Factors of allergic disease progression in children (literature review)

The development of atopic dermatitis at an early age and subsequent allergic rhinitis and asthma at a later age is known as the atopic march phenomenon. Despite the complexity and diversity of mechanisms of atopy development, it has been shown that atopic dermatitis and allergic respiratory diseases share a common pathogenesis. It was determined that the atopic dermatitis progression to bronchial asthma and rhinitis is associated with a complex interaction of genetic, immunologic, environmental, and psychosocial factors. In particular, the progression of atopy is influenced by the presence of filaggrin gene mutations, the onset and severity of atopic dermatitis, epicutaneous sensitization to aeroallergens, and colonization by bacterial superantigens. Despite significant progress in the studying of the role of skin barrier defects, impaired Th2 activation, hereditary component and environmental factors in the formation of atopy, to date no generally accepted algorithm for determining the risk of progression of atopic diseases has been developed. Information about the most significant factors associated with an increased risk of atopic march development may be useful for specialists providing medical care to children with allergic diseases.