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Dynamics of allergy development during the first 5 years of life

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Abstract

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.

Conclusions: The proportion of multi-symptom allergies increased while single-symptom forms decreased. The observed temporal trends of allergic symptoms correspond to the atopic march.

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.

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Abbreviations

AD:

Atopic dermatitis

FA:

Food allergy

RC:

Rhino conjunctivitis

Ur:

Urticaria

Wh:

Wheezing

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Acknowledgements

We gratefully acknowledge the participation of all children, parents, pediatricians, and allergists at the clinics in the Slovak Republic.

Funding

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).

Author information

Authors and Affiliations

  1. Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, Brno, Czech Republic

    Marketa Vrbova, Petra Dorociakova, Roman Vyskovsky, Eva Budinska & Vojtech Thon

  2. Department of Internal Gastroenterology, Faculty of Medicine, Masaryk University, University Hospital Brno, Brno, Czech Republic

    Marketa Vrbova

  3. Department of Clinical Immunology and Allergy, Faculty of Medicine, Masaryk University, St. Anne’s University Hospital, Pekarska 53, 656 91, Brno, Czech Republic

    Marketa Vrbova & Vojtech Thon

  4. Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic

    Roman Vyskovsky

  5. Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University in Bratislava, Bratislava, Slovak Republic

    Lubica Palkovicova Murinova, Katarina Rausova & Eva Reichrtova

  6. 1st Department of Pediatrics, Faculty of Medicine, Comenius University, Bratislava, Slovakia

    Peter Ciznar

  7. Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, Emory University, Atlanta, GA, USA

    Scott J. N. McNabb

Authors
  1. Marketa Vrbova
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  2. Petra Dorociakova
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  3. Roman Vyskovsky
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  4. Lubica Palkovicova Murinova
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  5. Peter Ciznar
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  6. Katarina Rausova
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  7. Scott J. N. McNabb
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  8. Eva Reichrtova
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  9. Eva Budinska
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  10. Vojtech Thon
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Contributions

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

Corresponding author

Correspondence to Vojtech Thon.

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Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

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.

Additional information

Communicated by Nicole Ritz

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Vrbova, M., Dorociakova, P., Vyskovsky, R. et al. Dynamics of allergy development during the first 5 years of life. Eur J Pediatr 177, 1317–1325 (2018). https://doi.org/10.1007/s00431-018-3188-9

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  • DOI: https://doi.org/10.1007/s00431-018-3188-9

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