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Atopic Dermatitis and Food Allergy: A Complex Interplay What We Know and What We Would Like to Learn

Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritus, eczematous lesions, and relapsing course. It presents with great clinical heterogeneity, while underlying pathogenetic mechanisms involve a complex interplay between a dysfunctional skin barrier, immune...

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Autores principales: Papapostolou, Niki, Xepapadaki, Paraskevi, Gregoriou, Stamatis, Makris, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317394/
https://www.ncbi.nlm.nih.gov/pubmed/35887996
http://dx.doi.org/10.3390/jcm11144232
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author Papapostolou, Niki
Xepapadaki, Paraskevi
Gregoriou, Stamatis
Makris, Michael
author_facet Papapostolou, Niki
Xepapadaki, Paraskevi
Gregoriou, Stamatis
Makris, Michael
author_sort Papapostolou, Niki
collection PubMed
description Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritus, eczematous lesions, and relapsing course. It presents with great clinical heterogeneity, while underlying pathogenetic mechanisms involve a complex interplay between a dysfunctional skin barrier, immune dysregulation, microbiome dysbiosis, genetic and environmental factors. All these interactions are shaping the landscape of AD endotypes and phenotypes. In the “era of allergy epidemic”, the role of food allergy (FA) in the prevention and management of AD is a recently explored “era”. Increasing evidence supports that AD predisposes to FA and not vice versa, while food allergens are presumed as one of the triggers of AD exacerbations. AD management should focus on skin care combined with topical and/or systemic treatments; however, in the presence of suspected food allergy, a thorough allergy evaluation should be performed. Food-elimination diets in food-allergic cases may have a beneficial effect on AD morbidity; however, prolonged, unnecessary diets are highly discouraged since they can lead to loss of tolerance and potentially increase the risk of IgE-mediated food allergy. Preventive AD strategies with the use of topical emollients and anti-inflammatory agents as well as early introduction of food allergens in high-risk infants seem promising in managing and preventing food allergy in AD patients. The current review aims to overview data on the complex AD/FA relationship and provide the most recent developments on whether food allergy interventions change the AD course and vice versa.
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spelling pubmed-93173942022-07-27 Atopic Dermatitis and Food Allergy: A Complex Interplay What We Know and What We Would Like to Learn Papapostolou, Niki Xepapadaki, Paraskevi Gregoriou, Stamatis Makris, Michael J Clin Med Review Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritus, eczematous lesions, and relapsing course. It presents with great clinical heterogeneity, while underlying pathogenetic mechanisms involve a complex interplay between a dysfunctional skin barrier, immune dysregulation, microbiome dysbiosis, genetic and environmental factors. All these interactions are shaping the landscape of AD endotypes and phenotypes. In the “era of allergy epidemic”, the role of food allergy (FA) in the prevention and management of AD is a recently explored “era”. Increasing evidence supports that AD predisposes to FA and not vice versa, while food allergens are presumed as one of the triggers of AD exacerbations. AD management should focus on skin care combined with topical and/or systemic treatments; however, in the presence of suspected food allergy, a thorough allergy evaluation should be performed. Food-elimination diets in food-allergic cases may have a beneficial effect on AD morbidity; however, prolonged, unnecessary diets are highly discouraged since they can lead to loss of tolerance and potentially increase the risk of IgE-mediated food allergy. Preventive AD strategies with the use of topical emollients and anti-inflammatory agents as well as early introduction of food allergens in high-risk infants seem promising in managing and preventing food allergy in AD patients. The current review aims to overview data on the complex AD/FA relationship and provide the most recent developments on whether food allergy interventions change the AD course and vice versa. MDPI 2022-07-21 /pmc/articles/PMC9317394/ /pubmed/35887996 http://dx.doi.org/10.3390/jcm11144232 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Papapostolou, Niki
Xepapadaki, Paraskevi
Gregoriou, Stamatis
Makris, Michael
Atopic Dermatitis and Food Allergy: A Complex Interplay What We Know and What We Would Like to Learn
title Atopic Dermatitis and Food Allergy: A Complex Interplay What We Know and What We Would Like to Learn
title_full Atopic Dermatitis and Food Allergy: A Complex Interplay What We Know and What We Would Like to Learn
title_fullStr Atopic Dermatitis and Food Allergy: A Complex Interplay What We Know and What We Would Like to Learn
title_full_unstemmed Atopic Dermatitis and Food Allergy: A Complex Interplay What We Know and What We Would Like to Learn
title_short Atopic Dermatitis and Food Allergy: A Complex Interplay What We Know and What We Would Like to Learn
title_sort atopic dermatitis and food allergy: a complex interplay what we know and what we would like to learn
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317394/
https://www.ncbi.nlm.nih.gov/pubmed/35887996
http://dx.doi.org/10.3390/jcm11144232
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