Atopic disease is a misnomer

Published Online: November 17, 2015

Misclassification is a key challenge in research into pediatric asthma and eczema.

Atopy vs. non-atopy is a widely used tradition to sub-divide these diseases by suspected different underlying mechanisms (endotypes). The term ‘atopic disease’ suggests that the disease is associated with a genetic predisposition to excessive IgE production without distinction between symptomatic vs. asymptomatic sensitization.

In a new article in The Journal of Allergy and Clinical Immunology (JACI), Schoos et al. report that “atopic disease” in children is unlikely to represent a true endotype.

The study followed 399 at-risk children from the Copenhagen Prospective Studies in Asthma in Childhood (COPSAC). The associations between allergic sensitization, asthma and eczema were investigated from birth to 13 years of age. Allergic sensitization was measured at ½, 1½, 4, 6, and 13 years of age, by skin prick tests and serum specific IgE against 28 common airborne and food allergens.
The study showed very little inter-dependency between asthma, eczema and allergic sensitization through childhood. Particularly, the associations were highly dependent on the age of the child as well as the method used for testing for sensitization. Therefore atopy in children is unlikely representing a true endotype.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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