Does atopic dermatitis cause food allergy? A systematic review - 06/04/16
Abstract |
Background |
The association between atopic dermatitis (AD) and food allergy (FA) is not fully understood, although a causal relationship has been suggested. This has important implications for prevention and treatment.
Objective |
We aimed to review the association between AD and FA, the effect of FA on AD severity, chronicity, and age of onset, and the temporal relationship between the two.
Methods |
Medline and Embase were systematically searched from inception to November 2014 for studies investigating both AD and FA.
Results |
Sixty-six studies were identified. Eighteen were population-based, 8 used high-risk cohorts, and the rest comprised patients with either established AD or FA. In population-based studies, the likelihood of food sensitization was up to 6 times higher in patients with AD versus healthy control subjects at 3 months of age (odds ratio, 6.18; 95% CI, 2.94-12.98; P < .001). Other population-based studies reported that up to 53% of subjects with AD were food sensitized, and up to 15% demonstrated signs of FA on challenge. Meanwhile, studies including only patients with established AD have reported food sensitization prevalences up to 66%, with challenge-proven FA prevalences reaching up to 81%. Sixteen studies suggested that FA is associated with a more severe AD phenotype. Six studies indicated that AD of earlier onset or increased persistence is particularly associated with FA. Finally, one study found that AD preceded the development of FA.
Conclusions |
This systematic review confirms a strong and dose-dependent association between AD, food sensitization, and FA. AD of increased severity and chronicity is particularly associated with FA. There is also evidence that AD precedes the development of food sensitization and allergy, in keeping with a causal relationship.
Le texte complet de cet article est disponible en PDF.Key words : Atopic dermatitis, eczema, food allergy, food sensitization
Abbreviations used : AD, aOR, DBPCFC, FA, FLG, OFC, OR, PPV, sIgE, SPT, UK
Plan
| Disclosure of potential conflict of interest: S. Baron has served as a consultant for Abbvie, receives payment for lectures regarding psychodermatology training and also received travel support from Abbvie. G. du Toit receives research funding from National Institute of Allergy and Infectious Diseases (NIAID)/National Institutes of Health (NIH), Food Allergy & Research Education (FARE), the MRC & Asthma UK Centre, the UK Department of Health through the NIHR, the National Peanut Board (NPB), and Osem and received grants from UK Food Standards Agency (FSA) during the conduct of the study. S. Till serves as a consultant for ALK-Abelló, receives payment for lectures for Thermo Fisher, and receives unrestricted research funding from ALK-Abelló. C. Flohr serves as a consultant for Roche/Regeneron and has received payments for lecture from Nutricia. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 137 - N° 4
P. 1071-1078 - avril 2016 Retour au numéro
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