Objective

The classical allergic march model posits that atopy begins in infancy with atopic dermatitis and progresses to asthma and allergic rhinitis in a subset of individuals. The growing prevalence and severity of allergic diseases have prompted renewed interest in refining this model. This review outlines epidemiologic evidence for the existence of allergic march trajectories (distinct paths of atopy development in individuals); reviews the roles that genetics, environment, and disease endotypes play in determining trajectory outcomes; and discusses the clinical utility of the trajectory model.

Data Sources

PubMed search of English-language articles and reviews without date limits pertaining to the epidemiology, genetics, and immunologic mechanisms of allergic march trajectories and disease endotypes.

Study Selections

Studies and reviews were selected based on their high quality and direct relevance to the review topic.

Results

Recent work in the field has revealed that immunoglobulin E–mediated food allergy and eosinophilic esophagitis are components of the allergic march. Furthermore, the field is acknowledging that variability exists in the number and sequence of allergic manifestations that individuals develop. These allergic march pathways, or trajectories, are influenced by genetic, environmental, and psychosocial factors that are incompletely understood.

Conclusion

Continued elucidation of the landscape and origins of allergic march trajectories will inform efforts to personalize allergic disease prevention, diagnosis, and treatment.

中文翻译：

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一次行军，多条路径：洞察过敏行军轨迹

客观的

经典的过敏游行模型假定，特应性在婴儿期开始患有特应性皮炎，并在部分个体中发展为哮喘和过敏性鼻炎。过敏性疾病的日益流行和严重程度促使人们对改进这一模型重新产生了兴趣。本综述概述了过敏行进轨迹（个体特应性发展的不同路径）存在的流行病学证据；回顾遗传学、环境和疾病内型在确定轨迹结果中的作用；并讨论了轨迹模型的临床效用。

数据源

PubMed 搜索与过敏行进轨迹和疾病内型的流行病学、遗传学和免疫机制有关的无日期限制的英语文章和评论。

研究选择

研究和评论的选择是基于它们的高质量和与评论主题的直接相关性。

结果

该领域最近的工作表明，免疫球蛋白 E 介导的食物过敏和嗜酸性食管炎是过敏进程的组成部分。此外，该领域承认个体发展的过敏表现的数量和顺序存在可变性。这些过敏行进路径或轨迹受到尚未完全了解的遗传、环境和社会心理因素的影响。

结论

继续阐明过敏行进轨迹的景观和起源将为个性化过敏性疾病预防、诊断和治疗提供信息。