-Review-

Dual Factors May Be Necessary for Development of Atopic March in Early Infancy

Shoichiro Taniuchi¹, Kazuhiko Soejima², Yasuko Hatano², Masaya Takahashi² and Hirotaka Minami¹

¹Department of Pediatrics, Takatsuki General Hospital, Osaka, Japan
²Department of Pediatrics, Kansai Medical University, Osaka, Japan

The incidence of atopic diseases, including atopic dermatitis (AD), food allergies, allergic rhinitis, and asthma, has increased in recent decades, and currently affects approximately 20% of the population. Atopic march is the development of AD in infancy and subsequent food allergies, allergic rhinitis, and asthma in later childhood. Patients with infantile eczema may develop typical symptoms of AD, allergic rhinitis, and asthma at certain ages. Some patients' symptoms persist for several years, whereas others may have resolution with aging. Development of these diseases is strongly influenced by the following two factors: skin dysfunction caused by filaggrin mutations and development of colonization of microflora in early infancy. Filaggrin mutations predisposing to asthma, allergic rhinitis, and allergic sensitization, only in the presence of AD, strongly support the role of filaggrin in the pathogenesis of AD and in subsequent progression of the atopic march. Several studies have shown that development of colonization of microflora in early infancy might affect development of allergic disease or food desensitization. Therefore, massive allergen exposure to genetic skin dysfunction in early infancy and an imbalance of microflora might be necessary for development of atopic march.

J Nippon Med Sch 2018; 85: 2-10

Keywords
atopic march, skin dysfunction, filaggrin mutation, microflora, infantile eczema

Correspondence to
Shoichiro Taniuchi, MD, Department of Pediatrics, Takatsuki General Hospital, 1-3-13 Kosobe-cho, Takatsuki-City, Osaka 569-1192, Japan
taniuchishoichiro@gmail.com

Received, July 27, 2017
Accepted, October 2, 2017