Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, Brno, Czech Republic.
Department of Internal Gastroenterology, Faculty of Medicine, Masaryk University, University Hospital Brno, Brno, Czech Republic.
Eur J Pediatr. 2018 Sep;177(9):1317-1325. doi: 10.1007/s00431-018-3188-9. Epub 2018 Jun 22.
Allergic diseases have increased in developed countries during the past decades. A cohort of Slovak children was followed from birth to track allergic symptoms dynamics in early childhood. Information on allergic symptoms (atopic dermatitis = AD, rhino conjunctivitis = RC, wheezing = Wh, urticaria = Ur) and food allergies among children was based on clinical evaluation of children by allergists at three developmental stages (infant, toddler, preschool). Out of 320 cases of allergies, 64 infants, 145 toddlers, and 195 preschool children suffered from AD, RC, Wh, Ur, or their combinations (i.e., significant increase with age, p < 0.001). AD first appeared in infants, Wh and/or RC rose mainly in toddlers, and Ur among preschool children. AD in infants or toddlers disappeared in the subsequent developmental stage in approximately one third of all cases. Single AD persistence without remission or extension was not common and accounted only for 6.9% of AD infants' allergic manifestations. In addition to single-symptom allergic diseases, this study also identified several combinations of atopic symptoms.Conclusions: The proportion of multi-symptom allergies increased while single-symptom forms decreased. The observed temporal trends of allergic symptoms correspond to the atopic march. What is Known: • The observed temporal trends of allergic symptoms correspond to the atopic march. What is New: • Allergic diseases in children were first manifested as single forms, with atopic dermatitis (AD) commonly functioning as the "entry point" to allergies. • The overall proportion of single-symptom allergic disorders decreased over time while the proportion of multi-symptom allergies increased.
在过去几十年中,过敏疾病在发达国家有所增加。 对斯洛伐克儿童进行了队列研究,以追踪儿童早期过敏症状的动态变化。 通过过敏专家在三个发育阶段(婴儿,幼儿和学龄前)对儿童进行临床评估,获得了儿童过敏症状(特应性皮炎= AD,鼻结膜炎= RC,喘息= Wh,荨麻疹= Ur)和食物过敏的信息。 在 320 例过敏病例中,有 64 例婴儿,145 例幼儿和 195 例学龄前儿童患有 AD,RC,Wh,Ur 或其组合(即,随年龄增长而显着增加,p <0.001)。 AD 首先出现在婴儿中,Wh 和/或 RC 主要在幼儿中出现,而 Ur 则出现在学龄前儿童中。 在大约三分之一的所有病例中,婴儿或幼儿的 AD 在随后的发育阶段中消失。 没有缓解或扩展的单一 AD 持续存在并不常见,仅占 AD 婴儿过敏表现的 6.9%。 除了单一症状的过敏性疾病外,本研究还发现了几种特应性症状的组合。
多症状过敏的比例增加,而单一症状形式减少。 观察到的过敏症状的时间趋势与特应性进行曲相对应。
•观察到的过敏症状的时间趋势与特应性进行曲相对应。
•儿童的过敏疾病最初表现为单一形式,特应性皮炎(AD)通常作为过敏的“切入点”。
•随着时间的流逝,单一症状过敏疾病的总体比例下降,而多症状过敏的比例增加。