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Atopic dermatitis, food allergy aggravated allergic progression

Atopic dermatitis associated with food allergy in early childhood accelerated the progression of allergic march, according to study results.

Researchers in Japan mailed questionnaires to 3,321 first-year university students (mean age, 18.4 years; 66.5% men) about allergic diseases. Questionnaires included personal and family histories of doctor-diagnosed allergic diseases, clinical courses and aggravating factors.

Students’ lifetime prevalence of any atopic disease from birth to questionnaire reply was 47.6% and was greater among men than women (49.52% vs. 43.88%; P=.002). Based on medical diagnoses, lifetime prevalence was 35.7% for allergic rhinitis (AR); 16.5%, atopic dermatitis (AD); 9.9%, bronchial asthma (BA); and 7.0%, food allergy (FA). Men had a greater prevalence of AR and BA (P<.001 for both) than women. Family history of AD, BA and AR was a significant risk factor for disease development.

The number of family histories of allergic disease and comorbidity displayed a positive correlation (Pearson’s correlation coefficient, R=0.37; P<.001). The onset ages of BA (P=.01) and AR (P<.001) were lowered by AD comorbidity. The greatest risk factor for progression of allergic march was comorbidity with FA, particularly with AD (OR=8.7; 95% CI, 5.47-13.84).

While AD, BA and AR improved as most students aged, peak recurrence was seen during adolescence.

“We showed that FA significantly raised the risk of allergic disease comorbidity (AD, BA and AR), especially AD, and critically increased the numbers of diseases with which it was comorbid,” the researchers reported. “These results suggest that FA and AD are closely associated and aggravate allergic march.

“Our results suggest that AD comorbid with FA in early childhood … is thought to be a key period for prevention of allergic march, and adolescence is another key period for the prevention of recurrence. The prevention of recurrence would decrease allergic disease in adulthood.”