Atopic phenotypes and their implication in the atopic march
File(s)Manuscript clean R2 final.docx (179.69 KB)
Accepted version
Author(s)
Custovic, Adnan
Custovic, Darije
Kljaic Bukvic, Blazenka
Fontanella, Sara
Haider, Sadia
Type
Journal Article
Abstract
Eczema, allergic rhinitis, and asthma are traditionally considered atopic (or allergic) diseases. They are complex, multifactorial, and are caused by a variety of different mechanisms, which result in multiple heterogeneous clinical phenotypes. Atopic march is usually interpreted as the sequential development of symptoms from eczema in infancy, to asthma, and then allergic rhinitis. Areas covered: The authors reviewed the evidence on the multimorbidity of eczema, asthma, and rhinitis, and the implication of results of data-driven analyses on the concept framework of atopic march. A literature search was conducted in the PubMed and Web of Science for peer-reviewed articles published until July 2020. Application of Bayesian machine learning framework to rich phenotypic data from birth cohorts demonstrated that the postulated linear progression of symptoms (atopic march) does not capture the heterogeneity of allergic phenotypes. Expert opinion: Eczema, wheeze, and rhinitis co-exist more often than would be expected by chance, but their relationship can be best understood in a multimorbidity framework, rather than through atopic march sequence. The observation of their co-occurrence does not imply any specific relationship between them, and certainly not a progressive or causal one. It is unlikely that a sngle mechanism such as allergic sensitization underpins different multimorbidity manifestations.
Date Issued
2020-09-09
Date Acceptance
2020-08-28
Citation
Expert Review of Clinical Immunology, 2020, 16 (9), pp.873-881
ISSN
1744-666X
Publisher
Taylor and Francis
Start Page
873
End Page
881
Journal / Book Title
Expert Review of Clinical Immunology
Volume
16
Issue
9
Copyright Statement
© 2020 Taylor & Francis. This is an Accepted Manuscript of an article published by Taylor & Francis in Expert Review of Clinical Immunology on 16 September 2020, available online: https://doi.org/10.1080/1744666X.2020.1816825
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000569447000001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Immunology
eczema
allergic rhinitis
asthma
atopic march
allergic sensitization
personalized medicine
machine learning
HAY-FEVER
CONTROLLED-TRIAL
NATURAL COURSE
BIRTH COHORT
RISK-FACTORS
FOLLOW-UP
ASTHMA
ECZEMA
DERMATITIS
SENSITIZATION
Publication Status
Published
Date Publish Online
2020-09-16