Dynamics of allergy development during the first 5 years of life
Allergic diseases have increased in developed countries during the past decades. A cohort of Slovak children was followed from birth to track allergic symptoms dynamics in early childhood. Information on allergic symptoms (atopic dermatitis = AD, rhino conjunctivitis = RC, wheezing = Wh, urticaria = Ur) and food allergies among children was based on clinical evaluation of children by allergists at three developmental stages (infant, toddler, preschool). Out of 320 cases of allergies, 64 infants, 145 toddlers, and 195 preschool children suffered from AD, RC, Wh, Ur, or their combinations (i.e., significant increase with age, p < 0.001). AD first appeared in infants, Wh and/or RC rose mainly in toddlers, and Ur among preschool children. AD in infants or toddlers disappeared in the subsequent developmental stage in approximately one third of all cases. Single AD persistence without remission or extension was not common and accounted only for 6.9% of AD infants’ allergic manifestations. In addition to single-symptom allergic diseases, this study also identified several combinations of atopic symptoms.
What is Known:
• The observed temporal trends of allergic symptoms correspond to the atopic march.
What is New:
• Allergic diseases in children were first manifested as single forms, with atopic dermatitis (AD) commonly functioning as the “entry point” to allergies.
• The overall proportion of single-symptom allergic disorders decreased over time while the proportion of multi-symptom allergies increased.
KeywordsAllergy Asthma Atopic dermatitis Atopic march Questionnaire Rhino conjunctivitis
We gratefully acknowledge the participation of all children, parents, pediatricians, and allergists at the clinics in the Slovak Republic.
MV: main author of the manuscript
PD: statistical processing of the data
RV: statistical analyses, graphs preparation
LPM: study realization and data collection
PC: study preparation and data collection supervisor, professional guarantee in allergy
KR: study realization and data collection
SM: study preparation and data collection supervisor, professional guarantee in epidemiology
ER: study realization and data collection
EB: statistical analyses, graphs and manuscript preparation
VT: data interpretation and manuscript preparation, professional guarantee in allergy
The study was supported by the Agency for International Science and Technology Cooperation, US–SR Science and Technology Program, Grant No. 012/95, project of the National Health Promotion Program no. 23 and by Ministry of Education Youth and Sports the Czech Republic (LM2015051 and CZ.02.1.01/0.0/0.0/15_003/0000469).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This study was done with the approval of the Institutional Review Boards of the Institute of Preventive and Clinical Medicine, Slovak Republic and the Centre’s for Disease Control and Prevention in Atlanta, GA, USA. All procedures respected ethical standards established by the Declaration of Helsinki.
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