Взаимосвязь атопического дерматита и пищевой аллергии

Смолкина О.Ю., Дворянкова Е.В., Невозинская З.А., Корсунская И.М. Взаимосвязь атопического дерматита и пищевой аллергии. Педиатрия. Consilium Medicum. 2020; 3: 43–46. DOI: 10.26442/26586630.2020.3.200260

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Smolkina O.Iu., Dvoriankova E.V., Nevozinskaia Z.A., Korsunskaia I.M. Relationship between atopic dermatitis and food allergy. Pediatrics. Consilium Medicum. 2020; 3: 43–46. DOI: 10.26442/26586630.2020.3.200260

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Аннотация

Атопический дерматит (АтД) нередко сопровождается пищевой аллергией. Развитие аллергии к пищевым продуктам может усугублять течение АтД. Рост заболеваемости АтД и пищевой непереносимостью может быть связан с изменением эпигенома под влиянием окружающей среды. Также существует множество пренатальных и перинатальных факторов, способных увеличить риск развития пищевой аллергии и/или АтД: изменение кишечной микробиоты матери во время беременности, кесарево сечение, сезон рождения ребенка и др. В постнатальном периоде важными факторами риска развития обозначенных заболеваний становятся изменения состава микробиома и воздействие пищевых аллергенов. Как показывают собственные наблюдения, в зависимости от возрастной группы набор пищевых аллергенов может меняться и играть меньшую роль в обострении АтД. В случаях, когда провоцирующим фактором АтД выступает аллергический компонент, в терапию обязательно включение антигистаминного препарата. Наш опыт показывает эффективность применения дезлоратадина в детской практике совместно с топическими глюкокортикостероидами и увлажняющими средствами.

Ключевые слова: атопический дерматит, пищевая аллергия, дезлоратадин, коморбидность.

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Atopic dermatitis (AD) is often associated with food allergies. The development of food allergies can worsen the course of AD. The increase in the incidence of AD and food intolerance may be associated with changes in the epigenome under the influence of the environment. There are also many prenatal and perinatal factors that can increase the risk of developing food allergies and/or AD: changes in the intestinal microbiota of the mother during pregnancy, caesarean section, the season of childbirth, etc. In the postnatal period, changes in the composition of the microbiome become important risk factors for the development of these diseases. exposure to food allergens. As shown by our own observations, depending on the age group, the set of food allergens may change and play a lesser role in exacerbation of AD. In cases where an allergic component acts as a provoking factor for AD, an antihistamine must be included in the therapy. Our experience shows the effectiveness of the use of desloratadine in pediatric practice together with topical glucocorticosteroids and moisturizers.

Key words: atopic dermatitis, food allergy, desloratadine, comorbidity.

Список литературы

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1. Thomsen SF. Epidemiology and natural history of atopic diseases. Eur Clin Respir J 2015; 2 (1): 24642.
2. Spergel JM. From atopic dermatitis to asthma: the atopic march. Ann Allergy Asthma Immunol 2010; 105 (2): 99–106.
3. Alduraywish SA, Lodge CJ, Campbell B et al. The march from early life food sensitization to allergic disease: a systematic review and meta-analyses of birth cohort studies. Allergy 2016; 71: 77–89.
4. Platts-Mills TA. The allergy epidemics: 1870–2010. J Allergy Clin Immunol 2015; 136: 3–13.
5. Nwaru BI, Hickstein L, Panesar SS et al. The epidemiology of food allergy in Europe: a systematic review and meta-analysis. Allergy 2014; 69: 62–75.
6. Lockett GA, Huoman J. Does allergy begin in utero? Pediatr Allergy Immunol 2015; 26: 394–402.
7. McFadden JP, Thyssen JP, Basketter DA et al. T helper cell 2 immune skewing in pregnancy/early life: chemical exposure and the development of atopic disease and allergy. Br J Dermatol 2015; 172: 584–91.
8. Pyrhonen K, Laara E, Hiltunen L et al. Season of the first trimester of pregnancy predicts sensitisation to food allergens in childhood: a population-based cohort study from Finland. J Epidemiol Community Health 2012; 66: 49–56.
9. Kramer MS, Kakuma R. Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Cochrane Database Syst Rev 2012; CD000133.
10. Abrahamsson TR, Wu RY, Jenmalm MC. Gut microbiota and allergy: the importance of the pregnancy period. Pediatr Res 2015; 77: 214–9.
11. Tanaka K, Matsui T, Sato A et al. The relationship between the season of birth and early-onset food allergies in children. Pediatr Allergy Immunol 2015; 26: 607–13.
12. Matsui T, Tanaka K. Sun exposure inversely related to food sensitization during infancy. Pediatr Allergy Immunol 2015; 26: 628–33.
13. Kelleher M, Dunn-Galvin A, Hourihane JO et al. Skin barrier dysfunction measured by transepidermal water loss at 2 days and 2 months predates and predicts atopic dermatitis at 1 year. J Allergy Clin Immunol 2015; 135: 930–5.e1.
14. Honda K, Littman DR. The microbiota in adaptive immune homeostasis and disease. Nature 2016; 535: 75–84.
15. Azad MB, Konya T, Guttman DS et al. Infant gut microbiota and food sensitization: associations in the first year of life. Clin Exp Allergy 2015; 45: 632–43.
16. Pastor-Vargas C, Maroto AS, Diaz-Perales A et al. Sensitive detection of major food allergens in breast milk: first gateway for allergenic contact during breastfeeding. Allergy 2015; 70: 1024–7.
17. Agrawal DK. Anti-inflammatory properties of desloratadine. Clin Exp Allergy 2004; 34: 1342–8.
18. Anthes J, Richard C, West R et al. Functional characteristics of desloratadine and other anhistamines in human Yl receptors. Allergy 2000; 55 (Suppl. 63), S279 (Abstract 994).
19. Horak F, Stubner U, Zieglmayer R et al. Onset and duration of action of desloratadine. XIX Congress of Europ. Lisbon: Academy of Allergology and Clinical Immunology, 2000.
20. Belousova T.A., Goryachkna M.V. Mesto naruzhnoy kortikosteroidnoy terapii v praktike vracha-dermatologa. Dermatology (Suppl. Consilium Medicum). 2008; 1: 3–6 (in Russian).
21. Kondrat'eva Iu.S., Shepileva T.N., Eroshenko N.V. Dinamika morfofunktsional'nykh parametrov kozhi pri khronicheskikh dermatozakh na fone ispol'zovaniia emolentov. Mezhdunarodnyi zhurnal prikladnykh i fundamental'nykh issledovanii. 2015; 5–2: 224–8 (in Russian).

Авторы

О.Ю. Смолкина1, Е.В. Дворянкова*2, З.А. Невозинская3, И.М. Корсунская2

1 Научно-клинический консультативный центр аллергологии и иммунологии, Москва, Россия;
2 ФГБУН «Центр теоретических проблем физико-химической фармакологии» РАН, Москва, Россия;
3 ГБУЗ «Московский научно-практический центр дерматовенерологии и косметологии» Департамента здравоохранения г. Москвы, Москва, Россия
*dvoriankova@mail.ru

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Olga Iu. Smolkina1, Evgeniia V. Dvoriankova*2, Zofiia A. Nevozinskaia3, Irina M. Korsunskaia2

1 Scientific and Clinical Advisory Center for Allergology and Immunology, Moscow, Russia;
2 Center for Theoretical Problems of Physicochemical Pharmacology, Moscow, Russia;
3 Moscow Scientific and Practical Center for Dermatovenereology and Cosmetology, Moscow, Russia
*dvoriankova@mail.ru

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