multiple food sensitizations than in children with only one food sensitization (33.3% versus 7.7%; P = 0.032).

“This study showed that late allergic respiratory disease in children with early Alzheimer’s disease was associated with food sensitization independent of early wheezing, and persistence of Alzheimer’s disease was associated with multiple sensitizations food”, concluded the author of the study.

Reference

Özcan C. Atopic march in children with early onset atopic dermatitis: a retrospective study. Reverend Father Allergol. Published online May 31, 2022. doi:10.1016/j.reval.2022.04.006

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