HQ Team
December 19, 2024: Recent studies have revealed a significant relationship between food allergies and atopic dermatitis (AD) in pediatric patients, indicating that specific food allergies may contribute to uncontrolled AD and its persistence over time. This research highlights the need for increased awareness and monitoring of children with concurrent atopic conditions.
Leveraging data from over 8,000 pediatric patients enrolled in the Pediatric Eczema Elective Registry (PEER), researchers found that food allergy status is closely associated with uncontrolled AD at the time of registry enrollment and long-term AD persistence over a decade. The study particularly emphasized milk, egg, and peanut allergies, which showed pronounced effects on AD outcomes.
According to the 2022 Global Report on Atopic Dermatitis, AD affects up to 20% of children, with an estimated 223 million individuals living with the condition worldwide. Among these, a significant proportion—43 million—are children aged 1-4 years. Food allergies are also prevalent in children, affecting approximately 5.8% of those aged 0–17, as reported by a 2021 National Health Interview Survey.
Mechanisms behind the connection
The link between food allergies and AD is rooted in shared immunological features that drive inflammation and hypersensitivity reactions in both conditions. Jessica Wong, PhD, from the University of Pennsylvania, noted that while both conditions exhibit similar mechanisms, the influence of food allergies on long-term AD outcomes remains inadequately understood.
To explore this further, researchers analyzed PEER data, which tracks children’s responses to pimecrolimus cream—a treatment for AD—over ten years. Parents reported their children’s food allergies and perceptions of AD control during enrollment.
Key findings
The study included 8,015 children with an average age of 7.5 years. Among them, 22.73% had food allergies, predominantly to peanuts (9.72%), eggs (7.16%), and milk (5.86%). Notably, children with food allergies were less likely to have a family history of AD and lower family incomes but exhibited higher rates of uncontrolled AD and additional comorbidities.
The findings revealed that children with any food allergy were significantly more likely to experience uncontrolled AD compared to those without (adjusted odds ratio [aOR], 1.29). Over the ten-year period, those with food allergies had a greater likelihood of persistent AD (aOR, 1.36). Specific allergens like milk (aOR, 1.46), egg (aOR, 1.49), and peanut (aOR, 1.50) were linked to even stronger effects on long-term persistence.
Implications for care
The study’s conclusions underscore food allergy as a crucial prognostic factor for long-term AD outcomes. This relationship suggests that children with concurrent atopic conditions require closer monitoring since ongoing allergic responses can exacerbate symptoms and lead to more persistent manifestations.
However, researchers acknowledged limitations in their findings, including the exclusion of severe AD cases and reliance on caregiver-reported food allergy statuses without confirmatory tests.
The emerging evidence connecting food allergies with atopic dermatitis in children emphasizes the importance of comprehensive care strategies that address both conditions simultaneously. As healthcare providers gain insights into these relationships, they can better manage pediatric patients suffering from these common yet complex atopic diseases.
The study was published in the Paediatric Allergy and Immunology Journal.
