A REVIEW OF ATOPIC DERMATITIS AND RESPIRATORY ALLERGIC DISEASES

The object of this article is to review the mechanisms of the allergic march from atopic dermatitis to asthma, considering the various steps from the primary skin lesion to respiratory allergy. The data sources used were PubMed databases, researching articles from the last 15 years. Most of the evidence on which the concept of the atopic march is based comes from cross-sectional population studies at different ages. Reduced filaggrin expression is implicated as a major predisposing factor for atopy. Other gene products and factors play an important role. The mechanism that triggers the atopic march is represented by defects in the epidermal barrier that predispose to primary sensitisation and consequent later sensitisation in the airways. The major predisposing factor is a primary inherited epithelial barrier defect resulting from filaggrin gene mutation, but other factors may also play a role in this complex mechanism. Further research into preventative and treatment strategies is needed.