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Food allergy and atopic eczema

Worth, Allison; Sheikh, Aziz

Current Opinion in Allergy & Clinical Immunology: June 2010 - Volume 10 - Issue 3 - p 226–230
doi: 10.1097/ACI.0b013e3283387fae
Food allergy: Edited by Alessandro Fiocchi and Anna Nowak-Wegrzyn

Purpose of review: To review recent developments on the inter-relationship between food allergy and atopic eczema, with a particular focus on understanding the role of filaggrin gene defects.

Recent findings: Filaggrin gene defects have recently been identified as a major risk factor for the development of atopic eczema. These skin barrier defects increase the risk of early onset, severe and persistent forms of atopic eczema. They also increase the risk of allergic sensitization, and asthma and allergic rhinitis in those with co-existent eczema. These skin barrier defects are also likely to increase the risk of food allergy.

Summary: Atopic dermatitis and food allergy are frequently herald conditions for other manifestations of ‘the allergic march’. They commonly co-exist, particularly in those with early onset, severe and persistent atopic eczema. Filaggrin gene defects substantially increase the risk of atopic eczema. The increased skin permeability may increase the risk of sensitization to food and other allergens, this pointing to the possible role of cutaneous allergen avoidance in early life to prevent the onset of atopic eczema and food allergy. Emerging evidence also indicates that oral exposure to potentially allergenic foods may be important for inducing immunological tolerance.

Allergy & Respiratory Research Group, Centre for Population Health Sciences: General Practice Section, The University of Edinburgh, Edinburgh, Scotland, UK

Correspondence to Professor Aziz Sheikh, Allergy & Respiratory Research Group, Centre for Population Health Sciences: General Practice Section, The University of Edinburgh, Doorway 3, Medical School, Teviot Place, Edinburgh EH8 9AG, UK Tel: +44 131 651 4151; fax: +44 131 650 9119; e-mail: aziz.sheikh@ed.ac.uk

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