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New insights into the phenotypes of atopic dermatitis linked with allergies and asthma in children: An overview

机译：与儿童过敏和哮喘有关的特应性皮炎表型的新见解：概述

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Summary Atopic dermatitis ( AD ) is a complex disease with multiple causes and complex mechanistic pathways according to age of onset, severity of the illness, ethnic modifiers, response to therapy and triggers. A group of difficult‐to‐manage patients characterized by early‐onset AD and severe lifelong disease associated with allergic asthma and/or food allergy (FA) has been identified. In this study, we focus on these severe phenotypes, analysing their links with other atopic comorbidities, and taking into account the results from recent cohort studies and meta‐analyses. The main hypothesis that is currently proposed to explain the onset of allergic diseases is an epithelial barrier defect. Thus, the atopic march could correspond to an epithelial dysfunction, self‐sustained by a secondary allergenic sensitization, explaining the transition from AD to allergic asthma. Furthermore, AD severity seems to be a risk factor for associated FA. Results from population‐based, birth and patient cohorts show that early‐onset and severe AD , male gender, parental history of asthma, and early and multiple sensitizations are risk factors leading to the atopic march and the development of asthma. The importance of environmental factors should be recognized in these high‐risk children and prevention programs adapted accordingly. Effective targeted therapies to restore both barrier function and to control inflammation are necessary; early emollient therapy is an important approach to prevent AD in high‐risk children. Clinicians should also keep in mind the specific risk of atopic comorbidities in case of filaggrin loss‐of‐function mutations and the rare phenotypes of orphan syndromes due to heritable mutations in skin barrier components.
机译：发明内容特应性皮炎（AD）是一种复杂的疾病，具有多种原因和复杂的机械途径，根据发病年龄，疾病严重程度，种族修饰剂，治疗和触发的反应。已经确定了一群难以管理的难以治疗的患者，其特征在于早发哮喘和与过敏性哮喘和/或食物过敏（FA）相关的患者。在这项研究中，我们专注于这些严重表型，分析了与其他特征性的联合症的联系，并考虑到最近的队列研究和荟萃分析的结果。目前提出解释过敏性疾病发病的主要假设是上皮屏障缺陷。因此，Atopic 3月可以对应于上皮功能障碍，通过次级过敏性敏化进行自我维持，解释从AD到过敏性哮喘的转变。此外，广告严重程度似乎是相关FA的危险因素。人口基础，出生和患者队列的结果表明，早期和严重的广告，男性性别，哮喘的父母历史以及早期和多重敏感性都是导致阿胃部的危险因素和哮喘的发展。环境因素的重要性应在这些高危儿童和预防计划中得到相应的预防计划。有效的靶向疗法，以恢复屏障功能和控制炎症是必要的;早期润肤治疗是预防高危儿童广告的重要方法。临床医生还应记住，如果皮肤屏障组分中的遗传突变导致的杂草功能突变和孤儿综合征的罕见表型。

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    Amat F.; Soria A.; Tallon P.; Bourgoin‐Heck M.; Lambert N.; Deschildre A.; Just J.;

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    Department of AllergologyAssistance Publique‐H?pitaux de ParisParis France;

    UPMC Univ Paris 06Sorbonne UniversitésParis France;

    Department of AllergologyAssistance Publique‐H?pitaux de ParisParis France;

    Department of AllergologyAssistance Publique‐H?pitaux de ParisParis France;

    Department of AllergologyAssistance Publique‐H?pitaux de ParisParis France;

    Pediatric Pulmonology and Allergy DepartmentCHRU LilleLille France;

    Department of AllergologyAssistance Publique‐H?pitaux de ParisParis France;

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  • 正文语种 eng
  • 中图分类 医学免疫学;
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