Background

The atopic march describes the progression from atopic dermatitis during infancy to asthma and allergic rhinitis in later childhood. In a Canadian birth cohort we investigated whether concomitant allergic sensitization enhances subsequent development of these allergic diseases at age 3 years.

Methods

Children completed skin prick testing at age 1 year. Children were considered sensitized if they produced a wheal 2 mm or larger than that elicited by the negative control to any of 10 inhalant or food allergens. Children were also assessed for atopic dermatitis by using the diagnostic criteria of the UK Working Party. At age 3 years, children were assessed for asthma, allergic rhinitis, food allergy, and atopic dermatitis. Data from 2311 children were available.

Results

Atopic dermatitis without allergic sensitization was not associated with an increased risk of asthma at age 3 years after adjusting for common confounders (relative risk [RR], 0.46; 95% CI, 0.11-1.93). Conversely, atopic dermatitis with allergic sensitization increased the risk of asthma more than 7-fold (RR, 7.04; 95% CI, 4.13-11.99). Atopic dermatitis and allergic sensitization had significant interactions on both the additive (relative excess risk due to interaction, 5.06; 95% CI, 1.33-11.04) and multiplicative (ratio of RRs, 5.80; 95% CI, 1.20-27.83) scales in association with asthma risk. There was also a positive additive interaction between atopic dermatitis and allergic sensitization in their effects on food allergy risk (relative excess risk due to interaction, 15.11; 95% CI, 4.19-35.36).

Conclusions

Atopic dermatitis without concomitant allergic sensitization was not associated with an increased risk of asthma. In combination, atopic dermatitis and allergic sensitization had strong interactive effects on both asthma and food allergy risk at age 3 years.

中文翻译：

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预测特应性进行：加拿大健康婴儿纵向发展研究的结果

背景

特应性游行描述了从婴儿期的特应性皮炎到儿童期后期的哮喘和变应性鼻炎的进展。在加拿大的一个出生队列中，我们调查了并发变态反应致敏在3岁时是否能增强这些变态反应疾病的后续发展。

方法

儿童在1岁时完成了皮肤点刺测试。如果儿童对10种吸入或食物过敏原中的任一种产生的风团大于或小于阴性对照引起的风团2毫米，则被认为是敏化的。还使用英国工作组的诊断标准对儿童进行了特应性皮炎评估。在3岁时，对儿童进行了哮喘，过敏性鼻炎，食物过敏和特应性皮炎的评估。现有2311名儿童的数据。

结果

校正常见混杂因素后，无过敏致敏性特应性皮炎与3岁时哮喘风险增加无关（相对风险[RR]为0.46； 95％CI为0.11-1.93）。相反，过敏性变应性皮炎将哮喘的风险增加了7倍以上（RR，7.04; 95％CI，4.13-11.99）。特应性皮炎和过敏性致敏在加性（因相互作用引起的相对过度风险，5.06； 95％CI，1.33-11.04）和乘法（RR比率，5.80； 95％CI，1.20-27.83）量表上均具有显着的相互作用。有哮喘风险。特应性皮炎和变态反应致敏对食物过敏风险的影响之间也存在积极的加性相互作用（相互作用引起的相对过量风险为15.11； 95％CI为4.19-35.36）。

结论

没有伴随变态反应致敏的特应性皮炎与哮喘风险增加无关。结合使用，特应性皮炎和过敏致敏在3岁时对哮喘和食物过敏风险均具有很强的交互作用。