REVIEW ARTICLE
Epicutaneous sensitization to food allergens in atopic dermatitis: What do we know?
Elizabeth Huiwen Tham MMed, MCI,
Mohana Rajakulendran MMed, MRCPCH,
Bee Wah Lee MD,
Hugo P. S. Van Bever PhD,
Corresponding Author
Elizabeth Huiwen Tham MMed, MCI
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
Correspondence
Elizabeth Huiwen Tham, Division of Allergy & Immunology, Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Level 12 NUHS Tower Block, Singapore 119228, Singapore.
Email: [email protected]
Search for more papers by this authorMohana Rajakulendran MMed, MRCPCH
Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
Search for more papers by this authorBee Wah Lee MD
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Search for more papers by this authorHugo P. S. Van Bever PhD
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
Search for more papers by this authorElizabeth Huiwen Tham MMed, MCI,
Mohana Rajakulendran MMed, MRCPCH,
Bee Wah Lee MD,
Hugo P. S. Van Bever PhD,
Corresponding Author
Elizabeth Huiwen Tham MMed, MCI
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
Correspondence
Elizabeth Huiwen Tham, Division of Allergy & Immunology, Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Level 12 NUHS Tower Block, Singapore 119228, Singapore.
Email: [email protected]
Search for more papers by this authorMohana Rajakulendran MMed, MRCPCH
Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
Search for more papers by this authorBee Wah Lee MD
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Search for more papers by this authorHugo P. S. Van Bever PhD
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
Search for more papers by this authorFunding information
Tham EH is funded by the National Medical Research Council (NMRC) Research Training Fellowship Grant [MH 095:003\008-225] from the National Medical Research Council (NMRC), Singapore.
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease mainly affecting children, which has no definitive curative therapy apart from natural outgrowing. AD is persistent in 30%-40% of children. Epithelial barrier dysfunction in AD is a significant risk factor for the development of epicutaneous food sensitization, food allergy, and other allergic disorders. There is evidence that prophylactic emollient applications from birth may be useful for primary prevention of AD, but biomarkers are needed to guide cost-effective targeted therapy for high-risk individuals. In established early-onset AD, secondary preventive strategies are needed to attenuate progression to other allergic disorders such as food allergy, asthma, and allergic rhinitis (the atopic march). This review aims to describe the mechanisms underpinning the development of epicutaneous sensitization to food allergens and progression to clinical food allergy; summarize current evidence for interventions to halt the progression from AD to food sensitization and clinical food allergy; and highlight unmet needs and directions for future research.
CONFLICT OF INTEREST
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors do not have any conflicts of interests to declare.
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