New insights into the allergic march.

PURPOSE OF REVIEW: The allergic march of childhood describes an association between atopic dermatitis, IgE-mediated food allergy, allergic asthma, and allergic rhinitis that begins with an atopic family history. This review summarizes recent insights into the nature of these conditions and their associations.

RECENT FINDINGS: In recent years, common allergic diseases have become more prevalent and increased rates of food allergies remain incompletely understood. This review explores a newly described major genetic risk factor, a mutation in the skin matrix protein filaggrin, as it relates to the allergic march of childhood. New paradigms of understanding the interrelationships between atopic dermatitis, food allergy, and asthma are described. A surge of investigative effort has been directed toward the prevention and treatment of food allergy. Risk factors for allergic asthma in young children have been used to predict patient response to treatment. A recent practice parameter on furry animal/pet avoidance updates current understanding of allergen avoidance in modifying allergic phenotypes.

SUMMARY: Understanding of the interrelationships of atopic diseases allows earlier diagnosis of allergic conditions in at-risk patient populations and may lead to novel approaches to health promotion and disease prevention.